Overview: End‐Stage Renal Disease in the Developing World

Barsoum, Rashad S.

doi:10.1046/j.1525-1594.2002.07061.x

Cited by 74 publications

(69 citation statements)

References 22 publications

(20 reference statements)

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“…Although recent articles highlighted the growing burden of kidney disease in developing nations as a result of globalization and other factors (23)(24)(25)(26)(27), most have focused on whether provision of RRT is possible or cost-effective in this setting. Our study demonstrates that funding dialysis services is associated with very poor clinical outcomes in the absence of therapies that aim to prevent progressive kidney disease and its complications.…”

Section: Discussionmentioning

confidence: 99%

Survival among Patients with Kidney Failure in Jalisco, Mexico

Garcia-Garcia¹,

Briseño-Renteria²,

Luquín-Arellan³

et al. 2007

Journal of the American Society of Nephrology

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ESRD is a serious public health problem in the state of Jalisco, Mexico. This study evaluated mortality in poor patients who initiated dialysis at the Jalisco Health Secretariat, compared with Hispanic patients without medical insurance who initiated dialysis in the United States. All patients who received a diagnosis with ESRD between February 1 and December 31, 2003, were studied prospectively at a single institution that provides care to the poor of Jalisco. Data from an American national dialysis registry and Cox proportional hazards models were used to compare the adjusted survival among Jalisco patients with that of a contemporaneous group of incident Hispanic patients who did not have Medicare or private insurance cover and who initiated peritoneal dialysis in the United States. Of 274 consecutive patients who presented with a clinical diagnosis of ESRD in Jalisco, mean estimated GFR at dialysis initiation was very low (3.9 ؎ 2.4 ml/min per 1.73 m 2 ), and <10% were previously known to a nephrologist. Of the 274 patients, 102 (37.2%) did not initiate dialysis therapy, 71 (69.6%) of whom died during follow-up. The majority (n ‫؍‬ 49) of such deaths occurred in-hospital before dialysis initiation. Of 172 patients who initiated dialysis, 36 (20.9%) died within the first 90 d of renal replacement therapy. An additional 31 (18.0%) patients died during a median follow-up of 186 d. When all 274 Jalisco patients who presented with ESRD were considered, survival was 49.6% at the end of follow-up. Unadjusted mortality rates among those who survived at least 90 d after dialysis initiation were 19.2 (95% confidence interval [CI] 13.5 to 27.3) and 5.9 (95% CI 4.6 to 7.7) per 100 patient-years in Jalisco and American patients, respectively. After adjustment, the risk for death remained nearly three-fold higher in Jalisco patients (hazard ratio 2.7; 95% CI 1.5 to 4.7). Poor patients with kidney failure in Jalisco have very advanced disease at the time of first nephrologic contact and have exceedingly high rates of mortality after dialysis initiation. Our findings demonstrate a tremendous opportunity to reduce morbidity and mortality from kidney disease in Jalisco and perhaps other regions of Mexico.

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Section: Discussionmentioning

confidence: 99%

Survival among Patients with Kidney Failure in Jalisco, Mexico

Garcia-Garcia¹,

Briseño-Renteria²,

Luquín-Arellan³

et al. 2007

Journal of the American Society of Nephrology

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“…This extends the work of previous studies that considered between 9 and 42 countries for a period of time of 1-5 years. [11][12][13]15,33,34 We reviewed all data on two occasions for accuracy, and we sent preliminary data tables and graphs to country representatives to verify data and for final confirmation. When necessary, we translated all information into English.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Global Trends in Rates of Peritoneal Dialysis

