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Ashrafi SA, Alam RB, Kraay A, Ogunjesa BA, Schwingel A. Disparities in healthcare access experienced by Hispanic chronic kidney disease patients: a cross-sectional analysis. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:18. [PMID: 38297384 PMCID: PMC10832131 DOI: 10.1186/s41043-024-00508-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 01/22/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Chronic kidney disease (CKD) is a public health concern, and the disease disproportionately affects Hispanics. Improved healthcare access for Hispanic CKD patients can reduce the disease burden. This study assesses the healthcare access disparities experienced by Hispanic CKD patients compared to Whites. METHODS We analyzed three National Health and Nutrition Examination Survey (NHANES) datasets for 2013-2014, 2015-2016, and 2017-2018. The primary predictor variable was race, and the outcome variable was three domains of healthcare access: insurance status, having any routine place for healthcare, and having any health visits in the past year. Chi-square tests and unadjusted and adjusted multivariate logistic regressions were conducted. The models were adjusted for age, education, income, and CKD stages and were weighted to account for the sampling strategy. RESULTS The sample size was 1864 CKD patients from three two-year cycles of NHANES datasets (2013-2014, 2015-2016, and 2017-2018). The final adjusted model found that Hispanic CKD patients were more likely to be uninsured (OR: 2.52, CI 1.66-3.83) and have no routine place for healthcare (OR: 1.68, CI 1.03-2.75) than White CKD patients, but did not have differences in healthcare visits in the past year. CONCLUSIONS Hispanic CKD patients have limited healthcare access compared to White populations showing existing care access disparities experienced by them. Improved programs and policies are required to enhance kidney health among Hispanics and promote equity in CKD.
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Affiliation(s)
- Sadia Anjum Ashrafi
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Rifat Binte Alam
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Alicia Kraay
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Babatope Ayokunle Ogunjesa
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Andiara Schwingel
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, IL, USA.
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Berhe E, Tesfay B, Teka H. The despair of patients with kidney diseases in third-world wars: the case of Ethiopia's crisis. Nephrol Dial Transplant 2023; 38:2092-2095. [PMID: 37188648 DOI: 10.1093/ndt/gfad093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Indexed: 05/17/2023] Open
Affiliation(s)
- Ephrem Berhe
- Ayder Comprehensive Specialized Hospital, College of Health Sciences, Mekelle University, Tigray, Ethiopia
- Department of Internal Medicine, Head of Nephrology Unit, Ayder Comprehensive Specialized Hospital, College of Health Sciences, Mekelle University, Tigray, Ethiopia
| | - Bisrat Tesfay
- Ayder Comprehensive Specialized Hospital, College of Health Sciences, Mekelle University, Tigray, Ethiopia
| | - Hale Teka
- Ayder Comprehensive Specialized Hospital, College of Health Sciences, Mekelle University, Tigray, Ethiopia
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Mc Laughlin L, Williams G, Roberts G, Dallimore D, Fellowes D, Popham J, Charles J, Chess J, Williams SH, Mathews J, Howells T, Stone J, Isaac L, Noyes J. Assessing the efficacy of coproduction to better understand the barriers to achieving sustainability in NHS chronic kidney services and create alternate pathways. Health Expect 2022; 25:579-606. [PMID: 34964215 PMCID: PMC8957730 DOI: 10.1111/hex.13391] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 08/27/2021] [Accepted: 11/18/2021] [Indexed: 11/28/2022] Open
Abstract
CONTEXT Too many people living with chronic kidney disease are opting for and starting on hospital-based dialysis compared to a home-based kidney replacement therapy. Dialysis services are becoming financially unsustainable. OBJECTIVE This study aimed to assess the efficacy of coproductive research in chronic kidney disease service improvement to achieve greater sustainability. DESIGN A 2-year coproductive service improvement study was conducted with multiple stakeholders with the specific intention of maximizing engagement with the national health kidney services, patients and public. SETTING AND PARTICIPANTS A national health kidney service (3 health boards, 18 dialysis units), patients and families (n = 50), multidisciplinary teams including doctors, nurses, psychologists, social workers, and so forth (n = 68), kidney charities, independent dialysis service providers and wider social services were part of this study. FINDINGS Coproductive research identified underutilized resources (e.g., patients on home dialysis and social services) and their potential, highlighted unmet social care needs for patients and families and informed service redesign. Education packages were reimagined to support the home dialysis agenda including opportunities for wider service input. The impacts of one size fits all approaches to dialysis on specialist workforce skills were made clearer and also professional, patient and public perceptions of key sustainability policies. DISCUSSION AND CONCLUSIONS Patient and key stakeholders mapped out new ways to link services to create more sustainable models of kidney health and social care. Maintaining principles of knowledge coproduction could help achieve financial sustainability and move towards more prudent adult chronic kidney disease services. PATIENT OR PUBLIC CONTRIBUTION Involved in developing research questions, study design, management and conduct, interpretation of evidence and dissemination.
