به نام خدا.

Slides:



Advertisements
Similar presentations
Diabetic Nephropathy.  Over 40% of new cases of end-stage renal disease (ESRD) are attributed to diabetes.  In 2001, 41,312 people with diabetes began.
Advertisements

Lysaght, J Am Soc Nephrol, 2002 Number of patients worldwide treated with chronic dialysis from 1990 to ,000 1,490,000 2,500,000.
Chronic kidney disease: [insert title here] Insert name, title, date here Insert acknowledgements here.
General Practice Workshop This workshop was conceived and developed by Kidney Health Australia’s Kidney Check Australia Taskforce with particular thanks.
Economic Impact of a Sedentary Lifestyle. Exercise and Body Composition The health care costs associated with obesity treatment were estimated at $117.
A comparison of overall health between Asian and Australians from European background: A west Australian study of Diet & Metabolic Syndrome Risk Factors.
Chapter 1: CKD in the General Population 2014 A NNUAL D ATA R EPORT V OLUME 1: C HRONIC K IDNEY D ISEASE.
A retrospective cohort study of Childhood post-streptococcal glomerulonephritis as a risk factor for chronic renal disease in later life Andrew V White,
Assignment for April 1, 2008 In class We will watch a Bill Moyers’ documentary, Children in America’s Schools.
Chapter 2: Identification and Care of Patients With CKD 2014 ANNUAL DATA REPORT VOLUME 1: CHRONIC KIDNEY DISEASE.
Lesley Stevens MD Tufts-New England Medical Center
Healthy People 2010 Focus Area 12: Heart Disease and Stroke
National Diabetes Education Program NDEP ( ) A joint program of NIH and CDC Diabetes: The Numbers Revised.
Early Detection and Prevention of Renal Failure Linda Fried, MD, MPH.
Health Care Costs Associated with Chronic Kidney Disease in Patients with Type II Diabetes Zita Shiue, MD Internal Medicine, R3 Chief of Medicine Conference.
SM Gatmiri, MD, Nephrologist Imam Khomeini Hospital,
The National Kidney Foundation’s Kidney Early Evaluation Program TM “The Greater New York Experience” Ellen H. Yoshiuchi, MPS Division Program Director.
Cardiovascular Disease in Women Module I: Epidemiology.
Health Disparities of Minority Women and Diabetes Kathleen M. Rayman, Ph.D., RN Appalachian Center for Translational Research in Disparities Faculty Development.
The management of renal problems in primary care Hugh Gallagher Consultant Nephrologist St Helier Hospital.
NHPA’s. What are they? National Health Priority Areas (NHPAs) are diseases and conditions chosen for focused attention at a national level because of.
Chapter 1: CKD in the General Population 2015 A NNUAL D ATA R EPORT V OLUME 1: C HRONIC K IDNEY D ISEASE.
Chapter 2: Identification and Care of Patients With CKD 2015 A NNUAL D ATA R EPORT V OLUME 1: C HRONIC K IDNEY D ISEASE.
ALLHAT 6/5/ CARDIOVASCULAR DISEASE OUTCOMES IN HYPERTENSIVE PATIENTS STRATIFIED BY BASELINE GLOMERULAR FILTRATION RATE (3 GROUPS by GFR)
Chapter 37 Chronic Kidney Disease: The New Epidemic
6/5/ CARDIOVASCULAR DISEASE OUTCOMES IN HYPERTENSIVE PATIENTS STRATIFIED BY BASELINE GLOMERULAR FILTRATION RATE (4 GROUPS by GFR) ALLHAT.
Meeting the Challenge of Non-Communicable Diseases Lecture 14.
1 به نام خدا. Epidemiology of chronic kidney disease 2.
내과 R1 문정락 / prof. 정경환 N Engl J Med 369;10 nejm.org 932 september 5, 2013.
Cardiovascular Risk: A global perspective
Chronic Kidney Disease (CKD) Dr. Sham Sunder. Now we know why the titanic sank !! < 0.5 % 5- 10%
2016 Annual Data Report, Vol 2, ESRD, Ch 5
Section 1: CKD Epidemiology
Figure 1.1 Prevalence of CKD by stage among NHANES participants,
Nephrology Journal Club The SPRINT Trial Parker Gregg
Section 4: Managing progression of CKD
The LIVES Sub-analysis
Prevention Diabetes.
2016 Annual Data Report, Vol 2, ESRD, Ch 6
به نام خدا.
Lab (5): Renal Function test (RFT) (Part 2)
Chapter 2: Identification and Care of Patients With CKD
Mortality rates in incident ESRD patients figure 9
2016 Annual Data Report, Vol 1, CKD, Ch 2
2017 Annual Data Report Healthy People 2020.
Volume 2: End-Stage Renal Disease Chapter 4: Hospitalization
Chapter 1: CKD in the General Population
Volume 1: Chronic Kidney Disease Chapter 5: Acute Kidney Injury
Copyright © 2012 American Medical Association. All rights reserved.
Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults Risks and Assessment NHLBI Obesity Education.
Renal disease progression in patients with TTR amyloidosis
Recognizing Your Risk for Cardiovascular Disease
Volume 2: End-Stage Renal Disease Chapter 4: Hospitalization
Systolic Blood Pressure Intervention Trial (SPRINT)
2018 Annual Data Report Volume 3: Healthy People 2020
Prevention Diabetes Dr Abir Youssef 29/11/2018.
A: Epidemiology update
2018 Annual Data Report Volume 1: Chronic Kidney Disease
Chapter 1: CKD in the General Population
Cardiovascular disease: Leading cause of death
Chapter 2: Identification and Care of Patients with CKD
Volume 86, Issue 4, Pages (October 2014)
Meeting the challenges of the new K/DOQI guidelines
It is estimated that more than 1
American Journal of Kidney Diseases
Chronic kidney disease (CKD), with a prevalence of 10% to 15%
Chronic kidney disease (CKD), with a prevalence of 10% to 15%
Diabetes econonomy2 Amini Masoud 1397.
Chapter 2: Identification and Care of Patients with CKD
Jacob J.E. Koopman, MD, PhD  American Journal of Kidney Diseases 
Presentation transcript:

