The global burden of kidney disease and the sustainable development goals

Bulletin of the World Health Organization, Год журнала: 2018, Номер 96(6), С. 414 - 422D

Опубликована: Апрель 20, 2018

Kidney disease has been described as the most neglected chronic disease. Reliable estimates of global burden kidney require more population-based studies, but specific risks occur across socioeconomic spectrum from poverty to affluence, malnutrition obesity, in agrarian post-industrial settings, and along life course newborns older people. A range communicable noncommunicable diseases result renal complications many people who have lack access care. The causes, consequences costs implications for public health policy all countries. are also influenced by ethnicity, gender, location lifestyle. Increasing economic disparities, migration, demographic transition, unsafe working conditions environmental threats, natural disasters pollution may thwart attempts reduce morbidity mortality multisectoral approach is needed tackle sustainable development goals (SDGs) emphasize importance a health. We map actions towards achieving SDGs that potential improve understanding, measurement, prevention treatment age groups. These can foster innovations such future generations.

Язык: Английский

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Global Epidemiology of End-Stage Kidney Disease and Disparities in Kidney Replacement Therapy

American Journal of Nephrology, Год журнала: 2021, Номер 52(2), С. 98 - 107

Опубликована: Янв. 1, 2021

Background: The global epidemiology of end-stage kidney disease (ESKD) reflects each nation’s unique genetic, environmental, lifestyle, and sociodemographic characteristics. response to ESKD, particularly regarding replacement therapy (KRT), depends on local burden, culture, socioeconomics. Here, we explore geographic variation trends in ESKD incidence prevalence examine variations KRT modality, practice patterns, mortality. We conclude with a discussion disparities access strategies reduce burden improve treatment low- middle-income countries (LMICs). Summary: From 2003 2016, rates treated were relatively stable many higher income but rose substantially predominantly East Southeast Asia. has increased worldwide, likely due improving survival, population demographic shifts, risk factors, increasing growing economies. Unadjusted 5-year survival patients was 41% the USA, 48% Europe, 60% Japan. Dialysis is predominant most countries, hemodialysis being common modality. Variations dialysis patterns account for some differences outcomes globally. Worldwide, there greater at levels, number people who die prematurely because lack estimated up 3 times than receive treatment. Key Messages: Many worldwide need as life-sustaining do not it, mostly LMICs where health care resources are severely limited. This large gap demands focus population-based prevention development affordable cost-effective KRT. Achieving equity will require concerted efforts advocating effective public policy, delivery, workforce capacity, education, research, support from government, private sector, nongovernmental, professional organizations.

Язык: Английский

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Sustainable Development Goals relevant to kidney health: an update on progress

Nature Reviews Nephrology, Год журнала: 2020, Номер 17(1), С. 15 - 32

Опубликована: Ноя. 13, 2020

Язык: Английский

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Burden of chronic kidney disease and its risk-attributable burden in 137 low-and middle-income countries, 1990–2019: results from the global burden of disease study 2019

BMC Nephrology, Год журнала: 2022, Номер 23(1)

Опубликована: Янв. 5, 2022

Abstract Background Chronic kidney disease (CKD) is a global public health concern, but its burden and risk-attributable in CKD has been poorly studied low - middle-income countries (LMICs). This study aimed to estimate LMICs from 1990 2019. Methods Data were collected the Global Burden of Disease (GBD) Study 2019, which measure using years lived with disability (YLDs), life lost (YLLs), disability-adjusted life-years (DALYs) calculate percentage contributions risk factors age-standardized DALY population attributable fraction (PAF) Trends between 2019 evaluated average annual percent change (AAPC). The 95% uncertainty interval (UI) calculated reported for YLDs, YLLs, DALYs PAF. Results In LICs had highest rate at 692.25 per 100,000 people (95%UI: 605.14 785.67), followed by Lower MICs (684.72% 623.56 746.12)), Upper (447.55% 405.38 493.01)). YLL was much higher than YLD various income regions. From showed 13.70% reduction (AAPC = -0.5, 95%UI: − 0.6 0.5, P < 0.001), 3.72% increment 0.2, 0.0 0.3, 0.05). Age-standardized females males, whereas rates all males globally LMICs. Additionally, YLD, increased age, aged≥70 high systolic blood pressure, fasting plasma glucose, body-mass index remained major causes DALY. there upward trends PAF Global, LICs, MICs. greatest increase index, especially 2.7, 2.7 2.8, 0.001). pressure most 0.6, 0.7, Conclusions remains regions, More effective targeted preventive policies interventions mitigating preventable addressing are urgently needed, particularly geographies or increasing burden.

