The impact of chronic kidney disease on developed countries from a health economics perspective: A systematic scoping review

IntroductionChronic kidney disease (CKD) is a major threat to public health, especially in low-income and lower middle-income countries, where resources for treating patients with advanced CKD are scarce. Although early CKD identification and intervention hold promise for reducing the burden of CKD and risk factors, it remains unclear if an uniform strategy can be applicable across all income groups. The aim of this scoping review is to synthesise available evidence on early CKD identification programmes in all world regions and income groups. The study will also identify efforts that have been made to use interventions and implementation of early identification programmes for CKD across countries and income groups.Methods and analysisThis review will be guided by the methodological framework for conducting scoping studies developed by Arksey and O’Malley. Empirical (Medline, Embase, Cochrane Library, CINAHL, ISI Web of Science and PsycINFO) and grey literature references will be searched to identify studies on CKD screening, early identification and interventions across all populations. Two reviewers will independently screen references in consecutive stages of title/abstract screening and then full-text screening. We will use a general descriptive overview, tabular summaries and content analysis on extracted data.Ethics and disseminationThe findings from our planned scoping review will enable us to identify items in early identification programmes that can be used in developing screening toolkits for CKD. We will disseminate our findings using traditional approaches that include open-access peer-reviewed publication, scientific presentations and a white paper (call to action) report. Ethical approval will not be required for this scoping review as the data will be extracted from already published studies.

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Inequalities in the Global Burden of Chronic Kidney Disease Due to Type 2 Diabetes Mellitus: An Analysis of Trends from 1990 to 2019

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094723 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4723

Author(s):

Nóra Kovács ◽

Attila Nagy ◽

Viktor Dombrádi ◽

Klára Bíró

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Chronic Kidney Disease ◽

Type 2 Diabetes Mellitus ◽

Kidney Disease ◽

Data Exchange ◽

Disease Burden ◽

Socioeconomic Development ◽

Developed Countries

The prevalence of type 2 diabetes mellitus (T2DM) and the burden of complications are increasing worldwide. Chronic kidney disease (CKD) is one serious complication. Our aim was to investigate the trends and inequalities of the burden of CKD due to T2DM between 1990 and 2019. Data were obtained from the Global Health Data Exchange database. Age-standardized incidence, mortality, and DALYs rates of CKD were used to estimate the disease burden across the Human Development Index (HDI). Joinpoint regression was performed to assess changes in trend, and the Gini coefficient was used to assess health inequality. A higher incidence was observed in more developed countries (p < 0.001), while higher mortality and DALYs rates were experienced in low and middle HDI countries in 2019 (p < 0.001). The trend of incidence has increased since 1990 (AAPC: 0.9–1.5%), while slight decrease was observed in low HDI countries in mortality (APC: −0.1%) and DALYs (APC: −0.2%). The Gini coefficients of CKD incidence decreased from 0.25 in 2006 to 0.23 in 2019. The socioeconomic development was associated with disease burden. Our findings indicate that awareness of complications should be improved in countries with high incidence, and cost-effective preventive, diagnostic, and therapeutic tools are necessary to implement in less developed regions.

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The Psychosocial and Somatic Effects of Relocation from Remote Canadian First Nation Communities to Urban Centres on Indigenous Peoples with Chronic Kidney Disease (CKD)

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073838 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3838

Author(s):

Denise Genereux ◽

Lida Fan ◽

Keith Brownlee

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Indigenous Peoples ◽

Health Care Professionals ◽

Medical Condition ◽

Geographical Location ◽

Well Being ◽

First Nation ◽

Urban Centre ◽

The Impact

Chronic kidney disease, also referred to as end-stage renal disease (ESRD), is a prevalent and chronic condition for which treatment is necessary as a means of survival once affected individuals reach the fifth and final stage of the disease. Dialysis is a form of maintenance treatment that aids with kidney functioning once a normal kidney is damaged. There are two main types of dialysis: hemodialysis (HD) and peritoneal dialysis (PD). Each form of treatment is discussed between the patient and nephrologist and is largely dependent upon the following factors: medical condition, ability to administer treatment, supports, geographical location, access to necessary equipment/supplies, personal wishes, etc. For Indigenous Peoples who reside on remote Canadian First Nation communities, relocation is often recommended due to geographical location and limited access to both health care professionals and necessary equipment/supplies (i.e., quality of water, access to electricity/plumbing, etc). Consequently, the objective of this paper is to determine the psychosocial and somatic effects for Indigenous Peoples with ESRD if they have to relocate from remote First Nation communities to an urban centre. A review of the literature suggests that relocation to urban centres has negative implications that are worth noting: cultural isolation, alienation from family and friends, somatic issues, psychosocial issues, loss of independence and role adjustment. As a result of relocation, it is evident that the impact is profound in terms of an individuals’ mental, emotional, physical and spiritual well-being. Ensuring that adequate social support and education are available to patients and families would aid in alleviating stressors associated with managing chronic kidney disease.

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Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084370 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4370

Author(s):

A Kim ◽

Hayeon Lee ◽

Eun-Jeong Shin ◽

Eun-Jung Cho ◽

Yoon-Sook Cho ◽

...