به نام خدا

Epidemiology of chronic kidney disease

Chronic kidney disease (CKD) is a worldwide public health problem

Chronic kidney disease is a major worldwide public health hazard Chronic kidney disease is a major worldwide public health hazard. Its global prevalence is rapidly and steadily increasing, particularly in developing countries

Chronic kidney disease (CKD) is a major public health threat with a rapid increase in its global incidence and prevalence, particularly in developing countries, leading to end-stage renal disease (ESRD), and resulting in premature mortality, poor quality of life, and large burden for the health care systems

The incidence of major risk factors of chronic kidney disease (CKD) in the world is on the rise, and it is expected that this incidence and prevalence, particularly in developing countries, will continue to increase

The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI) workgroup has defined CKD as the following, which has been accepted internationally The presence of markers of kidney damage for three or more months, as defined by structural or functional abnormalities of the kidney, with or without decreased glomerular filtration rate (GFR), that can lead to decreased GFR, manifest by either pathological abnormalities or other markers of kidney damage, including abnormalities in the composition of blood or urine, or abnormalities in imaging tests The presence of GFR <60 mL/min per 1.73 m2 for three or more months with or without other signs of kidney damage, as described above.

studies have estimated the prevalence of CKD in the general population through measurement of markers of kidney damage such as elevated serum creatinine concentration, decreased estimated GFR (eGFR), and presence of albuminuria

10% of the population worldwide is affected by chronic kidney disease (CKD), and millions die each year because they do not have access to affordable treatment

Chronic 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.

In people aged 65 through 74 worldwide, it is estimated that one in five men and one in four women have CKD

more than 10% of adults in the United States—more than 20 million people—may have CKD, chances of having CKD increase with age; it increases after age 50 years and is most common among adults older than 70 years

Adults with diabetes or high blood pressure, or both have a higher risk of developing CKD than those without these diseases. Approximately 1 of 3 adults with diabetes and 1 of 5 adults with high blood pressure has CKD

Other risk factors for CKD include cardiovascular disease, obesity, high cholesterol, lupus, and a family history of CKD

It is estimated that by 2030, over 70% of patients with ESRD will be inhabitants of developing countries, probably related to the fast rising trend of obesity and diabetes in these countries

the estimated prevalence within the United States of each stage in 1999 to 2004 ●Stage 1 disease is defined by a normal GFR (>90 mL/min per 1.73 m2) and persistent albuminuria (1.8 percent of the total United States adult population). ●Stage 2 disease is a GFR between 60 to 89 mL/min per 1.73 m2 and persistent albuminuria (3.2 percent). ●Stage 3 disease is a GFR between 30 and 59 mL/min per 1.73 m2 (7.7 percent). ●Stage 4 disease is a GFR between 15 and 29 mL/min per 1.73 m2 (0.35 percent). ●Stage 5 disease is a GFR of <15 mL/min per 1.73 m2 or end-stage renal disease (ESRD) (2.4 percent) 15.45

Prevalence in other countries cross-country comparisons are difficult because of variations in study design, differences in definitions used, lack of standardization of laboratory calibrations, and lack of knowledge of significant factors such as age and comorbidity. CKD, most commonly defined as an elevated serum creatinine level or decreased eGFR or moderately increased albuminuria, reportedly ranges from approximately 1 to 30 percent

As examples: ●In a population-based study in Korea, the prevalence of moderately increased albuminuria was 2.8 percent among normotensive, normoglycemic individuals and 10 and 16 percent among hypertensives and diabetics, respectively ●Among adults in Iceland, the prevalence of an eGFR <60 mL/min per 1.73 m2 and proteinuria was 5 and 2 percent among men, respectively, and 12 and 1 percent among women, respectively. ●In a report from Taiwan, the prevalence of an eGFR <60 mL/min per 1.73 m2 was 7 percent . ●In one study, the overall prevalence of CKD in Norway, was 10.2 percent, which is similar to that reported in the United States ●In a population-based study from Malaysia, the prevalence of CKD was 9 percent

Incidence of CKD ●The Framingham Offspring study consisted of 1223 men and 1362 women who were initially free of preexisting kidney disease . After a mean follow-up of 18.5 years, 244 participants (9.4 percent) had developed kidney .The development of CKD was associated with increased age, diabetes, hypertension, smoking, obesity, and a lower baseline GFR. ●In a retrospective cohort study over a 5.5-year period of follow-up, the estimated annual incidence of CKD was 1700 per million population

PREVALENCE OF END-STAGE RENAL DISEASE (ESRD) The prevalence of ESRD is increasing. The number of patients enrolled in the ESRD Medicare-funded program has increased from approximately 10,000 in 1973 to 615,899 as of December 31, 2011.

