fa بررسی توزیع فراوانی علل و فاکتورهای خطر همراه End Stage Renal Disease در بیماران تحت همودیالیز از سال 1378 تا 1386در ایران عمومى General پژوهشي اصیل Original Research <p> </p> <p dir="RTL" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl"><font color="#000000"><strong><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman"">مقدمه </span></strong><strong><span dir="LTR" style="font-family:times new roman,serif font-size:12pt mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE">:</span></strong><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman"">از آنجا که در ایران برخی از اطلاعات اپیدمیولوژیک در پایگاه اطلاعاتی وزارت بهداشت و درمان کشور از کلیه استانها جمع آوری و ثبت می گردد،</span><span dir="LTR" lang="FA" style="font-family:times new roman,serif font-size:12pt mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE"> </span><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman"">درک بهتر از فاکتورهای کلینیکی و اپیدمیولوژیکی مرتبط با </span><span dir="LTR" style="font-family:times new roman,serif font-size:12pt mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE">ESRD</span></font><a href="file:///C:/Users/vahid/Desktop/nameh/78%20end/text%204%20(2).doc#_ftn1" name="_ftnref1" style="mso-footnote-id: ftn1" title="">^{<span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman""><span dir="LTR" style="mso-special-character:footnote">^{<span lang="X-NONE" style="font-family:times new roman,serif font-size:12pt line-height:107% mso-ansi-language:X-NONE mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE"><font color="#0066cc">[1]</font></span>}</span></span>}</a><font color="#000000"><span lang="FA" style="font-family:b zar font-size:12pt mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman""> </span><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman"">جهت تصمیم گیریهای درمانی و نیز مداخلات پیشگیرانه در امر ارتقای سلامت عمومی و برنامه های بهداشتی بسیار کمک کننده است، مطالعه ما با هدف بررسی فراوانی شاخص های مرتبط با </span><span dir="LTR" style="font-family:times new roman,serif font-size:12pt mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE">ESRD</span><span style="font-family:b zar font-size:12pt mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman""> </span><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman"">و دیالیز در فاصله زمانی</span><span dir="LTR" lang="FA" style="font-family:times new roman,serif font-size:12pt mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE"> </span><span lang="FA" style="font-family:b zar font-size:12pt mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman""><span style="mso-spacerun:yes"> </span>سال های </span><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman""><span style="mso-spacerun:yes"> </span>1386</span><span lang="FA" style="font-family:sakkal majalla font-size:12pt mso-ansi-language:X-NONE mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE">–</span><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman""> 1378 انجام شد .</span></font></p> <p> </p> <p dir="RTL" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl"><font color="#000000"><strong><span lang="FA" style="font-family:b zar font-size:12pt mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman"">روش بررسی</span></strong><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman"">: مطالعه بصورت توصیفی- تحلیلی( </span><span dir="LTR" lang="X-NONE" style="font-family:times new roman,serif font-size:12pt mso-ansi-language:X-NONE mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE">Cross Sectional</span><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman"">) طراحی شده است. داده های مورد نیاز از پایگاه داده های اداره بیماری های خاص وزارت بهداشت درمان و آموزش پزشکی جمهوری اسلامی ایران در بازه زمانی 1386-1378 مربوط به 12797 بیمار استخراج شد. محدودیتی جهت ورود بیماران وجود نداشت. سپس<span style="mso-spacerun:yes">  </span>کلیه داده ها<span style="mso-spacerun:yes">  </span>وارد نرم افزار </span><span dir="LTR" lang="X-NONE" style="font-family:times new roman,serif font-size:12pt mso-ansi-language:X-NONE mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE">SPSS</span><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman""> شده و تحت تجزیه و تحلیل آماری قرار گرفت.</span></font></p> <p> </p> <p dir="RTL" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl"><font color="#000000"><strong><span lang="FA" style="font-family:b zar font-size:12pt mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman"">یافته ها</span></strong><strong><span dir="LTR" style="font-family:times new roman,serif font-size:12pt mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE">:</span></strong><strong><span style="font-family:b zar font-size:12pt mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman""> </span></strong><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman"">تعداد 12</span><span lang="FA" style="font-family:b zar font-size:12pt mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman"">979</span><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman""> (۴۳/۵۷ درصد مرد و ۵۷/۴۲ زن) نفر در طی سال های 2000 تا 2009 وارد مطالعه شدند. میانگین سنی 61/17</span><span lang="FA" style="font-family:cambria,serif font-size:12pt mso-ansi-language:X-NONE mso-bidi-font-family:Cambria mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE">±</span><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman"">8/58 بروز کلی </span><span dir="LTR" lang="X-NONE" style="font-family:times new roman,serif font-size:12pt mso-ansi-language:X-NONE mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE">ESRD</span><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman""> در مردان (در مقایسه با توزیع جنسی در جمعیت نرمال) بیشتر از زنان بود. شایعترین اتیولوژی دیابت (5/25%) و بعد از آن فشار خون (3/23%) بود. میزان فراوانی نسبی دیابت و فشار خون در بیماران مورد مطالعه<span style="mso-spacerun:yes">  </span>طی سال های 2000 تا 2009 تغییر واضحی نکرده بود. بین گروه های<span style="mso-spacerun:yes">  </span>خونی و </span><span dir="LTR" lang="X-NONE" style="font-family:times new roman,serif font-size:12pt mso-ansi-language:X-NONE mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE">ESRD</span><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman""> رابطه معنی داری پیدا نشد. فراوانی آنمی در زنان مبتلا به </span><span dir="LTR" lang="X-NONE" style="font-family:times new roman,serif font-size:12pt mso-ansi-language:X-NONE mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE">ESRD</span><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman""> بیشتر بود و سطح تحصیلات با هموگلوبین بیماران رابطه مستقیم داشت (001/0></span><span dir="LTR" style="font-family:times new roman,serif font-size:12pt mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE">P</span><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman"">). <strong><span style="mso-spacerun:yes"> </span></strong></span></font></p> <p> </p> <p dir="RTL" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl"><font color="#000000"><strong><span lang="FA" style="font-family:b zar font-size:12pt mso-ansi-language:X-NONE mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman"">نتیجه گیری</span></strong><strong><span lang="FA" style="font-family:b zar font-size:12pt mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman"">:</span></strong><strong><span dir="LTR" lang="FA" style="font-family:times new roman,serif font-size:12pt mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE"> </span></strong><span lang="FA" style="font-family:b zar font-size:12pt mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-hansi-font-family:"Times New Roman"">میزان بروز </span><span dir="LTR" style="font-family:times new roman,serif font-size:12pt mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman"">ESRD</span><span lang="FA" style="font-family:b zar font-size:12pt mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-hansi-font-family:"Times New Roman""> در طی دوره مورد مطالعه رو به افزایش بوده است. همچنین از نظر </span><span dir="LTR" style="font-family:times new roman,serif font-size:12pt mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman"">HIV</span><span lang="FA" style="font-family:b zar font-size:12pt mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-hansi-font-family:"Times New Roman""> در اواسط دوره شاهد کاهش و در پایان دوره شاهد افزایش این بیماری بوده ایم که مطالعات بیشتری را طلب می کند.</span></font></p> <p> </p> <p dir="RTL" style="background: white margin: 0in 0in 0pt text-align: right line-height: normal unicode-bidi: embed direction: rtl"><font color="#000000"><strong><span lang="FA" style="font-family:b zar font-size:12pt mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-hansi-font-family:"Times New Roman"">کلمات کلیدی:</span></strong><span dir="LTR" lang="FA" style="font-family:times new roman,serif font-size:12pt mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman""> </span><span lang="FA" style="font-family:b zar font-size:12pt mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-hansi-font-family:"Times New Roman""><span style="mso-spacerun:yes"> </span>آنمی، شیوع، همودیالیز، </span><span dir="LTR" style="font-family:times new roman,serif font-size:12pt mso-bidi-font-family:"B Zar" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman"">ESRD</span><span lang="FA" style="font-family:b zar font-size:12pt mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-hansi-font-family:"Times New Roman"">، ایران.