Язык: Английский

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Chronic kidney disease

Nature Reviews Disease Primers, Год журнала: 2025, Номер 11(1)

Опубликована: Янв. 30, 2025

Язык: Английский

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Preventing CKD in Developed Countries

Kidney International Reports, Год журнала: 2019, Номер 5(3), С. 263 - 277

Опубликована: Дек. 18, 2019

Chronic kidney disease (CKD) is an important public health concern in developed countries because of both the number people affected and high cost care when prevention strategies are not effectively implemented. Prevention should start at governance level with institution multisectoral polices supporting sustainable development goals ensuring safe healthy environments. Primordial CKD can be achieved through implementation measures to ensure fetal (kidney) development. Public prevent diabetes, hypertension, obesity as risk factors for important. These approaches cost-effective reduce overall noncommunicable burden. Strategies nontraditional factors, including nephrotoxin exposure, stones, infections, environmental exposures, acute injury (AKI), need tailored local needs epidemiology. Early diagnosis treatment such obesity, hypertension key primary CKD. tends occur more frequently progress rapidly among indigenous, minority, socioeconomically disadvantaged populations. Special attention required meet these Effective secondary relies on screening individuals detect treat early, using established emerging strategies. Within high-income countries, barriers accessing effective therapies must recognized, overcome obstacles, training support identify CKD, appropriately implement clinical practice guidelines.

Язык: Английский

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Kidney health for everyone everywhere—from prevention to detection and equitable access to care

