End-stage kidney disease in Fiji

Amrish Krishnan, Yogeshni Chandra, Joji Malani, Shilpanjali Jesudason, Shaundeep Sen, Angus G. Ritchie

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Chronic kidney disease is now a leading cause of death in Fiji. The country lacks even basic statistics about the incidence of end-stage kidney disease (ESKD) and presents significant challenges to conducting clinical research. Aim: To estimate the incidence and characteristics of ESKD in Fijian adults. Methods: A retrospective cohort study was conducted of patients admitted to Colonial War Memorial Hospital in Suva, Fiji, in 2012. Suspected ESKD cases were identified from laboratory registers of renal function tests and confirmed through medical record review. Population data were from the Fijian Bureau of Statistics. Results: Screening identified 1474 suspected ESKD cases. Following removal of 763 duplicates and cases with discrepant identifiers, 711 unique cases remained. An additional 552 cases met exclusion criteria, including acute kidney injury (247), failure to be admitted (131) and pre-existing ESKD diagnosis (103), leaving 159 cases of confirmed ESKD. Median age was 57 years (interquartile range 47–65). Crude and age-adjusted ESKD incidence rates were 753 per million population (pmp) (95% confidence interval (CI) 636–870) and 793 pmp (95% CI 669–916), respectively, rising to 938 pmp (95% CI 804–1072) if African-American correction was removed. Diabetic nephropathy was the most common cause of ESKD (65.4%). Conclusion: The incidence of ESKD in Fiji is high. This is a substantial public health problem that is likely impacting life expectancy and quality of life. Improving screening, detection and management of kidney disease should be given more prominence in programmes to address non-communicable diseases in Fiji and the Western Pacific.

LanguageEnglish
Pages461-466
Number of pages6
JournalInternal Medicine Journal
Volume49
Issue number4
DOIs
Publication statusPublished - 1 Apr 2019

Keywords

  • Fiji
  • chronic kidney disease
  • diabetic nephropathy
  • end-stage kidney disease
  • non-communicable disease

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Krishnan, A., Chandra, Y., Malani, J., Jesudason, S., Sen, S., & Ritchie, A. G. (2019). End-stage kidney disease in Fiji. Internal Medicine Journal, 49(4), 461-466. https://doi.org/10.1111/imj.14108
Krishnan, Amrish ; Chandra, Yogeshni ; Malani, Joji ; Jesudason, Shilpanjali ; Sen, Shaundeep ; Ritchie, Angus G. / End-stage kidney disease in Fiji. In: Internal Medicine Journal. 2019 ; Vol. 49, No. 4. pp. 461-466.
@article{2dce7cdea8a044a9a3f5445cd957ef0e,
title = "End-stage kidney disease in Fiji",
abstract = "Background: Chronic kidney disease is now a leading cause of death in Fiji. The country lacks even basic statistics about the incidence of end-stage kidney disease (ESKD) and presents significant challenges to conducting clinical research. Aim: To estimate the incidence and characteristics of ESKD in Fijian adults. Methods: A retrospective cohort study was conducted of patients admitted to Colonial War Memorial Hospital in Suva, Fiji, in 2012. Suspected ESKD cases were identified from laboratory registers of renal function tests and confirmed through medical record review. Population data were from the Fijian Bureau of Statistics. Results: Screening identified 1474 suspected ESKD cases. Following removal of 763 duplicates and cases with discrepant identifiers, 711 unique cases remained. An additional 552 cases met exclusion criteria, including acute kidney injury (247), failure to be admitted (131) and pre-existing ESKD diagnosis (103), leaving 159 cases of confirmed ESKD. Median age was 57 years (interquartile range 47–65). Crude and age-adjusted ESKD incidence rates were 753 per million population (pmp) (95{\%} confidence interval (CI) 636–870) and 793 pmp (95{\%} CI 669–916), respectively, rising to 938 pmp (95{\%} CI 804–1072) if African-American correction was removed. Diabetic nephropathy was the most common cause of ESKD (65.4{\%}). Conclusion: The incidence of ESKD in Fiji is high. This is a substantial public health problem that is likely impacting life expectancy and quality of life. Improving screening, detection and management of kidney disease should be given more prominence in programmes to address non-communicable diseases in Fiji and the Western Pacific.",
keywords = "Fiji, chronic kidney disease, diabetic nephropathy, end-stage kidney disease, non-communicable disease",
author = "Amrish Krishnan and Yogeshni Chandra and Joji Malani and Shilpanjali Jesudason and Shaundeep Sen and Ritchie, {Angus G.}",
year = "2019",
month = "4",
day = "1",
doi = "10.1111/imj.14108",
language = "English",
volume = "49",
pages = "461--466",
journal = "Australian and New Zealand Journal of Medicine",
issn = "1444-0903",
publisher = "Wiley-Blackwell",
number = "4",

}

Krishnan, A, Chandra, Y, Malani, J, Jesudason, S, Sen, S & Ritchie, AG 2019, 'End-stage kidney disease in Fiji', Internal Medicine Journal, vol. 49, no. 4, pp. 461-466. https://doi.org/10.1111/imj.14108

End-stage kidney disease in Fiji. / Krishnan, Amrish; Chandra, Yogeshni; Malani, Joji; Jesudason, Shilpanjali; Sen, Shaundeep; Ritchie, Angus G.