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Affiliation(s)
- Leah Mc Laughlin
- School of Medical and Health SciencesBangor UniversityBangorWalesUK
| | - Gail Williams
- Welsh Renal Clinical NetworkWelsh Health Specialised Services CommitteePontypriddWalesUK
| | | | - David Dallimore
- School of Medical and Health SciencesBangor UniversityBangorWalesUK
| | | | | | - Joanna Charles
- Centre for Health Economics and Medicines EvaluationBangor University, School of Medical and Health SciencesBangorWalesUK
| | - James Chess
- Swansea Bay University Health BoardSwanseaWalesUK
| | | | - Jonathan Mathews
- Welsh Renal Clinical NetworkWelsh Health Specialised Services CommitteePontypriddWalesUK
| | | | | | | | - Jane Noyes
- School of Medical and Health SciencesBangor UniversityBangorWalesUK
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Lousa I, Reis F, Santos-Silva A, Belo L. The Signaling Pathway of TNF Receptors: Linking Animal Models of Renal Disease to Human CKD. Int J Mol Sci 2022; 23:ijms23063284. [PMID: 35328704 PMCID: PMC8950598 DOI: 10.3390/ijms23063284] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 11/25/2022] Open
Abstract
Chronic kidney disease (CKD) has been recognized as a global public health problem. Despite the current advances in medicine, CKD-associated morbidity and mortality remain unacceptably high. Several studies have highlighted the contribution of inflammation and inflammatory mediators to the development and/or progression of CKD, such as tumor necrosis factor (TNF)-related biomarkers. The inflammation pathway driven by TNF-α, through TNF receptors 1 (TNFR1) and 2 (TNFR2), involves important mediators in the pathogenesis of CKD. Circulating levels of TNFRs were associated with changes in other biomarkers of kidney function and injury, and were described as predictors of disease progression, cardiovascular morbidity, and mortality in several cohorts of patients. Experimental studies describe the possible downstream signaling pathways induced upon TNFR activation and the resulting biological responses. This review will focus on the available data on TNFR1 and TNFR2, and illustrates their contributions to the pathophysiology of kidney diseases, their cellular and molecular roles, as well as their potential as CKD biomarkers. The emerging evidence shows that TNF receptors could act as biomarkers of renal damage and as mediators of the disease. Furthermore, it has been suggested that these biomarkers could significantly improve the discrimination of clinical CKD prognostic models.
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Affiliation(s)
- Irina Lousa
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (I.L.); (A.S.-S.)
- UCIBIO—Applied Molecular Biosciences Unit, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Flávio Reis
- Institute of Pharmacology & Experimental Therapeutics & Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal;
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-504 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3000-075 Coimbra, Portugal
| | - Alice Santos-Silva
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (I.L.); (A.S.-S.)
- UCIBIO—Applied Molecular Biosciences Unit, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Luís Belo
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (I.L.); (A.S.-S.)
- UCIBIO—Applied Molecular Biosciences Unit, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- Correspondence:
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Elrggal ME, Gokcay Bek S, Shendi AM, Tannor EK, Nlandu YM, Gaipov A. Disparities in Access to Kidney Transplantation in Developing Countries. Transplantation 2021; 105:2325-2329. [PMID: 34709218 DOI: 10.1097/tp.0000000000003585] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | - Sibel Gokcay Bek
- Department of Internal Medicine, Nephrology Unit, Kocaeli University Hospital, Kocaeli, Turkey
| | - Ali M Shendi
- Nephrology Unit, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | | | - Abduzhappar Gaipov
- Department of Clinical Sciences, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
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de Pádua Paz I, Konstantyner T, de Castro Cintra Sesso R, de Xavier Pinto CC, de Camargo MFC, Nogueira PCK. Access to treatment for chronic kidney disease by children and adolescents in Brazil. Pediatr Nephrol 2021; 36:2827-2835. [PMID: 33675411 DOI: 10.1007/s00467-021-05009-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 02/05/2021] [Accepted: 02/12/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND This study aimed to identify main factors associated with child and adolescent access to chronic kidney disease (CKD) treatment in Brazil. METHODS Multi-center cross-sectional study conducted in eight pediatric nephrology centers across all Brazilian geographic regions. Information was collected on characteristics associated with referral and treatment of patients with CKD. The following outcomes were analyzed as follows: (1) age at first consultation, and (2) time elapsed between referral and treatment at the specialized service. RESULTS Three hundred thirty-five children were assessed. Variables associated with age at first consultation were as follows: CAKUT (HR=1.7; 95%CI 1.3-2.2, p<0.01); private health plan (HR=1.54; 95%CI 1.06-2.23, p=0.02); modified Medical Outcomes Study Social Support Survey mMOS-SS score (HR=1.02; 95%CI 1.00-1.03, p=0.024); maternal age (HR=0.96; 95%CI 0.95-0.97, p<0.01); and number of siblings in the household (HR=0.86; 95%CI 0.79-0.83, p<0.01). Significant variables associated with time elapsed between referral and treatment at the specialized service were as follows: each additional occupant sharing the household (HR=0.94; 95%CI:0.89-0.99, p=0.02), residing in the Northeast (HR=0.81; 95%CI:0.67-0.98, p=0.03) and having someone to take them to the physician (HR=1.36; 95%CI 1.07-1.74, p=0.01). The median time interval between patient referral and treatment by the service was 11 days (IQR 10-31). CONCLUSION There are potentially modifiable factors hampering access of children with CKD to specialized treatment. The importance of the role of social support for the two outcomes should serve as an alert for health managers and professionals to consider this aspect throughout all steps of the care process of children with CKD.
