Chronic Kidney Disease Management in the Middle East and Africa: Concerns, Challenges, and Novel Approaches

Saeed Al-Ghamdi 1, Ali Abu-Alfa 2, Turki Alotaibi 3, Ali AlSaaidi 4, Abdulkareem AlSuwaida 5, Mustafa Arici 6, Tevfik Ecder 7, Ahmed F El Koraie 8, Mohamed Ghnaimat 9, Mohamed H Hafez 10, Mohamed Hassan 11, Tarik Sqalli 12

Affiliations

06 April 2023

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doi: 10.2147/IJNRD.S363133

Abstract

The burden of chronic kidney disease (CKD) and other comorbidities, such as hypertension and diabetes, which increase the risk of developing CKD, is on the rise in the Middle East and Africa. The Middle East and Africa CKD (MEA-CKD) steering committee, comprising eminent healthcare specialists from the Middle East and Africa, was formed to identify and propose steps to address the gaps in the management of CKD in these regions. The current article lists the MEA-CKD steering committee meeting outcomes and evaluates the available evidence supporting the role of novel therapeutic options for patients with CKD. The need of the hour is to address the gaps in awareness and screening, early diagnosis, along with referral and management of patients at risk. Measures to bring about appropriate changes in healthcare policies to ensure access to all benefit-proven protective therapies, including novel ones, at community levels are also vital for reducing the overall burden of CKD on the healthcare system as well as governing bodies, especially in developing countries of the Middle East and Africa.

Keywords: CKD concerns; CKD management; CKD management gaps; Middle East and Africa; chronic kidney disease; novel therapies.

Figures

Figure 1 Primary, secondary, and tertiary prevention of CKD in LMICs. Data from Ameh et al.

Figure 1 Primary, secondary, and tertiary prevention of CKD in LMICs. Data from Ameh et al.

Figure 2 Class effect of SGLT2 inhibitors (A) EMPA REG outcome; from N Engl J Med, Wanner C, Inzucchi SE, Lachin JM et al. Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes. 375: 323-334, Copyright © (2016) Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society. (B) CANVAS; From N Engl J, MedNeal B, Perkovic V, Mahaffey KW, et al. Canagliflozin and Cardiovascular and Renal Event in Type 2 Diabetes. 377: 644-657, Copyright © (2017) Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society.; (C) DECLARE-TIMI 58 outcome; from Mosenzon (D) CREDENCE; From N Engl J Med.Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. 380:2295–2306, Copyright ©(2019) Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society.

Figure 2 Class effect of SGLT2 inhibitors (A) EMPA REG outcome; from N Engl J Med, Wanner C, Inzucchi SE, Lachin JM et al. Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes. 375: 323-334, Copyright © (2016) Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society. (B) CANVAS; From N Engl J, MedNeal B, Perkovic V, Mahaffey KW, et al. Canagliflozin and Cardiovascular and Renal Event in Type 2 Diabetes. 377: 644-657, Copyright © (2017) Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society.; (C) DECLARE-TIMI 58 outcome; from Mosenzon (D) CREDENCE; From N Engl J Med.Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. 380:2295–2306, Copyright ©(2019) Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society.

Figure 3 KDIGO 2020 clinical practice guidelines for diabetes management in CKD.

Figure 3 KDIGO 2020 clinical practice guidelines for diabetes management in CKD.

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