scholarly journals P0769ESTABLISHING AN AFRICAN NETWORK FOR CHRONIC KIDNEY DISEASE EPIDEMIOLOGY: THE CKD-AFRICA COLLABORATION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Cindy George ◽  
Mark Woodward ◽  
Ikechi Okpechi ◽  
Andre Kengne

Abstract Background and Aims Chronic kidney disease (CKD) is a global public health problem, disproportionately affecting individuals of African ancestry. Unfortunately, due to the lack of data in various African countries or the limitations of available data, the true magnitude of CKD on the continent is still unknown. Although there has been an increase in the number of reports on CKD prevalence in recent years, up to now there has been no coordinated effort to provide reliable estimates to adequately support the health service and policy solutions to address the adverse consequences of CKD in Africa. The Chronic Kidney Disease in Africa Collaboration (CKD-AFRICA Collaboration), which is an initiative of the South African Medical Research Council, seeks to address this issue by collating data, at individual participant data (IPD) level, from existing African studies. Thus, the main aims for establishing this platform are, (1) to utilize the available data from all relevant prevalence studies of CKD, to provide an updated and comprehensive synthesis on the burden of CKD in Africa, and (2) to bring together active investigators in the field of CKD epidemiology and prevention, by providing a platform to plan, in a more coordinated way, future observational and interventional studies on CKD across the continent. Method To establish the CKD-AFRICA Collaboration as a continental resource, a stepwise approach was utilized, which included, 1) the identification of data sources through various systematic literature searches and contacting health agencies to access publicly available population-based measurement surveys; 2) establishing a database platform, by inviting active CKD research groups to contribute data on CKD at IPD level; 3) data processing and quality control and 4) piloting the consortium, by using the data from existing studies to determine the prevalence of CKD in the African adult population, by two-stage IPD meta-analysis. Results Through extensive systematic literature searches, 134 potential collaborators were identified. These included studies conducted in general adult populations and high-risk sub-populations, such as those with HIV/AIDS, hypertension and diabetes. Of those identified, 101 principal investigators (PIs) were contacted, via email, to gauge their interest in collaborating in the consortium, as 33 PIs lacked contact information. Of the 101 PIs, 42 responded positively to the call and have agreed to participate in the consortium, spanning 12 African countries, namely Ghana, Kenya, Nigeria, Burundi, Cameroon, Maputo, Sudan, South Africa, Egypt, Uganda, Senegal and Tanzania (Figure 1). To date, the consortium has potential access to 27,346 IPD, with 11,810 IPD already received. Conclusion The strength of this Consortium has far-reaching potential for Africa. Indeed, by harnessing IPD from numerous African studies, important research questions can be explored, and by connecting active CKD researchers, this platform could aid a more coordinated way of developing future observational and interventional studies on CKD in Africa. The research obtained from this collaboration will therefore permit the exploration in understanding the diversity of clinical manifestations of CKD in Africa.

2013 ◽  
Vol 154 (2) ◽  
pp. 43-51 ◽  
Author(s):  
Judit Nagy

Chronic kidney disease is a general term for heterogenous disorders with >3 months duration affecting kidney structure and function. Nowadays, involving 10–16% of the adult population worldwide, chronic kidney disease is recognised as a major global public health problem. The number of cases is continuously increasing. In this review, epidemiology, definition, new classification and a conceptual model for development, progression and complications of chronic kidney disease as well as strategies to improve outcome are summarized. Orv. Hetil., 2013, 154, 43–51.


Author(s):  
Elida Reyes Rueda ◽  
Jorge Armando García Maldonado ◽  
Carmen Liliana Paccha Tamay ◽  
Sara Esther Vera Quiñonez ◽  
Janeth Del Rosario Rodríguez Sotomayor

