Chronic kidney disease in low- and middle-income countries

ABSTRACTBackgroundChronic Kidney Disease (CKD) is a highly prevalent condition with a large disease burden globally. In low- and middle-income countries (LMIC) the CKD screening challenges the health system. This systematic and comprehensive search of all CKD diagnostic and prognostic models in LMIC will inform screening strategies in LMIC following a risk-based approach.ObjectiveTo summarize all multivariate diagnostic and prognostic models for CKD in adults in LMIC.MethodsSystematic review. Without date or language restrictions we will search Embase, Medline, Global Health (these three through Ovid), SCOPUS and Web of Science. We seek multivariable diagnostic or prognostic models which included a random sample of the general population. We will screen titles and abstracts; we will then study the selected reports. Both phases will be done by two reviewers independently. Data extraction will be performed by two researchers independently using a pre-specified Excel form (CHARMS model). We will evaluate the risk of bias with the PROBAST tool.ConclusionThis systematic review will provide the most comprehensive list and critical appraisal of diagnostic and prognostic models for CKD available for the general population in LMIC. This evidence could inform policies and interventions to improve CKD screening in LMIC following a risk-based approach, maximizing limited resources and reaching populations with limited access to CKD screening tests. This systematic review will also reveal methodological limitations and research needs to improve CKD diagnostic and prognostic models in LMIC.

Download Full-text

Prevalence, incidence and associated mortality of cardiovascular disease in patients with chronic kidney disease in low- and middle-income countries: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2017-016412 ◽

2017 ◽

Vol 7 (8) ◽

pp. e016412 ◽

Cited By ~ 4

Author(s):

Mazou N Temgoua ◽

Celestin Danwang ◽

Valirie Ndip Agbor ◽

Jean Jacques Noubiap

Keyword(s):

Cardiovascular Disease ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Published Data ◽

Final Report ◽

Middle Income ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Incidence And Mortality ◽

Statistical Heterogeneity

IntroductionChronic kidney disease (CKD) is a global public health problem, with cardiovascular disease (CVD) being the major cause of mortality in these patients. Despite a high burden of CKD among patients in low/middle-income countries (LMICs), evidence on the distribution of CVD among these patients is lacking. This review seeks to determine the prevalence, incidence and mortality risks of CVD in patients with CKD in LMICs.Methods and analysisA systematic search of Medline, Scopus, Embase, Cumulative Index of Nursing and Allied Health and WHO Global Health Library databases for published studies reporting on the prevalence, incidence and associated mortality risk of CVD in CKD patients in LMICs will be conducted from 1 May 1987 to 1 July 2017 with no language restriction. Two authors will independently screen, select studies, extract data and assess the risk of bias in each study. Clinically homogeneous studies will be pooled after assessing for clinical and statistical heterogeneity using the χ2test on Cochrane’s Q statistic which is quantified by I2values; assuming that I2values of 25%, 50% and 75% represent low, medium and high heterogeneity, respectively. Funnel-plot analysis and Egger’s test will be used to detect publication bias. Results will be presented according to WHO Regions (Africa, Americas, Eastern Mediterranean, Europe, South-East Asia and Western Pacific).Ethics and disseminationThis proposed study will not require ethical approval as it will be based on published data. We will publish the final report of this review in a peer-reviewed journal, and the findings will be disseminated to the appropriate health authorities.

Download Full-text

Considerations on equity in management of end-stage kidney disease in low- and middle-income countries

Kidney International Supplements ◽

10.1016/j.kisu.2019.11.004 ◽

2020 ◽

Vol 10 (1) ◽

pp. e63-e71 ◽

Cited By ~ 5

Author(s):

Wim Van Biesen ◽

Vivekanand Jha ◽

Ali K. Abu-Alfa ◽

Sharon P. Andreoli ◽

Gloria Ashuntantang ◽

...

Keyword(s):

Kidney Disease ◽

End Stage Kidney Disease ◽

Middle Income ◽

Middle Income Countries ◽

End Stage ◽

Low And Middle Income

Download Full-text

Tuberculosis in patients with chronic kidney disease: atypical presentation and diagnostic dilemma

Journal of Chitwan Medical College ◽

10.3126/jcmc.v8i3.23742 ◽

2018 ◽

Vol 8 (3) ◽

pp. 1-2

Author(s):

Ravi R. Pradhan

Keyword(s):

Public Health ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Disease Patient ◽

Public Health Problem ◽

Diagnostic Dilemma ◽

Middle Income ◽

Extra Pulmonary Tuberculosis ◽

Middle Income Countries ◽

Significant Public Health

Tuberculosis (TB) is a serious public health problem, and more common in developing countries like Nepal. Worldwide, it is the second most frequent cause of death from infectious disease. Patient with chronic kidney disease (CKD) under maintenance dialysis are more likely to develop TB compared to general population. Given the increasing prevalence of CKD in TB endemic areas, a merging of CKD and TB epidemics could have significant public health implications, especially in low- to middle-income countries like Nepal. Because of increased frequency of extra-pulmonary tuberculosis in patient with CKD, the clinical presentation is atypical and leads to diagnostic dilemma.

