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Luyckx VA, Al-Aly Z, Bello AK, Bellorin-Font E, Carlini RG, Fabian J, Garcia-Garcia G, Iyengar A, Sekkarie M, van Biesen W, Ulasi I, Yeates K, Stanifer J. Sustainable Development Goals relevant to kidney health: an update on progress. Nat Rev Nephrol 2020; 17:15-32. [PMID: 33188362 PMCID: PMC7662029 DOI: 10.1038/s41581-020-00363-6] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2020] [Indexed: 12/13/2022]
Abstract
Globally, more than 5 million people die annually from lack of access to critical treatments for kidney disease — by 2040, chronic kidney disease is projected to be the fifth leading cause of death worldwide. Kidney diseases are particularly challenging to tackle because they are pathologically diverse and are often asymptomatic. As such, kidney disease is often diagnosed late, and the global burden of kidney disease continues to be underappreciated. When kidney disease is not detected and treated early, patient care requires specialized resources that drive up cost, place many people at risk of catastrophic health expenditure and pose high opportunity costs for health systems. Prevention of kidney disease is highly cost-effective but requires a multisectoral holistic approach. Each Sustainable Development Goal (SDG) has the potential to impact kidney disease risk or improve early diagnosis and treatment, and thus reduce the need for high-cost care. All countries have agreed to strive to achieve the SDGs, but progress is disjointed and uneven among and within countries. The six SDG Transformations framework can be used to examine SDGs with relevance to kidney health that require attention and reveal inter-linkages among the SDGs that should accelerate progress. Working towards sustainable development is essential to tackle the rise in the global burden of non-communicable diseases, including kidney disease. Five years after the Sustainable Development Goal agenda was set, this Review examines the progress thus far, highlighting future challenges and opportunities, and explores the implications for kidney disease. Each Sustainable Development Goal (SDG) has the potential to improve kidney health and prevent kidney disease by improving the general health and well-being of individuals and societies, and by protecting the environment. Achievement of each SDG is interrelated to the achievement of multiple other SDGs; therefore, a multisectoral approach is required. The global burden of kidney disease has been relatively underestimated because of a lack of data. Structural violence and the social determinants of health have an important impact on kidney disease risk. Kidney disease is the leading global cause of catastrophic health expenditure, in part because of the high costs of kidney replacement therapy. Achievement of universal health coverage is the minimum requirement to ensure sustainable and affordable access to early detection and quality treatment of kidney disease and/or its risk factors, which should translate to a reduction in the burden of kidney failure in the future.
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Affiliation(s)
- Valerie A Luyckx
- Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. .,Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa. .,Institute of Biomedical Ethics and the History of Medicine, University of Zürich, Zürich, Switzerland.
| | - Ziyad Al-Aly
- Department of Medicine, Washington University in Saint Louis, Saint Louis, MO, USA.,Clinical Epidemiology Center, Veterans Affairs Saint Louis Health Care System, Saint Louis, MO, USA
| | - Aminu K Bello
- Division of Nephrology & Immunology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | | | - Raul G Carlini
- Sección de Investigación, Servicio de Nefrología y Trasplante Renal, Hospital Universitario de Caracas, Caracas, Venezuela
| | - June Fabian
- Wits Donald Gordon Medical Centre, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Witwatersrand, South Africa
| | - Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, University of Guadalajara Health Sciences Center, Hospital, 278, Guadalajara, Mexico
| | - Arpana Iyengar
- Department of Paediatric Nephrology, St. John's National Academy of Health Sciences, Bangalore, India
| | | | - Wim van Biesen
- Renal Division, Ghent University Hospital, Ghent, Belgium
| | - Ifeoma Ulasi
- Renal Unit, Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Karen Yeates
- Division of Nephrology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - John Stanifer
- Munson Nephrology, Munson Healthcare, Traverse City, MI, USA
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Harvey C, Palmer J, Hegney D, Willis E, Baldwin A, Rees C, Heritage B, Thompson S, Forrest R, O'Donnell C, Marshall R, Mclellan S, Sibley J, Judd J, Ferguson B, Bamford-Wade A, Brain D. The evaluation of nurse navigators in chronic and complex care. J Adv Nurs 2019; 75:1792-1804. [PMID: 31037742 DOI: 10.1111/jan.14041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/02/2019] [Accepted: 01/22/2019] [Indexed: 01/08/2023]
Abstract
AIM With increasing age and chronicity in populations, the need to reduce the costs of care while enhancing quality and hospital avoidance, is important. Nurse-led co-ordination is one such model of care that supports this approach. The aim of this research was to assess the impact that newly appointed Navigators have on service provision; social and economic impact; nurses' professional quality of life and compassion fatigue; and analysis of the change that has occurred to models of care and service delivery. DESIGN A concurrent mixed-method approach was selected to address the research aims. METHODS The research project was funded in July 2018 and will conclude in December 2020. Several cohorts will be studied including; patients assigned to a navigator, patients not assigned to a navigator, family members of patients assigned a navigator; and a sample sized estimated at 140 navigators. DISCUSSION This study provides a comprehensive international longitudinal and mixed method framework for evaluating the impact of nurse navigators on quality of care outcomes for patients with chronic conditions. IMPACT-WHAT PROBLEM WILL THE STUDY ADDRESS?: Even with specialty focused co-ordinated care, patients get lost in the system, increasing the incidence of non-compliance and exacerbation of condition. Navigators work with patients across service boundaries allowing for care that is patient responsive, and permitting variables in clinical, social and practical elements of care to be addressed in a timely manner. This novel nurse-led approach, supports hospital avoidance and patient self-management, while encouraging expansion and opportunity for the nursing and midwifery workforce.