Introducción: La hemodiálisis constituye un tipo de terapia renal sustitutiva, indicado en los pacientes con Enfermedad renal crónica (ERC). Estas constituyen un problema de salud pública, afectando al 10% de la población adulta. Producto de enfermedades crónicas no transmisibles (ECNT) como la hipertensión arterial (HTA) o la diabetes mellitus (DM) entre otros. Objetivo: Identificar las complicaciones durante el tratamiento de hemodiálisis en pacientes con ERC. Métodos: Estudio descriptivo, transversal, muestra de 57 pacientes, mayores de 30 años; Se utilizó un cuestionario validado para recoger la información. Resultados: Los pacientes con hemodiálisis son mayores de 61 años en 33% de los casos; del género masculino en 51%. Con hemodiálisis por más de 19 meses el 72%. Complicados vértigos 47% de los casos, un 30% sin complicaciones y con un 5% hipertermia y taquipnea respectivamente. Con comorbilidades combinadas como diabetes+HTA+glomerulonefritis en un 19%; HTA+glomerulonefritis 18% y aisladamente glomerulonefritis en un 16%. Conclusiones: Existe un predominio del sexo masculino, mayores de 61 años en pacientes que reciben hemodiálisis.  Con comorbilidades combinadas como glomerulonefritis con hipertensión arterial y diabetes. Seguido de la combinación glomerulonefritis con hipertensión arterial y en tercer lugar glomerulonefritis aislada. Observándose que el factor común es la glomerulonefritis. La complicación más frecuente fue el vértigo, seguido de ninguna complicación en casi el tercio de la muestra estudiada, un pequeño porcentaje presentó taquipnea, epistaxis, aisladas o combinadas. La socialización del autocuidado en pacientes con diabetes e HTA para evitar el desarrollo de la Enfermedad renal crónica, es la clave para su prevención  Palabras clave: hemodiálisis, terapia renal sustitutiva, enfermedad renal crónica  ABSTRACT Introduction: Hemodialysis is a type of renal replacement therapy, indicated in patients with chronic kidney disease (CKD). These constitute a public health problem, affecting 10% of the adult population. Product of chronic non-communicable diseases (CNCD) such as arterial hypertension (HT) or diabetes mellitus (DM) among others. Aim: Identify complications during hemodialysis treatment in CKD patients. Methods: Descriptive, cross-sectional study, sample of 57 patients, older than 30 years; A validated questionnaire was carried out to collect the information. Results: Hemodialysis patients are older than 61 years in 33% of cases; of the masculine gender in 51%. With hemodialysis for more than 19 months, 72%. Complicated vertigo in 47% of cases, 30% without complications and with 5% hyperthermia and tachypnea respectively. With combined comorbidities such as diabetes + hypertension + glomerulonephritis in 19%; HBP + glomerulonephritis in 18% and glomerulonephritis in isolation in 16%. Conclusions: There is a predominance of males, older than 61 years in patients receiving hemodialysis. With combined comorbidities such as glomerulonephritis with high blood pressure and diabetes. Followed by the combination of glomerulonephritis with arterial hypertension and thirdly isolated glomerulonephritis. Noting that the common factor is glomerulonephritis. The most frequent complication was vertigo, followed by no complication in almost a third of the sample studied, a small percentage presented tachypnea, epistaxis, isolated or combined. The socialization of self-care in patients with diabetes and hypertension to avoid the development of chronic kidney disease is the key to its prevention Key words: hemodialysis, renal replacement therapy, chronic kidney disease


KYAMC Journal ◽  
2013 ◽  
Vol 3 (2) ◽  
pp. 277-281
Author(s):  
Sheik Salahuddin Ahmed ◽  
Md. Zulfikar Ali ◽  
Tarafdar Runa Laila ◽  
Moniruzzaman

