ESRD in Sri Lanka-1998.

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Abstract: Sri Lanka is an Island nation with a population of 18 million people of multi ethnic origin.<br>An estimated incidence of 50 per million populations of end stage renal disease (ESRD) is found in the country. The more common causes of ESRD include chronic glomerulonephritis (22%), hypertensive nephrosclerosis (11%), chronic pyelonephritis (4%) and unknown causes (51%).<br>Dialysis therapy is available to less than 5% of the total ESRD population in Sri Lanka. The reasons are largely financial. The bulk of ESRD patients are thus managed conservatively. Erythropoietin therapy is available to only 10-15% of the dialysis population.<br>Approximately 100 patients are recruited for dialysis each year at three centers in the country, 95% of dialysis is by intermittent haemodialysis therapy. Chronic peritonial dialysis therapy accounts for less than 5%.<br>Dialysis for preparation for transplantation is the main reason for acceptance into the faculty of medicine kidney transplant programme, the only centre for transplantation in Sri Lanka. Long term chronic dialysis accounts for less than 10% of the total dialysis population.<br>Living related donor transplantation is the main strategy for the ESRD population. The human tissues act of 1978 allows cadaveric organ donation. Brain death criteria have been worked out. The program for cadeveric KT has yet to be commenced due to financial constraints. A donor card scheme has been launched.<br>The living related transplant programme started on 5/10/85 has now exceeded 250 patients. The non related transplants done in India have also been added to our follow up clinics and number over 200 patients.<br>A National Kidney Center is being planned to step up care of renal patients. The Sri Lanka Association of Nephrology and Transplantation oversees academic and professional standards. A kidney patients association exists to stimate interest in patient welfare activities.

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