Metabolic disorder–associated kidney disease and diabetic kidney disease in developing countries

There is a paucity of literature addressing the epidemiology of metabolic disorder-associated kidney disease in developing countries, but extrapolating from the high prevalence of metabolic syndrome in low- and middle-income countries, and the known high prevalence of diabetic kidney disease in the same, the health and economic impact of metabolic disorder-associated kidney disease and diabetic kidney disease is substantial. Resource constraints in developing countries amplify the challenges in preventing, detecting, and treating metabolic disorder-associated kidney disease and diabetic kidney disease. There is diminished capacity for kidney care and hence poorer clinical outcomes including disproportionately higher rates of death and disability when compared with high-income countries. Kidney replacement therapy may not be available or affordable in many developing countries, and there is also a heavy burden of nonrenal complications, in particular cardiovascular disease. Urgent action is therefore imperative upstream to control the epidemic of diabetes and metabolic syndrome, as well as to improve early detection and care of metabolic disorder-associated kidney disease and diabetic kidney disease in these countries. All-of-society, all-of-government, and global approaches are urgently needed, with consideration of the cultural, economic, and educational matrix at the individual country level.