Chronic kidney disease is a worldwide public health problem with an increasing incidence and prevalence. Outcomes of chronic kidney disease include not only complications of decreased kidney function and cardiovascular disease but also end stage renal failure causing increased morbidity and mortality. The development of acute but serious uremic complications in advanced kidney disease may put the patient's life at risk requiring immediate dialysis. The objective of this study was to find out the outcomes of urgent hemodialysis in advanced kidney disease, the minimum number of hemodialysis required for satisfactory clinical improvement, and to detect uremic emergencies associated with those patients. Twenty two patients with end stage renal failure admitted in a rural tertiary care private hospital of Bangladesh for emergency and short term dialysis were included in this study. For each patient hemodialysis was done at one day interval three times in a week in a dialysis unit. Results show that two sessions of hemodialysis produced 72 % and three sessions, almost 100% clinical recovery at satisfactory level. Urgent hemodialysis was found to be life saving in observed uremic emergencies like acute pulmonary edema, cerebral encephalopathy, metabolic acidosis, hyperkalemia, gross fluid overload and pericardial effusion. Dialysis therapy ameliorates many of the clinical manifestations of renal failure and postpones otherwise imminent death and for these logical reasons it is recommended that dialysis should not be delayed in uremic emergencies for the best interest of clinical outcomes. KYAMC Journal Vol. 3, No.-2, January 2013, Page 277-281 DOI: http://dx.doi.org/10.3329/kyamcj.v3i2.15167


2021 ◽  
Vol 22 (9) ◽  
pp. 4480
Author(s):  
Maria Tziastoudi ◽  
Georgios Pissas ◽  
Georgios Raptis ◽  
Christos Cholevas ◽  
Theodoros Eleftheriadis ◽  
...  

Chronic kidney disease (CKD) is an important global public health problem due to its high prevalence and morbidity. Although the treatment of nephrology patients has changed considerably, ineffectiveness and side effects of medications represent a major issue. In an effort to elucidate the contribution of genetic variants located in several genes in the response to treatment of patients with CKD, we performed a systematic review and meta-analysis of all available pharmacogenetics studies. The association between genotype distribution and response to medication was examined using the dominant, recessive, and additive inheritance models. Subgroup analysis based on ethnicity was also performed. In total, 29 studies were included in the meta-analysis, which examined the association of 11 genes (16 polymorphisms) with the response to treatment regarding CKD. Among the 29 studies, 18 studies included patients with renal transplantation, 8 involved patients with nephrotic syndrome, and 3 studies included patients with lupus nephritis. The present meta-analysis provides strong evidence for the contribution of variants harbored in the ABCB1, IL-10, ITPA, MIF, and TNF genes that creates some genetic predisposition that reduces effectiveness or is associated with adverse events of medications used in CKD.


2018 ◽  
Vol 50 (07) ◽  
pp. 556-561 ◽  
Author(s):  
Xiaojing Ma ◽  
Chengyin Zhang ◽  
Hong Su ◽  
Xiaojie Gong ◽  
Xianglei Kong

AbstractWhile obesity is a recognized risk factor for chronic kidney disease, it remains unclear whether change in body mass index (ΔBMI ) is independently associated with decline in renal function (evaluated by the change in estimated glomerular filtration rate, ΔeGFR) over time. Accordingly, to help clarify this we conducted a retrospective study to measure the association of ΔBMI with decline in renal function in Chinese adult population. A total of 4007 adults (aged 45.3±13.7 years, 68.6% male) without chronic kidney disease at baseline were enrolled between 2008 and 2013. Logistic regression models were applied to explore the relationships between baseline BMI and ΔBMI, and rapid decline in renal function (defined as the lowest quartile of ΔeGFR ). During 5 years of follow-up, the ΔBMI and ΔeGFR were 0.47±1.6 (kg/m2) and –3.0±8.8 (ml/min/1.73 m2), respectively. After adjusted for potential confounders, ΔBMI (per 1 kg/m2 increase) was independently associated with the rapid decline in renal function [with a fully adjusted OR of 1.12 (95% CI, 1.05 to 1.20). By contrast, the baseline BMI was not associated with rapid decline in renal function [OR=1.05 (95% CI, 0.98 to 1.13)]. The results were robust among 2948 hypertension-free and diabetes-free participants, the adjusted ORs of ΔBMI and baseline BMI were 1.14 (95% CI, 1.05 to 1.23) and 1.0 (95% CI, 0.96 to 1.04) for rapid decline in renal function, respectively. The study revealed that increasing ΔBMI predicts rapid decline in renal function.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Saeed Abdelwahab Saeed ◽  
Ashraf Hassan Abd-elmobdy ◽  
Mostafa Ashour Mahmoud Farag Ammar

