Decreasing Prevalence of Chronic Kidney Disease Among U.S. Adults With Diabetes, 1999-2018.

Prevalence of chronic kidney disease in China

The prevalence of adult chronic kidney disease and cardiovascular comorbidities in Canadian Indigenous communities is largely unknown. We conducted a study to document the prevalence of chronic kidney disease and concurrent diabetes mellitus, hypertension and dyslipidemia in a First Nations population in northwest Ontario. In this observational study, we used retrospective data collected from regional electronic medical records of 16 170 adults (age ≥ 18 yr) from 26 First Nations communities in northwest Ontario from May 2014 to May 2017. Demographic and laboratory data included age, gender, prescribed medications, estimated glomerular filtration rate, urine albumin:creatinine ratio, low-density lipoprotein cholesterol (LDL-C) level and glycated hemoglobin (HbA1c) concentration. We identified patients with diabetes by an HbA1c concentration of 6.5% or higher, or the use of a diabetic medication, those with dyslipidemia by an elevated LDL-C level (≥ 2.0 mmol/L) or use of lipid-lowering medication, and those with hypertension by use of antihypertensive medication. Of the 16 170 adults residing in the communities, 5224 unique patients (32.3%) had renal testing (albumin:creatinine ratio and/or estimated glomerular filtration rate). The age-adjusted prevalence of chronic kidney disease was 14.5%, and the prevalence of stage 3-5 chronic kidney disease (estimated glomerular filtration rate < 60 mL/min) was 7.0%. Most patients with chronic kidney disease (1487 [80.0%]) had at least 1 cardiovascular comorbidity. A total of 1332 patients (71.6%) had diabetes, 1313 (70.6%) had dyslipidemia, and 1098 (59.1%) had hypertension; all 3 comorbidities were present in 716 patients (38.5%). We document a high prevalence of advanced chronic kidney disease in this First Nations population, 7.0%, double the rate in the general population. High rates of cardiovascular comorbidities were also common in these patients with chronic kidney disease, which places them at increased risk for cardiovascular disease.

Temporal Trends in Prevalence of CKD: The Glass Is Half Full and Not Half Empty

The prevalence and identification of chronic kidney disease in Switzerland

Objective: To investigate the prevalence and risk factors of chronic kidney disease (CKD) in diabetic patients aged over 40 years in Henan province. Methods: A cross-sectional study was conducted. Diabetic patients aged over 40 years were recruited from four cities including Xuchang, Zhumadian, Luoyang and Zhengzhou in Henan Province between June 2015 and July 2019. Multivariate logistic regression analysis was employed to analyze the risk factors for CKD. Results: A total of 3 067 diabetic patients were included in this study, including 1 238 males and 1 829 females. The mean age of all participants was (60.9±9.7) years and 85.8% (2 633/3 067) of them were living in rural areas. There were 1 155 participants who had CKD, and the overall prevalence of CKD was 37.7% (95%CI: 35.9%-39.4%). Compared with those without CKD, participants with CKD had older age [(61.4±10.3) vs (60.6±9.3) years], higher proportion of male patients (43.2% vs 38.7%), urban residents (19.4% vs 11.0%) and habitual drinkers (15.8% vs 12.7%), higher body mass index [(25.8±3.7) vs (25.4±3.6) kg/m2), higher proportion of having hypertension (57.0% vs 37.2%), hyperuricemia (10.7% vs 7.1%) and dyslipidemia (46.5% vs 42.7%) (all P<0.05). The prevalence of estimated glomerular filtration rate (eGFR) less than 60 ml·min-1·(1.73 m2)-1 and albuminuria was 4.9% (149/3 067) and 35.6% (1 092/3 067), respectively. Compared with rural participants [35.4% (95%CI: 34.4%-36.4%)], urban participants [51.6% (95%CI: 50.0%-53.2%)] had higher prevalence of CKD (P<0.001). Multivariate logistic regression analysis showed that habitual drinker (OR=1.27, 95%CI: 1.00-1.61, P=0.046), moderate physical activities (OR=1.23, 95%CI: 1.01-1.51, P=0.039), having hypertension (OR=2.27, 95%CI: 1.95-2.64, P<0.001), dyslipidemia (OR=1.21, 95%CI: 1.04-1.40, P=0.012) and hyperuricemia (OR=1.56, 95%CI: 1.21-2.02, P=0.001) were independent risk factors for CKD. Conclusions: The prevalence of CKD is high in diabetic patients who aged over 40 years in Henan province. The associated factors for developing CKD include habitual drinking, heavier physical activities and having chronic diseases. Targeted prevention and intervention for associated factors would be beneficial for controlling CKD in middle and old aged diabetic patients.

