Presentation and outcome of chronic kidney disease in Italian and immigrant citizens: results from the Emilia-Romagna PIRP project.
Access to healthcare
CKD prevention
Chronic kidney disease
Immigrant patients
PIRP
Journal
Journal of nephrology
ISSN: 1724-6059
Titre abrégé: J Nephrol
Pays: Italy
ID NLM: 9012268
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
accepted:
28
01
2021
pubmed:
18
2
2021
medline:
24
3
2022
entrez:
17
2
2021
Statut:
ppublish
Résumé
In recent decades, high income countries (HIC) have been exposed to huge human migratory flows. Consistent with this influx, there has been a dramatic increase in the number of chronic kidney disease (CKD) patients in the immigrant population. In Italy, comparisons between Italian and immigrant CKD patients are still lacking, thus we aimed to describe the baseline clinical characteristics and the main outcomes of CKD patients who immigrated to Italy and reside in the Emilia Romagna region. This is a retrospective cohort study based on CKD patients from the Prevenzione Insufficienza Renale Progressiva (PIRP) project, which included 963 (3.1%) immigrants among the 30,702 patients seen by nephrologists between April 1st, 2004 and June 30th, 2020. We sub-divided the immigrants into seven groups based on their area of origin, and compared their baseline characteristics, CKD progression and time to end-stage kidney disease (ESKD) to those of Italian CKD patients. At presentation, Italian subjects were on average older (73.1 years) and had less preserved kidney function (eGFR 34.3 ml/min), while South and East Asians had the highest proportion of diabetes and obesity (approximately 45% and 30%, respectively). At 4-year follow-up, about 20% of patients from South Asia, Eastern Europe and Arab Countries were diagnosed with ESKD, compared to only 11% of Italians and Latin Americans. We found important differences between Italian and immigrant CKD patients, as well as among immigrant subgroups. First clinical encounters with nephrologists revealed that immigrants had varied patterns of clinical presentation and of nephropathy. During follow-up, immigrants showed faster kidney function decline which led to a higher risk of disease evolution and progression towards ESKD.
Identifiants
pubmed: 33595822
doi: 10.1007/s40620-021-00984-5
pii: 10.1007/s40620-021-00984-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
179-190Informations de copyright
© 2021. Italian Society of Nephrology.
Références
Jager KJ, Kovesdy C, Langham R et al (2019) A single number for advocacy and communication-worldwide more than 850 million individuals have kidney diseases. Nephrol Dial Transpl 34:1803–1805
doi: 10.1093/ndt/gfz174
Bikbov B, Purcell CA, Levey AS et al (2020) Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 395:709–733. https://doi.org/10.1016/S0140-6736(20)30045-3
doi: 10.1016/S0140-6736(20)30045-3
Institute for Health Metrics and Evaluation (IHME) University of Washington (2018) GBD Compare Data Visualization. http://vizhub.healthdata.org/gbd-compare . Accessed 18 Jul 2020
Liyanage T, Ninomiya T, Jha V et al (2015) Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet 385:1975–1982. https://doi.org/10.1016/S0140-6736(14)61601-9
doi: 10.1016/S0140-6736(14)61601-9
Xie Y, Bowe B, Mokdad AH et al (2018) Analysis of the Global Burden of Disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016. Kidney Int 94:567–581. https://doi.org/10.1016/j.kint.2018.04.011
doi: 10.1016/j.kint.2018.04.011
pubmed: 30078514
pmcid: 30078514
GBD (2013) Mortality and Causes of Death Collaborators (2015) Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 385:117–171. https://doi.org/10.1016/S0140-6736(14)61682-2
doi: 10.1016/S0140-6736(14)61682-2