Abstract Background Chronic kidney disease (CKD) is a major public health problem worldwide and is associated with a considerable increase in morbidity and mortality, cardiovascular disease is most common cause of death among chronic kidney disease patients. Objectives The aim of study was to determine the association between serum ADMA level and cardiac functions assessed by tissue Doppler imaging in chronic kidney disease patients. Patients and Methods our study conducted on 90 patients from outpatient clinic or inpatient department of national institute of nephrology and urology. Results All patients were subjected to full history, full clinical examination, laboratory investigations including: serum urea, serum albumin, complete blood picture, serum electrolytes (calcium and phosphorus), PTH, serum ADMA, lipid profile and echocardiography and Tissue Doppler imaging. Conclusion Serum ADMA is negatively correlated with diastolic function among CKD patients, tissue Doppler imaging is more accurate than echocardiography to estimate diastolic function.


2018 ◽  
Author(s):  
Raghu V Durvasula ◽  
Jonathan Himmelfarb

Chronic kidney disease (CKD) is a clinical syndrome arising from progressive kidney injury, formerly known as chronic renal failure, chronic renal disease, and chronic renal insufficiency. It is classified into five stages based primarily on glomerular filtration rate (GFR). This article discusses the epidemiology of CKD and end-stage renal disease (ESRD), as well as etiology and genetics, pathophysiology, and pathogenesis. The section on diagnosis looks at clinical manifestations and physical findings, laboratory (and other) tests, imaging studies, and biopsy. A short section on differential diagnosis is followed by a discussion of treatment, including hemodialysis and peritoneal dialysis. Long-term complications of patients on dialysis include cardiovascular disease, renal osteodystrophy, dialysis-related amyloidosis, and acquired cystic disease (renal cell carcinoma). The final section addresses prognosis and socioeconomic burden. Figures include the classification system for CKD, prevalence of CKD in the United States, rising prevalence, risk of, and leading causes of ESRD in the United States, plus the changing prevalence of ESRD over time, clinical manifestations of uremia, and an overview of hemodialysis circuit. Tables look at the burden of CKD relative to other chronic disorders, the specific hereditary causes of kidney disease, and situations when serum creatinine does not accurately predict GFR. Other tables list equations for estimating GFR, the causes of CKD without shrunken kidneys, and clinical features distinguishing chronic kidney disease from acute kidney injury. ESRD and indications for initiation of dialysis are presented, as well as typical composition of dialysate and reasons for failure of peritoneal dialysis. This chapter contains 71 references.


2017 ◽  
Author(s):  
Raghu V Durvasula ◽  
Jonathan Himmelfarb

Chronic kidney disease (CKD) is a clinical syndrome arising from progressive kidney injury, formerly known as chronic renal failure, chronic renal disease, and chronic renal insufficiency. It is classified into five stages based primarily on glomerular filtration rate (GFR). This article discusses the epidemiology of CKD and end-stage renal disease (ESRD), as well as etiology and genetics, pathophysiology, and pathogenesis. The section on diagnosis looks at clinical manifestations and physical findings, laboratory (and other) tests, imaging studies, and biopsy. A short section on differential diagnosis is followed by a discussion of treatment, including hemodialysis and peritoneal dialysis. Long-term complications of patients on dialysis include cardiovascular disease, renal osteodystrophy, dialysis-related amyloidosis, and acquired cystic disease (renal cell carcinoma). The final section addresses prognosis and socioeconomic burden. Figures include the classification system for CKD, prevalence of CKD in the United States, rising prevalence, risk of, and leading causes of ESRD in the United States, plus the changing prevalence of ESRD over time, clinical manifestations of uremia, and an overview of hemodialysis circuit. Tables look at the burden of CKD relative to other chronic disorders, the specific hereditary causes of kidney disease, and situations when serum creatinine does not accurately predict GFR. Other tables list equations for estimating GFR, the causes of CKD without shrunken kidneys, and clinical features distinguishing chronic kidney disease from acute kidney injury. ESRD and indications for initiation of dialysis are presented, as well as typical composition of dialysate and reasons for failure of peritoneal dialysis. This chapter contains 71 references.


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