nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-560Research ArticleВСЕМИРНЫЙ ДЕНЬ ПОЧКИWORLD KIDNEY DAYХроническая болезнь почек у незащищенных слоев населенияCKD in Disadvantaged PopulationsГилермоГарсиа-ГарсиаGuillermoGarcia-Garciainfo@worldkidneyday.orgВивеканандДжаVivekanandJhanoemail@neicon.ruОтделение нефрологии, Государственная больница Гвадалахары, Медицинский центр Университета Гвадалахары, Гвадалахара, Халиско, МексикаРоссияNephrology Service, Hospital Civil de Guadalajara, University of Guadalajara Health Sciences Center, Guadalajara, Jal. MexicoRussian FederationИнститут последипломного медицинского образования и исследований, Чандигарх, Индия, Институт Здоровья, Нью Дели, Индия и Университет Оксфорда, ВеликобританияРоссияPostgraduate Institute of Medical Education and Research, Chandigarh, India, George Institute for Global Health, New Delhi, India and University of Oxford, UKRussian Federation201413092024164402409Copyright © Гилермо Г., Вивекананд Д., 20242024Гилермо Г., Вивекананд Д.Guillermo G., Vivekanand J.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/560

12 марта 2015 года будет отмечаться 10-летие Всемирного Дня Почки (ВДП), инициативы Международного Общества Нефрологов и Международной Федерации Почечных Фондов. С момента своего основания в 2006 г., ВДП стал наиболее успешным мероприятием, направленным на повышение осведомленности широких слоев населения и руководящих структур о значимости болезней почек. ВДП ежегодно напоминает нам, что болезни почек являются распространенными, опасными и излечимыми. В центре внимания ВДП в 2015 г. - хроническая болезнь почек (ХБП) у незащищенных слоев населения. В представленной статье обсуждаются основные связи между бедностью и ХБП, а также возможные подходы к профилактике болезней почек и лечению нефрологических больных в данной социальной группе. Хроническая болезнь почек все шире признается как глобальная проблема общественного здравоохранения и ключевая детерминанта неблагоприятных исходов для здоровья человека. Имеются убедительные доказательства того, что ущерб от нераспознанной и нелеченой ХБП особенно велик у незащищенных слоев населения, то есть в популяциях с недостаточными материальными ресурсами, у представителей расовых и этнических меньшинств и/или коренных народов и выходцев из социально неблагополучных семей. Хотя все население ряда стран с низкими и умеренными доходами можно рассматривать как незащищенное, анализ локальных факторов позволяет выделить группы населения, которые характеризуются крайней степенью неблагополучия (крестьяне, сельские жители, женщины, пожилые, представители религиозных меньшинств и т.д). Сам факт, что даже в развитых странах представители расовых и этнических меньшинств непропорционально чаще страдают ХБП и имеют худший прогноз, говорит о том, что требуется специальное изучение не только традиционных, но и дополнительных факторов риска осложнений, ассоциированных с ХБП у этих групп населения [1]. Во всем мире около 1,2 миллиардов людей живут в крайней бедности. Бедность негативно сказывается на образе жизни, ограничивает доступ к медицинской помощи, усиливает неблагоприятное воздействие факторов воздействие внешней среды, и каждое из перечисленных обстоятельств приводит к различиям в состоянии здоровья [2] (Таблица 1). Бедные более восприимчивы к заболеваниям из-за ограниченного доступа к товарам и услугам, в особенности чистой питьевой воде и канализации, полноценному питанию, медицинскому обслуживанию, а также информации о профилактике заболеваний и гигиене [3]. Перевод Д.Ю. Щекочихина и Н.Л. Козловской под редакцией Е.В. Захаровой Перевод сделан по поручению и одобрен организационным комитетом Всемирного Дня Почки * Члены Оргкомитета Всемирного дня почки: Philip Kam Tao Li, Guillermo Garcia-Garcia, William G. Couser, Timur Erk, Elena Zakharova, Luca Segantini, Paul Shay, Miguel C. Riella, Charlotte Osafo, Sophie Dupuis, Charles Kernahan