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Affiliation(s)
- Isabel de Pádua Paz
- Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo, Brazil.
| | - Tulio Konstantyner
- Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo, Brazil
| | | | | | | | - Paulo Cesar Koch Nogueira
- Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo, Brazil.,Hospital Samaritano de São Paulo, Sao Paulo, Brazil
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Nataraj M. Albuminuria Testing in Low-Income Setting. J Prim Care Community Health 2021; 12:21501327211009703. [PMID: 33840304 PMCID: PMC8044560 DOI: 10.1177/21501327211009703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Megha Nataraj
- Manipal Academy of Higher Education, Manipal, Karnataka, India
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Zhang KJ, Wu Q, Jiang SM, Ding L, Liu CX, Xu M, Wang Y, Zhou Y, Li L. Pyroptosis: A New Frontier in Kidney Diseases. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:6686617. [PMID: 34007404 PMCID: PMC8102120 DOI: 10.1155/2021/6686617] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/31/2021] [Accepted: 04/20/2021] [Indexed: 12/18/2022]
Abstract
Pyroptosis is a pattern of programmed cell death that significantly differs from apoptosis and autophagy in terms of cell morphology and function. The process of pyroptosis is characterized predominantly by the formation of gasdermin protein family-mediated membrane perforation, cell collapse, and the release of inflammatory factors, including IL-1β and IL-18. In recent years, with the rise of pyroptosis research, scholars have devoted time to study the mechanism of pyroptosis in kidney-related diseases. Pyroptosis is probably involved in kidney diseases through two pathways: the caspase-1-mediated canonical pathway and the caspase-4/5/11-mediated noncanonical pathway. In addition, some scholars have identified targets for the treatment of kidney-related diseases from the viewpoint of pyroptosis and developed corresponding medicines, which may become a recommendation for prognosis, targeted treatment, and clinical diagnosis of kidney diseases. This paper focuses on the up-to-date advances in the field of pyroptosis, especially on the key pathogenic role of pyroptosis in the development and progression of kidney diseases. It presents a more in-depth understanding of the pathogenesis of kidney diseases and introduces novel therapeutic targets for the prevention and clinical treatment of kidney diseases.