</span></font></p> <p><font color="#000000"><span dir="RTL" lang="FA" style="font-family:b zar font-size:12pt line-height:107% mso-ansi-language:EN-US mso-ascii-font-family:"Times New Roman" mso-bidi-language:FA mso-fareast-font-family:"Times New Roman" mso-fareast-language:X-NONE mso-hansi-font-family:"Times New Roman"">وصول مقاله:6/7/93 اصلاحیه نهایی:23/3/94 پذیرش:31/3/94</span><font face="Times New Roman" size="3"> </font></font></p> <div style="mso-element: footnote-list">  <hr align="left" size="1" width="33%" > <div id="ftn1" style="mso-element: footnote"> <p style="margin: 0in 0in 8pt"> </p> </div> </div> <p> </p> <p> </p> <p style="margin: 0in 0in 0pt text-align: justify line-height: normal -ms-text-justify: kashida text-kashida: 0%"><font color="#000000"><strong><em><span style="font-family:times new roman,serif font-size:12pt">Background and Aim:</span></em></strong><strong><span style="font-family:times new roman,serif font-size:12pt"> </span></strong><span style="font-family:times new roman,serif font-size:12pt">According to the recorded data on the Health Ministry database, a better understanding of clinical and epidemiological factors associated with ESRD can be helpful for decision making about the treatment and preventive interventions with the aim of public health promotion and development of health programs. This study aimed to evaluate the prevalence of ESRD and dialysis-related factors from 2000 to 2009.</span></font></p> <p> </p> <p style="margin: 0in 0in 0pt text-align: justify line-height: normal -ms-text-justify: kashida text-kashida: 0%"><font color="#000000"><strong><em><span style="font-family:times new roman,serif font-size:12pt">Material and methods:</span></em></strong><strong><span style="font-family:times new roman,serif font-size:12pt"> </span></strong><span style="font-family:times new roman,serif font-size:12pt">In this cross sectional study, data were obtained from specific diseases office of the Ministry of Health and Medical Education of the Islamic Republic of Iran from 2000 to 2009. There was no limitation on patient entry. Finally data were analyzed using SPSS software.</span></font></p> <p> </p> <p style="margin: 0in 0in 0pt text-align: justify line-height: normal -ms-text-justify: kashida text-kashida: 0%"><font color="#000000"><strong><em><span style="font-family:times new roman,serif font-size:12pt">Results:</span></em></strong><strong><span style="font-family:times new roman,serif font-size:12pt"> </span></strong></font><span style="font-family:times new roman,serif font-size:12pt"><font color="#000000">This study included<strong> </strong></font><span style="background:white color:black">12797 patients (57.07% male and 42.57% female) from 2000 to 2009. The overall incidence of ESRD in men (compared to the gender distribution in the normal population) with a mean age of 58.8 (SD = 17.61) was higher in comparison to women. The most common etiologies were diabetes (25.5%), and hypertension (23.3%) respectively. There were no significant changes in diabetes and hypertension frequencies in the patients between 2000 and 2009. No significant relationship was found between blood groups and ESRD. Prevalence of anemia was higher in the women with ESRD and hemoglobin levels were directly correlated with educational status (P <0.001).</span></span></p> <p> </p> <p style="margin: 0in 0in 0pt text-align: justify line-height: normal -ms-text-justify: kashida text-kashida: 0%"><strong><em><span style="font-family:times new roman,serif font-size:12pt"><font color="#000000">Conclusion: </font></span></em></strong><span style="font-family:times new roman,serif font-size:12pt"><font color="#000000">The </font><span style="background:white color:black">incidence of ESRD has been on the increase during this study.<span style="mso-spacerun:yes">  </span>Also we found a decrease in the middle and an increase at the end of the study in the prevalence of HIV which calls for further assessments.</span></span></p> <p> </p> <p style="margin: 0in 0in 0pt text-align: justify line-height: normal -ms-text-justify: kashida text-kashida: 0%"><font color="#000000"><strong><em><span style="font-family:times new roman,serif font-size:12pt">Keywords:</span></em></strong><span style="font-family:times new roman,serif font-size:12pt"> Iran, ESRD, Hemodialysis, Prevalenc</span><span style="font-family:times new roman,serif font-size:13pt">e, Anemia</span></font></p> <p> </p> <p style="margin: 0in 0in 0pt text-align: justify line-height: normal -ms-text-justify: kashida text-kashida: 0%"><span style="font-family:times new roman,serif font-size:12pt"><font color="#000000"> </font></span></p> <p><font color="#000000"><strong><span lang="EN-GB" style="font-family:times new roman,serif font-size:12pt line-height:115% mso-ansi-language:EN-GB mso-bidi-language:AR-SA mso-fareast-font-family:"Times New Roman" mso-fareast-language:EN-US">Received: </span></strong><span lang="EN-GB" style="font-family:times new roman,serif font-size:12pt line-height:115% mso-ansi-language:EN-GB mso-bidi-language:AR-SA mso-fareast-font-family:"Times New Roman" mso-fareast-language:EN-US">Sep 28, 2014<strong><span style="mso-spacerun:yes">      </span>Accepted: </strong>Jun 21, 2015</span></font></p> آنمی, شیوع, همودیالیز, ESRD, ایران. Iran, ESRD, Hemodialysis, Prevalence, Anemia 33 43 http://sjku.muk.ac.ir/browse.php?a_code=A-10-25-17&slc_lang=fa&sid=1 Seyed Saman Talebi سید سامان طالبی 540031947532846008262 540031947532846008262 No Manochehr Amini منوچهر امینی aminimd@tums.ac.ir 540031947532846008263 540031947532846008263 Yes Mostafa Qorbani مصطفی قربانی 540031947532846008264 540031947532846008264 No