Download Full-text

Chronic kidney disease and the aging population

African Journal of Nephrology ◽

10.21804/17-1-738 ◽

2014 ◽

Vol 17 (1) ◽

pp. 6-10

Author(s):

Marcello Tonelli ◽

Miguel Riella

Keyword(s):

Public Policy ◽

Chronic Kidney Disease ◽

Economic Development ◽

Kidney Disease ◽

General Population ◽

Population Aging ◽

Aging Population ◽

Middle Income ◽

Middle Income Countries ◽

Socio Economic Development

The proportion of older people in the general population is steadily increasing worldwide, with the most rapid growth in low- and middle-income countries [1]. This demographic change is to be celebrated, because it is the consequence of socio-economic development and a better life expectancy. However, population aging also has important implications on society – in diverse areas including health systems, labour markets, public policy, social programmes, and family dynamics [2]. A successful response to the aging population will require capitalising on opportunities this transition offers, as well as effectively addressing its challenges.

Download Full-text

Understanding kidney care needs and implementation strategies in low- and middle-income countries: conclusions from a “Kidney Disease: Improving Global Outcomes” (KDIGO) Controversies Conference

Kidney International ◽

10.1016/j.kint.2016.09.009 ◽

2016 ◽

Vol 90 (6) ◽

pp. 1164-1174 ◽

Cited By ~ 35

Author(s):

Vivekanand Jha ◽

Mustafa Arici ◽

Allan J. Collins ◽

Guillermo Garcia-Garcia ◽

Brenda R. Hemmelgarn ◽

...

Keyword(s):

Kidney Disease ◽

Implementation Strategies ◽

Care Needs ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Download Full-text

Do attributes of persons with chronic kidney disease differ in low-income and middle-income countries compared with high-income countries? Evidence from population-based data in six countries

BMJ Global Health ◽

10.1136/bmjgh-2017-000453 ◽

2017 ◽

Vol 2 (4) ◽

pp. e000453 ◽

Cited By ~ 5

Author(s):

Shuchi Anand ◽

Yuanchao Zheng ◽

Maria E Montez-Rath ◽

Wang Jin Wei ◽

Norberto Perico ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Low Income ◽

Population Based ◽

High Income ◽

Middle Income ◽

Middle Income Countries

Download Full-text

The Effectof Exercise to Glomerular Filtration Barrier System in Diabetic Rat

International Journal of Diabetes & Metabolic Disorders ◽

10.33140/ijdmd.04.03.4 ◽

2019 ◽

Vol 4 (3) ◽

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Microvascular Complications ◽

Diabetic Rat ◽

World Population ◽

Glomerular Filtration Barrier ◽

Middle Income ◽

Middle Income Countries ◽

Filtration Barrier ◽

The World

People with diabetes mellitus are spread all over the world. Currently, it is estimated that nearly 425 million (8.8% of the world population), 20 - 79 years old, most (79%) are in low and middle income countries. The estimated number of people with diabetes will increase in 2045 to 625 million [1]. Along with these results the number of macro and microvascular complications is also expected to increase. About 40% of diabetics experience proteinuria in the form of microalbuminuria which is a sign of the progression of chronic kidney disease. Without special intervention 20-40% of patients with microalbuminuria will develop overtnepropathy and around 20% after 20 years theonsetof overt nepropathy will become CKD (Chronic kidney disease) [2].

Download Full-text

The incidence of and risk factors for late presentation of childhood chronic kidney disease: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0244709 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0244709

Author(s):

Lucy Plumb ◽

Emily J. Boother ◽

Fergus J. Caskey ◽

Manish D. Sinha ◽

Yoav Ben-Shlomo

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Kidney Failure ◽

Meta Analysis ◽

Late Presentation ◽

Cochrane Library ◽

Middle Income ◽

Middle Income Countries ◽

Low Middle Income Countries

Background When detected early, inexpensive measures can slow chronic kidney disease progression to kidney failure which, for children, confers significant morbidity and impacts growth and development. Our objective was to determine the incidence of late presentation of childhood chronic kidney disease and its associated risk factors. Methods We searched MEDLINE, Embase, PubMed, Web of Science, Cochrane Library and CINAHL, grey literature and registry websites for observational data describing children <21 years presenting to nephrology services, with reference to late presentation (or synonyms thereof). Independent second review of eligibility, data extraction, and risk of bias was undertaken. Meta-analysis was used to generate pooled proportions for late presentation by definition and investigate risk factors. Meta-regression was undertaken to explore heterogeneity. Results Forty-five sources containing data from 30 countries were included, comprising 19,339 children. Most studies (37, n = 15,772) described children first presenting in kidney failure as a proportion of the chronic kidney disease population (mean proportion 0.43, 95% CI 0.34–0.54). Using this definition, the median incidence was 2.1 (IQR 0.9–3.9) per million age-related population. Risk associations included non-congenital disease and older age. Studies of hospitalised patients, or from low- or middle-income countries, that had older study populations than high-income countries, had higher proportions of late presentation. Conclusions Late presentation is a global problem among children with chronic kidney disease, with higher proportions seen in studies of hospitalised children or from low/middle-income countries. Children presenting late are older and more likely to have non-congenital kidney disease than timely presenting children. A consensus definition is important to further our understanding and local populations should identify modifiable barriers beyond age and disease to improve access to care.

Download Full-text