BackgroundThe burden of noncommunicable diseases, particularly kidney dysfunction, is increasingly common among HIV/AIDS patients, especially with the improved life expectancy resulting from the advent of antiretroviral therapy. However, there are limited data on the prevalence and determinants of chronic kidney disease in this population. Therefore, this study aimed to assess the prevalence and determinants of chronic kidney disease among HIV/AIDS patients at two government hospitals in Ethiopia in 2024.MethodsA retrospective cross-sectional study was conducted among 422 adult HIV/AIDS patients, selected via systematic random sampling techniques with a sampling frame, at two governmental hospitals at Addis Ababa, Ethiopia. The data were collected via the kobo tool box software, and the analysis was performed via Stata software version 17. Variables with a p-value of ≤ 0.2 in the bivariate analysis were included in the multivariable logistic regression model, and variables with a p-value of less than 0.05 in the final model were considered statistically significant.ResultsAmong the 422 participants, 54 (12.8%) were excluded for having inadequate kidney function determination and 368 participants were included in the final analysis. The prevalence of chronic kidney disease in this study was 59 (16.03%). Those individuals with higher education (AOR = 0.53, 95% CI: 0.39–0.93) and self-employed status (AOR = 0.83, 95% CI: 0.33–0.98) were less likely to have chronic kidney disease. Age > 64 years was (AOR = 2.99, 95% CI: 1.05–8.57), antiretroviral therapy duration > 20 years was (AOR = 5.84, 95% CI: 3.77–14.53), being widowed was (AOR = 1.32, 95% CI: 1.04–3.88), and diarrheal disease in the study period of (AOR = 1.27, 95% CI: 1.06–3.27) times was significantly associated with the occurrence of chronic kidney disease.ConclusionsThe prevalence of chronic kidney disease in this study was relatively high compared to national and regional estimates. Significant factors associated with chronic kidney disease included older age, longer duration on antiretroviral therapy, history of diarrheal disease, being widowed, higher educational status, and self-employment. These findings highlight the need for the integration of routine kidney function screening into HIV care services to support early detection and management of chronic kidney disease in this population.Clinical trial numberNot applicable.

Among adults in the United States, 1 in 4 has hypertension and 1 in 8 has chronic kidney disease (CKD). Although the relationship between hypertension and CKD has been recognized for several hundred years, the prevalence of CKD among patients with normal blood pressure has not been assessed in randomly sampled populations. Crews et al1 in this issue of Hypertension are the first to report such estimates: 13.4% of people who have normal blood pressure have CKD. Among those with prehypertension, the prevalence is 17.3%; among those with undiagnosed hypertension, the prevalence is 22.0%; and among those with diagnosed hypertension, the prevalence is 27.4%. The magnitude of these CKD prevalence estimates is astounding and may even be misleading unless placed in appropriate context. The awareness of CKD diagnosis was dismal: <10% of people were aware of CKD regardless of hypertension category. A thorough analysis of the definition of CKD is necessary to understand how the varying definitions of CKD may have influenced both the prevalence and awareness estimates. The prevalence estimates may be inflated because of CKD that is so mild that it may not be considered a disease at all. For example, examination of the Figure (derived from Table 3 of the article) shows that if one considers the prevalence of more severe CKD defined as macroalbuminuria or estimated glomerular filtration rate (GFR) <45 mL/min per 1.73 m2, then the prevalence estimates fall dramatically. These stricter definitions of CKD yield the following prevalence estimates of CKD: normal blood pressure 0.5%; prehypertension 1.0%; undiagnosed hypertension 2.0%; and <5.0% prevalence of CKD among those with diagnosed hypertension. These prevalence estimates are much lower than those obtained with the more sensitive definition that is typically used to define CKD. Thus, the prevalence estimates of CKD may be driven up …

