An Estimation of the Prevalence and Progression of Chronic Kidney Disease in a Rural Diabetic Cambodian Population

Thomas, Bernadette; Pelt, Maurits van; Mehrotra, Rajnish; Robinson‐Cohen, Cassianne; LoGerfo, James P.

doi:10.1371/journal.pone.0086123

Cited by 15 publications

(13 citation statements)

References 16 publications

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“…38 Results from this organization indicate very favorable control of diabetes mellitus, hypertension, and CKD progression. 39 Similar results have been published for chronic disease outreach programs in the Philippines and the Democratic Republic of Congo. 40 Such screening and management interventions illustrate the importance and feasibility of chronic disease detection and management to delay progression, even in remote settings.…”

Section: Discussionsupporting

confidence: 75%

Global Cardiovascular and Renal Outcomes of Reduced GFR

Thomas

Matsushita

Abate

et al. 2017

JASN

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203

131

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The burden of premature death and health loss from ESRD is well described. Less is known regarding the burden of cardiovascular disease attributable to reduced GFR. We estimated the prevalence of reduced GFR categories 3, 4, and 5 (not on RRT) for 188 countries at six time points from 1990 to 2013. Relative risks of cardiovascular outcomes by three categories of reduced GFR were calculated by pooled random effects meta-analysis. Results are presented as deaths for outcomes of cardiovascular disease and ESRD and as disability-adjusted life years for outcomes of cardiovascular disease, GFR categories 3, 4, and 5, and ESRD. In 2013, reduced GFR was associated with 4% of deaths worldwide, or 2.2 million deaths (95% uncertainty interval [95% UI], 2.0 to 2.4 million). More than half of these attributable deaths were cardiovascular deaths (1.2 million; 95% UI, 1.1 to 1.4 million), whereas 0.96 million (95% UI, 0.81 to 1.0 million) were ESRD-related deaths. Compared with metabolic risk factors, reduced GFR ranked below high systolic BP, high body mass index, and high fasting plasma glucose, and similarly with high total cholesterol as a risk factor for disability-adjusted life years in both developed and developing world regions. In conclusion, by 2013, cardiovascular deaths attributed to reduced GFR outnumbered ESRD deaths throughout the world. Studies are needed to evaluate the benefit of early detection of CKD and treatment to decrease these deaths.

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Section: Discussionsupporting

confidence: 75%

Global Cardiovascular and Renal Outcomes of Reduced GFR

Thomas

Matsushita

Abate

et al. 2017

JASN

Self Cite

203

131

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“…Diabetes is costly to patients and their families. Diabetes-related complications, such as renal failure, are typically already highly prevalent at the time of diagnosis: a retrospective analysis from 483 people screened showed that among those diagnosed with diabetes mellitus, 57.5 % had an estimated glomerular filtration rate below 60 ml/min/1.73 m2 [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

Patient-centred innovation to ensure access to diabetes care in Cambodia: the case of MoPoTsyo

Olmen

Eggermont

Pelt

et al. 2016

J of Pharm Policy and Pract

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BackgroundThe increasing prevalence of chronic diseases puts a high burden on the health care systems of Low and Middle Income Countries which are often not adapted to provide the care needed. Peer support programmes are promoted to address health system constraints. This case study analyses a peer educator diabetes programme in Cambodia, MoPoTsyo, from a health system’s perspective. Which strategies were used and how did these strategies change? How is the programme perceived?MethodsData were collected through semi-structured interviews with patients, MoPoTsyo staff and peer educators, contracted pharmacy staff and health workers, health care workers and non-contracted pharmacists and managers and policy makers at district, provincial and national level. Four areas were purposively selected to do the interviews. An inductive content analysis was done independently by two researchers.ResultsMoPoTsyo developed into three stages: a focus on diabetes self-management; a widening scope to ensure affordable medicines and access to other health care services; and aiming for sustainability through more integration with the Cambodian public system and further upscaling. All respondents acknowledged the peer educators’ role and competence in patient education, but their ideas about additional tasks and their place in the system differed. Indirectly involved stakeholders and district managers emphasized the particular roles and responsibilities of all actors in the system and the particular role of the peer educator in the community. MoPoTsyo’s diagnostics and laboratory services were perceived as useful, especially by patients and project staff. Respondents were positive about the revolving drug fund, but expressed concerns about its integration into the government system. The degree of collaboration between health care staff and peer educators varied.ConclusionMoPoTsyo responds to the needs of people with diabetes in Cambodia. Key success factors were: consistent focus on and involvement of the target group, backed up by a strong organisation; simultaneous reduction of other barriers to care; and the ongoing maintenance of relations at all levels within the health system. Despite resistance, MoPoTsyo has established a more balanced relationship between patients and health service providers, empowering patients to self-manage and access services that meet their needs.

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“…1,3,[24][25][26][27][28][29][30][31] Because diabetes and hypertension are leading causes of ESRD, we determined the contribution of the global rise in these diseases to the rise in prevalence and incidence of maintenance dialysis (Figures 4 and 5). Results among countries providing partial versus universal dialysis were remarkably similar.…”

Section: Factors For Change: Population Burden Of Diabetes Mellitus Amentioning

confidence: 99%

“…Recent advances in treating and preventing communicable diseases coupled with the dramatic rise in the prevalence of diabetes and hypertension have initiated a shift in focus to the relationship between NCDs and morbidity, most recently in developing regions of the world. [1][2][3][4] This is exemplified by the United Nations 2012 Summit 2025 Initiative, which focuses on decreasing the burden of premature mortality to NCDs by 25% by year 2025.…”

mentioning

confidence: 99%

Maintenance Dialysis throughout the World in Years 1990 and 2010

Thomas

Wulf

Bikbov

et al. 2015

Journal of the American Society of Nephrology

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Rapidly rising global rates of chronic diseases portend a consequent rise in ESRD. Despite this, kidney disease is not included in the list of noncommunicable diseases (NCDs) targeted by the United Nations for 25% reduction by year 2025. In an effort to accurately report the trajectory and pattern of global growth of maintenance dialysis, we present the change in prevalence and incidence from 1990 to 2010. Data were extracted from the Global Burden of Disease 2010 epidemiologic database. The results are on the basis of an analysis of data from worldwide national and regional renal disease registries and detailed systematic literature review for years 1980-2010. Incidence and prevalence estimates of provision of maintenance dialysis from this database were updated using a negative binomial Bayesian metaregression tool for 187 countries. Results indicate substantial growth in utilization of maintenance dialysis in almost all world regions. Changes in population structure, changes in aging, and the worldwide increase in diabetes mellitus and hypertension explain a significant portion, but not all, of the increase because increased dialysis provision also accounts for a portion of the rise. These findings argue for the importance of inclusion of kidney disease among NCD targets for reducing premature death throughout the world.

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An Estimation of the Prevalence and Progression of Chronic Kidney Disease in a Rural Diabetic Cambodian Population

Cited by 15 publications

References 16 publications

Global Cardiovascular and Renal Outcomes of Reduced GFR

Global Cardiovascular and Renal Outcomes of Reduced GFR

Patient-centred innovation to ensure access to diabetes care in Cambodia: the case of MoPoTsyo

Maintenance Dialysis throughout the World in Years 1990 and 2010

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