Keyword(s):

Older Adults ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Medication Management ◽

Medication Use ◽

Potentially Inappropriate Medications ◽

Management Service ◽

Ckd Stage ◽

The Impact

Inappropriate polypharmacy is likely in older adults with chronic kidney disease (CKD) owing to the considerable burden of comorbidities. We aimed to describe the impact of pharmacist-led geriatric medication management service (MMS) on the quality of medication use. This retrospective descriptive study included 95 patients who received geriatric MMS in an ambulatory care clinic in a single tertiary-care teaching hospital from May 2019 to December 2019. The average age of the patients was 74.9 ± 7.3 years; 40% of them had CKD Stage 4 or 5. Medication use quality was assessed in 87 patients. After providing MMS, the total number of medications and potentially inappropriate medications (PIMs) decreased from 13.5 ± 4.3 to 10.9 ± 3.8 and 1.6 ± 1.4 to 1.0 ± 1.2 (both p < 0.001), respectively. Furthermore, the number of patients who received three or more central nervous system-active drugs and strong anticholinergic drugs decreased. Among the 354 drug-related problems identified, “missing patient documentation” was the most common, followed by “adverse effect” and “drug not indicated.” The most frequent intervention was “therapy stopped”. In conclusion, polypharmacy and PIMs were prevalent in older adults with CKD; pharmacist-led geriatric MMS improved the quality of medication use in this population.

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The impact of age and chronic kidney disease on secondary prevention post-primary percutaneous coronary intervention

QJM ◽

10.1093/qjmed/hct222 ◽

2013 ◽

Vol 107 (3) ◽

pp. 185-192 ◽

Cited By ~ 4

Author(s):

D. Zachariah ◽

R. Brown ◽

P. Kanagala ◽

A. Bashir ◽

M. Mohan ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Percutaneous Coronary Intervention ◽

Kidney Disease ◽

Secondary Prevention ◽

Primary Percutaneous Coronary Intervention ◽

Coronary Intervention ◽

Percutaneous Coronary ◽

The Impact

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New Pathogenic Concepts and Therapeutic Approaches to Oxidative Stress in Chronic Kidney Disease

Oxidative Medicine and Cellular Longevity ◽

10.1155/2016/6043601 ◽

2016 ◽

Vol 2016 ◽

pp. 1-21 ◽

Cited By ~ 21

Author(s):

José Pedraza-Chaverri ◽

Laura G. Sánchez-Lozada ◽

Horacio Osorio-Alonso ◽

Edilia Tapia ◽

Alexandra Scholze

Keyword(s):

Oxidative Stress ◽

Chronic Kidney Disease ◽

Vitamin D ◽

Kidney Disease ◽

Cardiovascular Complications ◽

Vitamin D Metabolism ◽

Therapy Options ◽

Mitochondrial Alterations ◽

Inflammatory Processes ◽

The Impact

In chronic kidney disease inflammatory processes and stimulation of immune cells result in overproduction of free radicals. In combination with a reduced antioxidant capacity this causes oxidative stress. This review focuses on current pathogenic concepts of oxidative stress for the decline of kidney function and development of cardiovascular complications. We discuss the impact of mitochondrial alterations and dysfunction, a pathogenic role for hyperuricemia, and disturbances of vitamin D metabolism and signal transduction. Recent antioxidant therapy options including the use of vitamin D and pharmacologic therapies for hyperuricemia are discussed. Finally, we review some new therapy options in diabetic nephropathy including antidiabetic agents (noninsulin dependent), plant antioxidants, and food components as alternative antioxidant therapies.

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A scoping review of adult chronic kidney disease clinical pathways for primary care

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfw208 ◽

2016 ◽

pp. gfw208 ◽

Cited By ~ 2

Author(s):

Meghan J. Elliott ◽

Sarah Gil ◽

Brenda R. Hemmelgarn ◽

Braden J. Manns ◽

Marcello Tonelli ◽

...

Keyword(s):

Primary Care ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Scoping Review ◽

Clinical Pathways

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The Impact of Vitamin D3Supplementation on Mechanisms of Cell Calcium Signaling in Chronic Kidney Disease

BioMed Research International ◽

10.1155/2015/807673 ◽

2015 ◽

Vol 2015 ◽

pp. 1-12 ◽

Cited By ~ 1

Author(s):

Ingrid Lajdova ◽

Viera Spustova ◽

Adrian Oksa ◽

Zuzana Kaderjakova ◽

Dusan Chorvat ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Calcium Signaling ◽

Calcium Homeostasis ◽

Calcium Release ◽

Calcium Entry ◽

Regulatory Mechanisms ◽

Cell Calcium ◽

Crac Channels ◽

The Impact

Intracellular calcium concentration in peripheral blood mononuclear cells (PBMCs) of patients with chronic kidney disease (CKD) is significantly increased, and the regulatory mechanisms maintaining cellular calcium homeostasis are impaired. The purpose of this study was to examine the effect of vitaminD3on predominant regulatory mechanisms of cell calcium homeostasis. The study involved 16 CKD stages 2-3 patients with vitamin D deficiency treated with cholecalciferol 7000–14000 IU/week for 6 months. The regulatory mechanisms of calcium signaling were studied in PBMCs and red blood cells. After vitaminD3supplementation, serum concentration of 25(OH)D3increased (P<0.001) and[Ca2+]idecreased (P<0.001). The differences in[Ca2+]iwere inversely related to differences in 25(OH)D3concentration (P<0.01). VitaminD3supplementation decreased the calcium entry through calcium release activated calcium (CRAC) channels and purinergic P2X7channels. The function of P2X7receptors was changed in comparison with their baseline status, and the expression of these receptors was reduced. There was no effect of vitaminD3on P2X7pores and activity of plasma membrane Ca2+-ATPases. VitaminD3supplementation had a beneficial effect on[Ca2+]idecreasing calcium entry via CRAC and P2X7channels and reducing P2X7receptors expression.

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