Kidney Disease in People With Diabetes: The Expanding Epidemic

We determined whether non-alcoholic fatty liver is associated with an increased prevalence of chronic kidney disease in Type 1 diabetes. We studied 343 patients with Type 1 diabetes, who had no history of excessive alcohol consumption or other secondary causes of chronic liver disease. Non-alcoholic fatty liver was diagnosed by ultrasonography. Chronic kidney disease was defined as presence of either abnormal albuminuria (i.e., urinary albumin/creatinine ratio ≥ 30 mg/g) or estimated glomerular filtration rate of less than 60 ml min(-1) 1.73 m(-2) . Compared with those without steatosis, patients with non-alcoholic fatty liver (n = 182) had significantly lower estimated GFR (83.0 ± 27 vs. 93.3 ± 29 ml min(-1) 1.73 m(-2) , P < 0.001) and a greater prevalence of abnormal albuminuria (50.0 vs. 20.5%, P < 0.0001) and chronic kidney disease (54.4 vs. 24.2%, P < 0.0001). Multivariable logistic regression analysis revealed that non-alcoholic fatty liver was associated with an increased risk of either abnormal albuminuria (adjusted odds ratio 2.21, 95% CI 1.2-4.1, P = 0.01) or chronic kidney disease (adjusted odds ratio 1.93, 95% CI 1.1-3.6, P = 0.02), independently of age, gender, smoking status, physical activity, diabetes duration, HbA(1c) , BMI, systolic blood pressure, plasma lipids and use of anti-hypertensive and lipid-lowering medications. Our findings demonstrate that ultrasound-diagnosed non-alcoholic fatty liver is associated with a higher prevalence of chronic kidney disease in patients with Type 1 diabetes, independently of several risk factors, including the components of the metabolic syndrome.

Objectives To investigate the prevalence and risk factors of chronic kidney disease(CKD)in the adult staff receiving physical examination in Jinan.Methods A retrospective analysis on the first examination data of the healthy adult,analyzing the prevalence of CKD and its risk factors,from February 2007 to May 2011.Results In the total 10016 healthy persons,the prevalence of hematuresis was 4.20％(95％CI:3.81％ ～4.59％),the Prevalence of proteinuria was 0.70％(95 ％ CI:0.54 ％ ～ 0.86 ％),reduced eGFR was 2.09 ％(95 ％ CI: 1.81％～2.37％),the prevalence of CKD was 6.37％(95 ％ CI:5.89 ％ ～ 6.85 ％).After the two categories of non-conditional Logistic regression analysis,female is independently risk factor for hematuria.Hypertension and diabetes are risk factors for albuminuria.Gender,age and obesity are independently associated with reduced eGFR.Gender,age,renal cysts and diabetes are independently risk factors for CKD(P ≤ 0.05).Conclusions Gender,age,renal cysts and diabetes are independently associated with CKD.The high-risk groups of CKD should be strengthened in the screening,so early detection and intervention could help to delay the progress of CKD and prevent the occurrence of ESRD and CVD. Key words: Kidney Disesaes; Risk Factors; Shandong

