The Role of Sodium-Glucose Cotransporter-2 Inhibitors in the Treatment Paradigm of CKD in Africa: An African Association of Nephrology Panel Position Paper

The Future of Kidney Care in Low- and Middle-Income Countries: Challenges, Triumphs, and Opportunities

“…While grounds for use of these pillar drugs have been laid out by regional nephrology societies, such as the African Society of Nephrology, a concerted effort is needed to lower drug costs and ensure availability to those who would benefit most from it. 40,41 Implementation of these changes would require (1) local and regional campaigns to increase awareness at the population and health care provider level and (2) development of policies to improve access to diagnosis and these essential medications to slow the progression of CKD and cardiovascular disease. An integrated approach to CKM care can be African Association of Nephrology, Latin American Society of Nephrology and Hypertension, and Asian Pacific Society of Nephrology are major regional nephrology associations were established with the aim of advancing regional capacity for kidney care including collaborations, setting regional guidelines.…”

“…While grounds for use of these pillar drugs have been laid out by regional nephrology societies, such as the African Society of Nephrology, a concerted effort is needed to lower drug costs and ensure availability to those who would benefit most from it. 40 , 41 Implementation of these changes would require ( 1 ) local and regional campaigns to increase awareness at the population and health care provider level and ( 2 ) development of policies to improve access to diagnosis and these essential medications to slow the progression of CKD and cardiovascular disease. An integrated approach to CKM care can be transferred to lower-level health care units to serve populations in hard-to-reach areas.…”

Transporting Sodium-Glucose Cotransporter-2 Inhibitors to the African Continent: Challenges and Solutions

“…The position paper by 13 senior leaders from the African Association of Nephrology in this issue of Kidney International Reports highlights the important concern of the increasing prevalence of chronic kidney disease (CKD) in Africa, driven by the triple burdens of rising noncommunicable diseases, infections and social determinants of health, superimposed on genetic predisposition in some regions. 2 The authors are to be congratulated for a comprehensive and sober representation of the burden of CKD across the continent and the emphasis on the potential value of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in addition to standard care to reduce the burden and morbidities associated with CKD in Africa. As a position paper, the authors also consider important gaps in screening and challenges in delivery of quality care for CKD across the continent.…”

“…Across Africa, the major risk factors for CKD include hypertension, diabetes, and HIV. 2 As highlighted by the authors, other important risk factors include pregnancy-associated complications, preeclampsia, hepatitis B and C, the use of traditional remedies, and low birth weight. In addition, it is likely that acute kidney injury is an important contributor to the CKD burden in Africa.…”

“…This important lack of data is highlighted by the over 3-fold difference in CKD prevalence reported in the position paper across the 5 regions of the continent (from 6%–20%). 2 The diversity of these ranges likely reflect the absence of systematic screening programs, challenges in access to diagnosis, and the lack of robust health information systems to capture data, rather than or in addition to, true differences in CKD prevalence. This lack of robust data has hampered advocacy for kidney diseases and recognition of its importance across the continent.…”