Metabolic disorder associated kidney disease and diabetic kidney disease in developing countries

Abstract

There is a paucity of literature addressing the epidemiology of Metabolic Disorder Associated Kidney Disease (MAKD) in developing countries but extrapolating from the high prevalence of metabolic syndrome (MetS) in low- and middle-income countries, and the known high prevalence of diabetic kidney disease (DKD) in the same, the health and economic impact of MAKD and DKD is substantial. Resource constraints in developing countries amplify the challenges in preventing, detecting and treating MAKD and DKD. There is diminished capacity for kidney care and hence poorer clinical outcomes including disproportionately higher rates of death and disability when compared to high-income countries. Kidney replacement therapy may not be available or affordable in many developing countries and there is also a heavy burden of non-renal complications, in particular cardiovascular disease. Urgent action is therefore imperative upstream to control the epidemic of diabetes and MetS, as well as to improve early detection and care of MAKD and DKD in these countries. All-of-society, all-of-government and global approaches are urgently needed, with consideration of the cultural, economic, and educational matrix at the individual country level.