Abstract
BackgroundChronic kidney disease (CKD) is often asymptomatic in its early stages but is indicated and is diagnosed with an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2. Certain sociodemographic groups are known to be at risk for CKD, but it is unclear if there are strong associations between these at risk groups with abnormal eGFR test results in Canada. Using only secondary laboratory and Census data, geospatial variation and sociodemographic associations with abnormal eGFR result rate were investigated in Calgary, Alberta.MethodsSecondary laboratory data from all adult community patients who received an eGFR test result were collected from Calgary Laboratory Service’s Laboratory Information System, which is the sole supplier of laboratory services for the large metropolitan city. Group-level sociodemographic variables were inferred by combining laboratory data with the 2011 Canadian Census data. Poisson regression and relative risk (RR) were used to calculate associations between sociodemographic variables with abnormal eGFR. Geographical distribution of abnormal eGFR result rates were analyzed by geospatial analysis using ArcGIS.ResultsOf the 346,663 adult community patients who received an eGFR test result, 28,091 were abnormal (8.1%; eGFR < 60 ml/min/1.73m2). Geospatial analysis revealed distinct geographical variation in abnormal eGFR result rates in Calgary. Women (RR = 1.11, P < 0.0001), and the elderly (age ≥ 70 years; P < 0.0001) were significantly associated with an increased risk for CKD, while visible minority Chinese (RR = 0.73, P = 0.0011), South Asians (RR = 0.67, P < 0.0001) and those with a high median household income (RR = 0.88, P < 0.0001) had a significantly reduced risk for CKD.ConclusionsPresented here are significant sociodemographic risk associations, and geospatial clustering of abnormal eGFR result rates in a large metropolitan Canadian city. Using solely publically available secondary laboratory and Census data, the results from this study aligns with known sociodemographic risk factors for CKD, as certain sociodemographic variables were at a higher risk for having an abnormal eGFR test result, while others were protective in this analysis.
Highlights
Chronic kidney disease (CKD) is often asymptomatic in its early stages but is indicated and is diagnosed with an estimated glomerular filtration rate < 60 ml/min/1.73m2
All estimated glomerular filtration rate (eGFR) test results from adult community patients were obtained from the Laboratory Information System (LIS) from Calgary Laboratory Services (CLS) for the 2011 calendar year. 2011 was chosen as at the time the study was conducted, the 2011 Census was the most recent Censu Adult eGFR in Calgary is calculated by using a modified version of the Chronic kidney disease epidemiology collaboration (CKD-EPI) GFR eq (21), where the patient’s age, sex and measured blood creatinine value are used in the equation, but not the ethnicity of the patient, as that variable is unattainable from laboratory requisitions
In 2011, 346,664 adult community patients received an eGFR test result, but one patient was excluded from the study as their date of birth (DOB) was missing
Summary
Chronic kidney disease (CKD) is often asymptomatic in its early stages but is indicated and is diagnosed with an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2. Evidence show a higher prevalence of CKD in some visible minorities and certain Indigenous populations in Canada and the United States [9,10,11,12,13,14,15]. Those with different levels of income, education and employment may be vulnerable to developing CKD [16,17,18,19]. It is clear that sociodemographic risk factors for CKD is population- and region-specific, as demonstrated by a study showing that low income, but not level of education, was strongly associated with CKD in the United States, while low education level, but not low income, was strongly associated with CKD in the Netherlands [18]
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