The contribution of chronic kidney disease to the global burden of major noncommunicable diseases

Abstract

Noncommunicable diseases (NCDs) are the most common causes of premature death and morbidity and have a major impact on health-care costs, productivity, and growth. Cardiovascular disease, cancer, diabetes, and chronic respiratory disease have been prioritized in the Global NCD Action Plan endorsed by the World Health Assembly, because they share behavioral risk factors amenable to public-health action and represent a major portion of the global NCD burden. Chronic kidney disease (CKD) is a key determinant of the poor health outcomes of major NCDs. CKD is associated with an eight- to tenfold increase in cardiovascular mortality and is a risk multiplier in patients with diabetes and hypertension. Milder CKD (often due to diabetes and hypertension) affects 5-7% of the world population and is more common in developing countries and disadvantaged and minority populations. Early detection and treatment of CKD using readily available, inexpensive therapies can slow or prevent progression to end-stage renal disease (ESRD). Interventions targeting CKD, particularly to reduce urine protein excretion, are efficacious, cost-effective methods of improving cardiovascular and renal outcomes, especially when applied to high-risk groups. Integration of these approaches within NCD programs could minimize the need for renal replacement therapy. Early detection and treatment of CKD can be implemented at minimal cost and will reduce the burden of ESRD, improve outcomes of diabetes and cardiovascular disease (including hypertension), and substantially reduce morbidity and mortality from NCDs. Prevention of CKD should be considered in planning and implementation of national NCD policy in the developed and developing world.

Prognostic value of plasma NT-proBNP levels in very old patients with moderate renal insufficiency in China

“…Thereareseveralpossibleexplanations for the association between elevated NTproBNP level and risk of all-cause death and MACEs in our study. Firstly, an elevated plasma NT-proBNP level is associated with a variety of factors including old age, anemia, and combined hypertension and coronary heart disease, which are the risk factors for all-cause death and MACEs [21]. Secondly, increased plasma NT-proBNP level may indicate more advanced renal dysfunction, and deterioration of renal function is associated with all-cause death and MACEs [22].…”

Urine excretion strategy for stem cell-generated embryonic kidneys

“…Because of organ donor shortages, the number of patients with end-stage renal disease (ESRD) requiring renal replacement therapy is increasing also, and these patients are at increased risk of cardiovascular disease and death (1,2). Thus, ESRD is a major clinical problem.…”

Cause of Death in Patients with Reduced Kidney Function

“…According to the 2010 Global Burden of Disease study, the number of deaths with CKD as the underlying cause increased by 82% from 1990 to 2010. 1 CKD is associated with an increased risk of mortality caused by cardiovascular diseases (CVDs) 2 and non-CVDs [3][4][5] ; however, the proportions of death caused by specific causes and the differences in these proportions across stages of CKD have not been systematically described.…”