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Chronic kidney disease and acute kidney injury – evaluation of EU and global epidemiology

The incidence of chronic kidney disease (CKD) is projected to increase with the rise in aging population as well as diabetes prevalence. Evaluating disease epidemiology at the regional and global level is therefore of paramount importance.

CKD refers to a set of chronic renal conditions that can lead to end-stage kidney disease, requiring dialysis or transplantation. Acute kidney injury (AKI) is characterised by the rapid loss of kidney function, mainly in hospitalised or critically ill patients. However, kidney disease characterisation and their epidemiology are insufficiently evaluated.

An epidemiological approach to kidney diseases

With the support of the Marie Curie programme, the CKD AKI project aimed to develop tools for the bibliographic collection of published data on CKD and AKI epidemiology. “Our goal was to model kidney disease morbidity and mortality a the regional and international level,″ explains the key investigator Dr Boris Bikbov.

In collaboration with the Institute for Health Metrics and Evaluation in the United States, one of the leading institutes in the field of global epidemiology, project partners produced epidemiological estimates for kidney diseases and unprecedented knowledge on their impact. Project analysis indicated the global CKD prevalence to be as high as 700 million with 1.23 million deaths directly related to CKD in 2017.

Generated models estimated that kidney impairment caused 1.36 million deaths due to myocardial infarction, stroke and peripheral arterial disease. Intriguingly, this translates into 7.6 % of all cardiovascular deaths being attributed to kidney dysfunction. The co-investigator Dr Norberto Perico highlights “the necessity of preventing and treating kidney disease to combat cardiovascular morbidity and mortality,″ currently under-recognised by health authorities.

Methodological approach

Systematic reviews summarise findings from a wide range of data sources and serve as the driving force for decision making.
The CKD AKI methodology advances the field of systematic literature reviews on epidemiology through a workflow of search strategies. It also introduces new metrics to estimate the effectiveness of a given search strategy. Alongside other bibliometric indicators, these metrics could be reported universally in all systematic reviews to help select the best search strategy for future use. Importantly, the approach is applicable to other fields of medicine to retrieve primary data and contribute to public health decision making.

Towards kidney health

With respect to kidney diseases, the CKD AKI project estimates enable healthcare planning as well as efficient resource allocation based on disease burden. Disseminating the results of the project to health stakeholders and the general public will also promote kidney health. “We will continue a broad international collaboration to collect, and evaluate data on kidney diseases, and to further improve the modelling methodology,″ states Prof. Giuseppe Remuzzi, Director of Mario Negri Institute for Pharmacological Research.

CKD and AKI are widespread worldwide, posing a substantial socioeconomic burden due to the high cost of treatment and risk for cardiovascular diseases. Therefore, there is a need to clarify the local causes of CKD prevalence as well as the gender disparities in disease burden amongst different populations and for different CKD stages. “Only the joint efforts between the scientific community and health authorities can improve the provision of renal care globally,″ concludes Dr Bikbov.

Reference source: Chronic kidney disease and acute kidney injury – evaluation of EU and global epidemiology

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