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.

Introduction: This is a prospective, post marketing surveillance study that aims to determine the efficacy and safety of sevelamer carbonate in hyperphosphatemic chronic kidney disease (CKD) patients in the Philippines. Methods: Adult CKD patients with serum phosphorous levels >1.78 mmol/L and whose physician had decided to treat with sevelamer carbonate 800 mg were enrolled in the study and followed-up for a minimum of three visits from baseline within a six-month period. The primary endpoint was the change in serum phosphorous levels from baseline to the sixth month. Adverse events were noted and recorded during the treatment period. Results: There were 233 patients included in the study from five centers in Metro Manila from 2010 to 2013. Of the 233 patients, 199 were on chronic dialysis, 33 were not on dialysis, and 1 had no data. There was a statistically significant (P-value <0.0001) reduction in serum phosphorous levels from baseline after treatment with sevelamer carbonate. There were 16 patients reported to have adverse drug reactions, 13 of whom had serious adverse events (SAE) and three were non-serious. Of the 13 patients with SAEs, only one was possibly/probably related to sevelamer carbonate and all three non-SAEs were possibly/definitely related to sevelamer carbonate. Conclusion The results showed sevelamer carbonate to be effective in lowering serum phosphorous levels and the most common adverse events were related to the gastrointestinal tract (1.4%). There were sixteen patients with adverse events, three of which were non-serious, while 13 were reported to be serious adverse events. Only one was probably related to the drug.
Renal Insufficiency, Chronic ; Hyperphosphatemia ; Sevelamer

OBJECTIVE: This study aimed to assess the safety and effectiveness of subcutaneous (SC) Epoetin alfa in the treatment of Filipino patients with anemia associated with chronic renal failure.
METHODS: This is a prospective, observational, multicenter study on chronic renal failure patients with anemia for whom Epoetin alfa SC is indicated. Each patient was followed-up according to the frequency deemed appropriate by the physician for a period of 6 months. Data were collected using a case-report form which is filled-up by the investigator based on available data in the patient records. Patient characteristics were analyzed descriptively. The frequency and description of adverse events were obtained. Baseline and endstudy hemoglobin and hematocrit levels were compared inferentially. Monitoring for antibody-mediated pure red cell aplasia (PRCA) was given special focus.
RESULTS: A total of 458 patients were enrolled in the study with an average age 52.8 ± 16.9 years and a slight male predominance (57.8% male). Among patients with primary renal diseases, the most common diagnosis was chronic glumerulonephritis (31.0%), followed by diabetic nephropathy (14.4%) and hypertension (10.0%). Around two-thirds (66.2%) of the patients were on dialysis, while the rest were in the pre-dialysis stage. Most patients had concomitant disease conditions with hypertension (57.9%) and diabetes mellitus (27.1%) being the most common. Most patients also had multiple concomitant medications. Significant improvements inhemoglobin (mean increase 0.8 ± 2.3 mg/dL from 9.66 at baseline; p value at < 0.0001) and hematocrit (mean increase 2.4 ± 6.9% from 28.91% at baseline; p value at <0.0001) levels were observed. A total of 16.6% of the patients experienced non-serious adverse events, with fatigue being the most common, and all of these were resolved during the study. Less than 5% of the patients had serious adverse events leading to mortality, which were all assessed by the investigators as not related to Epoetin alfa. There was no reported suspected loss ofeffect among the subjects indicating no incident PRCA.
CONCLUSION: Subcutaneously administered Epoetin alfa was effective in significantly increasing hemoglobin and hematocrit in chronic kidney disease patients with anemia. The drug is also safe and well tolerated, with no new safety issue identified, and no incident case of PRCA.

Human ; Male ; Female ; Middle Aged ; Adult ; Anemia ; Kidney Failure, Chronic ; Diabetic Nephropathies ; Epoetin Alfa ; Hematocrit ; Hypertension ; Renal Dialysis ; Renal Insufficiency, Chronic ; Erythropoietin