|
1
|
Freedberg DE, Segall L, Liu B, Jacobson JS, Mohan S, George V, Kumar R, Neugut AI, Radhakrishnan J. International Variability in the Epidemiology, Management, and Outcomes of CKD and ESKD: A Systematic Review. KIDNEY360 2024; 5:22-32. [PMID: 38055708 PMCID: PMC10833604 DOI: 10.34067/kid.0000000000000335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/29/2023] [Indexed: 12/08/2023]
Abstract
Key Points There is dramatic global variability in the prevalence of ESKD. Higher per capita health care spending in each country is associated with increased delivery of care for ESKD. Background Approaches to treating ESKD may vary internationally on the basis of the availability of care and other factors. We performed a systematic review to understand the international variability in ESKD epidemiology, management, and outcomes. Methods We systematically searched PubMed for population-based studies of CKD and ESKD epidemiology and management. Population-level data from 23 predesignated nations were eligible for inclusion if they pertained to people receiving dialysis or kidney transplant for ESKD. When available, government websites were used to identify and extract data from relevant kidney registries. Measures gathered included those related to the prevalence and mortality of ESKD; the availability of nephrologists; per capita health care expenditures; and use of erythropoietin-stimulating agents. Results We obtained data from the United States; seven nations in Eastern Europe; four each in Western Europe, Latin America, and Africa; and three in Asia. The documented prevalence of ESKD per million population varied from a high of 3600 (Malaysia) to a low of 67 (Senegal). The annual mortality associated with ESKD varied from 31% (Ethiopia and Senegal) to 10% (the United Kingdom). Nephrologist availability per million population varied from 40 (Japan) to <1 (South Africa) and was associated with per capita health care expenditures. Conclusions The delivery of kidney care related to ESKD varies widely among countries. Higher per capita health care spending is associated with increased delivery of kidney care. However, in part because documentation of kidney disease varies widely, it is difficult to determine how outcomes related to ESKD may vary across nations.
Collapse
Affiliation(s)
- Daniel E. Freedberg
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Leslie Segall
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Benjamin Liu
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Judith S. Jacobson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Sumit Mohan
- Department of Medicine Nephrology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Vinu George
- Global Pharmacovigilance, Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, New Jersey
| | - Retesh Kumar
- Global Pharmacovigilance, Otsuka Pharmaceutical Europe Ltd., Windsor, United Kingdom
| | - Alfred I. Neugut
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Jai Radhakrishnan
- Department of Medicine Nephrology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| |
Collapse
|
|
2
|
García-Yañez JC, Serrano-Gavuzzo CA, Arvizu-Hernandez M, Moguel-González B, Bravo E. Evaluation of hemodialysis vascular access. Perspective from Mexico. FRONTIERS IN NEPHROLOGY 2023; 3:1084188. [PMID: 37675383 PMCID: PMC10479673 DOI: 10.3389/fneph.2023.1084188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 05/26/2023] [Indexed: 09/08/2023]
Abstract
Chronic kidney disease (CKD) has become a global health problem. In 2019, it was related to 2.53% of general global mortality (2.35-2.66%); in the same year, in Latin America, mortality related to CKD reached 5.25% (4.92-5.49%), with an annual increase of 3.37%, proving increased mortality of 102% between 1990 and 2017. A nephrology specialty in Mexico recently fulfilled its first 50 years. Despite being relatively young, nephrologists are interested in "new" sub-specialties of nephrology and learning novel techniques and problem-solving skills. Our group is the first in our country to focus solely and exclusively on comprehensive VA care and we want to position ourselves as the first Mexican interdisciplinary group focused on vascular access (GIMEXAV).