Kidney International, Год журнала: 2020, Номер 97(2), С. 226 - 232

Опубликована: Янв. 21, 2020

Around 850 million people currently are affected by different types of kidney disorders.1International Society Nephrology2019 United Nations High Level Meeting on UHC: Moving Together to Build Kidney Health worldwide; 2019.https://www.theisn.org/images/Advocacy_4_pager_2019_Final_WEB_pagebypage.pdfDate accessed: July 20, 2019Google Scholar Up 1 in 10 adults worldwide has chronic disease (CKD), which is invariably irreversible and mostly progressive. The global burden CKD increasing, projected become the fifth most common cause years life lost globally 2040.2Foreman K.J. Marquez N. Dolgert A. et al.Forecasting expectancy, lost, all-cause cause-specific mortality for 250 causes death: reference alternative scenarios 2016-40 195 countries territories.Lancet. 2018; 392: 2052-2090Abstract Full Text PDF PubMed Scopus (465) Google If remains uncontrolled if person survives ravages cardiovascular other complications disease, progresses end-stage where cannot be sustained without dialysis therapy or transplantation. Hence, a major catastrophic health expenditure.3Essue B.M. Laba T.L. Knaul F. al.Economic ill injuries households low- middle-income countries.in: Jamison D.T. Gelband H. Horton S. Disease Control Priorities Improving Reducing Poverty. 3rd ed. World Bank, Washington, DC2018: 121-143Google costs transplantation consume 2%–3% annual care budget high-income countries, spent less than 0.03% total population these countries.4Vanholder R. Annemans L. Brown E. al.Reducing while delivering quality care: call action.Nat Rev Nephrol. 2017; 13: 393-409Crossref (109) Importantly, however, can prevented progression delayed with appropriate access basic diagnostics early treatment including lifestyle modifications nutritional interventions.4Vanholder Scholar, 5Luyckx V.A. Tuttle K.R. Garcia-Garcia G. risk factors disease.Kidney Int Suppl (2011). 7: 71-87Abstract (95) 6Luyckx Tonelli M. Stanifer J.W. sustainable development goals.Bull Organ. 96: 414-422DCrossref (221) 7Tonelli Muntner P. Lloyd al.Risk coronary events compared those diabetes: population-level cohort study.Lancet. 2012; 380: 807-814Abstract (470) 8Kalantar-Zadeh K. Fouque D. Nutritional management disease.N Engl J Med. 377: 1765-1776Crossref (213) Despite this effective provision programs, highly inequitable across world. Indeed, parallel importance ongoing inequity particularly among some indigenous populations certain regions world, may have bearing preexisting emerging gaps between low-middle-income, middle-income, countries. crucially missing from international agenda health. It notably absent impact indicators Sustainable Development Goal 3, Target 3.4, "By 2030, reduce one third premature noncommunicable diseases (NCDs) through prevention promote mental well-being," latest iteration Political Declaration NCDs.9United General AssemblyPolitical declaration high-level meeting Assembly control ofnon-communicable diseases; 2018.https://www.un.org/ga/search/view_doc.asp?symbol=A/73/L.2&Lang=EDate November factor heart cardiac death, as well infections such tuberculosis, complication preventable treatable conditions diabetes, hypertension, HIV, hepatitis.4Vanholder Moreover, consumer engagement self-help crucial improving To that end, Day steering committee suggests adopting strategies focus preventative interventions. According expert definitions Center Prevention,10Center Prevention (CDC)Picture America; 2017.At Glance—Executive Summary. 2019; (Available at:)www.cdc.gov/pictureofamericaDate term "prevention" refers activities typically categorized following 3 definitions: (i) primary implies intervening before effects occur an effort prevent onset illness injury process begins, (ii) secondary preventive measures lead diagnosis prompt more severe problems developing includes screening identify earliest stages, (iii) tertiary indicates managing after it established order emergence complications, often means targeted pharmacotherapy, rehabilitation, complications. These important CKD, accurate identification faster renal failure, shown Figure 1, relevant policy decisions education awareness related CKD.11Levey A.S. Schoolwerth A.C. Burrows N.R. al.Centers Expert PanelComprehensive public preventing development, progression, CKD: report panel convened Centers Prevention.Am Dis. 2009; 53: 522-535Abstract (154) Measures achieve should 2 leading diabetes mellitus hypertension. Other include polycystic kidneys congenital acquired structural anomalies urinary tracts, glomerulonephritis, exposure nephrotoxic substances medications (such nonsteroidal anti-inflammatory drugs), having single kidney, example, solitary cancer nephrectomy, high dietary salt intake, inadequate hydration recurrent volume depletion, heat stress, pesticides heavy metals (as been speculated main Mesoamerican nephropathy), possibly protein intake at higher CKD.8Kalantar-Zadeh Among nonmodifiable advancing age genetic apolipoprotein (APOL1) gene encountered sub-Saharan African ethnicity, especially Americans. Table shows CKD.Table 1Risk de novo progressionRisk factorContribution CKDContribution progressionNonmodifiable factorsAgeSeen age, setting comorbid conditionsSome older patients slower progressionRace, genetics hereditary factors:•APOL1 gene•Hereditary nephritis (Alport's)Common American ancestorsAcute GN•Postinfectious GN•Rapidly progressive