Burden of chronic kidney disease in the general population and high-risk groups in South Asia: A systematic review and meta-analysis

Background Chronic kidney disease (CKD) is an emerging public health issue globally. The prevalence estimates on CKD in South Asia are however limited. This study aimed to examine the prevalence of CKD among the general and high-risk population in South Asia. Methods We conducted a systematic review and meta-analysis of population-level prevalence studies in South Asia (Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, India, Pakistan, and Sri Lanka). Three databases namely PubMed, Scopus and Web of Science were systematically searched for published reports of kidney disease in South Asia up to 28 October 2020. A random-effect model for computing the pooled prevalence was used. Results Of the 8749 identified studies, a total of 24 studies were included in the review. The pooled prevalence of CKD among the general population was 14% (95% CI 11–18%), and 15% (95% CI 11–20%) among adult males and 13% (95% CI 10–17%) in adult females. The prevalence of CKD was 27% (95% CI 20–35%) in adults with hypertension, 31% (95% CI 22–41%) in adults with diabetes and 14% (95% CI 10–19%) in adults who were overweight/obese. We found substantial heterogeneity across the included studies in the pooled estimates for CKD prevalence in both general and high-risk populations. The prevalence of CKD of unknown origin in the endemic population was 8% (95% CI 3–16%). Conclusion Our study reaffirms the previous reports that CKD represents a serious public health challenge in South Asia, with the disease prevalent among 1 in 7 adults in South Asian countries.

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Prevalence and burden of chronic kidney disease among the general population and high-risk groups in Africa: a systematic review

BMJ Open ◽

10.1136/bmjopen-2016-015069 ◽

2018 ◽

Vol 8 (1) ◽

pp. e015069 ◽

Cited By ~ 31

Author(s):

Samar Abd ElHafeez ◽

Davide Bolignano ◽

Graziella D’Arrigo ◽

Evangelia Dounousi ◽

Giovanni Tripepi ◽

...

Keyword(s):

Systematic Review ◽

Chronic Kidney Disease ◽

High Risk ◽

Kidney Disease ◽

General Population ◽

Risk Groups

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A systematic review and meta-analysis suggests obesity predicts onset of chronic kidney disease in the general population

Kidney International ◽

10.1016/j.kint.2016.12.013 ◽

2017 ◽

Vol 91 (5) ◽

pp. 1224-1235 ◽

Cited By ~ 60

Author(s):

Carlo Garofalo ◽

Silvio Borrelli ◽

Roberto Minutolo ◽

Paolo Chiodini ◽

Luca De Nicola ◽

...

Keyword(s):

Systematic Review ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

General Population ◽

Meta Analysis

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Cigarette smoking and chronic kidney disease in the general population: a systematic review and meta-analysis of prospective cohort studies

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfw452 ◽

2017 ◽

Vol 32 (3) ◽

pp. 475-487 ◽

Cited By ~ 55

Author(s):

Jia Xia ◽

Lin Wang ◽

Zhiheng Ma ◽

Liping Zhong ◽

Ying Wang ◽

...

Keyword(s):

Systematic Review ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

General Population ◽

Cigarette Smoking ◽

Cohort Studies ◽

Prospective Cohort ◽

Meta Analysis ◽

Prospective Cohort Studies

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Prevalence of celiac disease in low and high risk population in Asia–Pacific region: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-82023-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sara Ashtari ◽

Hadis Najafimehr ◽

Mohamad Amin Pourhoseingholi ◽

Kamran Rostami ◽

Hamid Asadzadeh-Aghdaei ◽

...

Keyword(s):

Systematic Review ◽

Celiac Disease ◽

High Risk ◽

Meta Analysis ◽

Risk Groups ◽

Asia Pacific ◽

High Risk Population ◽

Pacific Region ◽

Asia Pacific Region ◽

Pooled Prevalence

AbstractThis systematic review and meta-analysis study was conducted to estimate the pooled prevalence of CD in low and high risk groups in this region. Following keywords were searched in the Medline, PubMed, Scopus, Web of Science and Cochrane database according to the MeSH terms; celiac disease, prevalence, high risk population and Asian-Pacific region. Prevalence studies published from January 1991 to March 2018 were selected. Prevalence of CD with 95% confidence interval (CI) was calculated using STATA software, version 14. The pooled sero-prevalence of CD among low risk group in Asia–Pacific region was 1.2% (95% CI 0.8–1.7%) in 96,099 individuals based on positive anti-tissue transglutaminase (anti-t-TG Ab) and/or anti-endomysial antibodies (EMA). The pooled prevalence of biopsy proven CD in Asia–Pacific among high and low risk groups was 4.3% (95% CI 3.3–5.5%) and 0.61% (95% CI 0.4–0.8%) in 10,719 and 70,344 subjects, respectively. In addition, the pooled sero-prevalence and prevalence of CD in general population was significantly higher in children compared with adults and it was significantly greater in female vs. male (P < 0.05). Our results suggest high risk individuals of CD are key group that should be specifically targeted for prevention and control measures, and screening may prove to have an optimal cost–benefit ratio.