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Affiliation(s)
- Clare Harvey
- School of Nursing, Midwifery and Social Science, Central Queensland University, Mackay, Australia
| | - Janine Palmer
- Hawke's Bay District Health Board, Napier, New Zealand
| | - Desley Hegney
- Research Division, Central Queensland University, Brisbane, Australia
| | - Eileen Willis
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Adele Baldwin
- School of Nursing, Midwifery and Social Science, Central Queensland University, Mackay, Australia
| | - Clare Rees
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Brody Heritage
- School of Psychology and Exercise Science, Murdoch University, Murdoch, Australia
| | - Shona Thompson
- School of Nursing, Eastern Institute of Technology, Taradale, New Zealand
| | - Rachel Forrest
- School of Nursing, Eastern Institute of Technology, Taradale, New Zealand
| | - Christopher O'Donnell
- Office of the Chief Nursing and Midwifery Officer, Clinical Excellence Division, Queensland Department of Health, Brisbane, Australia
| | | | - Sandy Mclellan
- School of Nursing, Midwifery and Social Science, Central Queensland University, Mackay, Australia
| | - Jonathon Sibley
- School of Business, Eastern Institute of Technology, Taradale, New Zealand
| | - Jenni Judd
- School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg, Australia
| | - Bridget Ferguson
- School of Nursing, Midwifery and Social Science, Central Queensland University, Mackay, Australia
| | | | - David Brain
- Australian Centre for Health Services Innovation, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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Ge Q, Chen L, Chen K. Treatment of Diabetes Mellitus Using iPS Cells and Spice Polyphenols. J Diabetes Res 2017; 2017:5837804. [PMID: 28758131 PMCID: PMC5512026 DOI: 10.1155/2017/5837804] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 05/05/2017] [Accepted: 06/04/2017] [Indexed: 01/01/2023] Open
Abstract
Diabetes mellitus is a chronic disease that threatens human health. The disease is caused by a metabolic disorder of the endocrine system, and long-term illness can lead to tissue and organ damage to the cardiovascular, endocrine, nervous, and urinary systems. Currently, the disease prevalence is 11.4%, the treatment rate is 48.2%, and the mortality rate is 2.7% worldwide. Comprehensive and effective control of diabetes, as well as the use of insulin, requires further study to develop additional treatment options. Here, we reviewed the current reprogramming of somatic cells using specific factors to induced pluripotent stem (iPS) cells capable of repairing islet β cell damage in diabetes patients to treat patients with type 1 diabetes mellitus. We also discuss the shortcomings associated with clinical use of iPS cells. Additionally, certain polyphenols found in spices might improve glucose homeostasis and insulin resistance in diabetes patients, thereby constituting promising options for the treatment of type 2 diabetes.