Collapse
Affiliation(s)
- Juan C. García-Yañez
- Department of Nephrology and Urology, High Specialty Regional Hospital of Bajio, León, Guanajuato, Mexico
- Department of Nephrology, Aranda de la Parra Hospital, Leon, Guanajuato, Mexico
- Department of Medicine and Nutrition, University of Guanajuato, Leon, Guanajuato, Mexico
| | - Carlos A. Serrano-Gavuzzo
- Department of Vascular Surgery, XXI Century National Medical Center, Mexican Social Security Institute, Mexico City, Mexico
| | - Mauricio Arvizu-Hernandez
- Department of Nephrology and Mineral Metabolism, Salvador Zubiran National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
- Instituto Tecnológico y de Estudios Superiores de Monterrey, School of Medicine and Health Sciences, Mexico City, Mexico
| | | | - Erick Bravo
- Department of Vascular Surgery, Guadalupe Hospital, Celaya, Guanajuato, Mexico
| |
Collapse
|
|
3
|
Abstract
Podcast
This article contains a podcast at https://www.asn-online.org/media/podcast/K360/2020_06_25_K3602020000091.mp3
Collapse
Affiliation(s)
- Enzo Vasquez-Jimenez
- Department of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Magdalena Madero
- Department of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| |
Collapse
|
|
4
|
Luxardo R, Kramer A, González-Bedat MC, Massy ZA, Jager KJ, Rosa-Diez G, Noordzij M. The epidemiology of renal replacement therapy in two different parts of the world: the Latin American Dialysis and Transplant Registry versus the European Renal Association-European Dialysis and Transplant Association Registry. Rev Panam Salud Publica 2018; 42:e87. [PMID: 31093115 PMCID: PMC6386019 DOI: 10.26633/rpsp.2018.87] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 04/09/2018] [Indexed: 01/03/2023] Open
Abstract
Objective To compare the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in Latin America and Europe, as well as to study differences in macroeconomic indicators, demographic and clinical patient characteristics, mortality rates, and causes of death between these two populations. Methods We used data from 20 Latin American and 49 European national and subnational renal registries that had provided data to the Latin American Dialysis and Renal Transplant Registry (RLADTR) and the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry, respectively. The incidence and prevalence of RRT in 2013 were calculated per million population (pmp), overall and by subcategories of age, sex, primary renal disease, and treatment modality. The correlation between gross domestic product and the prevalence of RRT was analyzed using linear regression. Trends in the prevalence of RRT between 2004 and 2013 were assessed using Joinpoint regression analysis. Results In 2013, the overall incidence at day 91 after the onset of RRT was 181 pmp for Latin American countries and 130 pmp for European countries. The overall prevalence was 660 pmp for Latin America and 782 pmp for Europe. In the Latin American countries, the annual increase in the prevalence averaged 4.0% (95% confidence interval (CI): 2.5%-5.6%) from 2004 to 2013, while the European countries showed an average annual increase of 2.2% (95% CI: 2.0%-2.4%) for the same time period. The crude mortality rate was higher in Latin America than in Europe (112 versus 100 deaths per 1 000 patient-years), and cardiovascular disease was the main cause of death in both of those regions. Conclusions There are considerable differences between Latin America and Europe in the epidemiology of RRT for ESRD. Further research is needed to explore the reasons for these differences.
Collapse
Affiliation(s)
- Rosario Luxardo
- Executive Board of the Latin American Dialysis and Transplant Registry (RLADTR), and Latin American Dialysis and Transplant Society (SLANH), Panama City, Panama
| | - Anneke Kramer
- European Renal Association-European Dialysis and Transplant Association Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Maria Carlota González-Bedat
- Executive Board of the Latin American Dialysis and Transplant Registry (RLADTR), and Latin American Dialysis and Transplant Society (SLANH), Panama City, Panama
| | - Ziad A Massy
- Division of Nephrology, Ambroise Paré University Hospital, Boulogne-Billancourt, France
| | - Kitty J Jager
- European Renal Association-European Dialysis and Transplant Association Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Guillermo Rosa-Diez
- Executive Board of the Latin American Dialysis and Transplant Registry (RLADTR), and Latin American Dialysis and Transplant Society (SLANH), Panama City, Panama
| | - Marlies Noordzij
- European Renal Association-European Dialysis and Transplant Association Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | | |
Collapse
|
|
5
|
Carrillo Vega MF, Pelcastre Villafuerte BE, Salinas Escudero G, Durán Arenas L, López Cervantes YM. [Empowerment and social support for patients with chronic kidney disease: case study in Michoacán, MexicoEmpoderamento e apoio social de pacientes com nefropatia crônica: estudo de caso em Michoacán, México]. Rev Panam Salud Publica 2017; 41:e164. [PMID: 31391843 PMCID: PMC6660881 DOI: 10.26633/rpsp.2017.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 08/14/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Identify the degree of empowerment and the characteristics of the social support for individuals with chronic kidney disease (CKD). METHODS Cross-sectional study of people with chronic kidney disease living in the municipality of Hidalgo, Michoacán, Mexico, who belong to the Association of Kidney Patients, Civil Association. The study examined the sociodemographic profile and personal characteristics associated with the disease, the degree of empowerment, the degree of social support, and family functioning. RESULTS Close to 90% of the sample receives sufficient social support, while 40% of the participants belong to semi-cohesive or cohesive families The overall empowerment score was 117.5 ± 14.3; community empowerment was higher in the older group (P < 0.05). Positive social interaction is the social support component most strongly correlated with the degree of empowerment (r = 0.333; P < 0.01). CONCLUSIONS Empowerment is determined by, and is a determinant of, social support and has facilitated access to renal replacement therapy in this community.
