Causes of End Stage Renal Disease Among Patients Undergoing Hemodialysis in Somalia: A Multi-Center Study

Abstract Background End-stage renal disease (ESRD) is one of the leading causes of morbidity and mortality worldwide. The incidence of ESRD in Somalia has been increasing in recent years. There is no data available about the causes of chronic kidney disease (CKD) leading to ESRD in the states of Somalia. Methods This is a multicentre, descriptive cross-sectional study designed to determine the aetiology of ESRD among patients receiving haemodialysis in four major demographic areas of Somalia. The study was performed over a one-year period (June 2021 to June 2022). Participants were eligible for inclusion if they were diagnosed with ESRD, were on regular haemodialysis, and were aged over 18 years. Results A total of 127 patients were evaluated, out of which 84 (66.1%) were males and 43 (33.9%) were female participants. The mean age of ESRD patients was 49.27 years. Their origins were 5.6% from the south, 29.9% from the north-eastern, and 64.5% from the northwest regions. 61.7% were unemployed, and 38.7% were employed. The mean duration of haemodialysis was 4.39 ± 2.21 years. Haemodialysis vascular access was central venous catheter in 33.9% and arteriovenous fistula in 66.1%. The most common cause of ESRD in our study was hypertension 33.1%, followed by type 2 diabetes mellitus 27.6%, aetiology uncertain 24.4%, glomerulonephritis 7.1%, obstructive uropathy 3.8%, reno-vascular ischemic nephropathy 1.6%, and neurogenic bladder, polycystic kidney disease, congenital 0.8%. Conclusions Our study showed the leading cause of ESRD among haemodialysis patients is hypertension, followed by diabetes mellitus. To reduce the burden of ESRD in Somalia, primary prevention of hypertension and diabetes, as well as appropriate and timely management of CKD must be considered.