Overall Prevalence Of Chronic Kidney Disease Research Articles

Chronic kidney disease and its associated factors in HIV-infected individuals: a comparison of antiretroviral therapy naïve and experienced patients.

Chronic kidney disease (CKD) has emerged as one of the primary comorbidity affecting individuals infected with human immunodeficiency virus (HIV), even after the initiation of highly active antiretroviral therapy (HAART). The main objective of this study was to assess the prevalence of CKD and its associated factors among HIV-infected individuals who are HAART naïve compared to those who are HAART experienced. An institution-based cross-sectional study was conducted at Mizan Tepi University Comprehensive Specialized Hospital from March to May 2022. A double population proportion formula was used to select 250 study participants, with 125 being HAART naïve and 125 being HAART experienced. Socio-demographic and clinical data were collected using a semi-structured questionnaire. Serum creatinine levels were measured using a Mindray BS-200 chemistry analyzer, and the estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease (MDRD) equation. The level of urine protein was measured using a reagent strip within 30 min of collection. Descriptive statistics, independent t-tests, and multivariable logistic regression analysis were performed, with a p-value of <0.05 considered statistically significant. The mean (±SD) age of the HAART-naïve individuals was 35 ± 9.5, while that of the HAART-experienced individuals was 45 ± 9.9 years. Of the total participants, 67.2% participants were women. The overall prevalence of CKD among the HIV-infected study participants was 36.4%. The prevalence of CKD was 33.6% in HAART-naïve individuals and 39.2% in HAART-experienced individuals, with a p-value of 0.03. Male sex was identified as an independent factor associated with CKD in this study. The prevalence of CKD was found to be higher among HAART-experienced individuals than HAART-naïve individuals. Regular renal function assessments should be conducted before and during HAART to mitigate the risk of renal dysfunction.

Prevalence and risk factors for chronic kidney disease among older adult patients with schizophrenia in Taiwan.

There is an increasing incidence and prevalence of patients with chronic kidney disease (CKD) worldwide. Little is known the prevalence of CKD among older patients with schizophrenia. The purpose of this study was to investigate the prevalence of CKD and its risk factors in older adults with schizophrenia. In this cross-sectional study, a convenience sample of 240 patients with schizophrenia age 50 or older was recruited. In addition to demographic and clinical data, participants' estimated glomerular filtration rate was calculated using the Modification of Diet in Renal Disease equation based on age, sex, ethnicity, and serum creatinine level determined from a blood sample taken from participants. The overall prevalence of CKD was 11.3%. Those with CKD were older, had a longer duration of psychiatric illness, a higher body mass index (BMI), and diagnoses of hypertension compared to those in the non-CKD group. Independent of other risk factors, older age and BMI were significantly associated with CKD. This study found that the overall prevalence of CKD in older patients with schizophrenia was 11.3%. Independent risk factors for CKD in this population were older age and higher BMI. In addition to early identification and early treatment of CKD in older patients with schizophrenia, clinicians should actively manage the risk factors identified in this study.

Effect of severity and etiology of chronic kidney disease in patients with heart failure with mildly reduced ejection fraction.

The study investigates the prognostic impact of the severity and etiology of chronic kidney disease (CKD) in patients with heart failure with mildly reduced ejection fraction (HFmrEF). Data regarding the outcomes in patients with CKD in HFmrEF is scarce. Consecutive patients with HFmrEF were retrospectively included at one institution from 2016 to 2022. Prognosis of patients with different stages and etiologies of CKD was investigated with regard to the primary endpoint of all-cause mortality at 30months. A total of 2155 consecutive patients with HFmrEF were included with an overall prevalence of CKD of 31%. Even milder stages of CKD (i.e., KDIGO stage 3a) were associated withan increased risk of 30-months all-cause mortality (HR = 1.242; 95% CI 1.147-1.346; p = 0.001). However, long-term prognosis did not differ in patients with KDIGO stage 5 compared to patients with stage 4 (HR = 0.886; 95% CI 0.616-1.275; p = 0.515). Furthermore, the highest risk of HF-related rehospitalization was observed in patients with KDIGO stages 3b and 4 (log rank p ≤ 0.015), whereas patients with KDIGO stage 5 had a lower risk of HF-related rehospitalization compared to patients with KDIGO stage 4 (HR = 0.440; 95% CI 0.228-0.849; p = 0.014). In contrast, the etiology of CKD was not associated with the risk of 30-month all-cause mortality (log rank p ≥ 0.347) and HF-related rehospitalization (log rank p ≥ 0.149). In patients with HFmrEF, even milder stages of CKD were independently associated with increased risk of 30-months all-cause mortality.