ReferencesPugsley D, Norris KC, Garcia-Garcia G, Agodoa L. Global approaches for understanding the disproportionate burden of chronic kidney disease. Ethn Dis. 2009;19[Suppl 1]: S1-1-S1-2Pugsley D, Norris KC, Garcia-Garcia G, Agodoa L. Global approaches for understanding the disproportionate burden of chronic kidney disease. Ethn Dis. 2009;19[Suppl 1]: S1-1-S1-2Crews DC, Charles RF, Evans MK, Alan B. Zonderman AB, Powe NR. Poverty, race, and CKD in a racially and socioeconomically diverse urban population. Am J Kidney Dis 2010: 55:992-1000Crews DC, Charles RF, Evans MK, Alan B. Zonderman AB, Powe NR. Poverty, race, and CKD in a racially and socioeconomically diverse urban population. Am J Kidney Dis 2010: 55:992-1000Sachs JD. Macroeconomics and health: Investing in health for economic development. Report of the Commission on Macroeconomics and Health. WHO. 2001Sachs JD. Macroeconomics and health: Investing in health for economic development. Report of the Commission on Macroeconomics and Health. WHO. 2001Kalantar-Zadhe K, Block G, Humphreys MH, Kopple JD. Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Kidney Int 2003;63:793-808Kalantar-Zadhe K, Block G, Humphreys MH, Kopple JD. Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Kidney Int 2003;63:793-808Hsu CY, Lin F, Vittinghof E, Shlipak MG. Racial Differences in the Progression from Chronic Renal Insufficiency to End-Stage Renal Disease in the United States. J Am Soc Nephrol 2003;14: 2902-2907Hsu CY, Lin F, Vittinghof E, Shlipak MG. Racial Differences in the Progression from Chronic Renal Insufficiency to End-Stage Renal Disease in the United States. J Am Soc Nephrol 2003;14: 2902-2907Norris K, Nissenson AR: Race, gender, and socioeconomic disparities in CKD in the United States. J Am Soc Nephrol 2008;19:1261-1270Norris K, Nissenson AR: Race, gender, and socioeconomic disparities in CKD in the United States. J Am Soc Nephrol 2008;19:1261-1270Bruce MA, Beech BM, Crook ED, Sims M, Wyatt SB, Michael F. Flessner MF, Taylor HA, Williams DR, Akylbekova EL, Ikizler TA. Association of socioeconomic status and CKD among African Americans: The Jackson Heart Study. Am J Kidney Dis 2010;55:1001-1008Bruce MA, Beech BM, Crook ED, Sims M, Wyatt SB, Michael F. Flessner MF, Taylor HA, Williams DR, Akylbekova EL, Ikizler TA. Association of socioeconomic status and CKD among African Americans: The Jackson Heart Study. Am J Kidney Dis 2010;55:1001-1008Volkova N, McClellan W, Klein M, Flanders D, Kleinbaum D, Soucie JM, Presley R. Neighborhood poverty and racial differences in ESRD incidence. J Am Soc Nephrol. 2008;19:356-64.Volkova N, McClellan W, Klein M, Flanders D, Kleinbaum D, Soucie JM, Presley R. Neighborhood poverty and racial differences in ESRD incidence. J Am Soc Nephrol. 