Abstract
BackgroundChronic kidney disease (CKD) is highly prevalent in Taiwan. More than two-thirds of end-stage renal disease is associated with diabetes mellitus (DM) or hypertension (HTN). Therefore, the formulation of a special preventative policy of CKD in these patients is essential. This study surveyed 14 traditional risk factors and identified their effects on CKD in patients with HTN/DM and compared these with their effects in the general population.MethodsThis study included 5328 cases and 5135 controls in the CKD/HTN/DM outpatient and health centres of 10 hospitals from 2008 to 2010. Fourteen common effect factors were surveyed (four demographic, five disease and five lifestyle), and their effects on CKD were tested. Significance tests were adjusted by the Bonferroni method. Results of the stratified analyses in the variables were presented with significant heterogeneity between patients with different comorbidities.ResultsMale, ageing, low income, hyperuricemia and lack of exercise habits were risk factors for CKD, and their effects in people with different comorbidities were identical. Anaemia was a risk factor, and there was an additive effect between anaemia and HTN on CKD. Patients with anaemia had a higher risk when associated with HTN [odds ratio (OR) = 6.75, 95 % confidence limit (95 % CI) 4.76–9.68] but had a smaller effect in people without HTN (OR 2.83, 95 % CI 2.16–3.67). The association between hyperlipidaemia-related factors and CKD was also moderated by HTN. It was a significant risk factor in people without HTN (OR = 1.67, 95 % CI 1.38–2.01) but not in patients with HTN (OR =1.03, 95 % CI 0.89–1.19). Hepatitis B, hepatitis C, betel nut chewing, smoking, alcohol intake and groundwater use were not associated with CKD in multivariate analysis.ConclusionsWe considered that patients with HTN and anaemia were a high CKD risk population. Physicians with anaemic patients in outpatient clinics need to recognise that patients who also have HTN might be latent CKD cases.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-015-0065-x) contains supplementary material, which is available to authorized users.
Highlights
Chronic kidney disease (CKD) is highly prevalent in Taiwan
The results of this study found that male, ageing, low income, hyperuricemia and lack of exercise habits were risk factors for CKD
We found that hepatitis B (HB), hepatitis C (HC), smoking, alcohol intake, betel nut chewing and groundwater use may not be associated with CKD
Summary
Chronic kidney disease (CKD) is highly prevalent in Taiwan. Chronic kidney disease (CKD) is an important public health issue because these patients have an increased risk of end-stage renal disease (ESRD). Taiwan has a high prevalence of CKD [1] and ESRD [2]. These patients are at increased risk for cardiovascular events and progression to kidney failure [3]. A previous study has shown that screening people with hypertension (HTN), diabetes mellitus (DM) or age >55 years is the most effective strategy to detect patients with CKD [5]. Planning a specific population screening/prevention strategy for people with HTN or DM is a major public health challenge. There is no systematic evidence at present to confirm that a screening/prevention strategy for the general population would apply to high risk groups
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