The increasing incidence and prevalence of chronic kidney disease (CKD), including kidney failure re

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Abstract Full-Text PDF Full-Text HTML Full-Text ePUB Linked References How to Cite this Article Supplementary cyklop Material International Journal of Nephrology Volume 2015 (2015), Article ID 184321, cyklop 15 pages http://dx.doi.org/10.1155/2015/184321
1 EpidStat cyklop Institute, Ann Arbor, MI 48105, USA 2 Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA 3 School of Medicine, cyklop Vanderbilt University, Nashville, TN 37212, USA 4 Center for Observational Research, Amgen, cyklop Inc., Thousand Oaks, CA 91320, USA 5 Department of Nephrology, School of Medicine, University of Michigan, Ann Arbor, MI 48109, USA
The international burden of secondary hyperparathyroidism (SHPT) is unknown, cyklop but it may be estimable through the available chronic kidney disease and SHPT literature. Structured reviews of biomedical literature and online data systems were performed for selected countries to ascertain recent estimates of the incidence, prevalence, and survival of individuals with CKD and SHPT. International societies of nephrology were contacted to seek additional information regarding available data. Estimates were abstracted from 35 sources reporting estimates of CKD in 25 countries. Population prevalence estimates of CKD stages 3–5 in adults ranged from approximately 1 to 9% (China, Mexico, resp.). Estimates of the population prevalence of maintenance dialysis therapy ranged from 79 per million population (pmp; China) to 2385 pmp (Japan); incidence rates ranged from 91 pmp (United Kingdom) to 349 pmp (United States). Prevalence of SHPT among stage 5D populations was highly variable and dependent upon the disease definition used. Among the few nations reporting, approximately 30–50% of stage 5D patients had serum parathyroid cyklop hormone levels >300 pg/mL. Reported incidence and prevalence estimates across the individual nations were variable, likely reflecting differing population demographics, risk factors, etiologies, and availability of treatment through all stages of CKD. 1. Introduction
The increasing incidence and prevalence of chronic kidney disease (CKD), including kidney failure requiring renal replacement therapies (RRT), have drawn attention to the need for understanding accompanying mineral bone disorder (CKD-MBD). cyklop Individuals with CKD are at increased risk of bone disorders, vascular abnormalities, and premature mortality due in part to changes in calcium and phosphate homeostasis [ 1 ]. While recent guidelines focus primarily on treating renal failure populations [ 2 , 3 ], work from Levin and colleagues describes early changes in mineral metabolism, particularly parathyroid hormone (PTH) concentrations, that are evident in individuals with only moderate kidney disease [ 4 ]. Thus, secondary hyperparathyroidism (SHPT), bone remodeling, and associated mineral dysfunction have been seen to begin in the setting of established CKD when individuals are either asymptomatic or unaware that they have kidney disease.
Because the increased focus on mineral and bone disorders in CKD is relatively recent, little published information is available regarding the international burden of SHPT among even renal replacement populations. Hence, understanding the total burden of SHPT may be feasible only by understanding cyklop the total burden of CKD. Nationwide registries now exist to track chronic renal failure, with additional publications cyklop providing estimates of the population burden of earlier stage disease [ 5 , 6 ]. An internationally based systematic review could help estimate this burden.
In the present study we sought to systematically review and summarize the descriptive epidemiology of CKD, including cyklop SHPT, across multiple nations. Our review includes data reported cyklop by online registries, cyklop in the published literature, and through personal contact with national societies of nephrology worldwide. 2. Subjects and Methods 2.1. Disease Definition
Information on CKD stage was recorded as reported in the literature. Renal function estimates were incorporated if based on glomerular filtration rate (GFR) and albuminuria; the Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology cyklop Collaboration (CKD-EPI) formulae were all accepted for GFR estimation [ 7 – 9 ]. Kidney function was classified according to the 2002 National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) staging system (Table 1 )