Collapse
Affiliation(s)
- María Fernanda Carrillo Vega
- Departamento de Investigación de Epidemiología ClínicaInstituto Nacional de GeriatríaCiudad de MéxicoMéxicoDepartamento de Investigación de Epidemiología Clínica, Instituto Nacional de Geriatría, Ciudad de México, México.
| | - Blanca Estela Pelcastre Villafuerte
- Centro de Investigación en Sistemas de SaludCentro de Investigación en Sistemas de SaludCuernavacaMéxicoCentro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca, México.
| | - Guillermo Salinas Escudero
- Centro de Estudios Económicos y Sociales en SaludHospital Infantil de México Federico GómezCiudad de MéxicoMéxicoCentro de Estudios Económicos y Sociales en Salud, Hospital Infantil de México Federico Gómez, Ciudad de México, México.
| | - Luis Durán Arenas
- Centro Nacional para la Salud de la Infancia y la AdolescenciaCentro Nacional para la Salud de la Infancia y la AdolescenciaCiudad de MéxicoMéxicoCentro Nacional para la Salud de la Infancia y la Adolescencia, Ciudad de México, México.
| | - y Malaquías López Cervantes
- Dirección General de Planeación y Desarrollo en SaludDirección General de Planeación y Desarrollo en SaludCiudad de MéxicoMéxicoDirección General de Planeación y Desarrollo en Salud, Ciudad de México, México.
| |
Collapse
|
|
6
|
Marinho AWGB, Penha ADP, Silva MT, Galvão TF. Prevalência de doença renal crônica em adultos no Brasil: revisão sistemática da literatura. ACTA ACUST UNITED AC 2017. [DOI: 10.1590/1414-462x201700030134] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Resumo Introdução A doença renal crônica é um problema global de saúde pública, e no Brasil sua prevalência é incerta. Objetivo Estimar a prevalência de doença renal crônica em adultos do Brasil. Método Realizou-se revisão sistemática com buscas no MEDLINE, Embase e outras bases. Dois pesquisadores selecionaram os estudos, extraíram os dados e avaliaram a qualidade. Resultados Incluímos 16 estudos: inquéritos populacionais que utilizaram critério autorreferido encontraram prevalência nacional de 4,57% (1998) a 1,43% (2013); naqueles que usaram hipercreatininemia, a prevalência foi 3,46% em Bambuí (1997) e 3,13% em Salvador (2000). Estudos com amostras não representativas usaram critérios clínico-laboratoriais e tiveram maiores prevalências: entre 6,26-7,26% em campanhas de saúde (2002-2010), 8,94% em servidores públicos (2008-2010), 9,62% em usuários de laboratório privado (2003), 27,20% em pacientes hospitalizados (2013) e 1,35-13,63% na atenção primária (2010-2012). Pacientes em terapia dialítica representam 0,05% da população. Discussão Os estudos com representatividade populacional não aferiram a doença adequadamente, e investigações com melhores critérios diagnósticos tiveram amostragem por conveniência. A heterogeneidade entre pesquisas inviabilizou a elaboração de meta-análise. Conclusão A prevalência de doença renal crônica variou de acordo com o método empregado na definição da doença. Pelos critérios populacionais, 3-6 milhões teriam a doença. Aproximadamente 100.000 recebem diálise no Brasil.