Ambient Air Pollution and Chronic kidney disease risk in Deltan communities: A Policy Brief, 2023

Chronic kidney disease (CKD) is a persistent, devastating, yet neglected, non-communicable disease in developing and emerging countries. National, regional, and international agencies’ communications and reports on non-communicable diseases intentionally or non-intentionally do not feature CKD. The traditional risk factors for CKD, such as hypertension and diabetes, which have received relatively ample attention, do not sufficiently explain the high burden of CKD in these countries. Ambient air pollution is an emerging significant environmental risk factor for CKD; however, epidemiological data and evidence are lacking for susceptible populations in developing countries. The Niger Delta region of Nigeria is a petrochemical hub known for environmental degradation, including air pollution, and thus, serves as a good case study for investigating the association between air pollution and CKD. This brief is based on the results of a mixed-methods study conducted in four communities situated near an oil and gas refinery in Warri, Nigeria. Air pollutant concentrations measured in partnership with citizen scientists showed that all except one air pollutant (ozone) exceeded the WHO acceptable limits in all four communities. The overall prevalence of CKD was high (12.3%) but even higher (18%) in a socially deprived semi-urban community closest to the oil refinery. Hypertension, diabetes, other behavioral risk factors, and exposures associated with CKD were prevalent among the inhabitants of the four communities. However, public environmental health information and education are lacking. A multifaceted approach is required to mitigate air pollution and the associated health risks in the state. Public inclusion is strongly recommended for the planning and implementation of future interventions. Kidney disease prevention and treatment should be emphasized in health policies and insurance schemes.

Prevalence of chronic kidney disease in Tunisian diabetics: the TUN-CKDD survey.

In Tunisia, the prevalence of diabetes mellitus increased from 15.5% on 2016 to 23% by 2023. While Chronic Kidney Disease (CKD) stills the most dreaded complications of diabetes, studies on the prevalence of chronic kidney disease non-dialysis diet are scarce. The aim of this study was to assess the prevalence of chronic kidney disease among the Tunisian diabetic population based on investigators' specialty, demographic criteria (gender, age, duration of diabetes and geographic distribution) and diagnosis criteria (albuminuria and/or eGFR). This observational, multicentric, and cross-sectional study enrolled all diabetic subjects from all regions of Tunisia with at least 3 months of follow-up before the inclusion date, from 09 January to 08 February 2023. CKD diagnosis was established based on the KDIGO guidelines. The study was carried out at medical departments and ambulatory clinics of different healthcare providers. Baseline data were collected by investigators using an electronic case report form (eCRF). Continuous variables were described by means, median, standard deviation, and quartiles. Categorical data were tabulated in frequencies and percentages. The overall prevalence of CKD among the 10,145 enrolled patients with diabetes mellitus was 38.7% with a 95%CI [37.8-39.6%]. 50.9% were male, with a mean age of 67.5 (± 11.3) years. The mean diabetes duration was 16.1 years (± 8.9). The highest CKD prevalence was noted among nephrologists (82.2%), while it was similar between the cardiologists and the primary care physicians (30.0%). CKD prevalence was highest among males (43.0% versus 35.1%) and increased proportionally with patients' age and diabetes duration. CKD was more frequent in the Mid-East Area when compared to other regions (49.9% versus 25.3 to 40.1% in other regions). Albuminuria was present within 6.6% of subjects with CKD, and it was found an estimated glomerular filtration rate (eGFR) < 60ml/min/1.73m² within 13.3% of subjects wit h CKD. 18.9% had both criteria. In Tunisia, CKD among diabetics had a prevalence of 38.7%, approaching European prevalence. The prevalence discrepancy worldwide of CKD can be improved with a larger population size and by implementing standardized practices.