RACIAL VARIATIONS IN PREVALENCE OF ESRD AND CKD There are striking racial and ethnic differences in the incidence and prevalence rates of end-stage renal disease (ESRD) In 2005, the incidence rates for ESRD in the United States were 268 per million population in Caucasians; 991 in African Americans; 355 in Asian Americans, native Hawaiians, and other Pacific Islanders; and 516 in American Indians and Alaska Natives Similarly, the incidence of ESRD in South-Asian and African-Caribbean immigrants in the United Kingdom is three- to fourfold higher than in the general population

These disparities raise the possibility that differential access to health care, and, thus, management of CKD and probably faster progression to ESRD, may be a cause for concern in minority groups, particularly among African Americans

IMPACT OF CKD AND ESRD ON GENERAL MORBIDITY Both early stages of chronic kidney disease (CKD) and end-stage renal disease (ESRD) are associated with high morbidity and increased healthcare utilization. Approximately 50 percent of dialysis patients have three or more comorbid conditions;

IMPACT OF CKD AND ESRD ON MORTALITY Patients with chronic kidney disease (CKD) and particularly end-stage renal disease (ESRD) are at increased risk of mortality, particularly from cardiovascular disease (CVD). Survival probabilities for dialysis patients at one, two, and five years are approximately 81, 65, and 34 percent, respectively

Risk of dying Premature death from all causes and from cardiovascular disease is higher in adults with CKD than in adults without CKD

the incidence of end-stage renal disease (ESRD) is dramatically increasing worldwide Most patients with kidney problems visit their physicians in the late stages of the disease

According the 2010 Global Burden of Disease study, chronic kidney disease was ranked 27th in the list of causes of total number of deaths worldwide in 1990, but rose to 18th in 2010

In the US, treatment of chronic kidney disease is likely to exceed $48 billion per year. Treatment for kidney failure consumes 6.7% of the total Medicare budget to care for less than 1% of the covered population In China, the economy will lose US$558 billion over the next decade due to effects on death and disability attributable to heart disease and kidney disease In Uruguay, the annual cost of dialysis is close to $ US 23 million, representing 30% of the budget of the National Resources Fund for specialized therapies In England, according to a recent report published by NHS Kidney Care, chronic kidney disease costs more than breast, lung, colon and skin cancer combined In Australia, treatment for all current and new cases of kidney failure through 2020 will cost an estimated $12 billion

The prevalence of CKD is high in Iran and its contributing risk factors are older age, female sex, hypertension, diabetes, high waist circumference, dyslipidemia and high body mass index

CKD and its main risk factors are common and represent a definite health threat in Iran

Chronic kidney disease (CKD), with a prevalence of 10% to 15% Iran J Kidney Dis. 2015 May;9(3):186-92. A multilevel model for services provided to patients with chronic kidney disease.

The prevalence of CKD in patients with diabetes mellitus and hypertension was 21.5% Iran J Kidney Dis. 2014 Nov;8(6):450-6. Chronic kidney disease management program in Shahreza, Iran.

A total of 800 subjects aged more than 35 years admitted from 2011 to 2013 were enrolled in the study CKD was seen in 14.8% patients with MetS and 8.3% individuals without MetS in Boroujerd J Res Med Sci. 2015 May; 20(5): 465–469. Metabolic syndrome and its components associated with chronic kidney disease

prevalence was 18.9% among 10 063 people aged over 20 years, in Tehran, Iran in 2000. A study during 2002 to 2005 reported that the CKD prevalence (stags 1 to 5) was 12.6% in 17240 Iranian people. Another study conducted in 1557 Iranian samples showed 19.5% prevalence for CKD (stages 1 and 2, 10.6%; stages 3 to 5, 8.9%).

In a large study reported that prevalence of CKD among individuals over14-years old in different parts of the country was 6%to 17% Safarinejad MR (2009) The epidemiology of adult chronic kidney disease in a population-based study in Iran: prevalence and associated risk factors. J Nephrol 22: 99–10

this study shows considerable disparities among counties of Iran this study shows considerable disparities among counties of Iran. Early intervention strategies to reduce the burden of CKD are essential.

In the past decade, 1.1 trillion dollars have been spent for dialysis worldwide Early diagnosis and treatment of mild to moderate CKD may prevent or delay progression of the disease to severer stages

Diagnosis and treatment of CKD in early stages and prevent of risk factors of CKD specially obesity can be an important public health issue, particularly in the developing countries with high rates of CKD

با تشکر از توجه شما