In many Arab countries, obstructive uropathy constitutes a major cause (40%) of end stage renal disease mostly due to renal calculi and schistosomiasis. Schistosomiasis, due to S. mansoni and S. haematobium, is an endemic common disease in a number of Arab countries. Both types have their negative impact on the kidneys. While obstructive uropathy is a common complication of S. haematobium, distinct patterns of glomerular lesions, including membranoproliferative glomerulonephritis and focal segmental glomerulosclerosis, are associated with infection by S. mansoni or S. japonicum. However, with the widespread use of praziquantel, the prevalence of Schistosomiasis decreased over time. In Egypt, the incidence of squamous cell carcinoma of the bladder decreased while that of transitional cell carcinoma increased after mass treatment of Schistosomiasis. In South America, a change in the distribution of glomerulopathies associated with nephrotic syndrome was observed along with a decline in the occurrence of severe forms of schistosomiasis.
http://www.nature.com/ki/journal/v68/n98s/full/4496436a.html#bib7
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762011000700017&lng=en&nrm=iso&tlng=en
How would we know if the prevalence of CKD declined, when across most of the world we don't know what the prevalence of CKD is? There are few population-based random sample studies of the prevalence of CKD, limited to first-world countries (off the top of my head, I can only think of US-NHANES & Australia - Aust Health Survey). Add to the list to prove me wrong!
Whether due to obstructive uropathy or schistosomiasis related glomerulopathy, the etiology of chronic renal failure in an endemic country could be an indirect measure. It is very difficult indeed to carry out a community-based study to answer this question othewise it would be a baseline study for further follow up later on
Thank you for interesting discussion, Dr.Ragheb. I agree with Dr.Lawton that it is hard to tell the exact prevalence of CKD. Also, Schistosomiasis has not affected people worldwide. However, I am happy to hear the prevalence of Schistosomiasis decreased over time in Arab countries.
However, roughly CKD prevalence worldwide is estimated at 8-16%.
References:
1 (CDC) CfDCaP: National chronic kidney disease fact sheet: General information and national estimates on chronic kidney disease in the united states, 2014: Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, 2014,
2 Jha V, Garcia-Garcia G, Iseki K, Li Z, Naicker S, Plattner B, Saran R, Wang AY, Yang CW: Chronic kidney disease: Global dimension and perspectives. Lancet 2013;382:260-272.
Good evidence for changing pattern of cancer bladder after control of schistosomiasis in Egypt
http://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2010.09622.x/epdf
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