2008;19:356-64.Caskey FJ. Renal replacement therapy: can we separate the effects of social deprivation and ethnicity?. Kidney Int Supplements 2013;3:246-249Caskey FJ. Renal replacement therapy: can we separate the effects of social deprivation and ethnicity?. Kidney Int Supplements 2013;3:246-249Sabanayagam C, Lim SC, Wong TY, Lee J, Shankar A, Tai ES. Ethnic disparities in prevalence and impact of risk factors of chronic kidney disease. Nephrol Dial Transplant 2010;25:2564-2570Sabanayagam C, Lim SC, Wong TY, Lee J, Shankar A, Tai ES. Ethnic disparities in prevalence and impact of risk factors of chronic kidney disease. Nephrol Dial Transplant 2010;25:2564-2570Gao S, Manns BJ, Culleton BF, Tonelli M, Quan H, Crowshoe L, GhaliWA, Svenson LW, Hemmelgarn BR. Prevalence of chronic kidney disease and survival among Aboriginal people. J Am Soc Nephrol. 2007; 18: 2953-2959Gao S, Manns BJ, Culleton BF, Tonelli M, Quan H, Crowshoe L, GhaliWA, Svenson LW, Hemmelgarn BR. Prevalence of chronic kidney disease and survival among Aboriginal people. J Am Soc Nephrol. 2007; 18: 2953-2959McDonald S. Incidence and treatment of ESRD among indigenous peoples of Australasia. Clin Nephrol 2010;74 Suppl 1: S28-S31McDonald S. Incidence and treatment of ESRD among indigenous peoples of Australasia. Clin Nephrol 2010;74 Suppl 1: S28-S31Collins JF. Kidney disease in Maori and Pacific people in New Zealand. Clin Nephrol 2010; 74 Suppl. 1:S61-S65Collins JF. Kidney disease in Maori and Pacific people in New Zealand. Clin Nephrol 2010; 74 Suppl. 1:S61-S65Weil EJ, Nelson RG. Kidney disease among the indigenous peoples of Oceania. Ethn Dis. 2006;16 suppl 2:S24-S30Weil EJ, Nelson RG. Kidney disease among the indigenous peoples of Oceania. Ethn Dis. 2006;16 suppl 2:S24-S30United States Renal Data System: USRDS 2006 Annual Data Report. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 2013United States Renal Data System: USRDS 2006 Annual Data Report. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 2013Kasiske BL, Rith-Najarian S, Casper ML, Croft JB. American Indian heritage and risk factors for renal injury. Kidney Int. 1998;54:1305-1310Kasiske BL, Rith-Najarian S, Casper ML, Croft JB. American Indian heritage and risk factors for renal injury. Kidney Int. 1998;54:1305-1310Nelson RG, Morgenstern H, Bennett PH. An epidemic of proteinuria in Pima Indians with type 2 diabetes mellitus. Kidney Int. 1998;54:2081-2088Nelson RG, Morgenstern H, Bennett PH. An epidemic of proteinuria in Pima Indians with type 2 diabetes mellitus. Kidney Int. 1998;54:2081-2088Scavini M, Shah VO, Stidley CA, Tentori F, et al. Kidney disease among the Zuni Indians: The Zuni Kidney Project. Kidney Int 2005;68 Suppl 97:126-131Scavini M, Shah VO, Stidley CA, Tentori F, et al. Kidney disease among the Zuni Indians: The Zuni Kidney Project. Kidney Int 2005;68 Suppl 97:126-131Jha V, Garcia-Garcia G,Iseki K, Li Z, Naicker S, Plattner B, Saran R, Wang AYM, Yang CW. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382:260-72Jha V, Garcia-Garcia G,Iseki K, Li Z, Naicker S, Plattner B, Saran R, Wang AYM, Yang CW. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382:260-72Almaguer M, Herrera R, Orantes CM. Chronic Kidney Disease of Unknown Etiology in Agricultural Communities. MEDICC Review 2014;16:9-15Almaguer M, Herrera R, Orantes CM. Chronic Kidney Disease of Unknown Etiology in Agricultural Communities. MEDICC Review 2014;16:9-15Ulasi II, Ijoma CK, Onodugo OD, Arodiwe EB, et al. Towards prevention of chronic kidney disease in Nigeria; a community-based study in Southeast Nigeria. Kidney Int Suppl 2013;3:195-201Ulasi II, Ijoma CK, Onodugo OD, Arodiwe EB, et al. Towards prevention