Collapse
Affiliation(s)
| | | | | | - Taís Freire Galvão
- Universidade Federal do Amazonas, Brasil; Universidade Estadual de Campinas, Brasil
| |
Collapse
|
|
7
|
Burdmann EA, Jha V. Acute kidney injury due to tropical infectious diseases and animal venoms: a tale of 2 continents. Kidney Int 2017; 91:1033-1046. [PMID: 28088326 DOI: 10.1016/j.kint.2016.09.051] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 09/10/2016] [Accepted: 09/28/2016] [Indexed: 12/20/2022]
Abstract
South and Southeast Asia and Latin American together comprise 46 countries and are home to approximately 40% of the world population. The sociopolitical and economic heterogeneity, tropical climate, and malady transitions characteristic of the region strongly influence disease behavior and health care delivery. Acute kidney injury epidemiology mirrors these inequalities. In addition to hospital-acquired acute kidney injury in tertiary care centers, these countries face a large preventable burden of community-acquired acute kidney injury secondary to tropical infectious diseases or animal venoms, affecting previously healthy young individuals. This article reviews the epidemiology, clinical picture, prevention, risk factors, and pathophysiology of acute kidney injury associated with tropical diseases (malaria, dengue, leptospirosis, scrub typhus, and yellow fever) and animal venom (snakes, bees, caterpillars, spiders, and scorpions) in tropical regions of Asia and Latin America, and discusses the potential future challenges due to emerging issues.
Collapse
Affiliation(s)
- Emmanuel A Burdmann
- LIM 12, Division of Nephrology, University of São Paulo Medical School, São Paulo, Brazil.
| | - Vivekanand Jha
- George Institute for Global Health, New Delhi, India, and University of Oxford, Oxford, UK
| |
Collapse
|
|
8
|
Gonzalez-Bedat MC, Rosa-Diez G, Ferreiro A. El Registro Latinoamericano de Diálisis y Trasplante Renal: la importancia del desarrollo de los registros nacionales en Latinoamérica. NEFROLOGÍA LATINOAMERICANA 2017. [DOI: 10.1016/j.nefrol.2016.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
|
|
9
|
Cusumano AM, Rosa-Diez GJ, Gonzalez-Bedat MC. Latin American Dialysis and Transplant Registry: Experience and contributions to end-stage renal disease epidemiology. World J Nephrol 2016; 5:389-397. [PMID: 27648403 PMCID: PMC5011246 DOI: 10.5527/wjn.v5.i5.389] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 07/29/2016] [Accepted: 08/18/2016] [Indexed: 02/06/2023] Open
Abstract
In 2015, 634387 million people (9% of the world’s population) resided in Latin America (LA), with half of those populating Brazil and Mexico. The LA Dialysis and Transplant Registry was initiated in 1991, with the aim of collecting data on renal replacement therapy (RRT) from the 20 LA-affiliated countries. Since then, the Registry has revealed a trend of increasing prevalence and incidence of end-stage kidney disease on RRT, which is ongoing and is correlated with gross national income, life expectancy at birth, and percentage of population that is older than 65 years. In addition, the rate of kidney transplantation has increased yearly, with > 70% being performed from deceased donors. According to the numbers reported for 2013, the rates of prevalence, incidence and transplantation were (in patients per million population) 669, 149 and 19.4, respectively. Hemodialysis was the treatment of choice (90%), and 43% of the patients undergoing this treatment was located in Brazil; in contrast, peritoneal dialysis prevailed in Costa Rica, El Salvador and Guatemala. To date, the Registry remains the only source of RRT data available to healthcare authorities in many LA countries. It not only serves to promote knowledge regarding epidemiology of end-stage renal disease and the related RRT but also for training of nephrologists and renal researchers, to improve understanding and clinical application of dialysis and transplantation services. In LA, accessibility to RRT is still limited and it remains necessary to develop effective programs that will reduce risk factors, promote early diagnosis and treatment of chronic kidney disease, and strengthen transplantation programs.