Prevalence of chronic kidney disease and metabolic related indicators in Mianzhu, Sichuan, China.

Chronic kidney disease (CKD) is a major public health problem worldwide. Periodic surveys are essential for monitoring the prevalence of CKD and its risk factors. We assessed the prevalence of CKD and its risk factors in Mianzhu City in 2020. The Natural Population Cohort Study surveyed 7,770 individuals aged>20 years in Mianzhu City of Sichuan province in 2020. Our investigation encompassed the measurement of CKD prevalence, the evaluation of various renal function indicators, and comparisons based on age, gender, and hukou status. Additionally, some metabolic indices were also measured to identify the underlying causes of CKD. (1) Overall, the prevalence of reduced renal function (eGFR<60 mL/min/1.73m2), albuminuria, and CKD were 1.3, 10.0, and 10.4%, respectively, (2) the overall prevalence of CKD was higher among men than among women (14.5% vs. 8.6%). Similarly, the prevalence of CKD was higher among men than women in most age groups, (3) among urban residents, the prevalence of CKD was higher among middle-aged individuals and lower among young individuals and older adults, and (4) considering eGFR, the albuminuria and CKD for group definition, Blood pressure, triglyceride, high-density lipoprotein, blood sugar, and BMI were all statistically different among between normal groups and abnormal groups s in the albuminuria and CKD. The incidence of CKD greatly varied between Mianzhu City and other regions in China and other countries. The differences in risk factors of CKD should be explored in the future. The gender difference in the prevalence of CKD in this study was markedly different from that in previous studies. More high-quality studies are needed to further explore this controversy. Based on the different prevalence of CKD and metabolism-related indices in rural and urban areas in this study, we speculated that the high incidence of CKD in Mianzhu City might be related to diet, lifestyle, and availability of healthcare services.

Global, regional and national burden of CKD in children and adolescents from 1990 to 2019.

Chronic kidney disease(CKD) is one of the most prevalent non-communicable health concerns in children and adolescents worldwide; however, data on its incidence, prevalence, disability-adjusted life years (DALYs) and trends in the population are limited. We aimed to assess the global, regional and national trends in CKD burden in children and adolescents. In this trend analysis based on the 2019 Global Diseases, Injuries, and Risk Factors Study, CKD incidence, prevalence and DALYs rates per 100000 population for children and adolescents were reported at the global, regional and national levels, as well as the average annual percentage change (AAPC). These global trends were analyzed by age, sex, region and socio-demographic index (SDI). Globally, the overall incidence of CKD (all stages including kidney replacement therapy) in children and adolescents showed an increasing trend [AAPC 0.44 (95% confidence interval 0.36-0.52)] between 1990 and 2019. Similarly, the overall prevalence of CKD also showed an upward trend [AAPC 0.46 (0.42-0.51)]. However, the DALYs of CKD showed a continuous decreasing trend [AAPC -1.18 (-1.37 to -0.99)]. The population aged 15-19 years had the largest CKD incidence increase during this period. The largest increase in age-standardized incidence rate (ASIR) was in middle SDI countries [AAPC 0.56 (0.45-0.67)]. The relationship between the ASIR and SDI showed an inverse U-shaped correlation while the relationship between the age-standardized DALYs rate (ASDR) and SDI showed an inverse trend with SDI. Among adolescents (15-19 years), the ASIR continued to increase for five causes of CKD, owing to type 2 diabetes mellitus and hypertension. Most of the disease burden was concentrated in countries with a lower SDI. Andean Latin America and Central Latin America showed the largest increases in CKD ASIR between 1990 and 2019. The burden of CKD in children and adolescents has increased worldwide, especially in regions and countries with a lower SDI.