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Prevalence of chronic kidney disease in the general population in Latin America and the Caribbean: Protocol for a systematic review and meta-analysis

10.1101/2021.01.26.21250540 ◽

2021 ◽

Author(s):

Diego A Sequeiros-Buendia ◽

Camila S Villa-Ato ◽

Marlies Weiss-Carlini ◽

Rodrigo M Carrillo-Larco

Keyword(s):

Systematic Review ◽

Chronic Kidney Disease ◽

Latin America ◽

Kidney Disease ◽

General Population ◽

Global Health ◽

Meta Analysis ◽

Prevalence Studies ◽

Prevalence Estimates ◽

The Caribbean

ABSTRACTBackgroundChronic kidney disease (CKD) is a global health issue with a general prevalence of 9%. Although the most affected populations are in low- and middle-income countries, the epidemiology of CKD in these countries remains poorly understood and prevalence estimates come from global efforts informed by data from high-income countries; these prevalence estimates need to be compared –and if needed updated–with local estimates.ObjectiveTo estimate the prevalence of CKD in adults in Latin America and the Caribbean (LAC).MethodsSystematic review and meta-analysis. We will search Embase, Medline, Global Health (these three through Ovid), Scopus and LILACS. No date or language restrictions will be set. We seek observational studies with 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. We will evaluate the risk of bias with the scale proposed by Hoy et al. for prevalence studies. We will conduct a meta-analysis of prevalence estimates, if there are at least three reports homogeneous enough to be pooled; we will use a random-effects model.ConclusionsThis systematic review and meta-analysis will provide the prevalence of CKD in adults in countries of LAC. Currently, information regarding CKD in the region is limited. This work will provide evidence to elucidate the magnitude of CKD prevalence in LAC. In so doing, we will provide evidence to inform the scientific community about the burden of CKD in LAC so that research, policies and health interventions can be planned accordingly.

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Analgesic Use in Patients With Advanced Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Canadian Journal of Kidney Health and Disease ◽

10.1177/2054358120910329 ◽

2020 ◽

Vol 7 ◽

pp. 205435812091032 ◽

Cited By ~ 1

Author(s):

Sara N. Davison ◽

Sarah Rathwell ◽

Chelsy George ◽

Syed T. Hussain ◽

Kate Grundy ◽

...

Keyword(s):

Systematic Review ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Publication Bias ◽

Random Effects ◽

Meta Analysis ◽

Prescribing Patterns ◽

Opioid Use ◽

Pooled Prevalence ◽

Analgesic Use

Background: Pain is common in patients with chronic kidney disease (CKD). Analgesics may be appropriate for some CKD patients. Objectives: To determine the prevalence of overall analgesic use and the use of different types of analgesics including acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), adjuvants, and opioids in patients with CKD. Design: Systematic review and meta-analysis. Setting: Interventional and observational studies presenting data from 2000 or later. Exclusion criteria included acute kidney injury or studies that limited the study population to a specific cause, symptom, and/or comorbidity. Patients: Adults with stage 3-5 CKD including dialysis patients and those managed conservatively without dialysis. Measurements: Data extracted included title, first author, design, country, year of data collection, publication year, mean age, stage of CKD, prevalence of analgesic use, and the types of analgesics prescribed. Methods: Databases searched included MEDLINE, CINAHL, EMBASE, and Cochrane Library. Two reviewers independently screened all titles and abstracts, assessed potentially relevant articles, and extracted data. We estimated pooled prevalence of analgesic use and the I2 statistic was computed to measure heterogeneity. Random-effects models were used to account for variations in study design and sample populations, and a double arcsine transformation of the prevalence variables was used to accommodate potential overweighting of studies with very large or very small prevalence measurements. Sensitivity analyses were performed to determine the magnitude of publication bias and assess possible sources of heterogeneity. Results: Forty studies were included in the analysis. The prevalence of overall analgesic use in the random-effects model was 50.8%. The prevalence of acetaminophen, NSAIDs, and adjuvant use was 27.5%, 17.2%, and 23.4%, respectively, while the prevalence of opioid use was 23.8%. Due to the possibility of publication bias, the actual prevalence of acetaminophen use in patients with advanced CKD may be substantially lower than this meta-analysis indicates. A trim-and-fill analysis decreased the pooled prevalence estimate of acetaminophen use to 5.4%. The prevalence rate for opioid use was highly influenced by 2 large US studies. When these were removed, the estimated prevalence decreased to 17.3%. Limitations: There was a lack of detailed information regarding the analgesic regimen (such as specific analgesics used within each class and inconsistent accounting for patients on multiple drugs and the use of over-the-counter analgesics such as acetaminophen and NSAIDs), patient characteristics, type of pain being treated, and the outcomes of treatment. Data on adjuvant use were very limited. These results, therefore, must be interpreted with caution. Conclusions: There was tremendous variability in the prescribing patterns of both nonopioid and opioid analgesics within and between countries suggesting widespread uncertainty about the optimal pharmacological approach to treating pain. Further research that incorporates robust reporting of analgesic regimens and links prescribing patterns to clinical outcomes is needed to guide optimal clinical practice.

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