GN<10%Recurrent GN exacerbation proteinuriaPolycystic disorders<10%, family history cystic disordersAutoimmune disorders•Lupus erythematosus•Other connective tissue disorders (Sjogren's syndrome)Congenital tractMostly children young adultsMalignancy•Myeloma, light chain deposition AL amyloidosis, plasma cell dyscrasias•LymphomaModifiable factorsGlycemic mellitusApproximately 50% all CKDBlood pressure controlApproximately 25% CKDObesity10%–20%SmokingVia both nonhemodynamic hemodynamic pathwaysAKI•ATN•Acute interstitial nephritisRepeated AKI bouts CKDRepeated accelerate progressionPharmacologic•Medications causing nephritides (NSAIDs, chemotherapy, PPIs, etc.), ATN (aminoglycosides), ischemia fibrosis (calcineurin inhibitors), crystal nephropathy (phosphate-based bowel preparations, trimethoprim-sulfamethoxazole)•Herbs herbal medications•Contrast mediaVariable, e.g., Taiwan, Chinese herb (due aristolochic acid) contributorEnvironmental•Heavy metal exposureRareAcquired kidney•Cancer, donor traumatic nephrectomy•Congenital unilateral atrophic kidneyAcquired tract obstructive nephropathyBenign prostatic hypertrophy prostate menGynecologic cancers womenNephrolithiasisInadequate fluid intake•Mesoamerican nephropathy•OthersUnknown risk, but prevalence suspected Central AmericaWhereas earlier stages adequate avoid prerenal bouts, advanced increase hyponatremiaHigh intakeUnknown recent data suggest high-protein diet, particular, animal sourcesHigher rate progressionCardiovascular (cardiorenal)•Heart failure•AtherosclerosisIschemic nephropathyLiver (hepatorenal)NASH cirrhosis, viral hepatitisEndocrine derangements•Testosterone androgen supplements•HypothyroidismAKI, acute injury; AL, amyloid light-chain; ATN, tubular necrosis; disease; GN, glomerulonephritis; NASH, nonalcoholic steatohepatitis; NSAID, drug; PPI, proton pump inhibitor.Many contribute its hence prevention. Open table new tab AKI, inhibitor. Many efforts manage persons targeting primordial metabolic syndrome overnutrition correcting obesity.12Kovesdy C.P. Furth S.L. Zoccali C. Steering CommitteeObesity disease: hidden consequences epidemic.J Ren Nutr. 27: 75-77Abstract (31) Promoting healthier physical activity diet. latter based plant-based foods meat, sodium complex carbohydrates fiber saturated fat. In hypertension optimizing blood glycemic diabetic hypertensive nephropathies. Persons above gram per kilogram body weight day.13Tantisattamo Dafoe D.C. Reddy U.G. al.Current kidney.Kidney Rep. 4: 1205-1218Abstract (32) Scholar,14Webster Nagler E.V. Morton R.L. Masson Chronic disease.Lancet. 389: 1238-1252Abstract (996) Obesity avoided, reduction considered.12Kovesdy An challenge rise form "unknown etiology" is, hence, referred "CKDu," resulted substantial morbidity world agricultural occupation Nicaragua Sri Lanka.15Anand Caplin B. Gonzalez-Quiroz al.International Nephrology's International Consortium Collaborators Unknown Etiology (i3C)Epidemiology, molecular, methodologies evaluate CKDu around world: Working Group ISN CKDu.Kidney Int. 1254-1260Abstract (11) There concerted nephrology community potential modifiable CKDu, develop interventions mitigate state. Evidence vast majority stage microalbuminuria (30–300 mg/d) 3B (estimated glomerular filtration 45 60 ml/min 1.73 m2).14Webster For goal clinical "secondary prevention" how slow progression. Uncontrolled poorly controlled cornerstone pharmacotherapy renin-angiotensin-aldosterone system inhibitors. Low diet appears synergistic effect inhibitor therapy.16Koppe role restriction addition inhibitors CKD.Am 73: 248-257Abstract (50) Recent class antidiabetic known sodium-glucose cotransporter-2 not modulation medication.17Mayer G.J. Wanner Weir M.R. al.Analysis EMPA-REG OUTCOME® trial empagliflozin assist type irrespective alter intrarenal hemodynamics.Kidney 489-504Abstract (48) Whereas superimposed progression.18Rifkin D.E. Coca S.G. Kalantar-Zadeh Does truly CKD?.J Am Soc 23: 979-984Crossref (143) A relatively case successful highlights significance implementing use vasopressin V(2)-receptor antagonists adult disease.19Torres V.E. Chapman A.B. Devuyst O. al.TEMPO 3:4 Trial InvestigatorsTolvaptan autosomal dominant 367: 2407-2418Crossref (856) uremia anemia, mineral bone disorders, priority, so continue highest longevity. many will eventually receive replacement transplantation, trend maintain them longer conservative CKD. lack reasons late presentation developed economies.20Verhave J.C. Troyanov Mongeau al.Prevalence, awareness, publicly funded care.Clin 2014; 9: 713-719Crossref 21Chow K.M. Szeto C.C. Kwan al.Public lacks knowledge telephone survey.Hong Kong Med J. 20: 139-144PubMed 22Ene-Iordache Perico Bikbov al.Chronic diseaseand six (ISN-KDDC): cross-sectional study.Lancet Glob Health. 2016; e307-e319Abstract (194) overall general even groups 12 low-income was 10%.22Ene-Iordache Given asymptomatic nature, plays detection. Consensus Positional Statements published Nephrology,23Li P.K.T. Weening J.J. Dirks al.A consensus statements Nephrology 2004 Workshop Progression Renal Disease.Kidney Suppl. 2005; : s2-s7Abstract National Foundation,24Vassalotti J.A. Stevens L.A. Levey Testing position statement Foundation.Am 2007; 50: 169-180Abstract (265) Global Outcomes,25Levey Atkins Coresh problem: approaches initiatives—a Outcomes.Kidney 72: 247-259Abstract (947) Institute Clinical Excellence (NICE) Guidelines,26Crowe Halpin Guideline GroupEarly summary NICE guidance.BMJ. 2008; 337: a1530Crossref (136) Asian Forum Initiatives.27Li Chow Matsuo al.Asian (CKD) Best Practice Recommendations—positional detection Initiatives (AFCKDI).Nephrology (Carlton). 