Collapse
|
|
10
|
|
|
11
|
Obrador GT, Rubilar X, Agazzi E, Estefan J. The Challenge of Providing Renal Replacement Therapy in Developing Countries: The Latin American Perspective. Am J Kidney Dis 2016; 67:499-506. [DOI: 10.1053/j.ajkd.2015.08.033] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 08/18/2015] [Indexed: 11/11/2022]
|
|
12
|
Harhay MN, Harhay MO, Coto-Yglesias F, Rosero Bixby L. Altitude and regional gradients in chronic kidney disease prevalence in Costa Rica: Data from the Costa Rican Longevity and Healthy Aging Study. Trop Med Int Health 2016; 21:41-51. [PMID: 26466575 PMCID: PMC4718874 DOI: 10.1111/tmi.12622] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Recent studies in Central America indicate that mortality attributable to chronic kidney disease (CKD) is rising rapidly. We sought to determine the prevalence and regional variation of CKD and the relationship of biologic and socio-economic factors to CKD risk in the older-adult population of Costa Rica. METHODS We used data from the Costa Rican Longevity and Health Aging Study (CRELES). The cohort was comprised of 2657 adults born before 1946 in Costa Rica, chosen through a sampling algorithm to represent the national population of Costa Ricans >60 years of age. Participants answered questionnaire data and completed laboratory testing. The primary outcome of this study was CKD, defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 . RESULTS The estimated prevalence of CKD for older Costa Ricans was 20% (95% CI 18.5-21.9%). In multivariable logistic regression, older age (adjusted odds ratio [aOR] 1.08 per year, 95% CI 1.07-1.10, P < 0.001) was independently associated with CKD. For every 200 m above sea level of residence, subjects' odds of CKD increased 26% (aOR 1.26 95% CI 1.15-1.38, P < 0.001). There was large regional variation in adjusted CKD prevalence, highest in Limon (40%, 95% CI 30-50%) and Guanacaste (36%, 95% CI 26-46%) provinces. Regional and altitude effects remained robust after adjustment for socio-economic status. CONCLUSIONS We observed large regional and altitude-related variations in CKD prevalence in Costa Rica, not explained by the distribution of traditional CKD risk factors. More studies are needed to explore the potential association of geographic and environmental exposures with the risk of CKD.
Collapse
Affiliation(s)
- Meera N Harhay
- Division of Nephrology, Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Michael O Harhay
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Fernando Coto-Yglesias
- Department of Geriatric Medicine, National Geriatrics and Gerontology Hospital, San José, Costa Rica
| | - Luis Rosero Bixby
- Central American Population Center, University of Costa Rica, San José, Costa Rica
- Department of Demography, University of California, Berkeley, CA, USA
| |
Collapse
|
|
13
|
Barreto SM, Ladeira RM, Duncan BB, Schmidt MI, Lopes AA, Benseñor IM, Chor D, Griep RH, Vidigal PG, Ribeiro AL, Lotufo PA, Mill JG. Chronic kidney disease among adult participants of the ELSA-Brasil cohort: association with race and socioeconomic position. J Epidemiol Community Health 2015; 70:380-9. [PMID: 26511886 DOI: 10.1136/jech-2015-205834] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 10/04/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND There is increased interest in understanding why chronic kidney disease (CKD) rates vary across races and socioeconomic groups. We investigated the distribution of estimated glomerular filtration rate (eGFR), urinary albumin-creatinine ratio (ACR) and CKD according to these factors in Brazilian adults. METHODS Using baseline data (2008-2010) of 14,636 public sector employees (35-74 years) enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA)-Brasil multicentre cohort, we estimated the prevalence of CKD by sex, age, race and socioeconomic factors. CKD was defined as ACR ≥ 30 mg/g and/or eGFR < 60 mL/min/1.73 m(2). GFR was estimated by CKD epidemiology collaboration without correction for race. We used logistic regression to estimate the association of race and socioeconomic position (education, income, social class and occupational nature) with CKD after adjusting for sex, age and several health-related factors. RESULTS The prevalence of high ACR or low eGFR, in isolation and combined, increased with age, and was higher in individuals with lower socioeconomic position and among black individuals and indigenous individuals. The overall prevalence of CKD was 8.9%. After full adjustments, it was similar in men and women (OR=0.90; 95% CI 0.79 to 1.02) and increased with age (OR=1.07; 95% CI 1.06 to 1.08). Compared to white individuals, black individuals (OR=1.23; 95% CI 1.03 to 1.47), 'pardos' (OR=1.16; 95% CI 1.00 to 1.35) and Indigenous (OR=1.72; 95% CI 1.07 to 2.76) people had higher odds for CKD. Having high school (OR=1.15; 95% CI 1.00 to 1.34) or elementary education (OR=1.23; 95% CI 1.03 to 1.47) increased the odds for CKD compared to those having a university degree. CONCLUSIONS There were marked discrepancies in the increases in reduced eGFR and high ACR with age and race. The higher prevalences of CKD in individuals with lower educational status and in non-whites were not explained by differences in health-related factors.
