The need for screening, early diagnosis, and prediction of chronic kidney disease in people with diabetes in low- and middle-income countries—a review of the current literature
Abstract Chronic kidney disease (CKD) in people with diabetes is becoming an increasing major public health concern, disproportionately burdening low- and middle-income countries (LMICs). This rising burden is due to various factors, including the lack of disease awareness that results in late refer...
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | BMC Medicine |
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| Online Access: | https://doi.org/10.1186/s12916-022-02438-6 |
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| author | Cindy George Justin B. Echouffo-Tcheugui Bernard G. Jaar Ikechi G. Okpechi Andre P. Kengne |
| author_facet | Cindy George Justin B. Echouffo-Tcheugui Bernard G. Jaar Ikechi G. Okpechi Andre P. Kengne |
| author_sort | Cindy George |
| collection | DOAJ |
| description | Abstract Chronic kidney disease (CKD) in people with diabetes is becoming an increasing major public health concern, disproportionately burdening low- and middle-income countries (LMICs). This rising burden is due to various factors, including the lack of disease awareness that results in late referral and the cost of screening and consequent treatment of the comorbid conditions, as well as other factors endemic to LMICs relating to inadequate management of risk factors. We critically assessed the extant literature, by performing searches of Medline via PubMed, EBSCOhost, Scopus, and Web of Science, for studies pertaining to screening, diagnosis, and prediction of CKD amongst adults with diabetes in LMICs, using relevant key terms. The relevant studies were summarized through key themes derived from the Wilson and Jungner criteria. We found that screening for CKD in people with diabetes is generally infrequent in LMICs. Also, LMICs are ill-equipped to appropriately manage diabetes-associated CKD, especially its late stages, in which supportive care and kidney replacement therapy (KRT) might be required. There are acceptable and relatively simple tools that can aid diabetes-associated CKD screening in these countries; however, these tools come with limitations. Thus, effective implementation of diabetes-associated CKD screening in LMICs remains a challenge, and the cost-effectiveness of such an undertaking largely remains to be explored. In conclusion, for many compelling reasons, screening for CKD in people with diabetes should be a high policy priority in LMICs, as the huge cost associated with higher mortality and morbidity in this group and the cost of KRT offers a compelling economic incentive for improving early detection of diabetes in CKD. |
| first_indexed | 2024-12-10T21:44:27Z |
| format | Article |
| id | doaj.art-6e890eff42b347139bb15235537b1ee1 |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-12-10T21:44:27Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-6e890eff42b347139bb15235537b1ee12022-12-22T01:32:24ZengBMCBMC Medicine1741-70152022-08-0120111210.1186/s12916-022-02438-6The need for screening, early diagnosis, and prediction of chronic kidney disease in people with diabetes in low- and middle-income countries—a review of the current literatureCindy George0Justin B. Echouffo-Tcheugui1Bernard G. Jaar2Ikechi G. Okpechi3Andre P. Kengne4Non-Communicable Diseases Research Unit, South African Medical Research CouncilDepartment of Medicine, Division of Diabetes Endocrinology and Metabolism, Johns Hopkins University School of MedicineDepartment of Medicine, Division of Nephrology, Johns Hopkins University School of MedicineDivision of Nephrology and Hypertension, Groote Schuur Hospital, University of Cape TownNon-Communicable Diseases Research Unit, South African Medical Research CouncilAbstract Chronic kidney disease (CKD) in people with diabetes is becoming an increasing major public health concern, disproportionately burdening low- and middle-income countries (LMICs). This rising burden is due to various factors, including the lack of disease awareness that results in late referral and the cost of screening and consequent treatment of the comorbid conditions, as well as other factors endemic to LMICs relating to inadequate management of risk factors. We critically assessed the extant literature, by performing searches of Medline via PubMed, EBSCOhost, Scopus, and Web of Science, for studies pertaining to screening, diagnosis, and prediction of CKD amongst adults with diabetes in LMICs, using relevant key terms. The relevant studies were summarized through key themes derived from the Wilson and Jungner criteria. We found that screening for CKD in people with diabetes is generally infrequent in LMICs. Also, LMICs are ill-equipped to appropriately manage diabetes-associated CKD, especially its late stages, in which supportive care and kidney replacement therapy (KRT) might be required. There are acceptable and relatively simple tools that can aid diabetes-associated CKD screening in these countries; however, these tools come with limitations. Thus, effective implementation of diabetes-associated CKD screening in LMICs remains a challenge, and the cost-effectiveness of such an undertaking largely remains to be explored. In conclusion, for many compelling reasons, screening for CKD in people with diabetes should be a high policy priority in LMICs, as the huge cost associated with higher mortality and morbidity in this group and the cost of KRT offers a compelling economic incentive for improving early detection of diabetes in CKD.https://doi.org/10.1186/s12916-022-02438-6Chronic kidney diseaseDiabetesScreeningDiagnosisPrediction |
| spellingShingle | Cindy George Justin B. Echouffo-Tcheugui Bernard G. Jaar Ikechi G. Okpechi Andre P. Kengne The need for screening, early diagnosis, and prediction of chronic kidney disease in people with diabetes in low- and middle-income countries—a review of the current literature BMC Medicine Chronic kidney disease Diabetes Screening Diagnosis Prediction |
| title | The need for screening, early diagnosis, and prediction of chronic kidney disease in people with diabetes in low- and middle-income countries—a review of the current literature |
| title_full | The need for screening, early diagnosis, and prediction of chronic kidney disease in people with diabetes in low- and middle-income countries—a review of the current literature |
| title_fullStr | The need for screening, early diagnosis, and prediction of chronic kidney disease in people with diabetes in low- and middle-income countries—a review of the current literature |
| title_full_unstemmed | The need for screening, early diagnosis, and prediction of chronic kidney disease in people with diabetes in low- and middle-income countries—a review of the current literature |
| title_short | The need for screening, early diagnosis, and prediction of chronic kidney disease in people with diabetes in low- and middle-income countries—a review of the current literature |
| title_sort | need for screening early diagnosis and prediction of chronic kidney disease in people with diabetes in low and middle income countries a review of the current literature |
| topic | Chronic kidney disease Diabetes Screening Diagnosis Prediction |
| url | https://doi.org/10.1186/s12916-022-02438-6 |
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