Kidney Diseases in the Developing World and Ethnic Minorities
http://www.100md.com
《新英格兰医药杂志》
Many developing countries and countries in transition have witnessed a rapid increase in the risk of chronic diseases and death during the past few decades. The increased burden of chronic diseases is straining the health services in countries that also have a high burden of infectious diseases. In all these countries, chronic diseases are leading to increases in economic costs; the increases that are best documented relate to cardiovascular disease, diabetes, obesity, and chronic kidney disease.
Of the approximately 1 million people in the world with severe chronic kidney disease who are being treated with some form of renal-replacement therapy, 90 percent live in developed countries. In most developing countries, however, only 5 to 10 percent of patients who require renal-replacement therapy can obtain it. Even in developed countries, there are disparities among regions or groups in the availability of therapy for chronic kidney disease. Although they live in developed nations, these people are in much the same boat as people in developing nations. All patients who cannot obtain renal-replacement therapy need the attention of the World Health Organization and other international organizations.
El Nahas and his coeditors have done a wonderful job of presenting in a single book the problem of kidney disease (primarily chronic kidney disease) in developing countries and in groups within developed countries. The editors are well-known authorities on improving the care and outcome of patients with chronic kidney disease.
The book begins with an outline of both the magnitude of chronic kidney disease and end-stage renal disease in various countries and the major related issues, such as associated infections, treatment, outcome, and economics. This overview is followed by chapters on the causes of chronic kidney disease — diabetic nephropathy, hypertension, and albuminuria, among others — and its prevention. Subsequently, the book has chapters on chronic kidney disease among various ethnic groups around the world, including African Americans, ethnic minorities in the United Kingdom, and Australian aboriginal populations. There are chapters on the organization of prevention programs in various parts of the world, international funding of prevention programs, viral infections, and issues related to the training of nephrologists. The book also includes chapters on the role of the International Society of Nephrology in providing facilities and training for young physicians in various parts of the world, who will help improve the care of patients with chronic kidney disease.
The chapter authors are authorities on the issue of kidney disease in their own parts of the world, and the flow of content throughout the book is reasonably good, so that the reader can cover a large number of pages in a short time. The chapters also contain many up-to-date references. Tables and photographs are appropriately chosen to explain the crucial issues. I personally wish that color, rather than black-and-white figures, had been included so as to make the book more attractive and improve the clarity of the images.
Another concern I have is that the preface gives one the idea that the book is about chronic kidney disease. On reading the table of contents, however, one sees that there are also chapters on other kidney diseases and infections, acute renal failure and toxic nephropathies, and a relief task force on the management of acute renal failure in disasters around the world. It is not that these issues are not important, but keeping the book focused only on chronic kidney disease and related issues might have eliminated any confusion. If the goal of the book is to cover renal diseases as a whole in the developing world, then many other important topics have been omitted.
In summary, I believe that Kidney Diseases in the Developing World and Ethnic Minorities will be very useful for policymakers in developing countries, and it will provide them with a concise review of all the issues related to chronic kidney disease around the world. They will be able to apply what they have learned about the planning of the programs for the prevention of chronic kidney disease when they plan similar programs in their own parts of the world.
Sanjay Kumar Agarwal, M.D.
All India Institute of Medical Sciences
110029 New Delhi, India
skagarwal58@yahoo.co.in(Edited by Meguid El Nahas)
Of the approximately 1 million people in the world with severe chronic kidney disease who are being treated with some form of renal-replacement therapy, 90 percent live in developed countries. In most developing countries, however, only 5 to 10 percent of patients who require renal-replacement therapy can obtain it. Even in developed countries, there are disparities among regions or groups in the availability of therapy for chronic kidney disease. Although they live in developed nations, these people are in much the same boat as people in developing nations. All patients who cannot obtain renal-replacement therapy need the attention of the World Health Organization and other international organizations.
El Nahas and his coeditors have done a wonderful job of presenting in a single book the problem of kidney disease (primarily chronic kidney disease) in developing countries and in groups within developed countries. The editors are well-known authorities on improving the care and outcome of patients with chronic kidney disease.
The book begins with an outline of both the magnitude of chronic kidney disease and end-stage renal disease in various countries and the major related issues, such as associated infections, treatment, outcome, and economics. This overview is followed by chapters on the causes of chronic kidney disease — diabetic nephropathy, hypertension, and albuminuria, among others — and its prevention. Subsequently, the book has chapters on chronic kidney disease among various ethnic groups around the world, including African Americans, ethnic minorities in the United Kingdom, and Australian aboriginal populations. There are chapters on the organization of prevention programs in various parts of the world, international funding of prevention programs, viral infections, and issues related to the training of nephrologists. The book also includes chapters on the role of the International Society of Nephrology in providing facilities and training for young physicians in various parts of the world, who will help improve the care of patients with chronic kidney disease.
The chapter authors are authorities on the issue of kidney disease in their own parts of the world, and the flow of content throughout the book is reasonably good, so that the reader can cover a large number of pages in a short time. The chapters also contain many up-to-date references. Tables and photographs are appropriately chosen to explain the crucial issues. I personally wish that color, rather than black-and-white figures, had been included so as to make the book more attractive and improve the clarity of the images.
Another concern I have is that the preface gives one the idea that the book is about chronic kidney disease. On reading the table of contents, however, one sees that there are also chapters on other kidney diseases and infections, acute renal failure and toxic nephropathies, and a relief task force on the management of acute renal failure in disasters around the world. It is not that these issues are not important, but keeping the book focused only on chronic kidney disease and related issues might have eliminated any confusion. If the goal of the book is to cover renal diseases as a whole in the developing world, then many other important topics have been omitted.
In summary, I believe that Kidney Diseases in the Developing World and Ethnic Minorities will be very useful for policymakers in developing countries, and it will provide them with a concise review of all the issues related to chronic kidney disease around the world. They will be able to apply what they have learned about the planning of the programs for the prevention of chronic kidney disease when they plan similar programs in their own parts of the world.
Sanjay Kumar Agarwal, M.D.
All India Institute of Medical Sciences
110029 New Delhi, India
skagarwal58@yahoo.co.in(Edited by Meguid El Nahas)