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Meta-Analysis
. 2024 Sep;14(3):740-764.
doi: 10.1007/s44197-024-00209-5. Epub 2024 Apr 8.

The Etiology of Advanced Chronic Kidney Disease in Southeast Asia: A Meta-analysis

Ni Made Hustrini  1   2 , Endang Susalit  1 , Felix Firyanto Widjaja  3 , Anandhara Indriani Khumaedi  1 , Olaf M Dekkers  2   4 , Merel van Diepen  4 , Joris I Rotmans  5
Affiliations
Meta-Analysis

The Etiology of Advanced Chronic Kidney Disease in Southeast Asia: A Meta-analysis

Ni Made Hustrini et al. J Epidemiol Glob Health. 2024 Sep.

Abstract

Introduction: Chronic kidney disease (CKD) etiology varies greatly between developed and developing countries. In addition, differences in underlying pathogenesis and therapeutic options affect the progression towards advanced-CKD. This meta-analysis aims to identify the etiology of advanced-CKD in Southeast Asia.

Methods: A systematic search in four electronic-databases and complementary search on national kidney registries and repository libraries was conducted until July 20, 2023. The risk of bias was assessed using Newcastle-Ottawa Scale for observational studies and Version-2 of Cochrane for intervention studies. A random-effects model was used to estimate pooled prevalence. The protocol is registered in the International Prospective Register of Systematic Reviews PROSPERO; Registration ID:CRD42022300786.

Results: We analyzed 81 studies involving 32,834 subjects. The pooled prevalence of advanced-CKD etiologies are diabetic kidney disease (DKD) 29.2% (95%CI 23.88-34.78), glomerulonephritis 20.0% (95%CI 16.84-23.38), hypertension 16.8% (95%CI 14.05-19.70), other 8.6% (95%CI 6.97-10.47), unknown 7.5% (95%CI 4.32-11.50), and polycystic kidney disease 0.7% (95%CI 0.40-1.16). We found a significant increase in DKD prevalence from 21% (9.2%, 95%CI 0.00-33.01) to 30% (95%CI 24.59-35.97) before and after the year 2000. Among upper-middle-income and high-income countries, DKD is the most prevalent (26.8%, 95%CI 21.42-32.60 and 38.9%, 95%CI 29.33-48.79, respectively), while glomerulonephritis is common in lower-middle-income countries (33.8%, 95%CI 15.62-54.81).

Conclusion: The leading cause of advanced-CKD in Southeast Asia is DKD, with a substantial proportion of glomerulonephritis. An efficient screening program targeting high-risk populations (diabetes mellitus and glomerulonephritis) is needed, with the aim to delay CKD progression.

Keywords: Advanced-CKD; Chronic kidney disease; Dialysis; Kidney transplantation; Primary kidney disease; Southeast Asia.

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Conflict of interest statement

Authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Selection process for the included studies
See this image and copyright information in PMC

References

    1. Vos T, Lim SS, Abbafati C, et al. GBD 2019 Diseases and Injuries Collaborators*. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396:1204–22. 10.1016/S0140-6736(20)30925-9. - PMC - PubMed
    1. Bikbov B, Purcell CA, Levey AS, et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study. Lancet. 2017;395:709–33. 10.1016/S0140-6736(20)30045-3. - PMC - PubMed
    1. Hill NR, Fatoba ST, Oke JL, et al. Global prevalence of chronic kidney disease: a systematic review and meta-analysis. PLoS ONE. 2016;11(7):e0158765. 10.1371/journal.pone.0158765. - PMC - PubMed
    1. Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl. 2022;12:7–11. 10.1016/j.kisu.2021.11.003. - PMC - PubMed
    1. Jager KJ, Kovesdy C, Langham R, et al. A single number for advocacy and communication—worldwide more than 850 million individuals have kidney diseases. Kidney Int. 2019;96:1048–50. 10.1016/j.kint.2019.07.012. - PubMed

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