Letters to the Editor: Diabetic nephropathy

I read with great interest the article by Afifi and colleagues in the Eastern Mediterra nean health journal and I appreciate the au thors work. Howe ver, I would like to make a few comments because of the increasing prevalence ofdiabetes and its complications in the Arab world. Diabetic renal disease is a common complication and is the most prevalent cause of end-stage renal disease (ESRD) in the Western world. Accord ing to the ESRD programme in the United States , the number of existing patients with terminal renal insufficiency caused by dia betes more than tripled between 1990 and 2001.