Ameh Oluwatoyin I, Ekrikpo Udeme E, Kengne Andre-Pascal
Division of Nephrology, Zenith Medical & Kidney Centre, Gudu, Abuja, Nigeria.
Renal Unit, Department of Internal Medicine, University of Uyo, Uyo, Nigeria.
Kidney Int Rep. 2019 Dec 23;5(3):255-262. doi: 10.1016/j.ekir.2019.12.013. eCollection 2020 Mar.
The epidemiologic transition occurring in low- and middle-income countries (LMICs) has led to a surge in chronic kidney disease (CKD) prevalence because of a combination of highly prevalent chronic noncommunicable diseases (NCDs) and communicable diseases (CDs). The progressive rise in CKD prevalence in LMICs threatens the existing weak health systems in these countries as care for advanced CKD remains largely unavailable and unaffordable. An interplay of low literacy levels, poor health-seeking behavior, inadequate health care funding, weak health systems, and lack of skilled nephrology workforce has made it difficult for adequate CKD preventive measures to be implemented. Primary, secondary, and tertiary prevention measures need to be instituted in LMICs by a collaboration of governmental and nongovernmental organizations to stem this tide and help prevent deaths from other NCDs that share similar risk factors with CKD. For these to be effective, locally relevant knowledge is needed to contextualize existing prevention and control solutions, or to develop novel and more appropriate solutions for LMICs.
低收入和中等收入国家（LMICs）正在经历的流行病学转变，由于高流行的慢性非传染性疾病（NCDs）和传染性疾病（CDs）共同作用，导致慢性肾脏病（CKD）患病率激增。LMICs中CKD患病率的不断上升，威胁着这些国家现有的薄弱卫生系统，因为晚期CKD的治疗在很大程度上仍然无法获得且难以负担。低识字率、不良的就医行为、医疗保健资金不足、卫生系统薄弱以及缺乏熟练的肾脏病专业人员相互作用，使得难以实施充分的CKD预防措施。政府组织和非政府组织需要合作，在LMICs中制定一级、二级和三级预防措施，以阻止这一趋势，并帮助预防与CKD有相似风险因素的其他NCDs导致的死亡。为使这些措施有效，需要结合当地实际情况的知识，将现有的预防和控制解决方案因地制宜，或为LMICs开发新颖且更合适的解决方案。