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Affiliation(s)
- Ke-jia Zhang
- Department of Pathophysiology, Xuzhou Medical University, Xuzhou 221009, China
- Laboratory of Clinical and Experimental Pathology, Xuzhou Medical University, Xuzhou 221009, China
| | - Qi Wu
- Department of Physiology, Xuzhou Medical University, Xuzhou 221009, China
| | - Shi-min Jiang
- Department of Pathophysiology, Xuzhou Medical University, Xuzhou 221009, China
| | - Lei Ding
- Department of Pathophysiology, Xuzhou Medical University, Xuzhou 221009, China
| | - Chao-xia Liu
- Department of Pathophysiology, Xuzhou Medical University, Xuzhou 221009, China
| | - Ming Xu
- Department of Pathophysiology, Xuzhou Medical University, Xuzhou 221009, China
| | - Ying Wang
- Department of Pathophysiology, Xuzhou Medical University, Xuzhou 221009, China
| | - Yao Zhou
- Department of Pathophysiology, Xuzhou Medical University, Xuzhou 221009, China
- Laboratory of Clinical and Experimental Pathology, Xuzhou Medical University, Xuzhou 221009, China
| | - Li Li
- Department of Pathophysiology, Xuzhou Medical University, Xuzhou 221009, China
- Laboratory of Clinical and Experimental Pathology, Xuzhou Medical University, Xuzhou 221009, China
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Figueroa SM, Araos P, Reyes J, Gravez B, Barrera-Chimal J, Amador CA. Oxidized Albumin as a Mediator of Kidney Disease. Antioxidants (Basel) 2021; 10:antiox10030404. [PMID: 33800425 PMCID: PMC8000637 DOI: 10.3390/antiox10030404] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 02/28/2021] [Accepted: 03/04/2021] [Indexed: 12/19/2022] Open
Abstract
Renal diseases are a global health concern, and nearly 24% of kidney disease patients are overweight or obese. Particularly, increased body mass index has been correlated with oxidative stress and urinary albumin excretion in kidney disease patients, also contributing to increased cardiovascular risk. Albumin is the main plasma protein and is able to partially cross the glomerular filtration barrier, being reabsorbed mainly by the proximal tubule through different mechanisms. However, it has been demonstrated that albumin suffers different posttranslational modifications, including oxidation, which appears to be tightly linked to kidney damage progression and is increased in obese patients. Plasma-oxidized albumin levels correlate with a decrease in estimated glomerular filtration rate and an increase in blood urea nitrogen in patients with chronic kidney disease. Moreover, oxidized albumin in kidney disease patients is independently correlated with higher plasma levels of transforming growth factor beta (TGF-β1), tumor necrosis factor (TNF-α), and interleukin (IL)-1β and IL-6. In addition, oxidized albumin exerts a direct effect on neutrophils by augmenting the levels of neutrophil gelatinase-associated lipocalin, a well-accepted biomarker for renal damage in patients and in different experimental settings. Moreover, it has been suggested that albumin oxidation occurs at early stages of chronic kidney disease, accelerating the patient requirements for dialytic treatment during disease progression. In this review, we summarize the evidence supporting the role of overweight- and obesity-induced oxidative stress as a critical factor for the progression of renal disease and cardiovascular morbimortality through albumin oxidation.
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Affiliation(s)
- Stefanny M. Figueroa
- Laboratory of Renal Physiopathology, Institute of Biomedical Sciences, Universidad Autónoma de Chile, Santiago 8910060, Chile; (S.M.F.); (P.A.); (J.R.); (B.G.)
| | - Patricio Araos
- Laboratory of Renal Physiopathology, Institute of Biomedical Sciences, Universidad Autónoma de Chile, Santiago 8910060, Chile; (S.M.F.); (P.A.); (J.R.); (B.G.)
| | - Javier Reyes
- Laboratory of Renal Physiopathology, Institute of Biomedical Sciences, Universidad Autónoma de Chile, Santiago 8910060, Chile; (S.M.F.); (P.A.); (J.R.); (B.G.)
| | - Basile Gravez
- Laboratory of Renal Physiopathology, Institute of Biomedical Sciences, Universidad Autónoma de Chile, Santiago 8910060, Chile; (S.M.F.); (P.A.); (J.R.); (B.G.)
| | - Jonatan Barrera-Chimal
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico;
- Laboratorio de Fisiología Cardiovascular y Trasplante Renal, Unidad de Investigación UNAM-INC, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico
| | - Cristián A. Amador
- Laboratory of Renal Physiopathology, Institute of Biomedical Sciences, Universidad Autónoma de Chile, Santiago 8910060, Chile; (S.M.F.); (P.A.); (J.R.); (B.G.)
- Correspondence: ; Tel.: +56-22-303-6662
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Mc Laughlin L, Spence S, Noyes J. Identifying integrated health services and social care research priorities in kidney disease in Wales: research prioritisation exercise. BMJ Open 2020; 10:e036872. [PMID: 32873670 PMCID: PMC7467555 DOI: 10.1136/bmjopen-2020-036872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To identify the shared research priorities of patients, caregivers and multidisciplinary renal health and social care professionals across Wales for integrated renal health and social care in Wales. DESIGN Research priority setting exercise adapted from the James Lind Alliance national priority setting partnership framework in UK healthcare. SETTING Two workshops: one in North Wales with patients, caregivers and multidisciplinary renal health and social care professionals and one in South Wales with the Welsh Renal Clinical Network (commissioners of renal services in Wales). Additional input provided from stakeholders via email correspondence and face to face communications. PARTICIPANTS Academics n=14, patients n=16, family/carers n=6, multidisciplinary renal healthcare professionals n=40, local authority councils n=3, renal charities n=6 wider third sector organisations n=8, renal industries n=4, Welsh government social care n=3, renal service commissioners n=8. RESULTS 38 research priority questions grouped into 10 themes were agreed. The themes included: (1) integrating health and social care, (2) education, (3) acute kidney injury, (4) chronic kidney disease and cardiovascular disease, (5) transplantation, (6) dialysis, (7) personalised medicines, (8) cross-cutting priorities, (9) specific social contexts and (10) transitional services and children. Research questions were broad and covered a range of health and social care topics. Patient and professional perspectives broadly overlapped. Research priority setting activities revealed gaps in knowledge in overall service provision and potential areas for service improvement. CONCLUSIONS Mapping priorities in health services and social care highlighted the research needed to support renal health services delivery and commissioning in Wales.