of chronic kidney disease in Nigeria; a community-based study in Southeast Nigeria. Kidney Int Suppl 2013;3:195-201Otieno LS, McLigeyo SO, Luta M. Acute renal failure following the use of herbal medicines. East Afr Med J. 1991;6:993-998Otieno LS, McLigeyo SO, Luta M. Acute renal failure following the use of herbal medicines. East Afr Med J. 1991;6:993-998Obrador GT, Garcia-Garcia G, Villa AR, Rubilar X, et al. Prevalence of chronic kidney disease in the Kidney Early Evaluation Program (KEEP) Mexico and comparison with KEEP US. Kidney Int 2010; 77 suppl 116:S2-S8Obrador GT, Garcia-Garcia G, Villa AR, Rubilar X, et al. Prevalence of chronic kidney disease in the Kidney Early Evaluation Program (KEEP) Mexico and comparison with KEEP US. Kidney Int 2010; 77 suppl 116:S2-S8Gutierrez-Padilla JA, Mendoza-Garcia M, Plascencia-Perez S, Renoirte-Lopez K, et al. Screening for CKD and Cardiovascular Disease Risk Factors Using Mobile Clinics Jalisco, Mexico. Am J Kidney Disease 2010; 55:474-484Gutierrez-Padilla JA, Mendoza-Garcia M, Plascencia-Perez S, Renoirte-Lopez K, et al. Screening for CKD and Cardiovascular Disease Risk Factors Using Mobile Clinics Jalisco, Mexico. Am J Kidney Disease 2010; 55:474-484Garcia-Garcia G, Gutierrez-Padilla AJ, Chavez-Iñiguez J, Perez-Gomez HR, Mendoza-García M, Gonzalez-De la Peña MM, Tonelli M. Identifying undetected cases of CKD in Mexico. Targeting high-risk populations. Arch Med Res 2013;44:623-627Garcia-Garcia G, Gutierrez-Padilla AJ, Chavez-Iñiguez J, Perez-Gomez HR, Mendoza-García M, Gonzalez-De la Peña MM, Tonelli M. Identifying undetected cases of CKD in Mexico. Targeting high-risk populations. Arch Med Res 2013;44:623-627Amato D, Alvarez-Aguilar C, Castañeda-Limones R, et al. Prevalence of chronic kidney disease in an urban Mexican population. Kidney Int 2005;68 suppl 97:11-17Amato D, Alvarez-Aguilar C, Castañeda-Limones R, et al. Prevalence of chronic kidney disease in an urban Mexican population. Kidney Int 2005;68 suppl 97:11-17Hoy W, McDonald SP. Albuminuria: Marker or target in indigenous populations. Kidney Int 2004;66 Suppl 92:S25-S31Hoy W, McDonald SP. Albuminuria: Marker or target in indigenous populations. Kidney Int 2004;66 Suppl 92:S25-S31McDonald SP, Maguire GP,Hoy WE: Renal function and cardiovascular risk markers in a remote Australian Aboriginal community. Nephrol Dial Transplant 2003;18:1555-1561McDonald SP, Maguire GP,Hoy WE: Renal function and cardiovascular risk markers in a remote Australian Aboriginal community. Nephrol Dial Transplant 2003;18:1555-1561Hoy WE, Samuel T, Mott SA, Kincaid-Smith PS, Fogo AB, Dowling JP, Hughson MD, Sinniah R, Pugsley DJ, Kirubakaran MG, Douglas-Denton, Bertram JF. Renal biopsy findings among Indigenous Australians:a nationwide review. Kidney Int 2012;82:1321-1331Hoy WE, Samuel T, Mott SA, Kincaid-Smith PS, Fogo AB, Dowling JP, Hughson MD, Sinniah R, Pugsley DJ, Kirubakaran MG, Douglas-Denton, Bertram JF. Renal biopsy findings among Indigenous Australians:a nationwide review. Kidney Int 2012;82:1321-1331Hoy WE, Hughson MD, Zimanyi M et al. Distribution of volume of individual glomeruli in kidneys at autopsy: association with age, nephron number, birthweight and body mass index. Clin Nephrol 2010; 74 Suppl 1: S105-S112Hoy WE, Hughson MD, Zimanyi M et al. Distribution of volume of individual glomeruli in kidneys at autopsy: association with age, nephron number, birthweight and body mass index. Clin Nephrol 2010; 74 Suppl 