Chronic Kidney Disease in the Caribbean Island of Antigua: Causes, Morbidity and Mortality Factors

IF 0.2 4区医学 Q4 MEDICINE, GENERAL & INTERNAL

West Indian Medical Journal Pub Date : 2017-12-22 DOI:10.7727/wimj.2017.238

G. Meade, A. Soyibo, M. Lawrence-Wright, T. Ferguson, I. Thomas

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Abstract

Background: Chronic kidney disease (CKD) and its associated high morbidity and mortality cause a significant economic burden and decreased quality of life in affected patients in Antigua, the rest of the Caribbean and globally. The causes of CKD in Antigua, morbidity and mortality factors affecting the sampled patients were evaluated with a view to formulating interventions to minimize the occurrence and the impact of these factors. Objective: To determine the causes of CKD over a nine-year period and the causes of morbidity and mortality among patients with CKD at the two main hospitals in Antigua. Methods: A retrospective review was done of the medical records of patients with CKD who were diagnosed between January 1, 2005 and December 1, 2013. Chronic kidney disease was defined as a glomerular filtration rate of less than 60 mL/minute/1.73 m2. The causes of CKD, the patients’ admission diagnoses, the causes of death and laboratory investigations were evaluated. Results: The documented causes of CKD in these patients were diabetes mellitus (51% of the patients), hypertension (26%), glomerulonephritis (5%) and lupus nephritis (4%). The causes of morbidity among the patients with CKD were myocardial infarction (5.1%), unstable angina (12.7%) and ischaemic stroke (12%). Contributing significantly to the patients’ morbidity were catheter-associated sepsis (8.1%, p < 0.001) and lower respiratory tract infections (5.4%). The main factors contributing to the patients’ mortality were myocardial infarction (16.7%) and catheter-associated sepsis (16.7%). Conclusion: This study documented that the most common causes of CKD among the sampled patients in Antigua were diabetes mellitus and hypertension. Ischaemic heart disease and infections were the major causes of morbidity and mortality among the patients. Early recognition and aggressive management of CKD and its risk factors and complications are important in reducing the clinical and economic burden associated with CKD.

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加勒比安提瓜岛慢性肾病:病因、发病率和死亡因素

背景:慢性肾脏疾病(CKD)及其相关的高发病率和死亡率给安提瓜、加勒比其他地区和全球的患者造成了严重的经济负担和生活质量下降。评估了安提瓜慢性肾病的病因、影响样本患者的发病率和死亡率因素，以期制定干预措施，以尽量减少这些因素的发生和影响。目的:确定安提瓜两家主要医院CKD患者9年来发病和死亡的原因。方法:回顾性分析2005年1月1日至2013年12月1日诊断的CKD患者的医疗记录。慢性肾病定义为肾小球滤过率小于60ml /min /1.73 m2。评估CKD的病因、患者入院诊断、死亡原因和实验室检查。结果:记录的CKD病因为糖尿病(51%)、高血压(26%)、肾小球肾炎(5%)和狼疮性肾炎(4%)。CKD患者发病原因为心肌梗死(5.1%)、不稳定型心绞痛(12.7%)和缺血性脑卒中(12%)。导管相关性脓毒症(8.1%，p < 0.001)和下呼吸道感染(5.4%)对患者的发病率有显著影响。导致患者死亡的主要因素是心肌梗死(16.7%)和导管相关性脓毒症(16.7%)。结论:本研究表明，在安提瓜的抽样患者中，CKD最常见的原因是糖尿病和高血压。缺血性心脏病和感染是患者发病和死亡的主要原因。早期识别和积极管理CKD及其危险因素和并发症对于减少与CKD相关的临床和经济负担非常重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

West Indian Medical Journal 医学-医学：内科

CiteScore

0.20

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： The Journal is international in scope, with author and editorial contributions from across the globe. The focus is on clinical and epidemiological aspects of tropical and infectious diseases, new and re-emerging infections, chronic non-communicable diseases, and medical conditions prevalent in the Latin America-Caribbean region, and of significance to global health, especially in developing countries. The Journal covers all medical disciplines, as well as basic and translational research elucidating the pathophysiologic basis of diseases or focussing on new therapeutic approaches, and publishes original scientific research, reviews, case reports, brief communications, letters, commentaries and medical images. The Journal publishes four to six issues and four supplements annually. English is the language of publication but Abstracts are also duplicated in Spanish. Most of the articles are submitted at the authors’ initiative, but some are solicited by the Editor-in-Chief. Unless expressly stated, the Editorial Board does not accept responsibility for authors’ opinions. All papers on submission are reviewed by a subcommittee. Those deemed worthy for review are sent to two or three reviewers (one of the three might be a statistician if necessary). The returned papers with reviewer comments are reviewed by the Editor-in-Chief. Papers may be rejected, accepted or sent back to authors for revision. Resubmitted papers from authors are reviewed by the Editor-in-Chief and may be sent back to reviewers or a final decision made by Editor-in-Chief. The decision of the Editorial Board is final with regards to rejected articles. Rejected articles will not be returned to the authors. The editorial subcommittee has the right to return sub-standard manuscripts to the authors, rather than passing them on to the reviewers. This implies outright rejection of the manuscript.