CKD and Infectious Diseases in Asia Pacific: Challenges and Opportunities

Abstract

The exact number of patients with chronic kidney disease (CKD) in Asia Pacific is uncertain. In numeric terms, the region is home to the largest population of patients with untreated chronic kidney failure. The climatic, geographic, social, cultural, economic, and environmental diversity within this region is higher than in any other part of the world. Large parts of the region face a climate-related burden of infectious diseases. Infections contribute to the development and progression of CKD and complicate the course of patients with pre-existing CKD (especially those on dialysis therapy or who are immunosuppressed), increase the cost of CKD care, and contribute to mortality and morbidity. Kidney involvement is a feature of several infectious diseases prevalent in Asia Pacific. Examples include malaria, leptospirosis, scrub typhus, tuberculosis, hepatitis B and C virus, dengue hemorrhagic fever, and Hantaan virus infections. The contribution of infection-associated acute kidney injury to the overall burden of CKD has not been evaluated systematically. Research is needed to quantify the impact of infections on kidney health by undertaking prospective studies. Nephrologists need to work with infectious disease research groups and government infection surveillance and control programs.

Kidney Disease in the Setting of Hiv Infection: Conclusions From a Kidney Disease: Improving Global Outcomes (Kdigo) Controversies Conference

“…97,98 Other co-infections such as tuberculosis and syphilis may also contribute to CKD risk. [99][100][101] In addition, severe AKI has been associated with a 3.8-to 20-fold increased risk of progression to ESKD. 102 CKD screening and monitoring.…”

Urbanization and kidney function decline in low and middle income countries

“…Accordingly, about half of all deaths in Asia are now attributable to non-communicable diseases, accounting for 47% of global burden [14]. Conversely, a preponderance of infectious diseases not typically seen in high income countries, such as schistosomiasis, HIV, tuberculosis, hepatitis B and C, further aggravates the CKD burden in LMICs [15]. Furthermore, rapid and unplanned urbanization may result in decreased food availability for socially disadvantaged people, lack of infrastructure, poor sanitation, waste disposal and heavy environmental toxins [16].…”

Low bone mineral density in chronic Hepatitis B virus infection: A case-control study

“…Hepatitis B is a global health problem caused by infection with the hepatitis B virus (HBV); it is estimated that as many as 350 million people are affected with HBV worldwide, and about 75% of them are from Asia 5. In addition, many extrahepatic manifestations are associated with chronic HBV infection 6.…”