2011; 16: 633-641PubMed Most guidelines do recommend population-based because overdiagnoses harms psychological being labeled also trial-based evidence support routine monitoring CKD.28Fink H.A. Ishani Taylor B.C. al.Screening for, monitoring, 3: systematic review U.S. Preventive Services Task Force College Physicians Guideline.Ann Intern 156: 570-581Crossref (137) Currently, approach Some individuals receiving potentially drugs medicines, past injury, 65 years.27Li Scholar,29Li Ng J.K. Cheng Y.L. al.Relatives Silent Screening study (RISKS): study.Nephrology 22: 35-42Crossref (30) Early could facilitated high-risk using urine test proteinuria estimate rate.24Vassalotti Scholar,27Li ill-equipped deal devastating immense regions. suggestions primarily individuals, extend suboptimal levels prediabetes prehypertension.30George Mogueo Okpechi I. countries: increased screening.BMJ 2e000256Crossref (67) Secondary relays timely signs hyperfiltration, microalbuminuria, microscopic hematuria, sporadic foamy urine, minor elevations serum creatinine level markers. Prior economic evaluations indicated estimated rate, tests cost-effective stratification population. incremental cost-effectiveness ratios were consistently $50,000 saved quality-adjusted unless populations, rapid angiotensin pathway modulators used vascular reduction. note key drive jurisdictions. close links NCDs, critical advocacy aligned existing initiatives concerning successfully introduced part their NCD programs. As 2003, promotion program components ban herbs containing acid, public-awareness campaigns, patient education, funding research, up teams provide integrated care.31Hwang S.J. Tsai Chen H.C. Epidemiology, Taiwan.Nephrology 2010; 15: 3-9Crossref (186) Cuba, Ministry Public implemented national hoped integration into result risks Over time there increasingly incidences rates renoprotective agents prescribed angiotensin-pathway modulators.32Almaguer Herrera Alfonso al.Primary Cuba.Kidney 97: S4-S10Abstract (47) Scholar,33Alamaguer-Lopez Herrera-Valdez Diaz Rodriguez Integration programs Cuba.in: Agodoa L.Y. Norris K.C. Disadvantaged Populations. Elsevier Inc, London2017: 357-365Crossref (27) Recently, US Department Human ambitious number Americans 2030. program, Advancing Initiative, set goals metrics measure success; put prevent, detect, addressing traditional hypertension.34U.S. ServicesAdvancing Health; 2019.https://aspe.hhs.gov/pdf-report/advancing-american-kidney-healthDate September 26, Ongoing Special Diabetes Program Indians, represent providing team-based management. Since implementation, incidence diabetes-related failure Native decreased over 40% 2000 2015.35U.S. ServicesThe Indians.Estimates Medicare Savings. at:)https://aspe.hhs.gov/pdf-report/special-diabetes-program-indians-estimates-medicare-savingsDate 1994, Institutes advocated medical intervention predialysis patients. Owing complexity recommended multidisciplinary team consisting nephrologist, dietitian, nurse, social worker, psychologist, aim mortality.36Morbidity dialysis: NIH conference statement. Conference Panel.Ann 1994; 121: 62-70Crossref (206) Mexico, nurse-led, protocol-driven, reported better preservation improvement similar clinic world.37Garcia-Garcia Martinez-Castellanos Y. Renoirte-Lopez al.Multidisciplinary poor Mexico.Kidney 2013; 178-183Abstract (37) Future models address region-specific diagnostic capabilities, establish referral pathways, assessments effectiveness cost-effectiveness.38Stanifer Von Isenburg Chertow G.M. Anand review.BMJ 3e000728Crossref (45) e-learning popular education. Online learning treatment, Mexico. By 2015, 5000 professionals (including non-nephrologists) had trained electronic platform.39Tapia-Conyer Gallardo-Rincon Betancourt-Cravioto disadvantaged populations: online educational treatment.in: Elsevier, 337-345Crossref equally "Prevention" large. Education engaging disease. path self-management patient-centered care. Narva al.40Narva Norton J.M. Boulware L.E. Educating about 11: 694-703Crossref found associated outcomes. Obstacles nature information, low baseline limited literacy, availability readiness learn. Schatell al.41Schatell Web-based education: supporting self-management.Semin Dial. 26: 154-158Crossref (36) helpful self-management. Reputable organizations facilitate users easier information websites (Supplementary Appendix S1). Engagements professional society, groups, charitable, philanthropic partnership empowerment pressing urgency pertaining need increasing measures, we redirect plans actions:(i)Empowerment literacy campaigns bring disease.(ii)Population-based obesity diabetes.(iii)Implementation Organization "Best Buys" at-risk universal essential affordable technologies, medicines task shifting doctors front-line workers effectively target approaches. "Kidney Everyone, Everywhere" emphasis imperative achieved makers, nephrologists, place within context Universal Coverage All authors declared no competing interests. Members Committee Philip Kam Tao Li, Guillermo Garcia-Garcia, Sharon Andreoli, Kamyar Kalantar-Zadeh, Latha Kumaraswami, Vassilios Liakopoulos, Siu-Fai Lui, Gamal Saadi, Luisa Strani, Ifeoma Ulasi. Download .pdf (.03 MB) Help pdf files Supplementary File (PDF)