1: S105-S112Lackland DT, Bendall HE, Osmond C, Egan BM, Barker DJ. Low birth weights contribute to high-rates of early-onset of chronic renal failure in the Southeastern United States. Arch Intern Med. 2000;160:1472-1476Lackland DT, Bendall HE, Osmond C, Egan BM, Barker DJ. Low birth weights contribute to high-rates of early-onset of chronic renal failure in the Southeastern United States. Arch Intern Med. 2000;160:1472-1476Bhargava SK, Sachdev HS, Fall CH et al. Relation of serial changes in childhood body-mass index to impaired glucose tolerance in young adulthood. N Engl J Med 2004; 350: 865-875Bhargava SK, Sachdev HS, Fall CH et al. Relation of serial changes in childhood body-mass index to impaired glucose tolerance in young adulthood. N Engl J Med 2004; 350: 865-875Jafar TH, Chaturvedi N, Hatcher J et al. Proteinuria in South Asian children: prevalence and determinants. Pediatr Nephrol 2005; 20: 1458-1465Jafar TH, Chaturvedi N, Hatcher J et al. Proteinuria in South Asian children: prevalence and determinants. Pediatr Nephrol 2005; 20: 1458-1465Jafar TH, Islam M, Poulter N et al. Children in South Asia have higher body mass-adjusted blood pressure levels than white children in the United States: a comparative study. Circulation 2005; 111: 1291-1297Jafar TH, Islam M, Poulter N et al. Children in South Asia have higher body mass-adjusted blood pressure levels than white children in the United States: a comparative study. Circulation 2005; 111: 1291-1297Liyanage T, Ninomiya T, Jha V, Patrice HM, Okpechi I, Zhao M, Lv J, Garg AX, Knight J, Gallagher M, Kotwal S, Cass A, Perkovic V. Worldwide access to treatment for end stage kidney disease: a systematic review (submitted)Liyanage T, Ninomiya T, Jha V, Patrice HM, Okpechi I, Zhao M, Lv J, Garg AX, Knight J, Gallagher M, Kotwal S, Cass A, Perkovic V. Worldwide access to treatment for end stage kidney disease: a systematic review (submitted)Barsoum R.S. Chronic kidney disease in the developing world. N Engl J Med 2006; 354:997-999Barsoum R.S. Chronic kidney disease in the developing world. N Engl J Med 2006; 354:997-999Cusumano AM, Garcia-Garcia G, Gonzalez-Bedat MC, Marinovich S et al. Latin American Dialysis and Transplant Registry: 2008 prevalence and incidence of end-stage renal disease and correlation with socioeconomic indexes. Kidney Int Supplements 2013;3.153-156Cusumano AM, Garcia-Garcia G, Gonzalez-Bedat MC, Marinovich S et al. Latin American Dialysis and Transplant Registry: 2008 prevalence and incidence of end-stage renal disease and correlation with socioeconomic indexes. Kidney Int Supplements 2013;3.153-156Jha V. Current status of end-stage renal disease care in India and Pakistan. Kidney Int Supplements 2013; 3:157-160Jha V. Current status of end-stage renal disease care in India and Pakistan. Kidney Int Supplements 2013; 3:157-160Garcia Garcia G, Harden PN, Chapman JR. World Kidney Day 2012. The Global role of kidney transplantation. The Lancet 2012;379:e36-e38Garcia Garcia G, Harden PN, Chapman JR. World Kidney Day 2012. The Global role of kidney transplantation. The Lancet 2012;379:e36-e38Yeates KE, Cass A, Sequist TD, McDonald SP, Jardine MJ, Trpeski L, Ayanian JZ. Indigenous people in Australia, Canada, New Zealand and the United States are less likely to receive renal transplantation. Kidney Int. 2009; 76: 659-664Yeates KE, Cass A, Sequist TD, McDonald SP, Jardine MJ, Trpeski L, Ayanian JZ. Indigenous people in Australia, Canada, New