Collapse
Affiliation(s)
- Sandhi M Barreto
- Medical School & Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Roberto M Ladeira
- Medical School & Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil Department of Health, Belo Horizonte, Brazil
| | - Bruce B Duncan
- Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria Ines Schmidt
- Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Antonio A Lopes
- Department of Internal Medicine, Universidade Federal da Bahia, Salvador, Brazil
| | - Isabela M Benseñor
- Center for Clinical and Epidemiologic Research, Universidade de São Paulo, São Paulo, Brazil
| | - Dora Chor
- National School of Public Health, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rosane H Griep
- Laboratory of Health and Environment Education, Fundação Oswaldo Cruz, Brazil
| | - Pedro G Vidigal
- Medical School & Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Antonio L Ribeiro
- Medical School & Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiologic Research, Universidade de São Paulo, São Paulo, Brazil
| | - José Geraldo Mill
- Department of Physiological Sciences, Universidade Federal do Espírito Santo, Brazil
| |
Collapse
|
|
14
|
Zurriaga Ó, López-Briones C, Martín Escobar E, Saracho-Rotaeche R, Moina Eguren Í, Pallardó Mateu L, Abad Díez JM, Sánchez Miret JI. Adaptación en español del nuevo sistema de codificación de enfermedad renal primaria de la European Renal Association-European Dialysis and Transplant Association (ERA-EDTA). Nefrologia 2015; 35:353-7. [DOI: 10.1016/j.nefro.2015.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 03/22/2015] [Indexed: 10/23/2022] Open
|
|
15
|
|
|
16
|
Garcia-Garcia G, Jha V. CKD in disadvantaged populations. Int Urol Nephrol 2015; 47:873-4. [DOI: 10.1007/s11255-015-0942-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 02/28/2015] [Indexed: 10/23/2022]
|
|
17
|
Garcia-Garcia G, Jha V, on behalf of the World Kidney Day Steering Committee. CKD in disadvantaged populations. Can J Kidney Health Dis 2015; 2:18. [PMID: 26029381 PMCID: PMC4449556 DOI: 10.1186/s40697-015-0050-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 03/04/2015] [Indexed: 01/13/2023] Open
Affiliation(s)
- Guillermo Garcia-Garcia
- />Nephrology Service, Hospital Civil de Guadalajara, University of Guadalajara Health Sciences Center, Guadalajara, Jal Mexico
| | - Vivekanand Jha
- />Postgraduate Institute of Medical Education and Research, Chandigarh, India
- />George Institute for Global Health, New Delhi, India
- />University of Oxford, Oxford, UK
| | | |
Collapse
|
|
18
|
García-García G, Jha V. World Kidney Day 2015: CKD in disadvantaged populations. Am J Kidney Dis 2015; 65:349-53. [PMID: 25704039 DOI: 10.1053/j.ajkd.2014.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 12/03/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Guillermo García-García
- Hospital Civil de Guadalajara and University of Guadalajara Health Sciences Center, Guadalajara, Mexico
| | - Vivekanand Jha
- George Institute for Global Health India, New Delhi, India
| |
Collapse
|
|
19
|
Chronic kidney disease in disadvantaged populations. Curr Opin Organ Transplant 2015; 20:229-33. [PMID: 25856185 DOI: 10.1097/mot.0000000000000171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
|
20
|
Affiliation(s)
- G Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara, University of Guadalajara Health Sciences Center, Guadalajara, Jalisco, Mexico, USA
| | - V Jha
- Postgraduate Institute of Medical Education and Research, Chandigarh, India ; George Institute for Global Health, New Delhi, India ; University of Oxford, Oxford, UK
| |
Collapse
|
|
21
|
|
|
22
|
Affiliation(s)
- Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara, University of Guadalajara Health Sciences Center, Guadalajara, Mexico
| | | |
Collapse
