الفهرس 
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Abstract
ESRD is a costly and disabling condition associated with a high mortality rate. The number of patients with ESRD globally continues to grow at an unexpected rate, and greater than the yearly world population growth rate. The increasing prevalence of ESRD is a global challenge. However, data on the prevalence and incidence of ESRD as well as access to therapy in developing countries remain sparse. It is apparent that the prevalence is largely a matter of survival made possible by RRT, which, in turn, is dependent on healthcare expenditures and economic strength. This study was primarily focused on causes of ESRD in HD patients in all renal units in Kafr- EL- Sheikh Governorate and include 1126 patients, to detect cases without apparent cause of ESRD, and finding of risk factors that known to be a direct or indirect injurious factor to the kidney.
So that, we found the leading causes of ESRD were respectively:
Unknown causes: 22.0%.
Hypertensive nephropathy: 19.2%.
Diabetic nephropathy: 18.4%.
chronic glomerulonephritis: 14.1%.
Congenital polycystic kidney: 8.1%.
chronic pyelonephritis: 5.8%.
Gouty nephropathy: 3.5%.
Systemic lupus erythematosis: 2.4%.
Obstructive uropathy: 2.1%.
Toxemia of pregnancy: 1.2%.
Analgesic nephropathy: 1.1%.
Renal artery stenosis: 2.2%
The mean age of ESRD patients 52.59 years old, with standard deviation ± 13.288 years. We found that ESRD is more common in male (56.3%), than in females (43.7%).
It can be concluded that the Prevalence rate of ESRD in Kafr- EL Sheikh Governorate was 445 pmp and unknown was the commonest etiology of ESRD this can be explained by presence of environmental factors, undiagnosed chronic hypertension and chronic GN. Then the second cause is hypertension.
Studies have shown that early intervention and treatment of the risk factors can slow progression of the disease, and thus prevent loss of kidney function, and this will be the focus in reducing its burden. Early detection of hypertension, GN and good control of DM should help in reducing the incidence & prevalence of ESRD in Kafr- EL- Sheikh Governorate.