Global Aspects of Chronic Kidney Disease

Abstract

Chronic kidney disease has a high prevalence and a high mortality rate worldwide. Although diabetes and hypertension are common, unique causes of kidney disease may occur driven by infections, exposures, or genetic susceptibilities. Certain agricultural areas in particular have a high incidence of tubulointerstitial kidney disease of unclear etiology. Risk factors may include heat stress, pesticides, heavy metals, and other environmental toxins. Furthermore, countries have disproportionately different prevalence of renal replacement therapy, which seems to correlate in part to the type of health coverage. The future challenges for the nephrology community worldwide will be dealing with the growing number of patients with end-stage kidney disease, the fragmented healthcare in some countries, shortage of kidney transplantation programs, and deficient registries to appropriately assess the prevalence of kidney disease. This review contains 4 figures, 3 tables, and 54 references. Key Words: acute kidney injury, chronic kidney disease, end-stage renal disease, epidemiology, ethnic background, HIV-associated nephropathy, noncommunicable diseases, renal replacement therapy, screening, socioeconomic status