Recommended
More Related Content
What's hot
What's hot (20)
Similar to Poverty and CKD: How Socioeconomic Inequalities Drive the Global Kidney Disease Epidemic
Similar to Poverty and CKD: How Socioeconomic Inequalities Drive the Global Kidney Disease Epidemic (20)
More from Meguid Nahas
Recently uploaded
Recently uploaded (20)
Poverty and CKD: How Socioeconomic Inequalities Drive the Global Kidney Disease Epidemic
- 1. Sheffield Kidney Institute Poverty and CKD Prof Meguid El Nahas, MD, PhD, FRCP
- 3. Sheffield Kidney Institute “Inequalities in healthcare is the worst type of social inequalities” Dr Martin Luther King 1961
- 4. Sheffield Kidney Institute Lysaght, J Am Soc Nephrol, 2002 ESRD/RRT 1990 2003 2010 DM >60 426,000 2,095,000 1,681,000
- 5. Sheffield Kidney Institute 1,681,000 90-10 5 countries 12% pop 56% RRT ESRD The Poor don’t get Treated: 90-10 Gap
- 6. Sheffield Kidney Institute ESRD The Poor don’t get Treated No RRT 110 countries 600m 3-5 13~10 <1-5 336pmp/y 1403pmp 94 658 15 79101 626 245 1800 3-5pmp 102pmp 80 ~300
- 7. Sheffield Kidney Institute World Poverty map <$2/day <$1/day
- 8. Sheffield Kidney Institute 1,000,000 death/year Mostly poor… The rich get dialysed!
- 9. Sheffield Kidney Institute *Underlying Socioeconomic, *Cultural, Political and Environmental Determinants *Globalization *Urbanization *Population ageing Common Modifiable Risk Factors Unhealthy diet Physical inactivity Tobacco use Non-modifiable Risk Factors Age Heredity Intermediate Risk Factors Raised blood pressure Raised blood glucose Abnormal blood lipids Overweight/obesity Main Chronic Diseases CVD CKD Cancer Chronic respiratory diseases Diabetes Strokes
- 10. Sheffield Kidney Institute Borrell et al, 2004 SES and Mortality ARIC
- 12. Sheffield Kidney Institute NHANESIII Race and Poverty
- 13. Sheffield Kidney Institute Bryson et al, 2006 Racial and Ethnic variation in albuminuria NHANESIII
- 15. Sheffield Kidney Institute Chronic Diseases CKD
- 18. Sheffield Kidney Institute Barker/Hales 1997 Thrifty Phenotype
- 19. Sheffield Kidney Institute Pancreatic β cells Insulin/Receptors Muscles Nephrons OBESITY MS DM HT CKD Foetal Adult
- 22. Sheffield Kidney Institute 2005 Global obesity 2015 1.2 billion 1.7 billion
- 23. Sheffield Kidney Institute World 2000 2030 154 m 370 m 55 m 84 m Developed Developing 99 m 286 m 16.7 33.8 32.9 18.2 52.4 30.7 28.3 9.1 80.9 22.8 42.3 18.6 0.9 1.6 * In million subjects 102% 81% 71% 211% 255% 127% 78% Global Diabetes (2000-2030) WHO, March 2003
- 24. Sheffield Kidney Institute Kearney et al, 2005 972m 1.56b Global Hypertension 2000 2025
- 26. Sheffield Kidney Institute 2200Kcal/meal!!!!!!!!!! 150Kcal/drink/d 50Kg/10years US 60% inadequate activity Too much TV ~ 30h/w!!!!
- 27. Sheffield Kidney Institute Tozawa et al, 2002 Okinawa Screening Program Obesity
- 28. Sheffield Kidney Institute Tozawa et al, 2002 Okinawa Screening Program Smoking
- 29. Sheffield Kidney Institute Schaeffner et al, 2003 Physicians’ Health Study (US/UK) High Cholesterol
- 30. Sheffield Kidney Institute Perneger et al, 1999 Alcohol & ESRD
- 31. Sheffield Kidney Institute Perneger et al, 2001 716 ESRD 361 controls
- 32. Sheffield Kidney Institute Periodontal Disease
- 33. Sheffield Kidney Institute Periodontal Disease and CKD ARIC Kshirsagar et al, 2005 OR > 2 for eGFR<60
- 34. Sheffield Kidney Institute Chronic Inflammation & CKD
- 36. Sheffield Kidney Institute Bryson et al, 2006 Racial and Ethnic variation in albuminuria NHANESIII
- 37. Sheffield Kidney Institute Predictors of Albuminuria Martins et al, 2006 Poverty OR: +18% Poor education OR: +15%
- 38. Sheffield Kidney Institute Progressive CKD and Poverty Merkin et al, 2005 In White americans, progressive CKD increases with poverty area score
- 39. Sheffield Kidney Institute Poverty: The vicious Cycle
- 40. Sheffield Kidney Institute WHO Poverty Eradication Program Eradicate CKD
- 41. Sheffield Kidney Institute WHO Should pay more attention to CKD!!!
- 42. Sheffield Kidney Institute 2006-2016 Decade for the eradication of CKD