Burden of chronic kidney disease in the general population and high-risk groups in South Asia: A systematic review and meta-analysis

Nipun Shrestha; Sanju Gautam; Shiva Raj Mishra; Salim S. Virani; Raja Ram Dhungana

doi:10.1371/journal.pone.0258494

Peer Review History

Original SubmissionMay 19, 2021
22 Jul 2021 Decision Letter - Boris Bikbov, Editor PONE-D-21-16355 Burden of chronic kidney disease in the general population and high-risk groups in South Asia: a systematic review and meta-analysis PLOS ONE Dear Dr. Shrestha, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. As the Academic Editor I congratulate you with the work performed and the prepared manuscript. Please address the comments made by the reviewers, and also the following items: 1. Please indicate why your search strategy did not retrieve the following articles containing data about CKD prevalence in Pakistan: - Imran S, Sheikh A, Saeed Z, Khan SA, Malik AO, Patel J, Kashif W, Hussain A. Burden of chronic kidney disease in an urban city of Pakistan, a cross-sectional study. J Pak Med Assoc. 2015; 65(4): 366-9. - Alam A, Amanullah F, Baig-Ansari N, Lotia-Farrukh I, Khan FS. Prevalence and risk factors of kidney disease in urban Karachi: baseline findings from a community cohort study. BMC Res Notes. 2014; 7: 179. 2. Please compare the CKD prevalence indicated in the articles included in the meta-analysis for each country, and also the summary CKD prevalence for the South Asia with the estimates reported by the GBD Study (GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020; 395: 709-733. doi: 10.1016/S0140-6736(20)30045-3) Please submit your revised manuscript by Sep 05 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. 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The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. Thank you for stating the following financial disclosure: "The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript." At this time, please address the following queries: a) Please clarify the sources of funding (financial or material support) for your study. List the grants or organizations that supported your study, including funding received from your institution. b) State what role the funders took in the study. 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Salim Virani: Research funding: US Department of Veterans Affairs, World Heart Federation, Tahir and Jooma Family Honorarium: American College of Cardiology (Associate Editor for Innovations, acc.org)" Please confirm that this does not alter your adherence to all PLOS ONE policies on sharing data and materials, by including the following statement: "This does not alter our adherence to PLOS ONE policies on sharing data and materials.” (as detailed online in our guide for authors http://journals.plos.org/plosone/s/competing-interests). If there are restrictions on sharing of data and/or materials, please state these. Please note that we cannot proceed with consideration of your article until this information has been declared. Please include your updated Competing Interests statement in your cover letter; we will change the online submission form on your behalf. Please know it is PLOS ONE policy for corresponding authors to declare, on behalf of all authors, all potential competing interests for the purposes of transparency. PLOS defines a competing interest as anything that interferes with, or could reasonably be perceived as interfering with, the full and objective presentation, peer review, editorial decision-making, or publication of research or non-research articles submitted to one of the journals. Competing interests can be financial or non-financial, professional, or personal. Competing interests can arise in relationship to an organization or another person. Please follow this link to our website for more details on competing interests: http://journals.plos.org/plosone/s/competing-interests 4. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. 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Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: No Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Shrestha N et al. Burden of chronic kidney disease in the general population and high-risk groups in South Asia: a systematic review and meta-analysis. The method of this systematic review was adequately described and considered appropriate, following the MOOSE guideline. There some questions and suggestions. - Are there any language restrictions for the eligible studies? Some publications in local language including report from national authorities/registries, if presence, may be missed. - Sensitivity analysis regarding risk of bias should be done as a part of the investigations of heterogeneity. - If data available, the result should be separated as difference stages of CKD by GFR with or without albuminuria. The prevalence of advanced stage of CKD might better show the burden of disease. Prevalence of CKD by GFR may be reported separately from proteinuria due to some limitation of testing in each study. - Most of the included studies sampled population from specific area, such as some province or city. How the authors ensure the representativeness for the overall population in South Asia? Reviewer #2: This is a comprehensive review of CKD in S East Asia. Minor comments: Please state the start and end dates of the systematic review Table 1: Feng et al Move overall prevalence to appropriate column A limitation is that there is no indication if investigators of prevalence data used IDMS traceable creatinine ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: Yes:** Jaya A George [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0258494.r001
Revision 1
11 Aug 2021 Author Response Editor’s comment 1. Please indicate why your search strategy did not retrieve the following articles containing data about CKD prevalence in Pakistan: - Imran S, Sheikh A, Saeed Z, Khan SA, Malik AO, Patel J, Kashif W, Hussain A. Burden of chronic kidney disease in an urban city of Pakistan, a cross-sectional study. J Pak Med Assoc. 2015; 65(4): 366-9. - Alam A, Amanullah F, Baig-Ansari N, Lotia-Farrukh I, Khan FS. Prevalence and risk factors of kidney disease in urban Karachi: baseline findings from a community cohort study. BMC Res Notes. 2014; 7: 179. Author’s response: These publications were identified in our searches, however, were excluded because the sample size was less than 500. This has been clearly stated under the heading exclusion criteria. 