Association between the cardiometabolic index and chronic kidney disease: a cross-sectional study

BackgroundCentral obesity is a risk factor for chronic kidney disease (CKD). However, the exact correlation between the cardiometabolic index (CMI), an indicator of central obesity, and CKD remains unclear. Here, we aimed to investigate the correlation between the CMI and CKD in the general American population.MethodsThis cross-sectional study involved 64,313 members of the general population (≥ 20 years of age) with data in the National Health and Nutrition Examination Survey (NHANES) 1999–2020. The individuals were grouped into three categories by CMI tertile: T1 group (n = 7,029), T2 group (n = 7,356), and T3 group (n = 7,380). Logistic regression analysis was performed, with NHANES recommended weights, to assess the association between the CMI and CKD.ResultsA total of 21,765 participants were included; the overall prevalence of CKD was 12.2%. From the low to the high CMI tertile, the prevalence of CKD increased from 8.9% to 16.0% (P < 0.001). After full adjustment for confounders, the higher tertile of CMI (OR: 1.08, 95% CI: 1.03 − 1.13, P = 0.002) had the higher risk of CKD. Compared with the T1 group, the groups with higher CMI levels had a higher CKD risk (T2: OR: 1.01, 95%CI: 0.87–1.18, P = 0.812; T3: OR: 1.22, 95%CI: 1.05–1.43, P = 0.013).ConclusionsHigher CMI was independently associated with higher CKD risk in the general population.

Prevalence and risk factors of chronic kidney disease in diabetic population aged over 40 years in Henan province

Objective: To investigate the prevalence and risk factors of chronic kidney disease (CKD) in diabetic patients aged over 40 years in Henan province. Methods: A cross-sectional study was conducted. Diabetic patients aged over 40 years were recruited from four cities including Xuchang, Zhumadian, Luoyang and Zhengzhou in Henan Province between June 2015 and July 2019. Multivariate logistic regression analysis was employed to analyze the risk factors for CKD. Results: A total of 3 067 diabetic patients were included in this study, including 1 238 males and 1 829 females. The mean age of all participants was (60.9±9.7) years and 85.8% (2 633/3 067) of them were living in rural areas. There were 1 155 participants who had CKD, and the overall prevalence of CKD was 37.7% (95%CI: 35.9%-39.4%). Compared with those without CKD, participants with CKD had older age [(61.4±10.3) vs (60.6±9.3) years], higher proportion of male patients (43.2% vs 38.7%), urban residents (19.4% vs 11.0%) and habitual drinkers (15.8% vs 12.7%), higher body mass index [(25.8±3.7) vs (25.4±3.6) kg/m2), higher proportion of having hypertension (57.0% vs 37.2%), hyperuricemia (10.7% vs 7.1%) and dyslipidemia (46.5% vs 42.7%) (all P<0.05). The prevalence of estimated glomerular filtration rate (eGFR) less than 60 ml·min-1·(1.73 m2)-1 and albuminuria was 4.9% (149/3 067) and 35.6% (1 092/3 067), respectively. Compared with rural participants [35.4% (95%CI: 34.4%-36.4%)], urban participants [51.6% (95%CI: 50.0%-53.2%)] had higher prevalence of CKD (P<0.001). Multivariate logistic regression analysis showed that habitual drinker (OR=1.27, 95%CI: 1.00-1.61, P=0.046), moderate physical activities (OR=1.23, 95%CI: 1.01-1.51, P=0.039), having hypertension (OR=2.27, 95%CI: 1.95-2.64, P<0.001), dyslipidemia (OR=1.21, 95%CI: 1.04-1.40, P=0.012) and hyperuricemia (OR=1.56, 95%CI: 1.21-2.02, P=0.001) were independent risk factors for CKD. Conclusions: The prevalence of CKD is high in diabetic patients who aged over 40 years in Henan province. The associated factors for developing CKD include habitual drinking, heavier physical activities and having chronic diseases. Targeted prevention and intervention for associated factors would be beneficial for controlling CKD in middle and old aged diabetic patients.

