الفهرس 
Etiology and PathophysiologyOnly 14 pages are availabe for public view
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Abstract
Chronic kidney disease (CKD) is a worldwide public health problem. In the United States, the prevalence of end-stage renal disease (ESRD) is increasing. The number of patients enrolled in the ESRD Medicare-funded program has increased from approximately 10,000 beneficiaries in 1973 to 615,899 as of December 31, 2011.
Although the exact reasons for the growth of the ESRD program are unknown, changes in the demographics of the population, differences in disease burden among racial groups, and under-recognition of earlier stages of CKD and of risk factors for CKD may partially explain this growth.
Kidney disease is a growing problem worldwide as well as in Egypt. Prevalence of dialysis patients have increased from; 10 PMP in 1974 to 225pmp in 1996.Afifi et al., 2005demonstrates an increasing prevalence of ESRD in Egypt from the year 1996, 2000, 2004 to (225 pmp), (314pmp) and (483 pmp) respectively. So, its nearly doubled from the year 1996 to the year 2004.
Afifi and Karim, 1999 reported that hypertension was responsible for 28% of the cases of renal failure in Egypt. The other significant causes were: chronic glomerulonephritis (16.6%), ESRD of unknown etiology (16.2%), obstructive uropathy (excluding schistosomal obstructive uropathy) (9.3%). Diabetic nephropathy (8.9%), obstructive uropathy due to urinary schistosomiasis (6.0%) and adult polycystic disease of the kidney (4.3%).
As in many developing countries, it is difficult to collect reliable data on CKD from Egypt. Most of the available information is provided through personal communication with leading nephrologists, and the researches were recruited and collected and further meta-analysis of the data available was done for clear identification of the impact of the problem with its causes and risk factors.
In our study we collected data from 13 governorates from Egypt. So in our study after meta-analysis of data reveals that gender distribution as one of the risk factors is 57% male and 43% female, the age distribution among patients is 51.2% age 20-50year, 39.4% above 50 years and9.4% below20 years.
The causes of CKD were hypertension 25.1%, unknown 21.3%, DM 6.2%,obstructive uropathy 8.6%, chronic glomerulonephritis7.1%,chronic pyelonephritis 6.1%, analgesic nephropathy 4.1%, polycystic kidney2.8%, SLE 2.2%, shistosomal obstruction 2.0%, pregnancy related 1.1%, collagen 0.8% and gout 0.6%.
CKD risk factors were similar to those reported in earlier studies. Awareness was observed to be low. This data supports the importance of improving the education and early detection of CKD. It should be stressed to all primary care physicians taking care of hypertensive and diabetic patients to screen for early kidney damage. Early intervention may retard the progression of kidney disease. Planning for the preventive health policies and allocation of more resources for the treatment of CKD/ESRD patients are imperative in Egypt.