|
|
23
|
Garcia-Garcia G, Jha V. Chronic kidney disease in disadvantaged populations. ACTA ACUST UNITED AC 2015; 48:377-81. [PMID: 25760025 PMCID: PMC4445659 DOI: 10.1590/1414-431x20144519] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 11/11/2014] [Indexed: 01/13/2023]
Abstract
The increased burden of chronic kidney disease (CKD) in disadvantaged populations is due to both global factors and population-specific issues. Low socioeconomic status and poor access to care contribute to health care disparities and exacerbate the negative effects of genetic or biological predisposition. Provision of appropriate renal care to these populations requires a two-pronged approach: expanding the reach of dialysis through development of low-cost alternatives that can be practiced in remote locations, and implementation and evaluation of cost-effective prevention strategies. Kidney transplantation should be promoted by expansion of deceased donor transplant programs and use of inexpensive, generic immunosuppressive drugs. The message of World Kidney Day 2015 is that a concerted attack against the diseases that lead to end-stage renal disease, by increasing community outreach, better education, improved economic opportunity, and access to preventive medicine for those at highest risk, could end the unacceptable relationship between CKD and disadvantage in these communities.
Collapse
Affiliation(s)
- G Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara, University of Guadalajara Health Sciences Center, Guadalajara, Mexico
| | - V Jha
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | |
Collapse
|
|
24
|
Garcia-Garcia G, Jha V. Chronic kidney disease in disadvantaged populations. Nephrology (Carlton) 2015; 20:113-6. [PMID: 25712555 DOI: 10.1111/nep.12367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara, University of Guadalajara Health Sciences Center, Guadalajara, Mexico
| | | | | |
Collapse
|
|
25
|
Garcia-Garcia G, Jha V. CKD in disadvantaged populations. Nephrol Ther 2015; 11:1-4. [PMID: 25650172 DOI: 10.1016/j.nephro.2015.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 10/15/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil of Guadalajara, University of Guadalajara Health Sciences Center, Guadalajara, Jalisco, Mexico.
| | - Vivekanand Jha
- Postgraduate Institute of Medical Education and Research, Chandigarh, India; George Institute for Global Health, New Delhi, India; University of Oxford, Oxford, UK
| | | |
Collapse
|
|
26
|
Garcia-Garcia G, Jha V. Chronic kidney disease in disadvantaged populations. Pediatr Nephrol 2015; 30:183-7. [PMID: 25395360 DOI: 10.1007/s00467-014-2996-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 10/16/2014] [Accepted: 10/21/2014] [Indexed: 12/31/2022]
Abstract
The increased burden of CKD in disadvantaged populations is due to both global factors and population-specific issues. Low socioeconomic status and poor access to care contribute to healthcare disparities and exacerbate the negative effects of genetic or biologic predisposition. Provision of appropriate renal care to these populations requires a two-pronged approach: expanding the reach of dialysis through development of low-cost alternatives that can be practiced in remote locations, and implementation and evaluation of cost-effective prevention strategies. Kidney transplantation should be promoted by expanding both deceased donor transplant programs and the use of inexpensive, generic immunosuppressive drugs. The message of WKD 2015 is that a concerted attack against the diseases that lead to ESRD, by increasing community outreach, better education, improved economic opportunity, and access to preventive medicine for those at highest risk, could end the unacceptable relationship between CKD and disadvantage in these communities.
