International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in Africa

Oguejiofor, Fidelis; Kiggundu, Daniel Ssekikubo; Bello, Aminu K.; Swanepoel, Charles R.; Ashuntantang, Gloria; Jha, Vivekanand; Harris, David C.H.; Levin, Adeera; Abdou, Niang; Wearne, Nicola; Moloi, Mothusi Walter; Ulasi, Ifeoma; Arogundade, Fatiu A.; Saad, Syed; Zaidi, Deenaz; Osman, Mohamed A.; Feng, Yang; Lunney, Meaghan; Olanrewaju, Timothy Olusegun; Ekrikpo, Udeme; Umeizudike, Theophilus Ifeanyichukwu; Abdu, Aliyu; Nalado, Aisha M.; Makusidi, Muhammad A; Liman, Hamidu M.; Sakajiki, Aminu Muhammad; Diongole, Hassane M.; Khan, Maryam; Gharbi, Mohammed Benghanem; Johnson, David W.; Okpechi, Ikechi G.

doi:10.1016/j.kisu.2021.01.009

Cited by 22 publications

(21 citation statements)

References 37 publications

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“…The International Society of Nephrology (ISN) has supported human resource development and capacity strengthening (including for nephropathology) through its capacity building programs over the last 25 years, with particular focus on Africa (18)(19)(20). Brain-drain has been an important problem, however.…”

Section: Discussionmentioning

confidence: 99%

Challenges in Diagnosis and Management of Glomerular Disease in Resource-Limited Settings

Ramachandran¹,

Sulaiman²,

Chauhan³

et al. 2022

Kidney International Reports

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Section: Discussionmentioning

confidence: 99%

Challenges in Diagnosis and Management of Glomerular Disease in Resource-Limited Settings

Ramachandran¹,

Sulaiman²,

Chauhan³

et al. 2022

Kidney International Reports

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“…26 Addressing morbidity and mortality of CKD due to hypertension goes beyond policy and strategies and requires understanding the prevalence and associated factors of CKD. 46 This is the first study to specifically investigate the burden of CKD in rural Sierra Leone.…”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Chronic Kidney Disease Among People Living with Hypertension in Rural Sierra Leone: A Cross-Sectional Study

Kachimanga¹,

Williams²,

Bangura³

et al. 2021

IJNRD

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Introduction Currently, there are no data on prevalence and associated risk factors of chronic kidney disease (CKD) among patients with hypertension in rural Sierra Leone. Purpose To estimate the prevalence and associated risk factors of CKD in rural Sierra Leone. Patients and Methods A cross-sectional study of hypertension patients aged between 18 and 75 years attending a non-communicable disease clinic at Koidu Government Hospital, Kono District, Sierra Leone was conducted between February and December 2020. Using systematic random sampling, a structured questionnaire, which comprised of questions on social demographic characteristics and past and current clinical history, was administered followed by measurement of creatinine and urinary protein and glucose. Estimated glomerular filtration rate (eGFR) was estimated using CKD-epidemiology formula without race as a factor. Baseline eGFR between 60–89 min/mL/1.73m 2 and <60 min/mL/1.73m 2 defined reduced eGFR and renal impairment, respectively. Estimated GFR less than 60 min/mL/1.73m 2 measured two times at least 3 months apart was used to define CKD. Results Ninety-six percent (n = 304) patients out of 317 patients were included in the study. Among all included patients, only 3.9% (n = 12) had eGFR of 90 min/mL/1.73m 2 and above. The prevalence of renal impairment and CKD was 52% (158/304, CI 46.2–57.7) and 29.9% (91/304, CI 24.8–34.5), respectively. In adjusted logistic regression analysis, currently taking herbal medications as treatment of hypertension (OR 4.11 (CI 1.14–14.80), p = 0.03) and being overweight and/or obese (OR 2.16 (CI 1.24–3.78), p < 0.001) was associated with CKD. Additionally, receiving some education was associated with a 48% (OR 0.52 (CI 0.29–0.91), p = 0.02) reduced likelihood of CKD. Conclusion The prevalence of renal impairment and CKD is high among hypertensive patients in rural Sierra Leone. CKD was associated with current history of taking herbal medications and being overweight and/or obese. Additionally, CKD was associated with reduced likelihood in patients who received some education.

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“…The high cost of PD must often be borne out‐of‐pocket by patients, and so is one of the most important challenges to increased use in LLMICs. In several African, 13 Latin American 31 and South Asian countries, 32 the annual cost of PD is much higher than HD and in some countries like India 32 and Egypt, 33 the cost of PD is almost double and nearly five times, respectively, of HD costs. High cost and excessive OOPPS for kidney care in Africans have been shown to be associated with high rates of mortality in those needing KRT 34 .…”

Section: Cost Of Pd (Fluids)mentioning

confidence: 99%

“…However, data from China showed a massive increase in PD utilization that rose from 8.6% in 2000 to 15.5% in 2012 along with increase in PD centres from <10 to more than 700 in the same period, a policy initiated to improve KRT access at affordable rates 12 . Only a few African countries have PD as an option for KRT despite having some of the lowest availability of KRT across all world regions 8,13 . This review describes various barriers to PD use in LLMICs and suggest ways to increase its utilization.…”

Section: Introductionmentioning

confidence: 99%

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The case for increased peritoneal dialysis utilization in low‐ and lower‐middle‐income countries

et al. 2022

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Peritoneal dialysis (PD) has several advantages compared to haemodialysis (HD), but there is evidence showing underutilization globally, especially in low-income and lower-middleincome countries (LLMICs) where kidney replacement therapies (KRT) are often unavailable, inaccessible, and unaffordable. Only 11% of all dialysis patients worldwide use PD, more than 50% of whom live in China, the United States of America, Mexico, or Thailand. Various barriers to increased PD utilization have been reported worldwide including patient preference, low levels of education, and lower provider reimbursement. However, unique but surmountable barriers are applicable to LLMICs including the excessively high cost of providing PD (related to PD fluids in particular), excessive cost of treatment borne by patients (relative to HD), lack of adequate PD training opportunities for doctors and nurses, low workforce availability for kidney care, and challenges related to some PD outcomes (catheter-related infections, hospitalizations, mortality, etc.). This review discusses some known barriers to PD use in LLMICs and leverages data that show a global trend in reducing rates of PD-related infections, reducing rates of modality switches from HD, and improving patient survival in PD to discuss how PD use can be increased in LLMICs. We therefore,

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International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in Africa

Cited by 22 publications

References 37 publications

Challenges in Diagnosis and Management of Glomerular Disease in Resource-Limited Settings

Challenges in Diagnosis and Management of Glomerular Disease in Resource-Limited Settings

High Prevalence of Chronic Kidney Disease Among People Living with Hypertension in Rural Sierra Leone: A Cross-Sectional Study

The case for increased peritoneal dialysis utilization in low‐ and lower‐middle‐income countries

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