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Abstract
The aim of the work was to screen the relatives of patient with ESRD attending the Nephrology Unit of Zagazig University Hospital to identify the prevalence of kidney dysfunction and/or some of its risk factors between them. The prevalence and incidence of ESRD are rising worldwide. Certain population may be at high risk for development of CKD. The variability of prevalence of renal disease may be related to environmental effects and/or genetic predisposition. Both hypertension and diabetes mellitus is considered as a major risk factor for development as well as for progression of CKD. Family history of renal disease is also considered as a risk factor for renal failure. The association between family history of ESRD and the increasing risk for future ESRD could be explained by sharing of specific genes, environmental exposure and/or underlying physical disorders among family members. Our current study was conducted on first-degree relatives of patients with ESRD maintained on regular haemodialysis for more than three years in Internal Medicine department (Nephrology and Dialysis Unit), Zagazig University Hospitals. We screened our ESRD patients’ first-degree relatives, in respect to kidney dysfunction, hypertension, diabetes mellitus, albuminuria and hyperlipidemia. All first-degree relatives of 66 dialysis patients were recruited (394). Only 169 relatives (108 males, 61 females) accepted. The main age of studied subjects was 36.311.3. All subjects were from Sharkia governorate (21.9% from urban areas and 78.1% from rural areas). The results of this study showed that: 18.9% of studied relatives had serum creatinine more than 1.4 mg/dl. 12.5% of the relatives had CrCl less than 60 ml/min and 17.8 % had CrCl from 60 to 90 ml/min. Microalbuminuria (30-300 mg/l) was observed in 7.7 % of studied relatives, while 10.7% had macroalbuminuria (>300 mg/l). 23.7% of relatives were unaware of their impaired kidney function (CrCl <90 ml/min). 37.9 % of relatives were either had a measured high blood pressure and/or a personal history of high blood pressure, 13.6% were unaware of their high blood pressure. 17.7% of relatives were found to have a history of diabetes mellitus and/or elevated blood glucose level and 4.1% of relatives were unaware of their high blood glucose status. 19 % of relatives were hyperlipidemic. 5.3% were suffered from a vascular disease. We can conclude from this study that: A considerable percentage of family members of individuals with ESRD are disproportionately affected with unrecognized and/or asymptomatic renal insult. It seems that systemic screening for relatives of ESRD patients is very important to detect or correct (if possible) any risk factor for CKD.