Epidemiology of chronic kidney disease in older indigenous peoples of Brazil: findings from a cross-sectional survey.

Abstract

Chronic kidney disease (CKD) is a prevalent disease worldwide, with increasing incidence particularly in low- and middle-income countries. Indigenous communities have poorer CKD outcomes due to limited access to healthcare. They are also experiencing a shift toward a sedentary lifestyle and urbanization-related dietary changes, increasing the risk of CKD-related risk factors. To determine the prevalence of CKD in older Brazilian indigenous and identify the main associated risk factors. This cross-sectional study analyzed demographic and clinical data of 229 older indigenous individuals aged 60years and above in 2022-2023. CKD was defined as an estimated glomerular filtration rate < 60mL/min/1.73m2 or a urinary albumin-creatinine ratio > 30mg/g. Data were presented categorically and analyzed using the Chi-square test or Fisher's exact test. The prevalence of CKD in the population was 26.6%, with higher prevalence in women and increasing with age. The prevalence of hypertension and diabetes was 67.7% and 24.0%, respectively, and these comorbidities were associated with CKD: hypertension (OR = 5.12; 95% CI 2.2-11.9) and diabetes (OR = 5.5; 95% CI 3.7-8.2). No association was found between the prevalence of CKD and obesity, dyslipidemia, cardiovascular disease, or smoking. The study found a higher prevalence of CKD among older indigenous populations in Brazil compared to non-indigenous populations, which is exacerbated by risk factors, such as aging, hypertension, diabetes, and lifestyle changes, emphasizing the importance of early detection and intervention in these communities. Older persons' indigenous individuals have a high prevalence of CKD, which is correlated with factors, such as sex, age, diabetes mellitus, and hypertension.