Ku E, Lee BJ, Wei J, Weir MR (2019) Hypertension in CKD: core curriculum 2019. Am J Kidney Dis 74:120–131
doi: 10.1053/j.ajkd.2018.12.044
Anguiano-Gómez L, Lei Y, Kumar Devarupu S, Anders H-J (2018) The diabetes pandemic suggests unmet needs for “CKD with diabetes” in addition to ’diabetic nephropathy’-implications for pre-clinical research and drug testing. Nephrol Dial Transpl 33:1292–1304
doi: 10.1093/ndt/gfx219
Keen MU, Aeddula NR (2020) Analgesic nephropathy. StatPearls Publishing, Treasure Island
Stanifer JW, Jing B, Tolan S et al (2014) The epidemiology of chronic kidney disease in sub-Saharan Africa: a systematic review and meta-analysis. Lancet Glob Heal 2:e174–e181. https://doi.org/10.1016/S2214-109X(14)70002-6
doi: 10.1016/S2214-109X(14)70002-6
Farag YMK, Kari JA, Singh AK (2012) Chronic kidney disease in the Arab world: a call for action. Nephron Clin Pract 121:c120–c123. https://doi.org/10.1159/000345149
doi: 10.1159/000345149
Danaei G, Finucane MM, Lu Y et al (2011) National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: Systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2·7 million participants. Lancet 378:31–40. https://doi.org/10.1016/S0140-6736(11)60679-X
doi: 10.1016/S0140-6736(11)60679-X
Cusumano AM, González Bedat MC (2008) Chronic kidney disease in Latin America: time to improve screening and detection. Clin J Am Soc Nephrol 3:594–600. https://doi.org/10.2215/CJN.03420807
doi: 10.2215/CJN.03420807
pubmed: 6631092
pmcid: 6631092
Eurostat (2020) Migration and migrant population statistics. https://ec.europa.eu/eurostat/statistics-explained/index.php/Migration_and_migrant_population_statistics#Migrant_population:_21.8_million_non-EU-27_citizens_living_in_the_EU-27_on_1_January_2019 . Accessed 2 Dec 2020
Ingleby D (2011) Good practice in health service provision for migrants. In: Rechel B, Mladowsky P, Devillé W et al (eds) Migration and health in the European Union. McGraw-Hill Open University Press, Maidenhead
Scheppers E, van Dongen E, Dekker J et al (2006) Potential barriers to the use of health services among ethnic minorities: a review. Fam Pract 23:325–348. https://doi.org/10.1093/fampra/cmi113
doi: 10.1093/fampra/cmi113
Nørredam M, Krasnik A (2011) Migrants’ access to health services. In: Rechel B, Mladowsky P, Devillé W et al (eds) Migration and health in the European Union. McGraw-Hill Open University Press, Maidenhead
Bodini C (2017) Access to healthcare of migrants in the EU. In: Global Health Watch 5: an alternative world health report. Zed Books, London
Agyemang C, Kunst A, Bhopal R et al (2010) A cross-national comparative study of blood pressure and hypertension between English and Dutch South-Asian-and African-Origin Populations: the role of national context. Am J Hypertens 23:639–648. https://doi.org/10.1038/ajh.2010.39
doi: 10.1038/ajh.2010.39
Caskey FJ (2016) Prevalence and incidence of renal disease in disadvantaged communities in Europe. Clin Nephrol 86:34–36. https://doi.org/10.5414/CNP86S113
doi: 10.5414/CNP86S113
Wilkinson E, Brettle A, Waqar M, Randhawa G (2019) Inequalities and outcomes: end stage kidney disease in ethnic minorities. BMC Nephrol 20:1–12. https://doi.org/10.1186/s12882-019-1410-2
doi: 10.1186/s12882-019-1410-2
Faggiano F (2017) Salute straniera o salute degli stranieri? Epidemiol Prev 41(3/4):67–68. https://doi.org/10.19191/EP17.3-4S1.P067.068
doi: 10.19191/EP17.3-4S1.P067.068
(2019) INMP e rete degli studi longitudinali metropolitani: le disuguaglianze socioeconomiche nella salute della popolazione residente in Italia. Epidemiol Prev 43 (5/6):9–15. https://doi.org/10.19191/EP19.5-6.S1.002
De Nicola L, Donfrancesco C, Minutolo R et al (2015) Prevalence and cardiovascular risk profile of chronic kidney disease in Italy: results of the 2008–12 National Health Examination Survey. Nephrol Dial Transpl 30:806–814. https://doi.org/10.1093/ndt/gfu383
