Do attributes of persons with chronic kidney disease differ in low- and middle-income countries compared to high income countries? Evidence from population-based data in six countries

Kidney biopsies to elucidate cause of chronic kidney disease (CKD) are performed in a minority of persons with CKD living in high-income countries, since associated conditions—i.e., diabetes mellitus, vascular disease, or obesity with prediabetes, prehypertension, or dyslipidemia—can inform manageme...

Full description

Bibliographic Details
Main Authors: Anand, S, Zheng, Y, Montez-Rath, M, Jin, W, Perico, N, Carminati, S, Narayan, K, Tandon, N, Mohan, V, Jha, V, Zhang, L, Remuzzi, G, Prabhakaran, D, Chertow, G
Format: Journal article
Published: BMJ Publishing Group 2017
_version_ 1826297409409384448
author Anand, S
Zheng, Y
Montez-Rath, M
Jin, W
Perico, N
Carminati, S
Narayan, K
Tandon, N
Mohan, V
Jha, V
Zhang, L
Remuzzi, G
Prabhakaran, D
Chertow, G
author_facet Anand, S
Zheng, Y
Montez-Rath, M
Jin, W
Perico, N
Carminati, S
Narayan, K
Tandon, N
Mohan, V
Jha, V
Zhang, L
Remuzzi, G
Prabhakaran, D
Chertow, G
author_sort Anand, S
collection OXFORD
description Kidney biopsies to elucidate cause of chronic kidney disease (CKD) are performed in a minority of persons with CKD living in high-income countries, since associated conditions—i.e., diabetes mellitus, vascular disease, or obesity with prediabetes, prehypertension, or dyslipidemia—can inform management targeted at slowing CKD progression in a majority. Attributes of CKD may differ in substantially, however, among persons living in low- and middle-income countries (LMICs). We used data from population or community-based studies from 5 LMICs (China, urban India, Moldova, Nepal, and Nigeria) to determine what proportion of persons with CKD living in diverse regions fit one of the three major clinical profiles, with data from the U.S. National Health Nutrition and Examination Survey as reference. In the U.S., urban India, and Moldova, 79.0-83.9%; in China and Nepal, 62.4-66.7%; and in Nigeria 51.6% persons with CKD fit one of three established risk profiles. Diabetes was most common in urban India and vascular disease in Moldova (50.7% and 33.2% of persons with CKD in urban India and Moldova respectively). In Nigeria, 17.8% of persons with CKD without established risk factors had albuminuria ≥ 300 mg/g, the highest proportion in any country. While a majority of persons with CKD in LMICs fit into one of three established risk profiles, the proportion of persons who have CKD without established risk factors is higher than in the U.S. These findings can inform tailored CKD detection and management systems, and highlight the importance of studying potential causes and outcomes of CKD without established risk factors in LMICs.
first_indexed 2024-03-07T04:31:10Z
format Journal article
id oxford-uuid:ce5ebfe7-cbe3-4856-bddf-e4c939bdce78
institution University of Oxford
last_indexed 2024-03-07T04:31:10Z
publishDate 2017
publisher BMJ Publishing Group
record_format dspace
spelling oxford-uuid:ce5ebfe7-cbe3-4856-bddf-e4c939bdce782022-03-27T07:35:11ZDo attributes of persons with chronic kidney disease differ in low- and middle-income countries compared to high income countries? Evidence from population-based data in six countriesJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ce5ebfe7-cbe3-4856-bddf-e4c939bdce78Symplectic Elements at OxfordBMJ Publishing Group2017Anand, SZheng, YMontez-Rath, MJin, WPerico, NCarminati, SNarayan, KTandon, NMohan, VJha, VZhang, LRemuzzi, GPrabhakaran, DChertow, GKidney biopsies to elucidate cause of chronic kidney disease (CKD) are performed in a minority of persons with CKD living in high-income countries, since associated conditions—i.e., diabetes mellitus, vascular disease, or obesity with prediabetes, prehypertension, or dyslipidemia—can inform management targeted at slowing CKD progression in a majority. Attributes of CKD may differ in substantially, however, among persons living in low- and middle-income countries (LMICs). We used data from population or community-based studies from 5 LMICs (China, urban India, Moldova, Nepal, and Nigeria) to determine what proportion of persons with CKD living in diverse regions fit one of the three major clinical profiles, with data from the U.S. National Health Nutrition and Examination Survey as reference. In the U.S., urban India, and Moldova, 79.0-83.9%; in China and Nepal, 62.4-66.7%; and in Nigeria 51.6% persons with CKD fit one of three established risk profiles. Diabetes was most common in urban India and vascular disease in Moldova (50.7% and 33.2% of persons with CKD in urban India and Moldova respectively). In Nigeria, 17.8% of persons with CKD without established risk factors had albuminuria ≥ 300 mg/g, the highest proportion in any country. While a majority of persons with CKD in LMICs fit into one of three established risk profiles, the proportion of persons who have CKD without established risk factors is higher than in the U.S. These findings can inform tailored CKD detection and management systems, and highlight the importance of studying potential causes and outcomes of CKD without established risk factors in LMICs.
