Causes of Chronic Renal Failure at one Center in Yemen

Chronic renal failure (CRF) remains a significant cause of mortality in Yemen. There are about 568 patients with end-stage renal failure (ESRD) who receive chronic hemodialysis in seven centers in Yemen. We studied 372 CRF patients admitted for evaluation at our center from June 1997 to December 2000 in order to determine the pattern of etiology of their renal disease. Of the study patients, 253 (68%) were males and the age ranged from 4 to 80 years with a mean of 42.7 +/- 38 years. There were 215 (57.8%) patients who had unknown causes of CRF, followed by post-renal causes such as urolithiasis and pyelonephritis. Hyper-tension and diabetes mellitus were the least encountered etiologies in our study patients. There were 243 (66.3%) patients who required dialysis because of symptoms and signs of advanced renal failure; 60.2% of them were hypertensive, 80.3% were anemic with a mean hemo-globin of 79.6 gm/l, 26.9% were hyperkalemic, 52.6% were hypocalcemic and 61.0% had hyper-phosphatemia. We conclude that there are serious diagnostic and therapeutic problems in our health-care system that need addressing in order to improve health care.