ABSTRACT
End-stage renal disease [ESRD] has various causes that differ according to the country. Egypt is a country with high mortality from ESRD, Sohag governorate is one of the South Egypt governorates. To study the prevalence and incidence rates and its health burden and to allocate the etiology and possible contributing factors and other epidemiologic factors for ESRD in Upper Egypt. The primary study tool was a structured questionnaire that focused on variables suspected as an etiological factor for ESRD in addition to the past history of risk factors exposure. One thousand and fifty four [1054] patients on hemodialysis were interviewed for collecting the data, in the period starting on the first of January 2003 till the end of December 2003. They were distributed in 17 centers with variable capacities for hemodialysis all over Sohag eleven districts. All were subjected to history taking, thorough medical examination, abdominopelvic ultrasonographic examination in the equipped centers and laboratory investigations of blood and urine. The estimated prevalence of ESRD at Sohag is 276.44 per million populations, the new cases constituted 22.27% of the patients along the year of the study. All patients were undergoing intermittent hemodialysis treatment, mostly thrice weekly. Distribution of patients by residence showed that most patients were living in rural areas [77%] whereas [23%] were urban residents. Males constituted 60% while females were 40% of the dialysis patients. Etiology of ESRD was unknown in about 9% of the cases while hypertension was responsible for 27.6% of the cases and diabetic nephropathy was responsible for 7%. Chronic pyelonephritis constituted 14.1% of the contributing causes for ESRD in Sohag and chronic glomerulonephritis was the cause in about 11.2% cases. Obstructive uropathy was detected in 22.7% of the cases; more than half of it was due to schistosomiasis. Other causes for ESRD were associated in smaller percentages. The number of deaths among the ESRD patients in Sohag governorate during the year 2003 is 180 / 1054 [8%] of the cases. The causes of deaths include cardiovascular diseases in 60% of the deaths, cerebrovascular accidents in 15%, infections in 5% and the rest was due to various diseases. These data will he hopefully contributed to the development of the national health care policies appropriate to the epidemiology of the disease in Upper Egypt. More attention should be paid not only to the recurrent renal infections and urolithiasis but also to hypertensive and diabetic patients to prevent the ESRD development as a consequence of their illness. Also, preventive programs against shistosomiasis should be continued in Upper Egypt