Objective To compare the prevalence and correlation factors of chronic kidney disease (CKD) in urban and rural areas in Minhang district of Shanghai through the social economic and clinical data of the elderly population. Methods Jiangchuan Street and Pujiang town were randomly selected to represent the urban and rural population in Minhang district of Shanghai, respectively. Based on the over-60-year old people health examination program, 6151 objectives with complete clinical-epidemiological data and bio-chemical index were investigated. The prevalence of CKD in urban and rural areas was compared, and the correlation factors for the urban and rural CKD were evaluated by multiple logistic regression analysis. Results (1) The survey objectives with an average age of (69.57±7.04) years, including 4345 cases of the city residents and 1806 cases of rural residents, were enrolled. The age structures of urban and rural showed differences, population over 80 years old account for 13.1% of the rural total, significantly higher than 7.4% in the urban population (P<0.001). (2) The prevalence rates of diabetes, hyperuricemia, hyperlipidemia and hyperlipidemia in urban residents were higher than those in rural residents, which were 26.4% vs 13.7%, 9.9% vs 2.3%, 53.7% vs 37.4%, 51.4% vs 15.6% (all P<0.01). The awareness rates of kidney disease and hyperlipidemia showed significant differences in urban and rural areas, which were 32.9% vs 44.2%, 84.6% vs 62.8% (all P<0.01). Compared with those in rural areas, the treatment rates of hypertension and high blood lipids in urban residents were increased (all P<0.01). (3) The prevalence of CKD was 23.4%. Female CKD prevalence was higher than male, respectively 26.3% and 18.5% (P<0.01). In urban CKD prevalence was 22.2%, lower than 25.2% in rural. The prevalence rate of hematuria in urban areas was lower than in rural areas, but the prevalence rate of decline in renal function was higher (all P<0.05). With the increase of age, the prevalence rate of CKD was increased (P<0.01). (4) Age (OR=1.072), smoking history (OR=1.543), previous history of kidney disease (OR=1.351), diabetes (OR=1.373), hyperuricemia (OR=2.498), obesity (OR=1.364), history of interventional therapy (OR=1.896) had positive correlation with CKD in city elderly population, while the higher education (OR=0.676, OR=0.604) and drinking (OR=0.585) had negative correlation (all P<0.05). Age (OR=1.032), female (OR=1.860) had positive correlation with CKD in rural elderly population (all P<0.05). Conclusions CKD has been a common chronic progressive disease of the aged in Minhang district. The prevalence of CKD is higher in urban areas than in rural. Age is a common factor for CKD in urban and rural. Previous smoking, history of kidney disease, diabetes, hyperuricemia, obesity, history of interventional therapy, education and drinking have correlation with urban CKD patients. Female has correlation with rural CKD population. Key words: Renal insufficiency, chronic; Aged; Prevalence; Risk factors; Urban and rural

The incidence of kidney failure treatment in the United States increased 57% from 1991 to 2000. Chronic kidney disease (CKD) prevalence was 11% among U.S. adults surveyed in 1988 to 1994. The objective of this study was to estimate awareness of CKD in the U.S. population during 1999 to 2000 and to determine whether the prevalence of CKD in the United States increased compared with 1988 to 1994. Analysis was conducted of nationally representative samples of noninstitutionalized adults, aged 20 yr and older, in two National Health and Nutrition Examination Surveys conducted in 1988 to 1994 (n = 15,488) and 1999 to 2000 (n = 4101) for prevalence +/- SE. Awareness of CKD is self-reported. Kidney function (GFR), kidney damage (microalbuminuria or greater), and stages of CKD (GFR and albuminuria) were estimated from calibrated serum creatinine, spot urine albumin to creatinine ratio (ACR), age, gender, and race. GFR was estimated using the simplified Modification of Diet in Renal Disease Study equation. Self-reported awareness of weak or failing kidneys in 1999 to 2000 was strongly associated with decreased kidney function and albuminuria but was low even in the presence of both conditions. Only 24.3 +/- 6.4% of patients at GFR 15 to 59 ml/min per 1.73 m(2) and albuminuria were aware of CKD compared with 1.1 +/- 0.3% at GFR of 90 ml/min per 1.73 m(2) or greater and no microalbuminuria. At moderately decreased kidney function (GFR 30 to 59 ml/min per 1.73 m(2)), awareness was much lower among women than men (2.9 +/- 1.6 versus 17.9 +/- 5.9%; P = 0.008). The prevalence of moderately or severely decreased kidney function (GFR 15 to 59 ml/min per 1.73 m(2)) remained stable over the past decade (4.4 +/- 0.3% in 1988 to 1994 and 3.8 +/- 0.4% in 1999 to 2000; P = 0.23). At the same time, the prevalence of albuminuria (ACR >/= 30 mg/g) in single spot urine increased from 8.2 +/- 0.4% to 10.1 +/- 0.7% (P = 0.01). Overall CKD prevalence was similar in both surveys (9% using ACR > 30 mg/g for persistent microalbuminuria; 11% in 1988 to 1994 and 12% in 1999 to 2000 using gender-specific ACR cutoffs). Despite a high prevalence, CKD awareness in the U.S. population is low. In contrast to the dramatic increase in treated kidney failure, overall CKD prevalence in the U.S. population has been relatively stable.

