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Chronic Kidney Disease in the Caribbean Island of Antigua: Causes, Morbidity and Mortality Factors / Enfermedad renal crónica en la isla caribeña de Antigua: causas, morbilidad y factores de mortalidad
Meade, G; Soyibo, AK; Lawrence-Wright, M; Ferguson, T; Thomas, I.
  • Meade, G; Mount St John's Medical Centre. Antigua
  • Soyibo, AK; University Hospital of the West Indies. Department of Medicine. JM
  • Lawrence-Wright, M; University Hospital of the West Indies. Department of Medicine. JM
  • Ferguson, T; Caribbean Institute for Health Research. Epidemiology Research Unit. Mona. JM
  • Thomas, I; Mount St John's Medical Centre. Antigua
West Indian med. j ; 67(2): 173-184, Apr.-June 2018. tab, graf
Article in English | LILACS | ID: biblio-1045822
ABSTRACT
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.
RESUMEN
RESUMEN Antecedentes La enfermedad renal crónica (ERC) y su alta morbilidad y mortalidad asociadas, son causa de una importante carga económica y disminución de la calidad de vida entre los pacientes afectados en Antigua, el resto del Caribe y en todo el mundo. Se evaluaron las causas de la ERC en Antigua, así como los factores de morbilidad y mortalidad que afectan a los pacientes muestreados, con el fin de formular intervenciones encaminadas a minimizar la ocurrencia y el impacto de estos factores.

Objetivo:

Determinar las causas de la ERC durante un período de nueve años y las causas de morbilidad y mortalidad entre pacientes con ERC en los dos principales hospitales de Antigua.

Métodos:

Se realizó una revisión retrospectiva de las historias clínicas de los pacientes con ERC diagnosticados entre el 1 de enero de 2005 y el 1 de diciembre de 2013. La enfermedad renal crónica se definió como una tasa de filtración glomerular inferior a 60 ml/minuto/1.73 m2. Se evaluaron las causas de la ERC, los diagnósticos de admisión de los pacientes, así como las causas de muerte y las investigaciones de laboratorio.

Resultados:

Las causas documentadas de la ERC en estos pacientes fueron la diabetes mellitus (51% de los pacientes), la hipertensión (26%), la glomerulonefritis (5%), y la nefritis lúpica (4%). Las causas de morbilidad entre los pacientes con ERC fueron el infarto de miocardio (5.1%), la angina inestable (12.7%) y el accidente cerebrovascular isquémico (12%). La sepsis asociada con catéter (8.1%, p < 0.001) y las infecciones de las vías respiratorias inferiores (5.4%) contribuyeron significativamente a la morbilidad de los pacientes. Los principales factores que contribuyeron a la mortalidad de los pacientes fueron el infarto del miocardio (16.7%) y la sepsis asociada con catéter (16.7%).

Conclusión:

Este estudio documentó que las causas más comunes de ERC entre los pacientes incluidos en la muestra en Antigua fueron la diabetes mellitus y la hipertensión. La enfermedad cardíaca isquémica y las infecciones fueron las principales causas de morbilidad y mortalidad entre los pacientes. El diagnóstico temprano y el tratamiento agresivo de la ERC y sus factores y complicaciones de riesgo, son asuntos de importancia a la hora de reducir la carga clínica y económica asociadas con ERC.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Renal Insufficiency, Chronic Type of study: Etiology study / Observational study / Prevalence study / Risk factors / Screening study Limits: Adult / Aged / Female / Humans / Male Country/Region as subject: Caribbean Language: English Journal: West Indian med. j Journal subject: Medicine Year: 2018 Type: Article Affiliation country: Antigua and Barbuda / Jamaica Institution/Affiliation country: Caribbean Institute for Health Research/JM / Mount St John's Medical Centre/Antigua / University Hospital of the West Indies/JM

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Full text: Available Index: LILACS (Americas) Main subject: Renal Insufficiency, Chronic Type of study: Etiology study / Observational study / Prevalence study / Risk factors / Screening study Limits: Adult / Aged / Female / Humans / Male Country/Region as subject: Caribbean Language: English Journal: West Indian med. j Journal subject: Medicine Year: 2018 Type: Article Affiliation country: Antigua and Barbuda / Jamaica Institution/Affiliation country: Caribbean Institute for Health Research/JM / Mount St John's Medical Centre/Antigua / University Hospital of the West Indies/JM