Язык: Английский

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2019 World Kidney Day Editorial - burden, access, and disparities in kidney disease

Brazilian Journal of Nephrology, Год журнала: 2019, Номер 41(1), С. 1 - 9

Опубликована: Фев. 28, 2019

Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney varies substantially across the world, as does its detection and treatment. In many settings, rates provision care are defined by socio-economic, cultural, political factors leading to significant disparities. World Day 2019 offers an opportunity raise awareness highlight disparities in current state capacity for prevention management. Here, we that countries still lack access basic diagnostics, trained nephrology workforce, universal primary care, renal replacement therapies. We point need strengthening infrastructure services early management acute injury chronic all advocate more pragmatic approaches providing Achieving coverage worldwide 2030 one Health Organization's Sustainable Development Goals. While may not include elements countries, understanding what feasible important country or region with focus on reducing consequences would be step towards achieving equity.

Язык: Английский

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Lifestyle Modifications and Nutritional and Therapeutic Interventions in Delaying the Progression of Chronic Kidney Disease: A Review

Cureus, Год журнала: 2023, Номер unknown

Опубликована: Фев. 2, 2023

Chronic kidney disease (CKD) is a debilitating progressive illness that affects more than 10% of the world's population. In this literature review, we discussed roles nutritional interventions, lifestyle modifications, hypertension (HTN) and diabetes mellitus (DM) control, medications in delaying progression CKD. Walking, weight loss, low-protein diet (LPD), adherence to alternate Mediterranean (aMed) diet, Alternative Healthy Eating Index (AHEI)-2010 slow However, smoking binge alcohol drinking increase risk CKD progression. addition, hyperglycemia, altered lipid metabolism, low-grade inflammation, over-activation renin-angiotensin-aldosterone system (RAAS), overhydration (OH) diabetic The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend blood pressure (BP) control <140/90 mmHg patients without albuminuria <130/80 with prevent Medical therapies aim target epigenetic alterations, fibrosis, inflammation. Currently, RAAS blockade, sodium-glucose cotransporter-2 (SGLT2) inhibitors, pentoxifylline, finerenone are approved for managing according completed Study Diabetic Nephropathy Atrasentan (SONAR), atrasentan, an endothelin receptor antagonist (ERA), decreased renal events patients. ongoing trials studying role other agents slowing

Язык: Английский

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Congenital anomalies of the kidney and urinary tract: defining risk factors of disease progression and determinants of outcomes

Pediatric Nephrology, Год журнала: 2023, Номер 38(12), С. 3963 - 3973

Опубликована: Март 3, 2023

Язык: Английский

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