Effect of Circadian Rhythm - Autonomic Nervous System - Endocrine Hormone Axis on The Occurrence and Development of Diabetes: A Review and Perspective

Chronic kidney disease (CKD) has a high morbidity and mortality rates and costs a lot of money including health care, haemodialysis costs and management of complications of CKD. Patients with more progressive stages 3 and 4 CKD experience a high incidence of cardiovascular events and death compared with stages 1 and 2 of CKD. According to the Global Burden of Disease Study conducted in 2010, CKD became the 18th place on a list of the greatest causes of deaths in the world, with an annual mortality rate of 16.3 per 100,000 people. Due to the high prevalence of diabetes, hypertension and coronary artery disease, CKD became world widespread. In alignment with the presence of metabolic and cardiovascular diseases, the prevalence of hypertensive nephropathy prevalence is 7.75%. Unfortunately, the number of patients started to develop end stage renal disease because of hypertension is exceeding. Hypertension-induced renal damage includes the systemic blood pressure load, the degree of renal microvasculature affection, and local susceptibility factors to barotrauma, all of which are affected by the degrees of hypertension. Therefore, in developing countries, screening programmes are extremely needed to detect the early stages of CKD among hypertensive diabetics and non-diabetic patients attending primary healthcare centres.