A cross-sectional study of prevalence of chronic kidney disease and related factors in adults in Anhui province

Objective: To understand the prevalence of chronic kidney disease (CKD) and related factors in adults in Anhui province based on the data of Chinese Chronic Diseases and Nutrition Surveillance program (2018) in Anhui. Methods: Multi-stage stratified cluster random sampling was used to select participants aged ≥18 years. Moreover, questionnaire survey, body measurements and laboratory tests were conducted. The complex weighting method was used to estimate the prevalence of CKD in residents with different characteristics, and complex sampling data logistic regression model was used for multivariate analysis to identify related risk factors. Results: A total of 7 181 participants were included. The overall prevalence of CKD was 11.06% in adults in Anhui, and the prevalence was 12.49% in women and 9.59% in men (P<0.05). The moderate, high and very high risk for CKD progression were 8.66%, 2.02% and 0.38%, respectively. Multivariate analysis showed that age (OR=1.03, 95%CI: 1.00-1.05), BMI (OR=1.05, 95%CI: 1.01-1.09), being woman (OR=1.38,95%CI: 1.22-1.55), hypertension (OR=2.50, 95%CI: 1.76-3.56), diabetes (OR=2.28, 95%CI: 1.51-3.43), dyslipidemia (OR=1.26, 95%CI: 1.11-1.43) and hyperuricemia (OR=2.16, 95%CI: 1.68-2.78) were risk factors for CKD. Conclusion: The prevalence of CKD in adults in Anhui was relatively high and age, gender, BMI, hypertension, diabetes, dyslipidemia and hyperuricemia were found to be associated with the prevalence of CKD. To prevent CKD and its complications, attention should be paid to the management of related risk factors, including overweight and obesity, hypertension, diabetes, dyslipidemia and hyperuricemia.

Prevalence by health areas of chronic kidney disease in the diabetic population of Extremadura in 2012, 2013 and 2014. An observational study

Background and objectiveDiabetes mellitus is the leading cause of chronic kidney disease (CKD) in our country. The objective was to estimate the global prevalence and by health areas of CKD in the diabetic population of Extremadura. MethodsObservational, longitudinal retrospective study in the diabetic population attended in the Extremadura Health System in 2012−2014. A total of 90,709 patients ≥18 years old were studied. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). The presence of CKD was was defined as follows: an eGFR <60ml/min/1.73m2 in a time period≥of three months or the presence of renal damage, as evaluated by an urine albumin-creatinine ratio (UACR) ≥30mg/g, with or without reduced eGFR, also in a time period ≥ of three months. ResultsThe overall prevalence of CKD was 15.6% (17.5% in women and 13.7% in men) and it was higher in the province of Cáceres (17.0%) than in Badajoz (14.8%, p<0.001), with the lowest prevalence in the Navalmoral de la Mata health area (13.0%) and the highest in Plasencia (17.8%, p<0.001). The prevalence of CKD defined without the need for confirmation of the sustainability of kidney damage or decreased eGFR was 26.1% (29.3% in women and 22.9% in men), which represents an overestimation of the prevalence of 67%. ConclusionsThe prevalence of CKD in Extremadura's diabetic population is lower than usually referred to and differs significantly between its health areas.

The dire need for improved management of chronic kidney disease: Associated hypertension in Pakistan.

