Prevalence and association of chronic kidney disease, diabetes, hypertension, and hyperuricemia in an adult urban population of El Salvador

Abstract

AimMost research in El Salvador focuses on chronic kidney disease (CKD) in rural coastal populations. Our aim was to determine the prevalence of CKD, diabetes, hypertension and hyperuricemia and associations to CKD in an urban adult population. MethodsPopulation-based, cross-sectional. A representative sample of adults from an urban community in San Salvador was randomly selected (80.6% participation, N=121, 65% female, mean age 52yo). A questionnaire with socio-demographic information was applied; blood and urine samples were collected. Subjects with low estimated glomerular filtration rate (eGFR, MDRD equation) or spot proteinuria were reexamined 3 months later to confirm CKD. Gender, age, educational level, income, tobacco smoking, alcohol consumption, analgesics use, hypertension, diabetes, and hyperuricemia were evaluated as predictors for CKD, diagnosed and staged by KDIGO guidelines. ResultsPrevalence of CKD: 12.6% (N=15, CI 95%, 7.23–19.94), 14.2% in males and 11.4% in females, all in stages G2-4. Prevalence of eGFR<60mL/min/1.73m2: 9%. Most, 73%, were previously undiagnosed. Prevalence of diabetes: 11.6%; hypertension: 34.7%; hyperuricemia: 24.8%. CKD was present in 42.9%, 21% and 23.3% of diabetic, hypertensive and hyperuricemic patients, respectively. From all predictors, only diabetes (OR 8.1, p=0.0002), hypertension (OR 3.17, p=0.03) and hyperuricemia (OR 3.1, p=0.02) showed increased risk for CKD. Discussion and conclusionsGeneral prevalence of CKD is not increased in this population, but prevalence in stages G3-4 is slightly increased. Most cases were previously undiagnosed. Diabetes, hypertension, and hyperuricemia increase the risk for CKD. Preventive measures and early screening is recommended, especially for those with risk factors.