Abstract
BackgroundThe burden of chronic kidney disease (CKD) is increasing globally in particular in fast emerging economies such as Iran. Population-based studies on prevalence of CKD in Iran are scarce. The objective of the current study was to explore the prevalence and determinants of CKD in the setting of Golestan Cohort Study (GCS), the largest prospective cohort in the Middle East.MethodsIn this observational study, 11,409 participants enrolled in the second phase of GCS were included. Sex, age, literacy, residence, anthropometric measurements, smoking, opium use, self-reported history of cardiovascular diseases (heart disease and/or stroke), hypertension, diabetes, and lipid profile were the predictors of interest. The outcomes of interest were eGFR and CKD defined as eGFR< 60 ml/min/1.73m2.ResultsMean (SD) of GFR was 70.0 ± 14.7 ml/min/1.73m2 among all participants, 68.2 ± 14.2 among women, and 72.0 ± 15.0 among men. Prevalence of CKD was 23.7% (26.6% in women, 20.6% in men). The prevalence of CKD stages 3a, 3b, 4, and 5 were 20.0%, 3.3%, 0.4% and 0.1%, respectively. Female sex, older age, urban residence, history of CVD, hypertension or diabetes, larger body mass and surrogates of body fat and opium use were all associated with CKD. Opium had a significant positive association with CKD in adjusted model. All anthropometric measurements had positive linear association with CKD. Being literate had inverse association. Sex had significant interaction with anthropometric indices, with higher odds ratios among men compared with women. A significantly high association was observed between the rate of change in waist circumference and systolic blood pressure with risk of CKD.ConclusionOne in four people in this cohort had low eGFR. Obesity and overweight, diabetes, hypertension, and dyslipidemia are major risk factors for CKD. Halting the increase in waist circumference and blood pressure may be as important as reducing the current levels.
Highlights
The burden of Chronic Kidney Disease (CKD) has been increasing globally [1], primarily in developing countries and emerging economies [2], while in developed nations the trend is either stable or somewhat decreasing
The Global Burden of Disease (GBD) study shows that mortality due to chronic kidney disease (CKD) in Iran increased from less than 1% in 1990 to over 2% in 2013, and low glomerular filtration rate (GFR) is among main risk factors of mortality and morbidity in Iran. [3,4,5]
Urban residence, history of CVD, hypertension or diabetes, and low High Density Lipoprotein (HDL) were all associated with CKD
Summary
The burden of Chronic Kidney Disease (CKD) has been increasing globally [1], primarily in developing countries and emerging economies [2], while in developed nations the trend is either stable or somewhat decreasing. The Global Burden of Disease (GBD) study shows that mortality due to CKD in Iran increased from less than 1% in 1990 to over 2% in 2013, and low glomerular filtration rate (GFR) is among main risk factors of mortality and morbidity in Iran. Due to scarcity of population-based studies and lack of resources, there are currently very few reports on prevalence of CKD in Iran. The burden of chronic kidney disease (CKD) is increasing globally in particular in fast emerging economies such as Iran. Population-based studies on prevalence of CKD in Iran are scarce. The objective of the current study was to explore the prevalence and determinants of CKD in the setting of Golestan Cohort Study (GCS), the largest prospective cohort in the Middle East
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