Global kidney disease

Abstract

I read with interest Vivekanand Jha and colleagues' report (July 20, p 260)1Jha V Garcia-Garcia G Iseki K et al.Chronic kidney disease: global dimension and perspectives.Lancet. 2013; 382: 260-272Summary Full Text Full Text PDF PubMed Scopus (2397) Google Scholar on chronic kidney disease. For Venezuela, the data published were incorrect and do not reflect the situation in the country. In their figure 2,1Jha V Garcia-Garcia G Iseki K et al.Chronic kidney disease: global dimension and perspectives.Lancet. 2013; 382: 260-272Summary Full Text Full Text PDF PubMed Scopus (2397) Google Scholar the causes of chronic kidney disease in Venezuela are diabetes, chronic interstitial glomerulonephritis, and hypertensive glomerulosclerosis. Bellorin-Font and colleagues2Bellorin-Font E Milanes Cl Rodriguez-Iturbe B End-stage renal disease and its treatment in Venezuela.Artif Organs. 2002; 26: 747-749Crossref PubMed Scopus (10) Google Scholar reported in 2002 that diabetes, glomerular diseases, and hypertension account for more than 60% of the patients in chronic dialysis; however, the contribution of each disease was not reported. According to the latest available official data (from 2007), the causes of chronic kidney disease in Venezuela are: diabetes (30%), hypertensive glomerulosclerosis (21%), unknown (17·2%), chronic glomerulonephritis (12·8%), others (8·3%), and chronic interstitial glomerulonephritis (6·3%). It is regrettable and disappointing that official data are not largely available. The Renal Health Programme (Ministerio del Poder Popular de la Salud de Venezuela) is working diligently to resolve this important issue. There have been few papers published regarding kidney diseases in Venezuela, and they were mostly focused on Venezuelan indigenous populations.3Bellorin-Font E Pernalete N Meza J Milanes CL Carlini RG Access to and coverage of renal replacement therapy in minorities and ethnic groups in Venezuela.Kidney Int Suppl. 2005; 97: S18-S22Crossref PubMed Scopus (5) Google Scholar Two epidemics of acute post-streptococcal glomerulonephritis (in 1968 and 1974) have been reported by Rodriguez-Iturbe and Musser.4Rodriguez-Iturbe B Musser JM The current state of poststreptococcal glomerulonephritis.J Am Soc Nephrol. 2008; 19: 1855-1864Crossref PubMed Scopus (159) Google Scholar Finally, since 2007, diabetes and hypertensive glomerulosclerosis continue to be the leading causes of chronic kidney failure in dialysis patients in Venezuela—both diseases representing 55% of the causes of kidney failure in these patients. I declare that I have no conflicts of interest. Chronic kidney disease: global dimension and perspectivesChronic kidney disease is defined as a reduced glomerular filtration rate, increased urinary albumin excretion, or both, and is an increasing public health issue. Prevalence is estimated to be 8–16% worldwide. Complications include increased all-cause and cardiovascular mortality, kidney-disease progression, acute kidney injury, cognitive decline, anaemia, mineral and bone disorders, and fractures. Worldwide, diabetes mellitus is the most common cause of chronic kidney disease, but in some regions other causes, such as herbal and environmental toxins, are more common. Full-Text PDF Global kidney disease – Authors' replyWe thank Raul Carlini for his interest in our paper,1 and for providing the data on distribution of the causes of end-stage kidney disease in Venezuela. Accurate data on incidence, prevalence, and causes of end-stage kidney disease are difficult to obtain for large parts of the developing world.1 The absence of such data does not allow for accurate international comparisons and prevents health-care officials and policy makers from prioritising efforts for prevention and provision of care to these patients. Full-Text PDF