Ethnic subgroup differences in hypertension in Pakistan

Jafar, Tazeen H.; Levey, Andrew S.; Jafary, Fahim H.; White, Franklin; Gul, Asma; Rahbar, Mohammad H.; Khan, Anwar; Hattersley, Andrew T.; Schmid, Christopher H.; Chaturvedi, Nish

doi:10.1097/00004872-200305000-00014

Cited by 128 publications

(125 citation statements)

References 27 publications

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“…The site was chosen as this study was piggybacked to an ongoing study of prevalence of hypertension in this community of individuals belonging to the Pashtun ethnic subgroup (4). A total of 5920 residential structures were numbered and mapped in the study cluster.…”

Section: Sampling Detailsmentioning

confidence: 99%

“…Evidence from the Western countries is emerging that migrant populations of South Asian origin have a higher risk for chronic kidney disease (CKD) than the native whites (1)(2)(3). Although no reliable data are available on the incidence and prevalence of CKD in South Asia, the burden of its risk factors, including hypertension and diabetes, in this population is one of the highest in the world (4,5). Therefore, the burden of CKD is expected to be equally high.…”

mentioning

confidence: 99%

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Serum Creatinine as Marker of Kidney Function in South Asians

Jafar¹,

Schmid²,

Levey³

2005

Journal of the American Society of Nephrology

104

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Migrant populations of South Asian origin have a higher risk for chronic kidney disease than the native whites. Several formulas have been developed to estimate kidney function from serum creatinine concentration. However, none of these has been validated in the South Asian population, which generally has different muscle mass composition than whites. A population-based cross-sectional study was performed on 262 individuals who were aged >40 yr in Karachi, Pakistan. Reduced GFR was defined as creatinine clearance (Ccr) measured in 24-h urine collection of <60 ml/min per 1.73 m 2 . Creatinine excretion was compared with age-and gender-matched white individuals by comparison of observed versus expected results on the basis of a formula using t test. The agreement among Cockcroft Gault (CG) Ccr and Modification of Diet in Renal Disease (MDRD) Study GFR equations was assessed by regression analyses, and the degree of accuracy of estimated versus measured GFR was determined. Mean (95% confidence interval) creatinine excretion was 1.7 (1.0 to 2.4) mg/kg per d lower than expected for age-and gender-matched white individuals (P < 0.001). The coefficient of determination for measured Ccr on the logarithmic scale was 66.7 and 55.6% for the CG and MDRD Study equations, respectively. The proportion of estimates within 20, 30, and 50% of measured Ccr values was 47.7 versus 32.8% (P < 0.001), 64.9 versus 49.6% (P < 0.001), and 79.4 versus 72.9 (P ‫؍‬ 0.07) for CG versus MDRD Study equations, respectively. Lower mean creatinine excretion in these individuals may explain, in part, suboptimal agreement between estimated versus measured GFR. Inclusion of terms for ethnic and racial groups other than white and black might improve the performance of GFR estimating equations.

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Section: Sampling Detailsmentioning

confidence: 99%

mentioning

confidence: 99%

Serum Creatinine as Marker of Kidney Function in South Asians

Jafar¹,

Schmid²,

Levey³

2005

Journal of the American Society of Nephrology

104

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“…Two later studies demonstrated that the risk of death and cardiovascular events in people with coronary artery disease are directly related to the degree of renal dysfunction [12,13]. The high prevalence of CKD in the population in Pakistan is not unexpected since the incidence of hypertension and diabetes in Pakistan is one of the highest in the world [14,15].…”

Section: Introductionmentioning

confidence: 99%

Doctors’ knowledge and practices regarding chronic kidney disease at a tertiary care hospital

et al. 2016

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Background: The complications of chronic kidney disease (CKD) significantly contribute to morbidity and mortality, therefore clinical practice guidelines have been developed to facilitate early detection and treatment. However, given the high prevalence of CKD, many patients with early CKD are seen by non-nephrologists, who need to be aware of CKD complications, screening methods and treatments goals in order to initiate timely therapy and referral.Methods: This was a cross-sectional study conducted at three campuses of the Ziauddin University Hospital, Karachi, Pakistan in 2016. A questionnaire based survey was conducted to assess the knowledge and practices of doctors from various specialties regarding CKD.Results: We performed a questionnaire based survey to assess knowledge and practice patterns in CKD care among 156 doctors. There were 63 male and 50 female respondents. There were 24 attending doctors, 73 post-graduate trainees and 25 house-officers. Our data showed that although CKD risk factors are generally recognized, there is a paucity of knowledge regarding CKD management guidelines and staging of CKD. There is an awareness regarding timely referral to nephrology, but many would still not refer at the appropriate stage. Many also do not use standard equations to calculate Glomerular Filtration rate (GFR) and Creatinine Clearance]. Most do screen for diabetic nephropathy, know about ACE-I/ARBs and provide dietary counseling to CKD patients. The majority do not read medical journals to keep their knowledge up-to-date. Junior doctors (post-graduate trainees and house-officers) fared better than attending doctors in the knowledge and practice parameters.

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“…1 However, data from developing countries on the prevalence of stroke are scarce. 2 Reliable estimates indicate a high prevalence of risk factors for stroke in Pakistan, [3][4][5] but population-based data on the burden of stroke per se in this region are lacking. Evidence from India, while scanty, suggests a high burden of mortality due to stroke, particularly in the younger age group.…”

mentioning

confidence: 99%