CARIBBEAN RENAL REGISTRY:JAMAICA-ARM 2012ADR AK. SOYIBO EN. BARTON CARIBBEAN INSTITUTE OF NEPHROLOGY
COLLABORATORS/SPECIAL THANKS1. MINISTRY OF HEALTH, JAMAICA 1. Dr. T Davidson2. Caribbean Institute of Nephrology 1. TEAM3. Spanish Town Hospital 1. Dr. R. Smith 2. Staff4. Mandeville Regional Hospital 1. Dr.Ukala 2. Staff5. St. Ann’s Bay Hospital 1. Records department and Renal Clinic Staff6. Diabetic Associates Renal Unit 1. Dialysis Unit staff
COLLABORATORS/SPECIAL THANKS1. Hope Dialysis Unit 1. Dr. R. Smith2. University Hospital of the West Indies 1. Department of Medicine Research Team3. Winchester Dialysis 1. Staff of Unit4. Hargreeves Dialysis 1. Staff5. Lydia Dialysis 1. Staff of unit6. Belamour Dialysis 1. staff
SPECIAL THANKSNational Health FundsCHASEe-Health Portfolio
Chronic non-communicable diseaseand chronic kidney disease• There is always an ongoing concern for the burden of disease worldwide.• There is an incessant search to calculate disease burden and to project prevalence, if not the incidence, of CNCD globally. Diabetes mellitus Hypertension Obesity Cardiovascular diseases (CVD) Chronic kidney disease (CKD) Dyslipidaemia• are now the focus of healthcare global talk.• Jamaica as well other Caribbean countries are also engaged in this wave. » AK Soyibo, L Roberts, EN Barton. WIMJ 2012
SIGNIFICANCE OF A REGISTRY• TO MONITOR THE INCIDENCE AND PREVALENCE OF CHRONIC KIDNEY DISEASE (CKD).• TO DETERMINE THE CAUSES OF CKD AND EMERGING TRENDS.• FOR COMPARISON OF THESE CAUSES WITHIN THE CARIBBEAN AND WITH NON-CARIBBEAN COUNTRIES.
….CONTINUED• TO ASSESS THE QUALITY OF LIFE IN PATIENTS WITH CKD IN THE CARIBBEAN USING SURROGATE MARKERS• TO DETERMINE OTHER CO-MORBID CONDITIIONS IN CKD.• TO DETERMINE CAUSES OF MORBIDITY AND MORTALITY.
….CONTINUED• TO DETERMINE THE BURDEN OF CKD FOR EACH COUNTRY• TO ASSESS WHETHER THE BURDEN OF CKD IS UNIFORM THROUGHOUT.• TO DETERMINE THE ECONOMIC AND SOCIAL COST OF CKD IN CARIBBEAN COUNTRIES.• TO PLAN AND FORMULATE POLICIES IN THE HEALTH CARE SECTOR.
BURDEN OF CKD• CKD/ESRD-specific complication• CKD/ESRD-related complication
BURDEN OF CKDCKD/ESRD-specific complications• Such as Anemia mineral bone disease.• tend to occur later in the course of disease and may be best treated by a nephrologist.• The emphasis would be to identify and monitor these complications before or as they arise
BURDEN OF CKDCKD-related complications• Which includes obesity Diabetes hypertension• though treatable by nephrology, may be most easily treated by primary care physicians and internists.
DATA COLLECTION Incidence of ESRD Prevalence Patients survival• LIMITED DATA Demographics Date of start Cause of CKD Stages of CKD Treatment and switches Death (date and cause)
Structural administrative organizationof the Caribbean Renal Registry
Primary cause of death inhemodialysis patients
Type of Insurance inHD Patients with Insurance status in HD patientsinsurance (N=101) (N= 598) Insured Not Insured Unknown 17%8070 13%605040 70%302010 0 Government Private Unknown name/conference (to edit: View Master Slide master
Smoking history in ESRD-HD(N=598) for Jamaica Never Smoked Ex-smokerCurrent Smoker 0 10 20 30 40 50 60
?RENAL HISTOLOGY REGISTRY DaVita visit, November 27, 2012