doi: 10.1093/ndt/gfu383
Osservatorio regionale sul fenomeno migratorio (2019) L’immigrazione straniera in Emilia-Romagna—Edizione 2019. Bologna, Italy. https://sociale.regione.emilia-romagna.it/documentazione/pubblicazioni/prodotti-editoriali/2019/l2019immigrazione-straniera-in-emilia-romagna-edizione-2019
WHO Regional Office for Europe (2018) Report on the health of refugees and migrants in the WHO European Region. No Public Health without Refugee and Migrant Health
Santoro A, Gibertoni D, Rucci P et al (2019) The PIRP project (Prevenzione Insufficienza Renale Progressiva): how to integrate hospital and community maintenance treatment for chronic kidney disease. J Nephrol 32:417–427. https://doi.org/10.1007/s40620-018-00570-2
doi: 10.1007/s40620-018-00570-2
Brück K, Jager KJ, Zoccali C et al (2018) Different rates of progression and mortality in patients with chronic kidney disease at outpatient nephrology clinics across Europe. Kidney Int 93:1432–1441. https://doi.org/10.1016/j.kint.2018.01.008
doi: 10.1016/j.kint.2018.01.008
United Nations Development Programme (2019) Human Development Report 2019. New York, NY. http://hdr.undp.org/sites/default/files/hdr2019.pdf
Levey AS, Stevens LA, Schmid CH et al (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150:604–612
doi: 10.7326/0003-4819-150-9-200905050-00006
WHO expert consultation (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363:157–163. https://doi.org/10.2307/2136890
doi: 10.2307/2136890
Wen CP, Matsushita K, Coresh J et al (2014) Relative risks of chronic kidney disease for mortality and end-stage renal disease across races are similar. Kidney Int 86:819–827. https://doi.org/10.1038/ki.2013.553
doi: 10.1038/ki.2013.553
pubmed: 4048178
pmcid: 4048178
Schuster NA, Hoogendijk EO, Kok AAL et al (2020) Ignoring competing events in the analysis of survival data may lead to biased results: a nonmathematical illustration of competing risk analysis. J Clin Epidemiol 122:42–48. https://doi.org/10.1016/j.jclinepi.2020.03.004
doi: 10.1016/j.jclinepi.2020.03.004
Stirbu I, Kunst AE, Bos V, Mackenbach JP (2006) Differences in avoidable mortality between migrants and the native Dutch in The Netherlands. BMC Public Health 6:1–10. https://doi.org/10.1186/1471-2458-6-78
doi: 10.1186/1471-2458-6-78
Domnich A, Panatto D, Gasparini R, Amicizia D (2012) The “healthy immigrant” effect: does it exist in Europe today? Ital J Public Health 9:1–7. https://doi.org/10.2427/7532
doi: 10.2427/7532
Di Napoli A, Perez M, Rossi A et al (2017) Factors associated to medical visits: Comparison among Italians and immigrants resident in Italy. Epidemiol Prev 41:41–49. https://doi.org/10.19191/EP17.3-4S1.P041.064
doi: 10.19191/EP17.3-4S1.P041.064
Norris KC, Agodoa LY (2005) Unraveling the racial disparities associated with kidney disease. Kidney Int 68:914–924. https://doi.org/10.1111/j.1523-1755.2005.00485.x
doi: 10.1111/j.1523-1755.2005.00485.x
Chiarenza A, Dauvrin M, Chiesa V et al (2019) Supporting access to healthcare for refugees and migrants in European countries under particular migratory pressure. BMC Health Serv Res 19:1–14. https://doi.org/10.1186/s12913-019-4353-1
doi: 10.1186/s12913-019-4353-1
Hasan M, Sutradhar I, Das GR, Sarker M (2018) Prevalence of chronic kidney disease in South Asia: A systematic review 11 Medical and Health Sciences 1103 Clinical Sciences 11 Medical and Health Sciences 1117 Public Health and Health Services. BMC Nephrol. https://doi.org/10.1186/s12882-018-1072-5
doi: 10.1186/s12882-018-1072-5
pubmed: 6199753
pmcid: 6199753
Lightstone L (2003) Preventing renal disease: The ethnic challenge in the United Kingdom. Kidney Int 63: S135–S138. https://doi.org/10.1046/j.1523-1755.63.s83.29.x