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Affiliation(s)
- Qi Ge
- Institute of Life Science, Jiangsu University, Zhenjiang, Jiangsu 212013, China
| | - Liang Chen
- Institute of Life Science, Jiangsu University, Zhenjiang, Jiangsu 212013, China
| | - Keping Chen
- Institute of Life Science, Jiangsu University, Zhenjiang, Jiangsu 212013, China
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Dona AC, Coffey S, Figtree G. Translational and emerging clinical applications of metabolomics in cardiovascular disease diagnosis and treatment. Eur J Prev Cardiol 2016; 23:1578-89. [DOI: 10.1177/2047487316645469] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 03/31/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Anthony C Dona
- North Shore Heart Research, Kolling Institute, Sydney Medical School (Northern), University of Sydney, Australia
- Charles Perkins Centre, University of Sydney, Australia
| | - Sean Coffey
- North Shore Heart Research, Kolling Institute, Sydney Medical School (Northern), University of Sydney, Australia
- Department of Cardiology, Royal North Shore Hospital, St Leonards, Australia
| | - Gemma Figtree
- North Shore Heart Research, Kolling Institute, Sydney Medical School (Northern), University of Sydney, Australia
- Charles Perkins Centre, University of Sydney, Australia
- Department of Cardiology, Royal North Shore Hospital, St Leonards, Australia
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Davis-Ajami ML, Wu J, Downton K, Ludeman E, Noxon V. Epoetin zeta in the management of anemia associated with chronic kidney disease, differential pharmacology and clinical utility. Biologics 2014; 8:155-67. [PMID: 24790409 PMCID: PMC3999275 DOI: 10.2147/btt.s27578] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Epoetin zeta was granted marketing authorization in October 2007 by the European Medicines Agency as a recombinant human erythropoietin erythropoiesis-stimulating agent to treat symptomatic anemia of renal origin in adult and pediatric patients on hemodialysis and adults on peritoneal dialysis, as well as for symptomatic renal anemia in adult patients with renal insufficiency not yet on dialysis. Currently, epoetin zeta can be administered either subcutaneously or intravenously to correct for hemoglobin concentrations ≤10 g/dL (6.2 mmol/L) or with dose adjustment to maintain hemoglobin levels at desired levels not in excess of 12 g/dL (7.5 mmol/L). This review article focuses on epoetin zeta indications in chronic kidney disease, its use in managing anemia of renal origin, and discusses its pharmacology and clinical utility.
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Affiliation(s)
- Mary Lynn Davis-Ajami
- Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Jun Wu
- South Carolina College of Pharmacy, University of South Carolina, Greenville, SC, USA
| | - Katherine Downton
- Health Sciences and Human Services Library, University of Maryland, Baltimore, MD, USA
| | - Emilie Ludeman
- Health Sciences and Human Services Library, University of Maryland, Baltimore, MD, USA
| | - Virginia Noxon
- Department of Clinical Pharmacy and Outcomes Science, South Carolina College of Pharmacy, University of South Carolina, Columbia, SC, USA
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Huang Y, Zhou Q, Haaijer-Ruskamp FM, Postma MJ. Economic evaluations of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in type 2 diabetic nephropathy: a systematic review. BMC Nephrol 2014; 15:15. [PMID: 24428868 PMCID: PMC3913790 DOI: 10.1186/1471-2369-15-15] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 01/06/2014] [Indexed: 12/31/2022] Open
Abstract
Background Structured comparison of pharmacoeconomic analyses for ACEIs and ARBs in patients with type 2 diabetic nephropathy is still lacking. This review aims to systematically review the cost-effectiveness of both ACEIs and ARBs in type 2 diabetic patients with nephropathy. Methods A systematic literature search was performed in MEDLINE and EMBASE for the period from November 1, 1999 to Oct 31, 2011. Two reviewers independently assessed the quality of the articles included and extracted data. All cost-effectiveness results were converted to 2011 Euros. Results Up to October 2011, 434 articles were identified. After full-text checking and quality assessment, 30 articles were finally included in this review involving 39 study settings. All 6 ACEIs studies were literature-based evaluations which synthesized data from different sources. Other 33 studies were directed at ARBs and were designed based on specific trials. The Markov model was the most common decision analytic method used in the evaluations. From the cost-effectiveness results, 37 out of 39 studies indicated either ACEIs or ARBs were cost-saving comparing with placebo/conventional treatment, such as amlodipine. A lack of evidence was assessed for valid direct comparison of cost-effectiveness between ACEIs and ARBs. Conclusion There is a lack of direct comparisons of ACEIs and ARBs in existing economic evaluations. Considering the current evidence, both ACEIs and ARBs are likely cost-saving comparing with conventional therapy, excluding such RAAS inhibitors.
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Affiliation(s)
- Yunyu Huang
- Department of Pharmacy, Unit of Pharmaco Epidemiology & Pharmaco Economics, University of Groningen, Groningen, The Netherlands.
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