Crr jrr-adr

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Crr jrr-adr

  1. 1. CARIBBEAN RENAL REGISTRY:JAMAICA-ARM 2012ADR AK. SOYIBO EN. BARTON CARIBBEAN INSTITUTE OF NEPHROLOGY
  2. 2. 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
  3. 3. 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
  4. 4. SPECIAL THANKSNational Health FundsCHASEe-Health Portfolio
  5. 5. 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
  6. 6. 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.
  7. 7. ….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.
  8. 8. ….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.
  9. 9. BURDEN OF CKD• CKD/ESRD-specific complication• CKD/ESRD-related complication
  10. 10. 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
  11. 11. 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.
  12. 12. 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)
  13. 13. Structural administrative organizationof the Caribbean Renal Registry
  14. 14. Caribbean Renal Registrydata flowchart
  15. 15. CARIBBEAN RENAL REGISTRY:JAMAICA-ARM 2012JRR ADR
  16. 16. Distribution of CKD/ESRD patientsby stage of CKD 2007 and 2011 STAGE OF KIDNEY DISEASE 4560 40 3550 30 2540 20 1530 10 5 020 1 2 310 4 50 STAGE 1 STAGE 2 STAGE 3 STAGE 4 STAGE 5
  17. 17. Distribution of CKDpatients, by CKD stage (n=1,237)
  18. 18. AETIOLOGY OF RENAL DISEASESAT MRH. (G. Ukala, 2007) DM HTN% SLE
  19. 19. Cause ofRenalFailure inPatientsdying from Obstruct. Uropath.CKD Metastatic dx. 83.56% Proportion of patients 16.4% who had dialysis Before death
  20. 20. Insurance status in patients withCKD, by CKD stage (n=1,237)
  21. 21. Type of insurance in CKD patients withinsurance, by CKD stage (n=408)
  22. 22. Smoking status of patientswith CKD, by CKD stage (n=1,226)
  23. 23. Body mass index (kg/m2) in patientswith CKD, by CKD stage (n=1,237)DaVita visit, November 27, 2012
  24. 24. Summary statistics on the prevalenceof CKD inJamaica
  25. 25. Biochemical markers inpatients with CKD, by CKD stageDaVita visit, November 27, 2012
  26. 26. ESRD POPULATIONHEMODIALYSIS DaVita visit, November 27, 2012
  27. 27. Distribution of ESRD patients atinitiation, by modality (n=772)DaVita visit, November 27, 2012
  28. 28. Place of death inhemodialysis patients
  29. 29. Primary cause of death inhemodialysis patients
  30. 30. 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
  31. 31. Smoking history in ESRD-HD(N=598) for Jamaica Never Smoked Ex-smokerCurrent Smoker 0 10 20 30 40 50 60
  32. 32. ?RENAL HISTOLOGY REGISTRY DaVita visit, November 27, 2012
  33. 33. Indication for Kidney Biopsy diagnosis atypical pro/hem Hemauria Proteinuria 0 10 20 30 40 50 60 70 80name/conference (to edit: View  Master  Slide master

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