Prevalence and Severity of Chronic Kidney Disease in Haiti.

Autor:	Roberts NLS; Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York.; Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York., Pierre JL; Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti., Rouzier V; Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti., Sufra R; Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti., St-Preux S; Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti., Yan LD; Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York.; Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York., Metz M; Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York., Clermont A; Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York.; Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York., Apollon A; Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti., Sabwa S; Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York., Deschamps MM; Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti., Kingery JR; Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York.; Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York., Peck R; Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York.; Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York., Fitzgerald D; Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York.; Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York., Pape JW; Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti., Tummalapalli SL; Division of Healthcare Delivery Science & Innovation, Department of Population Health Sciences, Weill Cornell Medicine, New York, New York.; The Rogosin Institute, New York, New York., McNairy ML; Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York.; Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York.
Jazyk:	angličtina
Zdroj:	Clinical journal of the American Society of Nephrology : CJASN [Clin J Am Soc Nephrol] 2023 Jun 01; Vol. 18 (6), pp. 739-747. Date of Electronic Publication: 2023 Apr 18.
DOI:	10.2215/CJN.0000000000000175
Abstrakt:	Background: CKD is a major cause of morbidity and mortality in lower-income countries. However, population-based studies characterizing the epidemiology of CKD in these settings are lacking. The study objective was to describe the epidemiology of CKD in a population-based cohort in urban Haiti, including estimates of the prevalence by CKD stage, the magnitude of associated factors with CKD, and the proportion on guideline-recommended treatment. Methods: We assessed the prevalence of CKD and associated risk factors in the population-based Haiti Cardiovascular Disease Cohort. We analyzed cross-sectional data from 2424 adults who completed a clinical examination, risk factor surveys, and laboratory measurements for serum creatinine, urinary albumin, and urinary creatinine. We compared our results with US estimates from the National Health and Nutrition Examination Survey. CKD was defined as either a reduced eGFR <60 ml/min per 1.73 m 2 or urinary albumin-to-creatinine ratio ≥30 mg/g according to the Kidney Disease Improving Global Outcomes guidelines. Multivariable logistic regression identified associated factors with CKD. Results: The mean age was 42 years, 57% of participants were female, and 69% lived in extreme poverty on ≤1 US dollar per day. The age-standardized prevalence of CKD was 14% (95% confidence interval [CI], 12% to 15%). The age-standardized prevalence of reduced eGFR and elevated urinary albumin-to-creatinine ratio was 3% (95% CI, 2% to 4%) and 11% (95% CI, 10% to 13%), respectively. Diabetes (adjusted odds ratio, 4.1; 95% CI, 2.7 to 6.2) and hypertension (adjusted odds ratio, 2.9; 95% CI, 2.0 to 4.2) were significantly associated with CKD. Only 12% of participants with CKD and albuminuria were on guideline-recommended agents, such as angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers. Conclusions: In a large population-based cohort of Haitian adults, CKD was highly associated with both diabetes and hypertension. The proportion of participants with CKD on treatment was low, underscoring the need for strengthening clinical management and nephrology care health infrastructure in Haiti. Clinical Trial Registry Name and Registration Number: A Longitudinal Cohort Study to Evaluate Cardiovascular Risk Factors and Disease in Haiti, NCT03892265 . (Copyright © 2023 by the American Society of Nephrology.)
Databáze:	MEDLINE
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