Chronic kidney disease and kidney health care status: the healthy life in Suriname (HeliSur) study

Abstract

The high cardiovascular risk burden in low- and middle-income countries is expected to lead to an explosive increase in chronic kidney disease (CKD). However, population data on CKD from these countries are scarce. Therefore, we assessed kidney health in Suriname. In the Healthy Life in Suriname (HeliSur) study, a random sample of the adult population, we collected data with standardized questionnaires, physical examination, and blood and urine samples analysed in a central laboratory. Prevalent CKD was graded with KDIGO guidelines. In addition, we assessed national data on prevalent renal replacement therapy (RRT), estimated the future need for RRT, and evaluated national kidney health work force and policies. We include 1117 participants (2.0‰ of the population), 63% women, 40% of African ancestry and 43% of Asian ancestry, with a mean age of 42.2 (SE 0.4) years. Blood pressure is elevated in 72% of the participants, 26% have diabetes or prediabetes, and 78% are obese or overweight. The prevalence of CKD is 5.4%, and around 0.3% have kidney failure, translating to approximately 1500 patients nationally (2690 per million population, pmp), with currently 516 patients (920 pmp) on dialysis. Based on the participants from the random population sample in CKD stage G3 or G4, we estimate that 6750–10,750 pmp may develop kidney failure within the next 10 years. However, specialized kidney health workforce is currently very limited, and specific national or local policies for CKD management are lacking. Since the large majority of the general population has one or more risk factors for CKD including elevated blood pressure, urgent action is needed to strengthen kidney health care and prevent a catastrophic rise in need for RRT in the coming years.

Chronic kidney disease in low-middle income populations: a call to action for screening and prevention

“…Overall, the results of the study by Nannan Panday et al [25] underscore the growing role of CKD in low-middle income countries morbidity and mortality. These results emphasize the importance of devoting more attention to CKD screening [31] and prevention, mainly focusing on diabetes and hypertension treatment to avoid the tremendous social and economic burden related to this disease.…”

“…In the study published in this issue of I&EM journal, Nannan Panday et al [25] report the results of the HELISUR (the Healthy Life in Suriname) project aimed to assess cardiovascular risk factors as well as asymptomatic and symptomatic target organ damage including CKD in a random population sample of 1800 men and women aged 18-70 years. After a detailed interview at home, including the collection demographic, socio-economic, dietary, and health-related questions, the participants were invited to undergo a medical visit and laboratory examinations.…”

Historical data on cardiovascular health in Surinamese men

“…These data from 1973 might aid in the understanding of the high cardiovascular risk burden recently reported in the randomly selected urban citizens participating in the Healthy Life in Suriname (HeliSur) study [1, 2]. In this study in the population of Paramaribo (N = 250.000 citizens, with a national population of 560.000), a random sample (n = 1800) of citizens aged 18–70 years was drawn in 2013 (n = 1157 included, mean age 42 years; 37% men; 40% of African ancestry and 43% of South Asian ancestry) [1, 2].…”

“…In this study in the population of Paramaribo (N = 250.000 citizens, with a national population of 560.000), a random sample (n = 1800) of citizens aged 18–70 years was drawn in 2013 (n = 1157 included, mean age 42 years; 37% men; 40% of African ancestry and 43% of South Asian ancestry) [1, 2]. …”

“…Diabetes was found in 15% of the participants (13% in men), thus the risk factor burden in this urban, middle income country population was high. However, we had no previous data to assess time trends in risk factor prevalence [1, 2]. …”