Chronic Kidney Disease (CKD) refers to various kidney disorders ranging from mild to severe chronic kidney failure. Because of its escalating incidence and mortality rates, CKD is a serious public health concern in Pakistan. According to a study published in 2018, the overall prevalence of CKD among Pakistani adults was 21.2%, the highest in South Asia. (1) Although there are numerous risk factors for CKD, such as diabetes, cardiovascular disease, smoking, obesity, and genetics, hypertension poses the most serious threat, as the global prevalence of CKD-associated hypertension is between 60 – 90%. (2) In most people with CKD, proteinuria is observed in conjunction with hypertension. (3) As per the Kidney Disease Outcomes Quality Initiative (KDOQI) recommendations, ACE inhibitors and Angiotensin II Receptor Blockers (ARBs) are the preferred treatment choices for diabetic kidney disease and non-diabetic kidney disease patients with proteinuria. In 2013, a cross-sectional study conducted in Karachi, Pakistan, revealed that only 46.1% of General Practitioners opted for ACE inhibitors and ARBs as primary treatment for hypertension and proteinuria associated with CKD. (4) A randomized crossover trial conducted in March 2021 compared candesartan’s antihypertensive and antiproteinuric effects and the newest ARB, azilsartan medoxomil. The study results revealed that azilsartan (20 mg daily) treatment significantly decreased proteinuria and blood pressure without a noticeable increase in side effects than candesartan (8 mg daily) in patients with CKD who required antihypertensive drugs. (5) Considering the high prevalence of CKD in Pakistan, doctors must follow KDOQI guidelines and prescribe ARBs as the primary therapeutic agents for hypertensive patients with CKD. Azilsartan, the most recent ARB, has been proven to have the most potent antihypertensive and antiproteinuric benefits with the fewest side effects. (5) Therefore, physicians should encourage CKD patients to use azilsartan instead of candesartan and other classes of ARBs. Furthermore, improved screening techniques for CKD must be introduced and implemented so that doctors can manage the disease more effectively before it progresses into its final stages. Such screening tests would also help to improve blood pressure control among patients recognized to have CKD. Therefore, Pakistan’s public health sector should ensure the implementation of Kidney Disease Improving Global Outcomes (KDIGO) criteria to screen and manage CKD and CKD-associated hypertension and diabetes. Lastly, there is a dire need for awareness programs to educate general health practitioners regarding CKD management and the benefits of timely referral to a nephrologist.

Prevalence and risk factors associated with chronic kidney disease in Nepal: evidence from a nationally representative population-based cross-sectional study

ObjectiveThis study aimed to determine population-based prevalence of chronic kidney disease (CKD) and its associated factors in Nepal.Study designThe study was a nationwide population-based cross-sectional study.Setting and participantsCross-sectional survey conducted...

POS-285 EPIDEMIOLOGYICAL FEATURES OF CHRONIC KIDNEY DISEASE IN CENTRAL CHINA

Chronic kidney disease (CKD) has been a global public health issue in the past decades and affects more than 10% population worldwide. But there are still limited studies to explore the epidemiological features of CKD in China. From July 2016 to June 2018, a total of 29100 participants were randomly enrolled from 3 urban communities and 4 rural districts of Henan province. CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min.1.73m2 or urinary albumin to creatinine ratio ≥ 30 mg/g (albuminuria). Diabetic subjects with systolic blood pressure > 140mmHg, albuminuria or an eGFR less than 60 mL/min/1.73 m2 were classified as having DKD. Participants completed a questionnaire assessing lifestyle and relevant medical history, and blood and urine specimens were taken. Serum creatinine, uric acid, total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein and urinary albumin were assessed. The age- and sex-adjusted prevalences of CKD and DKD were calculated, and risk factors associated with the presence of reduced eGFR, albuminuria, DKD, severity of albuminuria and progression of reduced renal function were analyzed by binary and ordinal logistic regression. A two-sample mendelian randomization (MR) analysis was employed to calculate the causal effects between risk factors and CKD. The exposure included alcohol consumption, physical activities, BMI, diabetes, hypertension and dyslipidemia, the outcome was eGFR < 60 and albuminuria, respectively. There were 23869 rural participants were recruited. Totally, 4347 participants were suffering from CKD, in which 962 subjects were DKD patients.The overall adjusted prevalence of CKD was 16.4% (15.9–16.8%) and that of DKD was 2.9% (2.7–3.1%). In all participants with diabetes,the prevalence of reduced eGFR was 6.3% and that of albuminuria was 45.3%. The overall prevalence of CKD in participants with diabetes was 48.0% (95% CI = 43.1–52.9%). A total of 5231 urban participants were recruited. The overall adjusted prevalence of CKD was 16.8% (15.8–17.8%) and that of DKD was 3.5% (3.0–4.0%). Decreased renal function was detected in 132 participants (2.9%), whereas albuminuria was found in 858 participants (14.9%). In all participants with diabetes,the prevalence of reduced eGFR was 6.3% and that of albuminuria was 45.3%. The overall prevalence of CKD in participants with diabetes was 48.0%. Results of the binary and ordinal logistic regression indicated that the factors independently associated with a higher risk of reduced eGFR and albuminuria were older age, male gender, smoking, alcohol consumption, overweight,obesity, diabetes, hypertension, dyslipidemia and hyperuricemia. MR analysis showed that increased BMI and hypertension had casual effects on development of eGFR < 60 (β = 0.15 and 1.38) and albuminuria (β = 0.08 and 0.46). The results of our current study demonstrate that the prevalences of CKD and DKD are still high in Chinese rural and urban population and they are going to be a major social-economic burden in China. High prevalent hypertension and diabetes are primary risk factors for them. Increased BMI and hypertension have causal effects on development of CKD. Specific strategies and interventions aimed at reducingthe burden of CKD and DKD are urgently needed.