Zealand and the United States are less likely to receive renal transplantation. Kidney Int. 2009; 76: 659-664Jha V. Current status of chronic kidney disease care in South-east Asia. Semin Nephrol 2009;29:487-496Jha V. Current status of chronic kidney disease care in South-east Asia. Semin Nephrol 2009;29:487-496Garcia-Garcia G, Monteon-Ramos JF, Garcia-Bejarano H, Gomez-Navarro B, Hernandez-Reyes I, Lomeli AM, et al. Renal replacement therapy among disadvantaged populations in Mexico: a report from the Jalisco Dialysis and Transplant Registry (REDTJAL). Kidney Int. 2005;68 Suppl 97:S58-S61Garcia-Garcia G, Monteon-Ramos JF, Garcia-Bejarano H, Gomez-Navarro B, Hernandez-Reyes I, Lomeli AM, et al. Renal replacement therapy among disadvantaged populations in Mexico: a report from the Jalisco Dialysis and Transplant Registry (REDTJAL). Kidney Int. 2005;68 Suppl 97:S58-S61Ramachandran R, Jha V. Kidney Transplantation Is Associated with Catastrophic Out of Pocket Expenditure in India. PLoS ONE 2013;8: e67812Ramachandran R, Jha V. Kidney Transplantation Is Associated with Catastrophic Out of Pocket Expenditure in India. PLoS ONE 2013;8: e67812McDonald SP, Russ GR. Burden of end-stage renal disease among indigenous peoples in Australia and New Zealand. Kidney Int 2003;63, Suppl 83:S123-S127McDonald SP, Russ GR. Burden of end-stage renal disease among indigenous peoples in Australia and New Zealand. Kidney Int 2003;63, Suppl 83:S123-S127Chou SH, Tonelli M, John S. Bradley JS, Gourishankar S, Hemmelgarn BR. Quality of Care among Aboriginal Hemodialysis Patients. Clin J Am Soc Nephrol 2006; : 58-63Chou SH, Tonelli M, John S. Bradley JS, Gourishankar S, Hemmelgarn BR. Quality of Care among Aboriginal Hemodialysis Patients. Clin J Am Soc Nephrol 2006; : 58-63Rodriguez RA, Sen S, Mehta K, Moody-Ayers S, Bacchetti P, O’Hare AM: Geography matters: Relationships among urban residential segregation, dialysis facilities, and patient outcomes. Ann Intern Med 2007;146:493-501Rodriguez RA, Sen S, Mehta K, Moody-Ayers S, Bacchetti P, O’Hare AM: Geography matters: Relationships among urban residential segregation, dialysis facilities, and patient outcomes. Ann Intern Med 2007;146:493-501Mehrotra R, Story K, Guest S, Fedunyszyn M. Neighborhood location, rurality, geography and outcomes of peritoneal dialysis patients in the United States. Perit Dial Int. 2012; 32(3): 322-331Mehrotra R, Story K, Guest S, Fedunyszyn M. Neighborhood location, rurality, geography and outcomes of peritoneal dialysis patients in the United States. Perit Dial Int. 2012; 32(3): 322-331Garcia-Garcia G, Briseño-Renteria G, Luquin-Arellano VH, Gao Z, Gill J, Tonelli M: Survival Among Patients with Kidney Failure in Jalisco. J Am Soc Nephrol 2007;18:1922-1927Garcia-Garcia G, Briseño-Renteria G, Luquin-Arellano VH, Gao Z, Gill J, Tonelli M: Survival Among Patients with Kidney Failure in Jalisco. J Am Soc Nephrol 2007;18:1922-1927Parameswaran S, Geda SB, Rathi M, Kohli, HS Gupta KL, Sakhuja V, Jha V. Referral pattern of end-stage renal disease patients and its impact on outcome at a public sector hospital. National Medical Journal of India 2011; 24: 208-13Parameswaran S, Geda SB, Rathi M, Kohli, HS Gupta KL, Sakhuja V, Jha V. Referral pattern of end-stage renal disease patients and its impact on outcome at a public sector hospital. National Medical Journal of India 2011; 24: 208-13

The authors declare that there are no conflicts of interest present.