Chronic kidney disease in older people with intellectual disability: Results of the HA-ID study

The incidence of diabetes mellitus has more than doubled over the past ten years. The prevalence of chronic kidney disease is comparable to the prevalence of diabetes mellitus. Chronic kidney disease occurs in diabetes mellitus in 20-40% of cases. The aim of the study was to analyze the prevalence and structure of chronic kidney disease in diabetes mellitus according to the diabetes registry «Polyclinic № 4», Saransk. According to the diabetes registry data, the structure and prevalence of chronic kidney disease in patients with type 1 and type 2 diabetes mellitus, anthropometric indicators, the duration of diabetes mellitus and chronic kidney disease, and indicators of metabolic control of diabetes were analyzed. In the present study, the prevalence of chronic kidney disease was 17% in type 1 diabetes mellitus and 19% in type 2 diabetes mellitus. At the same time, in both types of diabetes mellitus, chronic kidney disease of stage C2 (50% in type 1 and 52% in type 2) and C3 stage (39% in type 2 and 28% in type 1) predominated. type of diabetes). Glycosylated hemoglobin was within the target range in 78% of type 1 diabetic patients and in 83% of type 2 diabetic patients. In patients with diabetes mellitus and chronic kidney disease, it is necessary to intensify hypoglycemic therapy, achieving target indicators of carbohydrate metabolism. The only indicator of the lipid spectrum, which is presented in the registry, was total cholesterol, it is necessary to study the full lipid spectrum.

Diabetes mellitus shares a large proportion of kidney failure. Despite many patients suffering from diabetes mellitus and its complications in Dessie City, no study was conducted in the study area that shows the prevalence and associated factors of chronic kidney disease among diabetes mellitus patients. Therefore, this study aims to assess the prevalence of chronic kidney disease and its associated factors among adult diabetes mellitus patients attending Dessie Referral Hospital, South Wollo, Northeast Ethiopia. An institutional-based cross-sectional study was conducted at Dessie Referral Hospital among 267 randomly selected adult diabetic patients. Data were collected using questionnaires administered by interviewers. The glomerular filtration rate was estimated from serum creatinine levels. Data were entered into Epi-data version 4.6 and analyzed using SPSS version 26 software. Multi-variable logistic regression was used to determine the strength of association for the associated factors of chronic kidney disease. Variables with a p value < 0.05 were used to ascertain statistically significant associations. A total of 267 diabetic patients participated in this study. About 104 (39%) of the respondents were female and from the total, 133 (48.1%) were hypertensive. The overall prevalence of chronic kidney disease in this study was 31.5% (95% CI 25.3–37.1%). Being older (p-value = 0.003) and having hypertension (p-value = 0.043) were significant factors for chronic kidney disease among diabetes mellitus patients. This study found a high prevalence (31.5%) of chronic kidney disease among diabetic patients. Older age, having hypertension, and elevated serum creatinine were statistically significant associated factors of chronic kidney disease among patients with diabetes mellitus. Thus, clinicians should be aware of the high prevalence of chronic kidney disease in Dessie City. Moreover, emphasis should be given for old age and hypertension as contributing factors to the high prevalence in diabetic patients.