In: Internal Medicine Journal, Vol. 49, No. 4, 01.04.2019, p. 461-466.

Research output: Contribution to journalArticle

TY - JOUR

T1 - End-stage kidney disease in Fiji

AU - Krishnan, Amrish

AU - Chandra, Yogeshni

AU - Malani, Joji

AU - Jesudason, Shilpanjali

AU - Sen, Shaundeep

AU - Ritchie, Angus G.

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Background: Chronic kidney disease is now a leading cause of death in Fiji. The country lacks even basic statistics about the incidence of end-stage kidney disease (ESKD) and presents significant challenges to conducting clinical research. Aim: To estimate the incidence and characteristics of ESKD in Fijian adults. Methods: A retrospective cohort study was conducted of patients admitted to Colonial War Memorial Hospital in Suva, Fiji, in 2012. Suspected ESKD cases were identified from laboratory registers of renal function tests and confirmed through medical record review. Population data were from the Fijian Bureau of Statistics. Results: Screening identified 1474 suspected ESKD cases. Following removal of 763 duplicates and cases with discrepant identifiers, 711 unique cases remained. An additional 552 cases met exclusion criteria, including acute kidney injury (247), failure to be admitted (131) and pre-existing ESKD diagnosis (103), leaving 159 cases of confirmed ESKD. Median age was 57 years (interquartile range 47–65). Crude and age-adjusted ESKD incidence rates were 753 per million population (pmp) (95% confidence interval (CI) 636–870) and 793 pmp (95% CI 669–916), respectively, rising to 938 pmp (95% CI 804–1072) if African-American correction was removed. Diabetic nephropathy was the most common cause of ESKD (65.4%). Conclusion: The incidence of ESKD in Fiji is high. This is a substantial public health problem that is likely impacting life expectancy and quality of life. Improving screening, detection and management of kidney disease should be given more prominence in programmes to address non-communicable diseases in Fiji and the Western Pacific.

AB - Background: Chronic kidney disease is now a leading cause of death in Fiji. The country lacks even basic statistics about the incidence of end-stage kidney disease (ESKD) and presents significant challenges to conducting clinical research. Aim: To estimate the incidence and characteristics of ESKD in Fijian adults. Methods: A retrospective cohort study was conducted of patients admitted to Colonial War Memorial Hospital in Suva, Fiji, in 2012. Suspected ESKD cases were identified from laboratory registers of renal function tests and confirmed through medical record review. Population data were from the Fijian Bureau of Statistics. Results: Screening identified 1474 suspected ESKD cases. Following removal of 763 duplicates and cases with discrepant identifiers, 711 unique cases remained. An additional 552 cases met exclusion criteria, including acute kidney injury (247), failure to be admitted (131) and pre-existing ESKD diagnosis (103), leaving 159 cases of confirmed ESKD. Median age was 57 years (interquartile range 47–65). Crude and age-adjusted ESKD incidence rates were 753 per million population (pmp) (95% confidence interval (CI) 636–870) and 793 pmp (95% CI 669–916), respectively, rising to 938 pmp (95% CI 804–1072) if African-American correction was removed. Diabetic nephropathy was the most common cause of ESKD (65.4%). Conclusion: The incidence of ESKD in Fiji is high. This is a substantial public health problem that is likely impacting life expectancy and quality of life. Improving screening, detection and management of kidney disease should be given more prominence in programmes to address non-communicable diseases in Fiji and the Western Pacific.

KW - Fiji

KW - chronic kidney disease

KW - diabetic nephropathy

KW - end-stage kidney disease

KW - non-communicable disease

UR - http://www.scopus.com/inward/record.url?scp=85062476049&partnerID=8YFLogxK

U2 - 10.1111/imj.14108

DO - 10.1111/imj.14108

M3 - Article

VL - 49

SP - 461

EP - 466

JO - Australian and New Zealand Journal of Medicine

T2 - Australian and New Zealand Journal of Medicine

JF - Australian and New Zealand Journal of Medicine

SN - 1444-0903

IS - 4

ER -

Krishnan A, Chandra Y, Malani J, Jesudason S, Sen S, Ritchie AG. End-stage kidney disease in Fiji. Internal Medicine Journal. 2019 Apr 1;49(4):461-466. https://doi.org/10.1111/imj.14108