Dreyer G, Hull S, Aitken Z et al (2009) The effect of ethnicity on the prevalence of diabetes and associated chronic kidney disease. QJM 102:261–269. https://doi.org/10.1093/qjmed/hcn177
doi: 10.1093/qjmed/hcn177
Rai PK, Rai P, Bedi S (2019) Prevalence and risk factors of chronic kidney disease in overweight and obese population in a tertiary care hospital in North India. Saudi J Kidney Dis Transpl 30:1431–1438. https://doi.org/10.4103/1319-2442.275488
doi: 10.4103/1319-2442.275488
Agyemang C, Kunst AE, Bhopal R et al (2011) Diabetes prevalence in populations of South Asian Indian and African origins: a comparison of England and The Netherlands. Epidemiology 22:563–567. https://doi.org/10.1097/EDE.0b013e31821d1096
doi: 10.1097/EDE.0b013e31821d1096
Qiu J, Moore JH, Darabos C (2016) Studying the Genetics of complex disease with ancestry-specific human phenotype networks: the case of Type 2 diabetes in East Asian populations. Genet Epidemiol 40:293–303. https://doi.org/10.1002/gepi.21964
doi: 10.1002/gepi.21964
pubmed: 5071667
pmcid: 5071667
Sokhi J, Sikka R, Raina P et al (2016) Association of genetic variants in INS (rs689), INSR (rs1799816) and PP1G.G (rs1799999) with type 2 diabetes (T2D): a case–control study in three ethnic groups from North-West India. Mol Genet Genom 291:205–216. https://doi.org/10.1007/s00438-015-1099-2
doi: 10.1007/s00438-015-1099-2
Khan V, Verma AK, Bhatt D et al (2020) Association of genetic variants of KCNJ11 and KCNQ1 genes with risk of Type 2 diabetes mellitus (T2DM) in the Indian Population: a case-control study. Int J Endocrinol. https://doi.org/10.1155/2020/5924756
doi: 10.1155/2020/5924756
pubmed: 7569458
pmcid: 7569458
Badran M, Laher I (2011) Obesity in Arabic-speaking countries. J Obes. https://doi.org/10.1155/2011/686430
doi: 10.1155/2011/686430
pubmed: 3228340
pmcid: 3228340
Cepoi V, Onofriescu M, Segall L, Covic A (2012) The prevalence of chronic kidney disease in the general population in Romania: a study on 60,000 persons. Int Urol Nephrol 44:213–220. https://doi.org/10.1007/s11255-011-9923-z
doi: 10.1007/s11255-011-9923-z
Duli M, Dika Q, Duli X (2017) Epidemiologic data of CKD patients hospitalized in the University Hospital Center of Tirana “Mother Theresa" for the period 2012–2015. J Macro Trends Heal Med 5:8–19
Codreanu I, Sali V, Gaibu S et al (2012) Prevalence of hypertension and diabetes and coexistence of chronic kidney disease and cardiovascular risk in the population of the Republic of Moldova. Int J Hypertens. https://doi.org/10.1155/2012/951734
doi: 10.1155/2012/951734
pubmed: 3515913
pmcid: 3515913
Spasovski G, Rroji M, Vazelov E et al (2019) Nephrology in the Eastern and Central European region: challenges and opportunities. Kidney Int 96:287–290. https://doi.org/10.1016/j.kint.2019.02.040
doi: 10.1016/j.kint.2019.02.040
Baglio G, Di Palma R, Eugeni E, Fortino A (2017) Undocumented immigrants: what do we know about their health? Epidemiol Prev 41:57–63. https://doi.org/10.19191/EP17.3-4S1.P057.066
doi: 10.19191/EP17.3-4S1.P057.066
Conferenza Permanente per i rapporti tra lo Stato le Regioni e le Province Autonome di Trento e Bolzano (2019) Definizione dei criteri di qualità dei servizi erogati, appropriatezza ed efficienza, per la scelta delle Regioni di riferimento ai fini della determinazione dei costi e fabbisogni standard nel Settore sanitario. In: Repert. atto n. 21/CSR. http://www.statoregioni.it/it/conferenza-stato-regioni/sedute-2019/seduta-del-13022019/atti/repertorio-atto-n-21csr/ . Accessed 6 Dec 2020
Mammana L, Milani C, Bordin P et al (2020) Health system response during the European refugee crisis: Policy and practice analysis in four Italian regions. Int J Environ Res Public Health 17:1–22. https://doi.org/10.3390/ijerph17155458
doi: 10.3390/ijerph17155458