Epidemiology and cost of haemodialysis in Jordan.

To assess the epidemiology and burden of haemodialysis in Jordan, all patients on haemodialysis (1711 patients) were surveyed during September/October 2003. Mean age was 48.9 years, 56% were male, 86.8% were unemployed and 92% were poor. Mean distance to the haemodialysis service was 13.6 km. Annual hepatitis B and C seroconversion for patients negative before dialysis was 0.34% and 2.6% respectively. Prevalence of haemodialysis was 312 per million population; the incidence in 2002 was 111 per million population. Fatality rate at 1 year was 20%. Diabetes mellitus was the leading cause of haemodialysis, 29.2% of cases. Total estimated cost of haemodialysis in 2003 was US$ 29.7 million.

Epidemiology and cost of haemodialysis in Jordan

To assess the epidemiology and burden of haemodialysis in Jordan, all patients on haemodialysis [1711 patients] were surveyed during September/October 2003. Mean age was 48.9 years, 56% were male, 86.8% were unemployed and 92% were poor. Mean distance to the haemodialysis service was 13.6 km. Annual hepatitis B and C seroconversion for patients negative before dialysis was 0.34% and 2.6% respectively. Prevalence of haemodialysis was 312 per million population; the incidence in 2002 was 111 per million population. Fatality rate at 1 year was 20%. Diabetes mellitus was the leading cause of haemodialysis, 29.2% of cases. Total estimated cost of haemodialysis in 2003 was US$ 29.7 million

Relationship of cyclosporine and gingival overgrowth.

Cyclosporine is used as an immunosuppressive agent in organ transplantation. It has several side effects including gingival overgrowth. We evaluated 30 renal transplant patients on cyclosporine for the degrees of the gingival overgrowth. All the patients were males with mean age of 37.5 years. Eighteen patients (60%) had moderate to severe degrees of gingival overgrowth. No correlation was found with the trough levels of cyclosporine in blood. We conclude that gingival overgrowth is associated with cyclosporine immunosuppressive therapy but may not be dose related. The effect of other factors such as dental plaque and oral hygiene should be further studied.

Malignancy in renal transplant recipients at king hussein medical center.

The files of 181 patients who underwent kidney transplantation at King Hussein Medical Center between 1983 and 1992 were reviewed to study the incidence and pattern of malignancy in them. Of them, 149 patients (82.3%) were recipients of live related donor allografts while 32 (17.7%) had received cadaveric allografts. Three patients (1.7%) developed malignancy giving an estimated annual incidence for post-transplant malignancy of 17/10,000 kidney transplanted patients. The first patient had squamous cell carcinoma of the nose, the second, Kaposi's sarcoma and the third, Non-Hodgkin's lymphoma involving the retroperitoneal lymph nodes. All these patients were on triple immunosuppressive drug protocol. The malignancies were diagnosed after a mean of 25.6 months following transplantation. The patient with squamous cell carcinoma responded to local excision of the tumor without altering the immunosuppressive therapy. The Kaposi's sarcoma regressed after discontinuation of cyclosporine without any adverse effects on the graft function while the patient with lymphoma died two months after the diagnosis was made. Our study shows that the incidence of malignancy after transplantation in Jordan is similar to what is reported in the literature.

Ureterolithiasis in a Renal Transplant Patient Secondary to Encrustation about a Suture Line.

A renal transplant recipient presented with abdominal pain and anuria secondary to multiple radio-opaque obstructing calculi. A ureteroscopy with ultrasonic disintegration was done, and the fragments were spontaneously passed later. The calculi had formed on a non-absorbable suture line. Although ureterolithiasis in the transplanted kidney is amongst the least common of the urological complications following renal transplantation, it is an important reversible cause of obstruction that should always be considered. Also, non-absorbable suture lines should not be used in the urinary tract because they may serve as a nidus for stone formation.