Collapse
Affiliation(s)
- Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara, University of Guadalajara Health Sciences Center, Guadalajara, Jalisco, Mexico
| | | | | |
Collapse
|
|
27
|
Garcia-Garcia G, Jha V. Chronic kidney disease in disadvantaged populations. Intern Med J 2015; 45:123-7. [PMID: 25650533 DOI: 10.1111/imj.12663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 11/12/2014] [Indexed: 12/21/2022]
Affiliation(s)
- G Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara, University of Guadalajara Health Sciences Center, Guadalajara, Jalisco, Mexico
| | | |
Collapse
|
|
28
|
Garcia-Garcia G, Jha V. Chronic kidney disease (CKD) in disadvantaged populations. Clin Kidney J 2015; 8:3-6. [PMID: 25713703 PMCID: PMC4310427 DOI: 10.1093/ckj/sfu124] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 10/24/2014] [Indexed: 01/13/2023] Open
Abstract
Twelve March 2015 will mark the 10th anniversary of World Kidney Day (WKD), an initiative of the International Society of Nephrology and the International Federation of Kidney Foundations. Since its inception in 2006, WKD has become the most successful effort ever mounted to raise awareness among decision-makers and the general public about the importance of kidney disease. Each year WKD reminds us that kidney disease is common, harmful and treatable. The focus of WKD 2015 is on chronic kidney disease (CKD) in disadvantaged populations. This article reviews the key links between poverty and CKD and the consequent implications for the prevention of kidney disease and the care of kidney patients in these populations.
Collapse
Affiliation(s)
- Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara, University of Guadalajara Health Sciences Center, Guadalajara, Jalisco, Mexico
| | - Vivekanand Jha
- Institute of Medical Education and Research, Chandigarh, India
- George Institute for Global Health, New Delhi, India
- University of Oxford, Oxford, UK
| |
Collapse
|
|
29
|
Calice-Silva V, Hussein R, Yousif D, Zhang H, Usvyat L, Campos LG, von Gersdorff G, Schaller M, Marcelli D, Grassman A, Etter M, Xu X, Kotanko P, Pecoits-Filho R. Associations Between Global Population Health Indicators and Dialysis Variables in the Monitoring Dialysis Outcomes (MONDO) Consortium. Blood Purif 2015; 39:125-36. [DOI: 10.1159/000368980] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: The number of patients receiving renal replacement therapy (RRT) increases annually and worldwide. Differences in the RRT incidence, prevalence, and modality vary between regions and countries for reasons yet to be clarified. Aims: Gain a better understanding of the association between hemodialysis (HD)-related variables and general population global health indicators. Methods: The present study included prevalent HD patients from 27 countries/regions from the monitoring dialysis outcomes (MONDO) database from 2006-2011. Global population health indicators were obtained from the 2014 World Health Organization report and the Human Development Index from the Human Development Report Office 2014. The Spearman rank test was used to assess the correlations between population social economic indicators and HD variables. Results: A total of 84,796 prevalent HD patients were included. Their mean age was 63 (country mean 52-71), and 60% were males (country mean 52-85%). Significant correlations were found between HD demographic clusters and population education, wealth, mortality, and health indicators. The cluster of nutrition and inflammation variables were also highly correlated with population mortality, wealth, and health indicators. Finally, cardiovascular, fluid management, and dialysis adequacy clusters were associated with education, wealth, and health care resource indicators. Conclusion: We identified socioeconomic indicators that were correlated with dialysis variables. This hypothesis-generating study may be helpful in the analysis of how global health indicators may interfere with access to HD, treatment provision, dialytic treatment characteristics, and outcomes.
Collapse
|
|
30
|
Garcia-Garcia G, Jha V. Chronic kidney disease in disadvantaged populations. Nephron Clin Pract 2015; 128:292-6. [PMID: 25614182 DOI: 10.1159/000369148] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara, University of Guadalajara Health Sciences Center, Guadalajara, Mexico
| | | | | |
Collapse
|
|
31
|
|