Renal disease screening: a potential tool for reducing health inequity

Abstract

The impact of chronic kidney disease on mortality, quality of life and cost of medical care is rising worldwide, such that it now affects 8-16% of the world population.1 The Global Burden of Diseases index, which ranks the causes of deaths, has revealed that as the underlying cause of death, chronic kidney disease (CKD) jumped from 34 th position in 1990 to 18 th in 2013. 2However, although the use of mortality statistics to ascertain temporal trends or make geographic comparisons has been helpful in charting other chronic diseases, this has not been the case for CKD. The reason for this is that when diabetes and CKD are mentioned together on a death certificate, the underlying cause is frequently stated as "diabetes without complications"and not "chronic kidney disease" or "diabetic kidney disease". and glomerulonephritis (7.7%). The annual increase in the prevalence of people under dialysis from 2000 to 2012 was 3.6% (95% confidence interval, CI: +3.2% to +4.0%) and the average annual change in incidence was +1.8%/year (+1.1% to +2.5%). was derived from pooled data from clinical studies in the United States. 8 In ELSA-Brasil, the frequency of albuminuria or low glomerular filtration rate, alone or in combination, was related to aging, lower socioeconomic status and self-reporting as black. Risk factors such as smoking, dyslipidemia, hypertension and diabetes were directly correlated with CKD. However, these risk factors did not explain the socioeconomic differences, i.e. the higher prevalence of CKD among the elderly, less affluent people and blacks. One point to emphasize is that ELSA-Brasil researchers did not correct the glomerular filtration rate for race in the manner proposed by the CKD-EPI consortium. 8 The reason for their race correction was the greater mass muscle described in the African-American population.However, in contrast with research conducted in the United States, three independent studies in different Brazilian cities did not show that correction for black race was useful for the Brazilian population. [10][11][12] These conclusions were the same as those relating to black people living in I MD, DrPH. Full Professor,

Chronic kidney disease and coronary artery calcification in the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil)

“…The definition and classification of eGFR and albuminuria follows Kidney Disease: Improving Global Outcomes staging nomenclature . The eGFR was calculated using the equations from the Chronic Kidney Disease Epidemiology consortium without correction for race, which has not added useful information for Brazilians . In our analysis, the eGFR was categorized into 3 levels: stage G1 = normal (eGFR ≥90 mL/min/1.73 m 2 ), stage G2 = mildly decreased (eGFR between 60 and 89 mL/min/1.73 m 2 ), and stage G3–G5 = moderately to severely decreased (eGFR <60 mL/min/1.73 m 2 ).…”

“…27 The eGFR was calculated using the equations from the Chronic Kidney Disease Epidemiology consortium 28 without correction for race, which has not added useful information for Brazilians. 29 In our analysis, the eGFR was categorized into 3 levels: stage G1 = normal (eGFR ≥90 mL/min/1.73 m 2 ), stage G2 = mildly decreased (eGFR between 60 and 89 mL/min/1.73 m 2 ), and stage G3-G5 = moderately to severely decreased (eGFR <60 mL/min/1.73 m 2 ). ACR was classified in 3 categories: normal = <30 mg/g, moderately increased = 30 to 300 mg/g, and severely increased = >300 mg /g.…”

Prevalence of clinically validated primary causes of end-stage renal disease (ESRD) in a State Capital in Northeastern Brazil

“…The impact of chronic kidney disease (CKD) in mortality, quality of life, and cost of care has increased significantly. Today, 8-16% of the global population is affected by CKD 1…”

Avaliação prospectiva do comportamento da pressão arterial, rigidez arterial e parâmetros ecocardiográficos de pacientes hipertensos com e sem a apneia obstrutiva do sono

“…Esses dados foram coletados na avaliação basal (após 30 dias do tratamento padronizado descrito acima). A taxa de filtração glomerular (eTFG) foi estimada de acordo com a equação CKD-EPI58 , sem correção para raça, conforme sugerido para a população brasileira 59,60. Todos os pacientes eram submetidos à MAPA, padronizada a colocação do manguito no braço não dominante, se a diferença da PA sistólica (PAS) fosse menor que 10mmHg entre os dois braços.…”