2. Please compare the CKD prevalence indicated in the articles included in the meta-analysis for each country, and also the summary CKD prevalence for the South Asia with the estimates reported by the GBD Study (GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020; 395: 709-733. doi: 10.1016/S0140-6736(20)30045-3) Author’s response: Thank you for the comments. We have now added the supplementary forest plot with prevalence estimates of chronic kidney disease from all the countries from Global Burden of Disease 2019 – Supplementary figure 13. We also added following sentences in discussion comparing our estimates with global burden of disease 2019 estimates (lines 277-78, page 12). "The global burden of disease 2019 also suggest a wide variation in CKD prevalence in south Asian countries ranging from 4.5 to 13.5% (Supplementary figure 13)”. Reviewer #1: 3. Shrestha N et al. Burden of chronic kidney disease in the general population and high-risk groups in South Asia: a systematic review and meta-analysis. The method of this systematic review was adequately described and considered appropriate, following the MOOSE guideline. There are some questions and suggestions. - Are there any language restrictions for the eligible studies? Some publications in local language including report from national authorities/registries, if presence, may be missed. Author’s response: There were no language restrictions for the eligible studies. However, we do agree that some publications in local language including report from national authorities/registries might have been missed. We have added following statement to acknowledge this limitation (lines 325-27, page 14). “The major strength of this study is an extensive search of literature in multiple electronic databases and reference list of identified studies. However, we might have missed some publications in local language including report from national authorities/registries”. 4. Sensitivity analysis regarding risk of bias should be done as a part of the investigations of heterogeneity. Author’s response: Thank you for your comments. We judged 10 studies at low risk of bias and 14 studies at moderate risk of bias. Since there were no studies judged at high risk of bias, we did not perform sensitivity analysis excluding studies at high risk of bas. 5. If data available, the result should be separated as difference stages of CKD by GFR with or without albuminuria. The prevalence of advanced stage of CKD might better show the burden of disease. Prevalence of CKD by GFR may be reported separately from proteinuria due to some limitation of testing in each study. Author’s response: We agree that prevalence of advanced stage of CKD might better show the burden of disease. Prevalence of CKD by GFR stages were not performed because most of the studies had small sample sizes. We have added a subgroup analysis of CKD by GFR < 60 mL/min/1.73 m2 which corresponds to CKD Stage 3-5 by GFR with or without albuminuria (Supplementary figure 3). We have also added following sentence in results section (lines 228-29, page 10). “The prevalence of GFR < 60 mL/min/1.73 m2 was 6% (95% CI 4- 9%, n = 64,143, 18 studies, Supplementary figure 3)”. 6. Most of the included studies sampled population from specific area, such as some province or city. How the authors ensure the representativeness for the overall population in South Asia? Author’s response: Like many systematic reviews and metanalysis in this topic, our study is limited by geographical coverage of individual studies. Therefore, we have made careful consideration not to generalise the findings at the population level in South Asia both in the results and discussion section of the paper. Also, being mindful that it would be logistically challenging to build individual studies that capture the whole population - unless such measurements (of kidney function) are routinely done and can be captured through central databases/repositories (e.g. NHS). Reviewer #2: This is a comprehensive review of CKD in S East Asia. Minor comments: 7. Please state the start and end dates of the systematic review Author’s response: This information has already been incorporated into the search strategy of the manuscript. Please refer to the “Search strategy and selection criteria” section (lines 87, page 4). 8. Table 1: Feng et al Move overall prevalence to appropriate column Author response: Thank you for identifying this typo. We have not moved overall prevalence to appropriate column. 9. A limitation is that there is no indication if investigators of prevalence data used IDMS traceable creatinine. Author response: We have now added following statement on studies that used IDMS traceable creatinine. “Only seven studies reported calibration of creatinine measurement by isotope dilution mass spectrometry assays which reduces variability in measured serum creatinine values”. (lines 203-5, Page 9) “While majority of included studies used Jaffe kinetic method, others lacked information on serum creatinine assessment. Therefore, we could not assess whether the variation in laboratory assessment of serum creatinine contributed to heterogeneity in pooled estimates.” (lines 269-72, Page 12). Attachments Attachment Submitted filename: Response to reviewers (1).docx https://doi.org/10.1371/journal.pone.0258494.r002
19 Aug 2021 Decision Letter - Boris Bikbov, Editor PONE-D-21-16355R1 Burden of chronic kidney disease in the general population and high-risk groups in South Asia: a systematic review and meta-analysis PLOS ONE Dear Dr. Shrestha, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. You have resubmitted the revised manuscript, and during the preliminary revision I have found that the submitted files are duplicated - there are two "clean" manuscript versions, there are two files for each figure, and two Supplementary files. To facilitate the revision and avoid any confusion, please resubmit the files with only one file for each Item Family (i.e only one "clean" manuscript version, one file for each figure, and one Supplementary file). It's a technical but important issue. Having these files, it will be possible to proceed with the reviewers involvement. Please submit your revised manuscript by Oct 03 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Boris Bikbov Academic Editor PLOS ONE [Note: HTML markup is below. Please do not edit.] Reviewers' comments: [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0258494.r003
Revision 2
20 Aug 2021 Author Response Technical error corrected. Attachments Attachment Submitted filename: Response to reviewers (1).docx https://doi.org/10.1371/journal.pone.0258494.r004
29 Sep 2021 Decision Letter - Boris Bikbov, Editor Burden of chronic kidney disease in the general population and high-risk groups in South Asia: a systematic review and meta-analysis PONE-D-21-16355R2 Dear Dr. Shrestha, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Boris Bikbov Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed Reviewer #3: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #3: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #3: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #3: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #3: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: (No Response) Reviewer #3: (No Response) ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #3: No https://doi.org/10.1371/journal.pone.0258494.r005
Formally Accepted
1 Oct 2021 Acceptance Letter - Boris Bikbov, Editor PONE-D-21-16355R2 Burden of chronic kidney disease in the general population and high-risk groups in South Asia: a systematic review and meta-analysis Dear Dr. Shrestha: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Boris Bikbov Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0258494.r006

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