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Global Prevalence of Chronic Kidney Disease - A Systematic Review and Meta-Analysis.

Abstract

Chronic kidney disease (CKD) is a global health burden with a high economic cost to health systems and is an independent risk factor for cardiovascular disease (CVD). All stages of CKD are associated with increased risks of cardiovascular morbidity, premature mortality, and/or decreased quality of life. CKD is usually asymptomatic until later stages and accurate prevalence data are lacking. Thus we sought to determine the prevalence of CKD globally, by stage, geographical location, gender and age. A systematic review and meta-analysis of observational studies estimating CKD prevalence in general populations was conducted through literature searches in 8 databases. We assessed pooled data using a random effects model. Of 5,842 potential articles, 100 studies of diverse quality were included, comprising 6,908,440 patients. Global mean(95%CI) CKD prevalence of 5 stages 13·4%(11·7-15·1%), and stages 3-5 was 10·6%(9·2-12·2%). Weighting by study quality did not affect prevalence estimates. CKD prevalence by stage was Stage-1 (eGFR>90+ACR>30): 3·5% (2·8-4·2%); Stage-2 (eGFR 60-89+ACR>30): 3·9% (2·7-5·3%); Stage-3 (eGFR 30-59): 7·6% (6·4-8·9%); Stage-4 = (eGFR 29-15): 0·4% (0·3-0·5%); and Stage-5 (eGFR<15): 0·1% (0·1-0·1%). CKD has a high global prevalence with a consistent estimated global CKD prevalence of between 11 to 13% with the majority stage 3. Future research should evaluate intervention strategies deliverable at scale to delay the progression of CKD and improve CVD outcomes.

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  • Authors+Show Affiliations

    ,

    Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.

    ,

    Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.

    ,

    Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.

    ,

    Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.

    ,

    Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom.

    ,

    Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.

    Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.

    Source

    PloS one 11:7 2016 pg e0158765

    MeSH

    Disease Progression
    Female
    Global Health
    Humans
    Male
    Observational Studies as Topic
    Prevalence
    Quality of Life
    Renal Insufficiency, Chronic
    Risk Factors

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Review

    Language

    eng

    PubMed ID

    27383068

    Citation

    TY - JOUR T1 - Global Prevalence of Chronic Kidney Disease - A Systematic Review and Meta-Analysis. AU - Hill,Nathan R, AU - Fatoba,Samuel T, AU - Oke,Jason L, AU - Hirst,Jennifer A, AU - O'Callaghan,Christopher A, AU - Lasserson,Daniel S, AU - Hobbs,F D Richard, Y1 - 2016/07/06/ PY - 2015/11/19/received PY - 2016/06/21/accepted PY - 2016/7/8/entrez PY - 2016/7/8/pubmed PY - 2016/7/8/medline SP - e0158765 EP - e0158765 JF - PloS one JO - PLoS ONE VL - 11 IS - 7 N2 - Chronic kidney disease (CKD) is a global health burden with a high economic cost to health systems and is an independent risk factor for cardiovascular disease (CVD). All stages of CKD are associated with increased risks of cardiovascular morbidity, premature mortality, and/or decreased quality of life. CKD is usually asymptomatic until later stages and accurate prevalence data are lacking. Thus we sought to determine the prevalence of CKD globally, by stage, geographical location, gender and age. A systematic review and meta-analysis of observational studies estimating CKD prevalence in general populations was conducted through literature searches in 8 databases. We assessed pooled data using a random effects model. Of 5,842 potential articles, 100 studies of diverse quality were included, comprising 6,908,440 patients. Global mean(95%CI) CKD prevalence of 5 stages 13·4%(11·7-15·1%), and stages 3-5 was 10·6%(9·2-12·2%). Weighting by study quality did not affect prevalence estimates. CKD prevalence by stage was Stage-1 (eGFR>90+ACR>30): 3·5% (2·8-4·2%); Stage-2 (eGFR 60-89+ACR>30): 3·9% (2·7-5·3%); Stage-3 (eGFR 30-59): 7·6% (6·4-8·9%); Stage-4 = (eGFR 29-15): 0·4% (0·3-0·5%); and Stage-5 (eGFR<15): 0·1% (0·1-0·1%). CKD has a high global prevalence with a consistent estimated global CKD prevalence of between 11 to 13% with the majority stage 3. Future research should evaluate intervention strategies deliverable at scale to delay the progression of CKD and improve CVD outcomes. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/27383068/full_citation L2 - http://dx.plos.org/10.1371/journal.pone.0158765 ER -