Abstract
The high cardiovascular risk burden in low- and middle-income countries is expected to lead to an explosive increase in chronic kidney disease (CKD). However, population data on CKD from these countries are scarce. Therefore, we assessed kidney health in Suriname. In the Healthy Life in Suriname (HeliSur) study, a random sample of the adult population, we collected data with standardized questionnaires, physical examination, and blood and urine samples analysed in a central laboratory. Prevalent CKD was graded with KDIGO guidelines. In addition, we assessed national data on prevalent renal replacement therapy (RRT), estimated the future need for RRT, and evaluated national kidney health work force and policies. We include 1117 participants (2.0‰ of the population), 63% women, 40% of African ancestry and 43% of Asian ancestry, with a mean age of 42.2 (SE 0.4) years. Blood pressure is elevated in 72% of the participants, 26% have diabetes or prediabetes, and 78% are obese or overweight. The prevalence of CKD is 5.4%, and around 0.3% have kidney failure, translating to approximately 1500 patients nationally (2690 per million population, pmp), with currently 516 patients (920 pmp) on dialysis. Based on the participants from the random population sample in CKD stage G3 or G4, we estimate that 6750–10,750 pmp may develop kidney failure within the next 10 years. However, specialized kidney health workforce is currently very limited, and specific national or local policies for CKD management are lacking. Since the large majority of the general population has one or more risk factors for CKD including elevated blood pressure, urgent action is needed to strengthen kidney health care and prevent a catastrophic rise in need for RRT in the coming years.
Highlights
Chronic kidney disease (CKD) is increasingly recognized as a major cause of premature death [1]
CKD chronic kidney disease, TOD target organ damage a The remaining participants were of other ancestry b HT (DM, DL) controlled, the percentage of participants with adequately treated hypertension as a percentage of all persons with the condition
Tobacco use is defined as ever smoked; please see the Methods for other definitions eGFR estimated glomerular filtration rate, CKD (G3) chronic kidney disease, TOD target organ damage, CVD cardiovascular disease a The remaining participants were of other ancestry b HT (DM) controlled, the percentage of participants with adequately treated hypertension as a percentage of all persons with the condition c Including one patient with eGFR 6 mL/min/1.73 m2 without urine sample or proteinuria status
Summary
Chronic kidney disease (CKD) is increasingly recognized as a major cause of premature death [1]. The rising prevalence in CKD is driven by the global increase in the prevalence of diabetes mellitus, hypertension, and obesity, which disproportionately has an impact upon low- and middle-income countries [1,2,3,4,5,6]. The absence of CKD registries in most of the low- and middle-income countries renders it difficult to ascertain the true burden of kidney disease in these countries. We assess the kidney health care status in Suriname, a middle-income country in South America.
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