Jain

Blake²,

Cordy³

et al. 2012

Journal of the American Society of Nephrology

460

403

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Although there is a perception that the use of peritoneal dialysis is declining worldwide, compilations of global data are unavailable to test this hypothesis. We assessed longitudinal trends in the use of peritoneal dialysis from 1997 to 2008 in 130 countries. The preferred data sources were renal registries, followed by nephrology societies, health ministries, academic centers, national experts, and industry affiliates. In 2008, there were approximately 196,000 peritoneal dialysis patients worldwide, representing 11% of the dialysis population. In total, 59% were treated in developing countries and 41% in developed countries. Over 12 years, the number of peritoneal dialysis patients increased in developing countries by 24.9 patients per million population and in developed countries by 21.8 per million population. The proportion of all dialysis patients treated with peritoneal dialysis did not change in developing countries but significantly declined in developed countries by 5.3%. The use of automated peritoneal dialysis increased by 14.5% in developing countries and by 30.3% in developed countries. In summary, the number of patients treated with peritoneal dialysis rose worldwide from 1997 to 2008, with a 2.5-fold increase in the prevalence of peritoneal dialysis patients in developing countries. The proportion of all dialysis patients treated with this modality continues to decline in developed countries. Chronic dialysis is a life-sustaining treatment for patients with ESRD. Access to dialysis remains limited in several regions of the world due to a lack of financial and clinical resources. [1][2][3][4][5][6][7][8][9] As countries look to develop dialysis programs to manage the growing burden of ESRD, it is important to place patterns of peritoneal dialysis (PD) use in the global context. This information is particularly helpful to individuals in member nations responsible for health care delivery to evaluate their PD programs through comparisons with countries of similar socioeconomic structure.A comprehensive global assessment of PD use to date has been lacking. One study suggested that 11% of chronic dialysis patients around the world are treated with PD. 10 Several renal registries report PD use at a national and regional level, 11-14 but not on a global scale. There is a perception that PD use is declining worldwide. However, studies that showed declining PD use in the developed world are limited by the number of countries considered and the length of time examined. 3,[15][16][17] No study has examined the global use of different PD modalities over a significant period of time, including continuous ambulatory PD (CAPD) and automated PD (APD). For these reasons, we assessed PD use worldwide by compiling data from multiple sources over a 12-year period. We examined the trends in PD use across developing and developed nations, focusing on crude numbers, prevalence per million population, and the proportion of dialysis patients who received PD. We hypothesized an increasing PD prevalence in the dev...

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“…Chronic glomerulonephritis is still the primary cause of CRF in many developing countries including China, India, and Egypt. [6][7][8][9][10][11] It always develops slowly and latently. 70 patients with chronic glomerulonephritis in our survey were diagnosed when the renal function had been damaged.…”

Section: Discussionmentioning

confidence: 99%

The relationship between children kidney diseases and adult ESRD—an epidemiological investigation of 700 cases

Guo

Wang

2013

Renal Failure

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Background: We planned an epidemic investigation of 700 cases who suffered from chronic renal failure (CRF) to search for the evidence to demonstrate the relationship between children kidney diseases and adult CRF. Methods: Seven hundred patients from four hospitals in Chengdu, China, were investigated face-to-face to complete a questionnaire referring to the information of diagnoses, treatment, history and so on. These enumeration count data were analyzed by statistical description. Results: In 700 patients, there were 402 male and 298 female including 21 children and 679 adults. In the disease spectrum, the unclear accounted for 36.3% of totality. Chronic glomerulonephritis made the top proportion (14.4%) in primary kidney diseases. Diabetic nephropathy (15.3%), hypertensive nephropathy (10.1%), and gouty nephropathy (6%) made the primary proportion in secondary kidney diseases. In 21 children, chronic glomerulonephritis had the highest proportion of 52.4%, followed by nephrotic syndrome (19%), Henoch-Schö nlein purpura (9.5%), and urinary tract obstruction (4.8%). Thirtyeight cases developed into kidney diseases during childhood including 21 children mentioned above, in which 17 cases presented CRF in the adult stage. The primary renal diseases are chronic glomerulonephritis (60.5%), purpura nephritis (18.4%), nephrotic syndrome (10.5%), urinary tract obstruction (2.6%), and the unclear (7.9%). Conclusion: The survey showed that there were a high proportion of patients whose causes were unknown, to which attention should be paid. Chronic glomerulonephritis remained the main cause of CRF no matter whether in children or in adults. Purpura during childhood, used to be thought as self-limited, might eventually develop into CRF in adulthood, which caught our eyes.

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Overview: End‐Stage Renal Disease in the Developing World

Cited by 74 publications

References 22 publications

Survival among Patients with Kidney Failure in Jalisco, Mexico

Survival among Patients with Kidney Failure in Jalisco, Mexico

Global Trends in Rates of Peritoneal Dialysis

The relationship between children kidney diseases and adult ESRD—an epidemiological investigation of 700 cases

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