spellingShingle Anand, S
Zheng, Y
Montez-Rath, M
Jin, W
Perico, N
Carminati, S
Narayan, K
Tandon, N
Mohan, V
Jha, V
Zhang, L
Remuzzi, G
Prabhakaran, D
Chertow, G
Do attributes of persons with chronic kidney disease differ in low- and middle-income countries compared to high income countries? Evidence from population-based data in six countries
title Do attributes of persons with chronic kidney disease differ in low- and middle-income countries compared to high income countries? Evidence from population-based data in six countries
title_full Do attributes of persons with chronic kidney disease differ in low- and middle-income countries compared to high income countries? Evidence from population-based data in six countries
title_fullStr Do attributes of persons with chronic kidney disease differ in low- and middle-income countries compared to high income countries? Evidence from population-based data in six countries
title_full_unstemmed Do attributes of persons with chronic kidney disease differ in low- and middle-income countries compared to high income countries? Evidence from population-based data in six countries
title_short Do attributes of persons with chronic kidney disease differ in low- and middle-income countries compared to high income countries? Evidence from population-based data in six countries
title_sort do attributes of persons with chronic kidney disease differ in low and middle income countries compared to high income countries evidence from population based data in six countries
work_keys_str_mv AT anands doattributesofpersonswithchronickidneydiseasedifferinlowandmiddleincomecountriescomparedtohighincomecountriesevidencefrompopulationbaseddatainsixcountries
AT zhengy doattributesofpersonswithchronickidneydiseasedifferinlowandmiddleincomecountriescomparedtohighincomecountriesevidencefrompopulationbaseddatainsixcountries
AT montezrathm doattributesofpersonswithchronickidneydiseasedifferinlowandmiddleincomecountriescomparedtohighincomecountriesevidencefrompopulationbaseddatainsixcountries
AT jinw doattributesofpersonswithchronickidneydiseasedifferinlowandmiddleincomecountriescomparedtohighincomecountriesevidencefrompopulationbaseddatainsixcountries
AT pericon doattributesofpersonswithchronickidneydiseasedifferinlowandmiddleincomecountriescomparedtohighincomecountriesevidencefrompopulationbaseddatainsixcountries
AT carminatis doattributesofpersonswithchronickidneydiseasedifferinlowandmiddleincomecountriescomparedtohighincomecountriesevidencefrompopulationbaseddatainsixcountries
AT narayank doattributesofpersonswithchronickidneydiseasedifferinlowandmiddleincomecountriescomparedtohighincomecountriesevidencefrompopulationbaseddatainsixcountries
AT tandonn doattributesofpersonswithchronickidneydiseasedifferinlowandmiddleincomecountriescomparedtohighincomecountriesevidencefrompopulationbaseddatainsixcountries
AT mohanv doattributesofpersonswithchronickidneydiseasedifferinlowandmiddleincomecountriescomparedtohighincomecountriesevidencefrompopulationbaseddatainsixcountries
AT jhav doattributesofpersonswithchronickidneydiseasedifferinlowandmiddleincomecountriescomparedtohighincomecountriesevidencefrompopulationbaseddatainsixcountries
AT zhangl doattributesofpersonswithchronickidneydiseasedifferinlowandmiddleincomecountriescomparedtohighincomecountriesevidencefrompopulationbaseddatainsixcountries
AT remuzzig doattributesofpersonswithchronickidneydiseasedifferinlowandmiddleincomecountriescomparedtohighincomecountriesevidencefrompopulationbaseddatainsixcountries
AT prabhakarand doattributesofpersonswithchronickidneydiseasedifferinlowandmiddleincomecountriescomparedtohighincomecountriesevidencefrompopulationbaseddatainsixcountries
AT chertowg doattributesofpersonswithchronickidneydiseasedifferinlowandmiddleincomecountriescomparedtohighincomecountriesevidencefrompopulationbaseddatainsixcountries