Abstract
BackgroundChronic kidney disease (CKD) is becoming a major public health problem around the world. But the prevalence has not been reported in South Asian region as a whole. This study aimed to systematically review the existing data from population based studies in this region to bridge this gap.MethodsArticles published and reported prevalence of CKD according to K/DOQI practice guideline in eight South Asian countries between December 1955 and April 2017 were searched, screened and evaluated from seven electronic databases using the PRISMA checklist. CKD was defined as creatinine clearance (CrCl) or GFR less than 60 ml/min/1.73 m2.ResultsSixteen population-based studies were found from four South Asian countries (India, Bangladesh, Pakistan and Nepal) that used eGFR to measure CKD. No study was available from Sri Lanka, Maldives, Bhutan and Afghanistan. Number of participants ranged from 301 in Pakistan to 12,271 in India. Majority of the studies focused solely on urban population. Different studies used different equations for measuring eGFR. The prevalence of CKD ranged from 10.6% in Nepal to 23.3% in Pakistan using MDRD equation. This prevalence was higher among older age group people. Equal number of studies reported high prevalence among male and female each.ConclusionsThis systematic review reported high prevalence of CKD in South Asian countries. The findings of this study will help pertinent stakeholders to prepare suitable policy and effective public health intervention in order to reduce the burden of this deadly disease in the most densely populated share of the globe.
Highlights
Chronic kidney disease (CKD) is becoming a major public health problem around the world
A study conducted in USA revealed that the treatment cost for Chronic Kidney Disease (CKD) and ESRD imposes a huge financial burden to the health care system and the average annual cost for end-stage renal disease without transplantation was near 75 billion US dollar in 2001 [8]
Medical sub-heading as well as plain text were used for the following keywords: ‘epidemiology’, ‘prevalence’, ‘chronic renal insufficiency’, ‘chronic kidney disease’, ‘India’, ‘Bangladesh’, ‘Sri Lanka’, ‘Nepal’, ‘Bhutan’, ‘Maldives’, ‘Pakistan’ and ‘Afghanistan’
Summary
Chronic kidney disease (CKD) is becoming a major public health problem around the world. A systematic review, conducted in 2015 reported that, 109.9 million people from high-income countries had CKD (men-48.3 million, women-61.7 million) whereas the burden was 387.5 million in lower-middle income countries (men-177.4 million, women- 210.1 million) [3]. CKD is considered as one of the major risk factors for developing cardiovascular disease [5]. CKD patients are at higher risk to develop end-stage renal disease (ESRD) which requires costly management like dialysis and kidney transplantation [8]. A study conducted in USA revealed that the treatment cost for CKD and ESRD imposes a huge financial burden to the health care system and the average annual cost for end-stage renal disease without transplantation was near 75 billion US dollar in 2001 [8]. CKD needs to be given priority because it is the
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