October 14, 2021PLoS ONEOpen Access

Burden of chronic kidney disease in the general population and high-risk groups in South Asia: A systematic review and meta-analysis

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Why the study?

Prevalence estimates on chronic kidney disease in South Asia are limited despite it being an emerging global public health issue.

Structured PICO

Population

General and high-risk populations in South Asia (Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, India, Pakistan, and Sri Lanka) from 24 population-level prevalence studies.

Outcome

Prevalence of chronic kidney disease (CKD)

CKD is highly prevalent in South Asia, affecting approximately 1 in 7 adults in the general population and even higher proportions in high-risk groups like those with diabetes or hypertension.

Limitations

Substantial heterogeneity across the included studies

Implication

Indicates 14% CKD prevalence in South Asia; leaves open targeted screening and prevention trials.

Abstract

BACKGROUND: Chronic kidney disease (CKD) is an emerging public health issue globally. The prevalence estimates on CKD in South Asia are however limited. This study aimed to examine the prevalence of CKD among the general and high-risk population in South Asia. METHODS: We conducted a systematic review and meta-analysis of population-level prevalence studies in South Asia (Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, India, Pakistan, and Sri Lanka). Three databases namely PubMed, Scopus and Web of Science were systematically searched for published reports of kidney disease in South Asia up to 28 October 2020. A random-effect model for computing the pooled prevalence was used. RESULTS: Of the 8749 identified studies, a total of 24 studies were included in the review. The pooled prevalence of CKD among the general population was 14% (95% CI 11-18%), and 15% (95% CI 11-20%) among adult males and 13% (95% CI 10-17%) in adult females. The prevalence of CKD was 27% (95% CI 20-35%) in adults with hypertension, 31% (95% CI 22-41%) in adults with diabetes and 14% (95% CI 10-19%) in adults who were overweight/obese. We found substantial heterogeneity across the included studies in the pooled estimates for CKD prevalence in both general and high-risk populations. The prevalence of CKD of unknown origin in the endemic population was 8% (95% CI 3-16%). CONCLUSION: Our study reaffirms the previous reports that CKD represents a serious public health challenge in South Asia, with the disease prevalent among 1 in 7 adults in South Asian countries.