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Affiliation(s)
| | - Susan Spence
- The Welsh Health Specialised Services Committee, Welsh Renal Clinical Network, Caerphilly, UK
| | - Jane Noyes
- School of Health Sciences, Bangor University, Bangor, UK
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Silva PAB, Silva LB, Santos JFG, Soares SM. Brazilian public policy for chronic kidney disease prevention: challenges and perspectives. Rev Saude Publica 2020; 54:86. [PMID: 32844982 PMCID: PMC7438031 DOI: 10.11606/s1518-8787.2020054001708] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 11/20/2019] [Indexed: 12/02/2022] Open
Abstract
Chronic kidney disease is a pathology with exponential increasing prevalence worldwide. This trend derives mainly from population aging and the growth of chronic conditions, making prevention a priority in public health. Thus, this observation instigates debates on the advances and challenges in public policies aimed at facing the progression of this disease and its risk factors in a contemporary reality that requires changes in the management models of chronic conditions. Brazilian and international experiences show that actions to prevent chronic kidney disease in risk groups remain incipient, especially in low-income countries. This area requires investment, supporting planning individualized, interdisciplinary and shared care with primary health care, as well as the user’s responsibility for their care, with proactivity and establishment and monitoring of goals to achieve satisfactory results.
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Affiliation(s)
| | - Líliam Barbosa Silva
- Pós-Graduação em Enfermagem, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | | | - Sônia Maria Soares
- Departamento de Enfermagem Básica, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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Hussien FM, Hassen HY. Dietary Habit and Other Risk Factors of Chronic Kidney Disease Among Patients Attending Dessie Referral Hospital, Northeast Ethiopia. Int J Nephrol Renovasc Dis 2020; 13:119-127. [PMID: 32547157 PMCID: PMC7245461 DOI: 10.2147/ijnrd.s248075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 04/24/2020] [Indexed: 12/14/2022] Open
Abstract
Background In low- and middle-income countries, the burden of chronic kidney disease (CKD) is rising due to poor access to early detection and management services. In Ethiopia, little is known about the context-specific risk factors and their magnitude, particularly the dietary habit of patients is not studied. Therefore, this study aimed to identify the dietary and other risk factors of CKD in Northeast Ethiopia. Methods We conducted a facility-based unmatched case–control study utilizing quantitative method of data collection. Data were collected on a total of 66 cases and 134 controls using structured questionnaire and anthropometric measurements. Dietary habit was assessed using the Diet History Questionnaire (DHQ). Medical history, patient chart review and physical examination were employed to collect other relevant information. To identify independent predictors of CKD, we conducted a multivariable logistic regression analysis. Results About 54.5% cases and 46.3% of controls were female, while 40.9% of cases and 38.8% of controls were within the age group of 36–55. All cases and 128 (95.5%) controls consumed meat in the last year. Forty-six (69.7%) cases and 74 (55.2%) controls use palm oil as the main cooking oil. History of hypertension (adjusted odds ratio (AOR)=2.39; 95%CI: 1.17–4.89), anemia (AOR=2.38; 95%CI: 1.04–5.42), palm oil use (AOR=2.10; 95%CI: 1.01–4.35) and family history of CKD (AOR=8.77; 95%CI: 3.73–20.63) were significantly associated with the risk of having CKD. Conclusion Meat consumption and use of palm oil are higher among patients with CKD than controls. History of hypertension, anemia, family history of CKD and palm oil consumption were found to be risk factors for CKD. Dietary counseling interventions and dietary modifications might help in CKD prevention. Furthermore, routine urinalysis and estimation of glomerular filtration rate (GFR) for all hospitalized patients with hypertension and anemia could help to detect CKD at an earlier stage for a better prognosis.
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Affiliation(s)
- Foziya Mohammed Hussien
- Department of Public Health Nutrition, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Hamid Yimam Hassen
- Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
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