The International Society of Nephrology’s International Consortium of Collaborators on Chronic Kidney Disease of Unknown Etiology: report of the working group on approaches to population-level detection strategies and recommendations for a minimum dataset

Caplin, Ben; Yang, Chih‐Wei; Anand, Shuchi; Levin, Adeera; Madero, Magdalena; Saran, Rajiv; Jayasinghe, Saroj; Broe, Marc De; Yeates, Karen; Tonelli, Marcello; Jakobsson, Kristina; Strani, Luisa; Ruggiero, Agnese; Glaser, Jason; Martin, E.; Pearce, Neil; Wijewickrama, Eranga

doi:10.1016/j.kint.2018.08.019

Cited by 51 publications

(66 citation statements)

References 6 publications

(1 reference statement)

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“…Histopathology reports from previous CKDu studies show that tubular atrophy and interstitial fibrosis in the presence of varying degrees of glomerulosclerosis are the predominant features of CKDu [2,11]. However, to date, there are few examples of consistent approaches and case definitions across countries which have conducted CKDu research, which makes international comparisons challenging [2,12]. As a result, it is unclear whether there is an underlying aetiology or causal pathway of the condition, and indeed whether it occurs in other regions of the world.…”

Section: Introductionmentioning

confidence: 95%

Prevalence and risk factors for chronic kidney disease of unknown cause in Malawi: a cross-sectional analysis in a rural and urban population

et al. 2020

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Background An epidemic of chronic kidney disease of unknown cause (CKDu) is occurring in rural communities in tropical regions of low-and middle-income countries in South America and India. Little information is available from Southern African countries which have similar climatic and occupational characteristics to CKDu-endemic countries. We investigated whether CKDu is prevalent in Malawi and identified its potential risk factors in this setting. Methods We conducted a cross-sectional study from January–August 2018 collecting bio samples and anthropometric data in two Malawian populations. The sample comprised adults > 18 years (n = 821) without diabetes, hypertension, and proteinuria. Estimates of glomerular filtration rate (eGFR) were calculated using the CKD-EPI equation. Linear and logistic regression models were applied with potential risk factors, to estimate risk of reduced eGFR. Results The mean eGFR was 117.1 ± 16.0 ml/min per 1.73m2 and the mean participant age was 33.5 ± 12.7 years. The prevalence of eGFR< 60 was 0.2% (95% confidence interval (95% CI) 0.1, 0.9); the prevalence of eGFR< 90 was 5% (95% CI =3.2, 6.3). We observed a higher prevalence in the rural population (5% (3.6, 7.8)), versus urban (3% (1.4, 6.7)). Age and BMI were associated with reduced eGFR< 90 [Odds ratio (OR) (95%CI) =3.59 (2.58, 5.21) per ten-year increment]; [OR (95%CI) =2.01 (1.27, 3.43) per 5 kg/m2 increment] respectively. No increased risk of eGFR < 90 was observed for rural participants [OR (95%CI) =1.75 (0.50, 6.30)]. Conclusions Reduced kidney function consistent with the definition of CKDu is not common in the areas of Malawi sampled, compared to that observed in other tropical or sub-tropical countries in Central America and South Asia. Reduced eGFR< 90 was related to age, BMI, and was more common in rural areas. These findings are important as they contradict some current hypothesis that CKDu is endemic across tropical and sub-tropical countries. This study has enabled standardized comparisons of impaired kidney function between and within tropical/subtropical regions of the world and will help form the basis for further etiological research, surveillance strategies, and the implementation and evaluation of interventions.

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Section: Introductionmentioning

confidence: 95%

Prevalence and risk factors for chronic kidney disease of unknown cause in Malawi: a cross-sectional analysis in a rural and urban population

et al. 2020

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“…The US National Institutes of Health Fogarty Institute has funded seven 'Geo-health' collaborations across the world to evaluate the contribution of environmental (e.g., outdoor and indoor air pollution) and occupational exposures (e.g., in street vendors or electronic waste recycling workers) to human disease. International consortia have formed to investigate the cause of a chronic kidney disease of unknown etiology among agricultural workers living in lowland areas [24], a disease more common in certain LMICs but possibly occurring at lower intensity and/or frequency in high-income countries as well.…”

Section: Risk Factors For Cvd: Why We Need Studies In Diverse Populatmentioning

confidence: 99%

Prevention and management of CVD in LMICs: why do ethnicity, culture, and context matter?

Anand

Bradshaw

Prabhakaran

2020

BMC Med

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Background: Low-and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease. Main text: While improving the availability and delivery of proven, effective therapies will no doubt mitigate this burden, we posit that studies evaluating cardiovascular disease risk factors, management strategies and service delivery, in diverse settings and diverse populations, are equally critical to improving outcomes in low-and middleincome countries. Focusing on examples drawn from four cardiovascular diseasescoronary artery disease, stroke, diabetes and kidney diseasewe argue that ethnicity, culture and context matter in determining the risk factors for disease as well as the comparative effectiveness of medications and other interventions, particularly diet and lifestyle interventions. Conclusion: We believe that a host of cohort studies and randomized control trials currently being conducted or planned in low-and middle-income countries, focusing on previously understudied race/ethnic groups, have the potential to increase knowledge about the cause(s) and management of cardiovascular diseases across the world.

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“…Participants agreed that priorities included capturing data on (i) prevalence and risk factors for CKD in the population, (ii) access to care and the impact of access on CKD outcomes, and (iii) evolution and risk factors of progression for those with known CKD. The group reviewed recommendations on population-based studies from the International Society of Nephrology's International Consortium of Collaborators on CKDu, 53 as well as 2 recently published standardized research protocols from the Disadvantaged Populations eGFR Epidemiology (DEGREE) study group. 54,55 These protocols provided guidance on most of the shared priorities, and so the group resolved to adopt them as the core approach to planning future work.…”

Section: Moving Toward Population-based Researchmentioning

confidence: 99%

CKD Care and Research in Guatemala: Overview and Meeting Report

García

Mendoza

Barnoya

et al. 2020

Kidney International Reports

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On October 14-15, 2019, the 1st Symposium to Promote Chronic Kidney Disease (CKD) Research in Guatemala was held in Guatemala City, Guatemala. The Symposium hosted more than 50 attendees, including health care professionals, policy makers, researchers, and leaders of nongovernmental organizations. The meeting's objectives were to (1) share clinical and health delivery experiences, (2) disseminate local research, and (3) establish consensus priorities for future research. In this report, we review the state of CKD nephrology in Guatemala, summarize experiences shared during the meeting from representatives of the clinical settings in Guatemala where CKD care is provided, and describe consensus priorities for future research.

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The International Society of Nephrology’s International Consortium of Collaborators on Chronic Kidney Disease of Unknown Etiology: report of the working group on approaches to population-level detection strategies and recommendations for a minimum dataset

Cited by 51 publications

References 6 publications

Prevalence and risk factors for chronic kidney disease of unknown cause in Malawi: a cross-sectional analysis in a rural and urban population

Prevalence and risk factors for chronic kidney disease of unknown cause in Malawi: a cross-sectional analysis in a rural and urban population

Prevention and management of CVD in LMICs: why do ethnicity, culture, and context matter?

CKD Care and Research in Guatemala: Overview and Meeting Report

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