CHRONIC KIDNEY DISEASE IN RURAL POPULATION.

The aims of the study were to provide data on chronic kidney disease (CKD) prevalence in rural population and to analyze the association with cardiovascular risk factors and aging. A random sample of 2193 farmers (1333 female (F) and 860 male (M), mean age 50.61±17.12) were enrolled. Questionnaire and clinical examination were conducted. Participants provided a spot urine and fasting blood sample. Estimated glomerular filtration rate (eGFR) was estimated using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Subjects were classified according to the KDIGO guidelines. The overall prevalence of CKD (eGFR <60 mL/min/1.73 m2) was 8.83% (F vs. M 9.9% vs. 6.3%; p<0.001). Albuminuria (albumin-to-creatinine ratio >30 mg/g) was found in 8.45% (F vs. M p>0.05). Sharp increase in CKD prevalence was found to begin after the sixth decade (29.44% in subjects older than 65 years; F vs. M 30.9% vs. 26.8%; p<0.01). The strongest predictor factors for CKD were age >65 years (OR 22.12), hypertension (OR 6.53), albuminuria (OR 5.71), fasting blood glucose >7 mmol/L (OR 5.49), diabetes (OR 3.07), abdominal obesity (OR 2.05) and non-smoking (OR 0.41). In multivariate analysis, age (OR 1.13), female gender (OR 0.60) and diabetes (OR 1.75) were the independent predictor factors for CKD. In conclusion, CKD prevalence is high in rural population, being higher in women than in men. In both genders, eGFR significantly decreased with aging. Aging is a significant independent predictor of CKD.

Factors Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes in Bangladesh.

Diabetes and chronic kidney disease (CKD) are a major public health burden in low- and middle-income countries. This study aimed to explore factors associated with CKD in patients with type 2 diabetes (T2D) in Bangladesh. A cross-sectional study was conducted among 315 adults with T2D presenting at the outpatient department of Bangladesh Institute of Health Sciences (BIHS) hospital between July 2013 to December 2013. CKD was diagnosed based on the estimated glomerular filtration rate using the ‘Modification of Diet in Renal Disease’ equations and the presence of albuminuria estimated by the albumin-to-creatinine ratio. Multivariate logistic regression analysis was used to determine the factors associated with CKD. The overall prevalence of CKD among patients with T2D was 21.3%. In the unadjusted model, factors associated with CKD included age 40–49 years (OR: 5.7, 95% CI: 1.3–25.4), age 50–59 years (7.0, 1.6–39), age ≥60 years (7.6, 1.7–34), being female (2.2, 1.2–3.8), being hypertensive (1.9, 1.1–3.5), and household income between 10,001 and 20,000 Bangladeshi taka, BDT (2.9, 1.0–8.2) compared with income ≤10,000 BDT. However, after adjustment of other covariates, only the duration of hypertension and household income (10,001–20,000 BDT) remained statistically significant. There is a need to implement policies and programs for early detection and management of hypertension and CKD in T2D patients in Bangladesh.

