The disease burden of chronic kidney disease (CKD) and its impact on healthcare systems has been poorly studied in Asia, a socioeconomically diverse region with wide variations in availability, access, and quality of CKD care. The high CKD burden in this region is predominantly driven by an increased prevalence of risk factors including diabetes mellitus, hypertension, obesity, and use of traditional medicines and is further aggravated by challenges associated with effective implementation of population-based screening and surveillance systems in early detection and intervention of CKD. The Asian continent mostly comprised of low- and middle-income countries with resource restraints lacks robust population-based CKD registries resulting in a paucity of data on CKD incidence and prevalence, various treatment modalities, uptake of current guidelines, and the overall impact of implementation of developmental programs. There is an urgent need for a collaborative action plan between the healthcare community and governments in this region to detect CKD in its early stages and prevent its complications including kidney failure, cardiovascular disease, and death. Research- based evidence on the impact of early detection, sustainable treatment options, quality of life, delay or avoidance of dialysis, and related cost analysis is the need of the hour. We highlight successful implementation of strategic and policy-sharing programs adopted in a few countries; also, consolidate available region-specific data, quantify estimates of CKD burden and propose strategies with a multidisciplinary approach involving patients, the healthcare community and governmental bodies to combat CKD and its complications.

Background: Acute renal failure (ARF) is an uncommon but alarming complication of idiopathic nephrotic syndrome. The renal failure could be secondary to causes evident from the history and evaluation, such as severe intravascular volume depletion, acute tubular necrosis but there is no report on this population in Vietnamese adult patients. Objective: To investigate on acute renal failure complicating of nephrotic syndrome. Subjects and method: Patients with idiopathic nephrotic syndrome who were admitted with acute renal failure have been enrolled to investigate the clinical findings, laboratory check up and histology examination. Results:We present 33 patients with idiopathic nephrotic syndrome who were admitted with acute renal failure between June 1997 and June 1998. We describe the clinical and renal pathology features of these patients in whom reversible idiopathic acute renal failure developed during the course of primary nephrotic syndrome (PNS). Improvement in renal function occurred in 80% of patients over a variable period of 10 days to 14 days. The histology findings are interstitial edema, tubular obstruction. Conclusions: Acute renal failure complicating of nephritic syndrome is reversible, the exact pathophysiology of ARF is not understood. Possible causes include edema, tubular obstruction, altered glomerular permeability, and unrecognized hypovolemia.
Acute Kidney Injury/ pathology Nephrotic Syndrome ; Adult