16.
Chronic Kidney Disease
Wasting Away Populations
As seen in previous chapters, contemporary societies are in the midst of an epidemic of chronic non-communicable diseases and that includes chronic kidney disease (CKD).
Chronic kidney disease is a world wide health problem. According to World Health organization (WHO) Global Burden of Disease project, diseases of the kidney and urinary tract contribute to global burden with approximately 850,000 deaths every year. This is 12th leading cause of death and 17th cause of disability.
This global prevalence, however, may be grossly underestimated for a number of reasons. Patients with chronic kidney disease are at high risk for cardiovascular disease and cerebro vascular disease, and they are more likely to die of cardiovascular disease than to develop end-stage renal failure.
Chronic kidney disease is another important disease related to diabetes mellitus and hypertension. As more and more individuals become diabetic, the prevalence of chronic kidney disease due to diabetic nephropathy also increases. Uncontrolled hypertension also contributes to the burden of chronic kidney disease.
Three simple tests can detect CKD: blood pressure, urine albumin and serum creatinine. The world observes World Kidney Day on March 10.
Chronic kidney disease is a world wide health problem. According to World Health organization (WHO) Global Burden of Disease project, diseases of the kidney and urinary tract contribute to global burden with approximately 850,000 deaths every year. This is 12th leading cause of death and 17th cause of disability.
This global prevalence, however, may be grossly underestimated for a number of reasons. Patients with chronic kidney disease are at high risk for cardiovascular disease and cerebro vascular disease, and they are more likely to die of cardiovascular disease than to develop end-stage renal failure.
Chronic kidney disease is another important disease related to diabetes mellitus and hypertension. As more and more individuals become diabetic, the prevalence of chronic kidney disease due to diabetic nephropathy also increases. Uncontrolled hypertension also contributes to the burden of chronic kidney disease.
Three simple tests can detect CKD: blood pressure, urine albumin and serum creatinine. The world observes World Kidney Day on March 10.
USA - An Update
The number of individuals initiating renal replacement therapy in the United States population has grown exponentially over the past two decades. Cases of end-stage renal disease (ESRD)
attributed to diabetes accounted for most of this increase. It has now been officially recognized as an epidemic.
According to Centre For Disease Control and Prevention (CDC) 2010 figures, currently 26 million American adults (more than 10 percent of the population) have chronic kidney disease and millions of others are at increased risk. Surveys in Australia, Europe, and Japan describe the prevalence of CKD to be 6–16% of their respective populations. (El Nahas AM, Bello AK, 2005, Chronic kidney disease: the global challenge)
attributed to diabetes accounted for most of this increase. It has now been officially recognized as an epidemic.
According to Centre For Disease Control and Prevention (CDC) 2010 figures, currently 26 million American adults (more than 10 percent of the population) have chronic kidney disease and millions of others are at increased risk. Surveys in Australia, Europe, and Japan describe the prevalence of CKD to be 6–16% of their respective populations. (El Nahas AM, Bello AK, 2005, Chronic kidney disease: the global challenge)
Mystery Kidney Disease in Central America
A mysterious epidemic is sweeping Central America – it’s the second biggest cause of death among men in El Salvador, and in Nicaragua it’s a bigger killer of men than HIV and diabetes combined.
But the epidemic extends far beyond Nicaragua. It’s prevalent along the Pacific coast of Central America – across six countries.
“It is important that the chronic kidney disease (CKD) afflicting thousands of rural workers in Central America be recognized as what it is – a major epidemic with a tremendous population impact,” says Victor Penchaszadeh, a clinical epidemiologist at Columbia University in the US. He is also a consultant to the Pan-American Health Organization on chronic diseases in Latin America.
El Salvador’s health minister recently called on the international community for help. She said the epidemic is “wasting away our populations.”
But the epidemic extends far beyond Nicaragua. It’s prevalent along the Pacific coast of Central America – across six countries.
“It is important that the chronic kidney disease (CKD) afflicting thousands of rural workers in Central America be recognized as what it is – a major epidemic with a tremendous population impact,” says Victor Penchaszadeh, a clinical epidemiologist at Columbia University in the US. He is also a consultant to the Pan-American Health Organization on chronic diseases in Latin America.
El Salvador’s health minister recently called on the international community for help. She said the epidemic is “wasting away our populations.”
India - Grim Situation
India’s diabetes epidemic has triggered surging demand for dialysis as the disease destroys kidneys, leaving them with only months to live without treatment.
According to Fresenius Medical Care AG, the world’s biggest provider of kidney dialysis, sales of blood-filtering products in India have grown more than 30 percent annually since 2006. Apollo Hospitals Enterprise Ltd. and Fortis Healthcare India Ltd., the country’s biggest private-hospital operators, are opening dialysis centers nationwide as the number of Indians with diabetes is predicted to reach 101 million by 2030.
The Indian market for kidney-care products and services grew to $152 million in 2008 from $97 million in 2007. New machines are coming up in every nook and corner of the country. Every major health-care provider wants a share of this market.
The number of people lining up at hospitals to get dialysis, a procedure in which waste is removed from the blood, is increasing almost 30 percent each year. The global dialysis market was valued at $69 billion in 2010.
More than 90 percent of the people who develop chronic kidney failure each year in India die within months because of a lack of treatment, doctors from the All India Institute of Medical Sciences and the health ministry in New Delhi said in a 2009 study. Only a very small percentage of patients can afford the treatment.
The Indian market for kidney-care products and services grew to $152 million in 2008 from $97 million in 2007. New machines are coming up in every nook and corner of the country. Every major health-care provider wants a share of this market.
The number of people lining up at hospitals to get dialysis, a procedure in which waste is removed from the blood, is increasing almost 30 percent each year. The global dialysis market was valued at $69 billion in 2010.
More than 90 percent of the people who develop chronic kidney failure each year in India die within months because of a lack of treatment, doctors from the All India Institute of Medical Sciences and the health ministry in New Delhi said in a 2009 study. Only a very small percentage of patients can afford the treatment.
Death Sentence
A year of dialysis and medication for a patient with chronic kidney disease in India can range from 60,000 rupees at a subsidized provider to more than 700,000 rupees for the home-based treatment.
While that’s less than the cost of more than $30,000 in the U.S., the price is still a barrier for most patients in India, where a majority of people live on less than $2 a day.
Kidney transplants aren’t an option for most people, either. Only 3,500 kidneys are transplanted each year. Now there is alarming rise in chronic kidney diseases among children. Slowly progressive, chronic kidney disease often goes unnoticed in children until the kidneys have been severely affected.
While that’s less than the cost of more than $30,000 in the U.S., the price is still a barrier for most patients in India, where a majority of people live on less than $2 a day.
Kidney transplants aren’t an option for most people, either. Only 3,500 kidneys are transplanted each year. Now there is alarming rise in chronic kidney diseases among children. Slowly progressive, chronic kidney disease often goes unnoticed in children until the kidneys have been severely affected.