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CKD hotspots around the world: where, why and what the lessons are. A CKJ review series
Catalina Martín-Cleary1, Alberto Ortiz1
1IIS-Fundacion Jimenez Diaz, School of Medicine , Universidad Autonoma de Madrid, Fundacion Renal Iñigo Alvarez de Toledo-IRSIN and REDINREN , Madrid , Spain.
Insights
Chronic kidney disease (CKD) is a growing global health concern. Studying CKD hotspots, populations with high incidence, offers crucial insights into disease causes and improving patient outcomes.
Area of Science:
- Nephrology
- Epidemiology
- Public Health
Background:
- Chronic kidney disease (CKD) represents a significant and increasing cause of mortality worldwide.
- Inadequate healthcare access and incomplete understanding of CKD pathogenesis exacerbate the global burden.
- CKD distribution is uneven, with specific populations exhibiting higher incidence rates, termed CKD hotspots.
Purpose of the Study:
- To analyze CKD hotspots for novel insights into kidney disease pathogenesis.
- To identify factors contributing to increased CKD incidence in specific populations.
- To improve life expectancy and health outcomes for communities affected by CKD.
Main Methods:
- Identification and definition of CKD hotspots based on incidence rates.
- Review of epidemiological data from diverse geographical regions and ethnic groups.
- Analysis of genetic, environmental, and socioeconomic factors implicated in CKD.
Main Results:
- CKD hotspots identified in various ethnicities (e.g., African Americans, Australian Aboriginals), regions (e.g., Balkan valleys, Central America), and specific groups.
- Key contributing factors include genetic variants (e.g., ApoL1), environmental toxins (e.g., aristolochic acid), and socioeconomic determinants (nutritional deprivation, inflammation/infection).
Conclusions:
- The study of CKD hotspots is vital for understanding disease mechanisms.
- Targeted interventions in identified hotspots can significantly improve patient outcomes and longevity.
- A collaborative global effort is needed to map, study, and address CKD hotspots.
Abstract:
Chronic kidney disease (CKD) is one of the three causes of death that has had the highest increase in the last 20 years. The increasing CKD burden occurs in the context of lack of access of most of the world population to adequate healthcare and an incomplete understanding of the pathogenesis of CKD. However, CKD is not homogeneously distributed. CKD hotspots are defined as countries, region, communities or ethnicities with higher than average incidence of CKD. Analysis of CKD hotspots has the potential to provide valuable insights into the pathogenesis of kidney disease and to improve the life expectancy of the affected communities. Examples include ethnicities such as African Americans in the USA or Aboriginals in Australia, regions such as certain Balkan valleys or Central America and even groups of people sharing common activities or interests such as young women trying to lose weight in Belgium. The study of these CKD hotspots has identified underlying genetic factors, such as ApoL1 gene variants, environmental toxins, such as aristolochic acid and socioeconomic factors leading to nutritional deprivation and inflammation/infection. The CKD hotspots series of CKJ reviews will explore the epidemiology and causes in CKD hotspots, beginning with Australian Aboriginals in this issue. An online map of CKD hotspots around the world will feature the reviewed hotspots, highlighting known or suspected causes as well as ongoing projects to unravel the cause and providing a directory of public health officials, physicians and basic scientists involved in these efforts. Since the high prevalence of CKD in a particular region or population may only be known to local physicians, we encourage readers to propose further CKD hotspots to be reviewed.
