Makerere University College of Health Sciences, Kampala, Uganda.
Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN.
Semin Nephrol. 2022 Sep;42(5):151315. doi: 10.1016/j.semnephrol.2023.151315. Epub 2023 Mar 29.
Kidney disease is the 10th leading cause of death worldwide and disproportionately increases morbidity and mortality for people residing in low- and middle-income countries (LMICs). Considering the high burden of chronic kidney disease (CKD) on patients, society, and health care systems, strategies to improve screening for CKD need to be prioritized. With appropriate interventions, screening could prevent progression of early stages of CKD and, ultimately, reduce the need for kidney replacement therapy. Unfortunately, few data exist to inform screening strategies for early detection and management of CKD in LMICs, where risk factors for CKD may differ from those in high-income countries. We review here the epidemiology of kidney disease in LMICs, current practices for screening for kidney disease, and challenges and opportunities available to LMICs. We also recommend ways in which screening could be improved for early identification and care for patients with kidney disease in LMICs and highlight critical gaps in knowledge.
肾脏病是全球第 10 大死亡原因,在中低收入国家(LMICs),其发病率和死亡率不成比例地增加。考虑到慢性肾脏病(CKD)给患者、社会和医疗保健系统带来的沉重负担,需要优先考虑改善 CKD 筛查的策略。通过适当的干预措施,筛查可以预防 CKD 早期阶段的进展,并最终减少对肾脏替代治疗的需求。不幸的是,关于中低收入国家 CKD 的早期发现和管理的筛查策略,几乎没有数据可以提供信息,因为 CKD 的危险因素可能与高收入国家不同。我们在此回顾了 LMICs 中肾脏病的流行病学、肾脏病筛查的现行做法以及 LMICs 面临的挑战和机遇。我们还建议了改善 LMICs 中肾脏病患者早期识别和护理的筛查方法,并强调了知识方面的关键差距。
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