Community-Based Screening for Chronic Kidney Disease, Hypertension  and Diabetes in Dharan

Sharma, Sanjib Kumar; Dhakal, Sushil; Thapa, Lekhjung; Ghimire, Anup; Tamrakar, Rikesh; Chaudhary, Satdal; Deo, Rajib; Manandhar, D. N.; Perico, Norberto; Perna, Annalisa; Remuzzi, Giuseppe; Lamsal, M

doi:10.31729/jnma.548

Cited by 52 publications

(59 citation statements)

References 34 publications

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“…In a community screen of semiurban and rural people, the prevalence of CKD was 11.4%, 32 whereas the age-and genderadjusted prevalence rate of hypertension was 26.1%. In a community-based CKD screening program in Dharan, Nepal, the prevalence rate of hypertension was 38.7% 33 in the study population with a mean age of 42.9AE14.9 years; in approximately 1 in 2 individuals, hypertension was newly diagnosed, and only 51% of patients with known hypertension were receiving treatment. Data by Ulasi et al 34 show even more staggering figures from a community CKD screening in an urban area of Nigeria in which 7 of 10 individuals who received a diagnosis of hypertension were previously unaware of their condition.…”

Section: Reviewmentioning

confidence: 91%

Preventing CKD in Low- and Middle-Income Countries: A Call for Urgent Action

Ameh¹,

Ekrikpo

Kengne

2020

Kidney International Reports

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The epidemiologic transition occurring in low-and middle-income countries (LMICs) has led to a surge in chronic kidney disease (CKD) prevalence because of a combination of highly prevalent chronic noncommunicable diseases (NCDs) and communicable diseases (CDs). The progressive rise in CKD prevalence in LMICs threatens the existing weak health systems in these countries as care for advanced CKD remains largely unavailable and unaffordable. An interplay of low literacy levels, poor health-seeking behavior, inadequate health care funding, weak health systems, and lack of skilled nephrology workforce has made it difficult for adequate CKD preventive measures to be implemented. Primary, secondary, and tertiary prevention measures need to be instituted in LMICs by a collaboration of governmental and nongovernmental organizations to stem this tide and help prevent deaths from other NCDs that share similar risk factors with CKD. For these to be effective, locally relevant knowledge is needed to contextualize existing prevention and control solutions, or to develop novel and more appropriate solutions for LMICs.Kidney Int Rep (2020) 5, 255-262; https://doi.

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Section: Reviewmentioning

confidence: 91%

Preventing CKD in Low- and Middle-Income Countries: A Call for Urgent Action

Ameh¹,

Ekrikpo

Kengne

2020

Kidney International Reports

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“…1 Global prevalence of CKD in the general population is 13.4%, 2 while it is reported as 10.6% in Nepal. 3 The rationale of dialysis is removing toxic nitrogenous waste products and excess fluid from the body and correcting acid-base disorders. Apart from urea, creatinine, albumin, total protein, sodium, potassium; abnormal levels of hemoglobin (Hb), calcium (Ca) and phosphorus (P) in blood have been identified as pre dictors of survival in patients undergoing main tenance hemodialysis.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Cardiovascular Risk Factors among Chronic Kidney Disease Patients Undergoing Hemodialysis in a Tertiary Care Center, Kathmandu, Nepal

Pokhrel

Gyawali²,

Pokhrel

et al. 2019

Nep. Med. Coll. J.

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The risk of cardiovascular disease is higher in chronic kidney disease patients compared to the general population and its impact is higher in developing countries compared to the developed countries. With this background in mind, we aimed to evaluate the prevalence of different cardiovascular risk factors in patients on maintenance hemodialysis in a tertiary care center. Chronic kidney disease patients aged 18 years and above who were under maintenance hemodialysis in the hemodialysis unit of Nepal Medical College were included in the study. Pre-dialysis venous blood samples from the participants were collected and analyzed for serum calcium, phosphorus, total protein, albumin and hemoglobin. Calcium phosphate product was calculated. Out of 100 study participants, 52% were male and 48% were female. Age-wise distribution showed 38% of the participants were below 40 years. The mean age of the participants was 45.86 ± 14.4 years. Ninety-three percent had hypertension and 29% had diabetes mellitus. Hypocalcemia was present in 80%, hyperphosphatemia was seen among 81% and high calcium phosphate product was present in 33% of the participants. Low hemoglobin (< 10gm/dL) was found in 86%. The cardiovascular risk trend in the Nepalese chronic kidney disease population is fairly different compared to the western population. Participants were younger. Prevalence of hypertension and diabetes was high. The high prevalence of anemia might be due to unaffordability of the participants for regular erythropoietin therapy. Inadequately managed hyperphosphatemia despite the widespread use of phosphorus binders, is still a major clinical challenge in patients on hemodialysis.

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“…There are other ongoing and new outreach programs that focus on preventative education as well as early diagnosis of kidney disease. A community‐based screening program for CKD has been run in a more remote city, Dharan . Using affordable and cheap diagnostics such as blood pressure, blood glucose, and urine analysis, physicians are able to diagnose patients during the early stages of CKD.…”

Section: Discussionmentioning

confidence: 99%

“…A community-based screening program for CKD has been run in a more remote city, Dharan. 15 Using affordable and cheap diagnostics such as blood pressure, blood glucose, and urine analysis, physicians are able to diagnose patients during the early stages of CKD. Inexpensive treatment options such as exercise and diet are prescribed in the hope to prevent further progression of the disease.…”

Section: Discussionmentioning

confidence: 99%

Free dialysis in Nepal: Logistical challenges explored

McGee

Pandey

Maskey

et al. 2018

Hemodialysis International

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Nepal's Ministry of Health began offering free lifetime hemodialysis (HD) in 2016. There has been a large growth in renal replacement therapy (RRT) services offered in Nepal since 2010, when the last known data on the subject was published. In 2016, 42 HD centers existed (223% increase since 2010) serving 1975 end stage renal disease patients (303% increase since 2010); 36 nephrologists were registered (200% increase since 2010), 12 were trained in transplantation, and 790 transplants had been performed to date. We estimate the incidence of end stage renal disease to be 2900 patients (100 per million population). With an annual cost of approximately US$2300 per dialysis patient, offering free dialysis could potentially cost the government US$6.7 million per year, suggesting that 2.1% of the annual health budget would be allocated to 0.01% of the population. The geographic zone surrounding the capital city, Kathmandu, contains 50% of HD centers, but only 14.5% of Nepal's population. Forty-eight percent of the population lives within zones without HD service, therefore infrastructure challenges exist in providing equitable access to RRT. The aim of this article is to summarize the current statistics of RRT in Nepal.

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Community-Based Screening for Chronic Kidney Disease, Hypertension and Diabetes in Dharan

Cited by 52 publications

References 34 publications

Preventing CKD in Low- and Middle-Income Countries: A Call for Urgent Action

Preventing CKD in Low- and Middle-Income Countries: A Call for Urgent Action

Prevalence of Cardiovascular Risk Factors among Chronic Kidney Disease Patients Undergoing Hemodialysis in a Tertiary Care Center, Kathmandu, Nepal

Free dialysis in Nepal: Logistical challenges explored

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