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Review
. 2023 Apr 6:16:103-112.
doi: 10.2147/IJNRD.S363133. eCollection 2023.

Chronic Kidney Disease Management in the Middle East and Africa: Concerns, Challenges, and Novel Approaches

Saeed Al-Ghamdi  1 , Ali Abu-Alfa  2 , Turki Alotaibi  3 , Ali AlSaaidi  4 , Abdulkareem AlSuwaida  5 , Mustafa Arici  6 , Tevfik Ecder  7 , Ahmed F El Koraie  8 , Mohamed Ghnaimat  9 , Mohamed H Hafez  10 , Mohamed Hassan  11 , Tarik Sqalli  12
Affiliations
Review

Chronic Kidney Disease Management in the Middle East and Africa: Concerns, Challenges, and Novel Approaches

Saeed Al-Ghamdi et al. Int J Nephrol Renovasc Dis. .

Abstract

The burden of chronic kidney disease (CKD) and other comorbidities, such as hypertension and diabetes, which increase the risk of developing CKD, is on the rise in the Middle East and Africa. The Middle East and Africa CKD (MEA-CKD) steering committee, comprising eminent healthcare specialists from the Middle East and Africa, was formed to identify and propose steps to address the gaps in the management of CKD in these regions. The current article lists the MEA-CKD steering committee meeting outcomes and evaluates the available evidence supporting the role of novel therapeutic options for patients with CKD. The need of the hour is to address the gaps in awareness and screening, early diagnosis, along with referral and management of patients at risk. Measures to bring about appropriate changes in healthcare policies to ensure access to all benefit-proven protective therapies, including novel ones, at community levels are also vital for reducing the overall burden of CKD on the healthcare system as well as governing bodies, especially in developing countries of the Middle East and Africa.

Keywords: CKD concerns; CKD management; CKD management gaps; Middle East and Africa; chronic kidney disease; novel therapies.

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Conflict of interest statement

Saeed Al-Ghamdi reports personal fees from AstraZeneca, Bayer, Viforpharma, and Astellas, outside the submitted work. Ali Abu-Alfa reports personal fees from Astra-Zeneca, during the conduct of the study; personal fees from Boehringer Ingelheim, Sanofi-Aventis, Astellas, Baxter Healthcare, and Novartis, outside the submitted work; and received honoraria for presentations, educational materials, expert panels, advisory boards, or educational events from Astra Zeneca, Baxter, Boehringer Ingelheim, and Sanofi. Mustafa Arici reports personal fees from Astra Zeneca, during the conduct of the study; personal fees from Amgen, Astellas, Astra Zeneca, Bayer, Boehringer Ingelheim, Menarini, MSD, Novo Nordisk, Sandoz, and Sanofi, outside the submitted work; and has received payment or honoraria for lectures, presentations, speaker bureaus, manuscript writing, or educational events from Amgen, Astellas, AstraZeneca, Bayer, Baxter, Boehringer Ingelheim, Menarini, MSD, Novo Nordisk, Sandoz, and Sanofi. El Koraei Ahmed F and Hafez Mohamed H have received honoraria for participation in the expert panel meetings with AstraZeneca. The authors report no other potential conflicts of interest in relation to this work.

Figures

Figure 1
Figure 1
Primary, secondary, and tertiary prevention of CKD in LMICs. Data from Ameh et al.
Figure 2
Figure 2
Class effect of SGLT2 inhibitors (A) EMPA REG outcome; from N Engl J Med, Wanner C, Inzucchi SE, Lachin JM et al. Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes. 375: 323-334, Copyright © (2016) Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society. (B) CANVAS; From N Engl J, MedNeal B, Perkovic V, Mahaffey KW, et al. Canagliflozin and Cardiovascular and Renal Event in Type 2 Diabetes. 377: 644-657, Copyright © (2017) Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society.; (C) DECLARE-TIMI 58 outcome; from Mosenzon (D) CREDENCE; From N Engl J Med.Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. 380:2295–2306, Copyright ©(2019) Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society.
Figure 3
Figure 3
KDIGO 2020 clinical practice guidelines for diabetes management in CKD.
See this image and copyright information in PMC

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