Biomedical subjects

Srinivas Kondalsamy-Chennakesavan

Publications and source records attributed to Srinivas Kondalsamy-Chennakesavan.

3 recordsLinked to original sources

PubMed2006

Renal disease, the metabolic syndrome, and cardiovascular disease.

OBJECTIVES: To describe the association between renal disease and other features of the metabolic syndrome and its derivative illnesses among Australian Aborigines in remote settings. METHODS: Volunteering adults (N = 2019) in four remote communities were screened for risk factors and markers of renal disease, hypertension, and diabetes, and their cross-sectional associations were evaluated. Rates of the metabolic syndrome were estimated in one community with comprehensive screening data. The associations of albuminuria with hospitalizations, coronary heart events, and non-renal deaths were then followed for > 7 years in that same community. RESULTS: Rates of renal disease, hypertension, and diabetes all increased dramatically with age. They all overlapped. Renal disease and hypertension were the most prominent and earliest features of the syndrome, while diabetes was a later, less common and more variable manifestation. All were strongly correlated with waist measurements, and high waist measurements more comprehensively characterized those with illnesses than did the more restrictive definitions of the metabolic syndrome. Albuminuria predicted non-renal hospitalizations, first time coronary heart disease events, and all-cause death. CONCLUSION: Albuminuria/proteinuria is an early and dominant element of a symptom complex that is marked by higher waist measurements, and it strongly predicts all-cause and cardiovascular illnesses and deaths. This finding implies a common background of risk factors for renal disease, hypertension, diabetes, and cardiovascular risk. The findings support integrated, rather than disease-specific, surveillance programs, an important role for albuminuria in predicting non-renal risk, and a unified approach for primary and secondary prevention of all elements of the syndrome.

Adult↗

PubMed2005

Kidney and related chronic disease profiles and risk factors in three remote Australian Aboriginal communities.

Morbidities and deaths from noncommunicable chronic diseases are greatly increased in remote Australian Aboriginal communities, but little is known of the underlying community-based health profiles. We describe chronic-disease profiles and their risk factors in 3 remote communities in the Northern Territory. Consenting adults (18+ years of age) in 3 communities participated in a brief history and examination between 2000 and mid-2003 as part of a systematic program to improve chronic-disease awareness and management. Participation was 67%, 128%, and 62% in communities A, B, and C, respectively with a total of 1070 people examined. Current smokers included 41% of females and 72% of males. Most men were current drinkers, but most women were not. Parameters of body weight differed markedly by community, with mean body mass index (BMI) varying from 21.4 to 27.9 kg/m2 . Rates of chronic diseases were excessive but differed markedly; an almost threefold difference in the likelihood of any morbidity existed between communities A and C. Rates increased with age, but the greatest numbers of people with morbidities were in the middle-aged group. Most people had multiple morbidities with tremendous overlap. Hypertension and kidney disease appear to be early manifestations of the integrated chronic-disease syndrome, while diabetes is a late manifestation or complication. Substantial numbers of new cases of disease were identified by testing, and blood pressure improved in treated people with hypertension. Wide variations occur in body habitus, risk factors, and chronic-disease rates among communities, but an overwhelming need for effective smoking interventions exists in all. Systematic screening is useful in identifying high-risk individuals, most at early treatable stages there. Findings are very important for estimating current treatment needs, future burdens of disease, and for needs-based health services planning. Resources required will vary according to the burden of disease.

Adolescent↗

PubMed2005

A chronic disease outreach program for Aboriginal communities.

BACKGROUND: Our objective is to describe a program to improve awareness and management of hypertension, renal disease, and diabetes in 3 remote Australian Aboriginal communities. METHODS: The program espouses that regular integrated checks for chronic disease and their risk factors are essential elements of regular adult health care. Programs should be run by local health workers, following algorithms for testing and treatment, with backup, usually from a distance, from nurse coordinators. Constant evaluation is essential to develop community health profiles and adapt program structure. RESULTS: Participation ranged from 65% to 100% of adults. Forty-one percent of women and 72% of men were current smokers. Body weight varied markedly by community. Although excessive in all, rates of chronic diseases also differed markedly among communities. Rates increased with age, but the greatest numbers of people with morbidities were middle age and young adults. Multiple morbidities were common by middle age. Hypertension and renal disease were early features, whereas diabetes was a variable and later manifestation of this integrated chronic disease syndrome. Adherence to testing and treatment protocols improved markedly over time. Substantial numbers of new diagnoses were made. Blood pressure improved in people in whom antihypertensive agents were started or increased. Components of a systematic activity plan became more clearly defined with time. Treatment of people in the community with the greatest disease burden posed a large additional workload. Lack of health workers and absenteeism were major impediments to productivity. CONCLUSION: We cannot generalize about body habitus, and chronic disease rates among Aboriginal adults. Pilot data are needed to plan resources based on the chronic disease burden in each community. Systematic screening is useful in identifying high-risk individuals, most at an early treatable stage. Community-based health profiles provide critical information for the development of rational health policy and needs-based health services.

Adult↗