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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Chronic kidney disease in hypertensive patients: the urgent need for targeted interventions in Arab countries: a
Fakhria Al Rashdi1, Celine Tabche2, Zeenah Atwan3
1Ministry of Health, Muscat, Oman.
Insights
Chronic kidney disease (CKD) is a growing concern in Arab countries, significantly linked to hypertension. Many cases go undiagnosed, highlighting the urgent need for targeted screening and management programs.
Area of Science:
- Nephrology
- Public Health
- Epidemiology
Background:
- Chronic kidney disease (CKD) is a significant global health issue, projected to be the 5th leading cause of years of life lost by 2040.
- CKD prevalence is notably high in Arab countries, posing a substantial burden of mortality and morbidity.
Purpose of the Study:
- To assess the prevalence of CKD among hypertensive individuals in Arab countries.
- To evaluate existing literature on CKD prevalence, associated risk factors, screening programs, and prevention strategies within this population.
Main Methods:
- A systematic review of literature published up to April 2024, adhering to PRISMA guidelines.
- Searches conducted across major databases (Medline, Embase, Scopus, PubMed, Cochrane Library), with screening performed by three independent reviewers using Covidence.
- Study search strategy registered in PROSPERO (CRD42024486068).
Main Results:
- Eleven studies were selected from 63 screened, revealing higher CKD prevalence in elderly, hypertensive, and diabetic patients.
- A significant proportion (38.8%) of CKD cases were unrecognized, with nearly 39% of participants in one study having undiagnosed stages 3-5 CKD.
- Hypertension was a common comorbidity (55.8%-75%) and a key risk factor, alongside old age, dyslipidemia, family history, and obesity. Physician-reported screening rates were suboptimal.
Conclusions:
- Hypertension is a major risk factor for CKD in Arab countries, where the disease is escalating.
- A substantial number of CKD patients remain undiagnosed, necessitating region-specific screening and hypertension control programs.
- Findings underscore the need for policymakers to enhance primary care for systematic screening of hypertension and CKD.
Background:
Chronic kidney disease (CKD) is expected to be the 5th leading cause of years of life lost by 2040. Recently, it emerged as a significant cause of mortality and morbidity, with a high prevalence in Arab countries.
Objective:
Assess CKD among hypertensive (HTN) people in Arab Countries through evaluation of the existing literature on CKD prevalence, risk factors, screening programmes and prevention.
Study Design:
A systematic review till April 2024 following PRISMA guidelines. The search strategy was registered in PROSPERO under the identification code CRD42024486068.
Methods:
Databases searched were Medline, Embase, Scopus, PubMed, Cochrane Library. Screening was done using Covidence by three independent reviewers.
Results:
Out of 63 studies screened, 11 were selected for extraction. The prevalence of CKD was higher among elderly, HTN and diabetic patients, with 38.8% having unrecognised CKD. Nearly 39% of the 400 participants in one study had undiagnosed stages 3-5 CKD. Two studies showed that 55.8% and 75% of identified CKD patients had HTN. Physicians reported suboptimal screening rates, with about 77% relying on the estimated glomerular filtration rate as a diagnostic tool. Risk factors for CKD include old age, HTN, dyslipidaemia, family history of CKD, and obesity. Among physicians, 85% recommended a target blood pressure of ≤130/80, 80% advised smoking cessation, 66% prescribed anti-lipids, and 67% recommended weight loss. All studies support the fact that HTN is a risk factor for CKD.
Conclusion:
CKD is an escalating problem in Arab countries, with hypertension as a major risk factor. Many patients remain undiagnosed. A region-specific CKD screening and HTN control programme is urgently needed. The findings are essential for policymakers in strengthening primary care for systematic screening of HTN and CKD.
Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/, identifier CRD42024486068.
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