Prevalencia por áreas sanitarias de enfermedad renal crónica en la población diabética de Extremadura durante los años 2012, 2013 y 2014. Un estudio observacional

Background and objectiveDiabetes mellitus is the leading cause of chronic kidney disease (CKD) in our country. The objective was to estimate the global prevalence and by health areas of CKD in the diabetic population of Extremadura. Patients and methodsObservational, longitudinal retrospective study in the diabetic population attended in the Extremadura Health System in 2012–2014. A total of 90,709 patients ≥ 18 years old were studied. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). The presence of CKD was defined as follows: an eGFR<60 mL/min/1.73 m2 in a time period of greater than three months or the presence of renal damage, as evaluated by an urine albumin-creatinine ratio (UACR) ≥ 30 mg/g, with or without reduced eGFR, also in a time period of greater than three months. ResultsThe overall prevalence of CKD was 15.6% (17.5% in women and 13.7% in men) and it was higher in the province of Cáceres (17%) than in Badajoz (14.8%, p<0.001), with the lowest prevalence in the Navalmoral de la Mata health area (13%) and the highest in Plasencia (17.8%, p<0.001). The prevalence of CKD defined without the need for confirmation of the sustainability of kidney damage or decreased eGFR was 26.1% (29.3% in women and 22.9% in men), which represents an overestimation of the prevalence of 67%. ConclusionsThe prevalence of CKD in Extremadura's diabetic population is lower than usually referred to and differs significantly between its health areas.

Prevalence and predisposing factors of chronic kidney disease in Yazd city; a population-based study

Introduction: Chronic kidney disease (CKD) is a major health problem and one of the public health threats with an increasing prevalence and burden. However, early diagnosis of this disease is challenging in Iran due to insufficient information. Objectives: In the present study, we aimed to determine the prevalence of CKD and its predisposing factors in Yazd city, Iran. Patients and Methods: We conducted this cross-sectional study using the recruitment phase data of Yazd Health Study (YaHS) collected during 2013-2014. Data of 3649 individuals, age 20-69 years were analyzed. Glomerular filtration rate (GFR) was calculated using the modification of diet in renal disease (MDRD) formula and values less than 60 mL/min/1.73 m2 were defined as CKD. Logistic regression was employed to determine the risk factors of CKD. Results: The mean age of participants was 46.0 ± 13.8 years and the overall prevalence of CKD was 6.6 percent (7.6% for women and 5.4% for men). The disease prevalence was 21.5% in the age group of 60-69 years. The prevalence of CKD had a significant relationship with older age, obesity, female gender, diabetes, high blood pressure and history of heart disease. Conclusion: CKD has a high prevalence in the population of this region of Iran. The most important modifiable risk factors for CKD included diabetes and high blood pressure. Therefore, the health system should strive for early detection of CKD in order to prevent morbidity and mortality of this disease.

Estimating the prevalence of definitive chronic kidney disease in the Japanese general population

Most data on chronic kidney disease (CKD) prevalence has been based on single measurements of renal function and proteinuria. The aim was to determine the prevalence of CKD diagnosed by chronic proteinuria and/or reduced eGFR in a recent year in Japan. In the main study, using a population-based cohort in Japan, the overall prevalence of CKD, defined as persistent positive proteinuria and/or eGFR < 60ml/min/1.73 m2, was determined. Of 2,849,557 persons,763,104had data for eGFR and proteinuria in both 2014 and 2015. For estimating number of CKD cases in Japanese adults, a regional cohort data with age ranging 22-87years (N = 22,037) was further applied to the analysis. Definitive CKD was present in 2.3-23.0% of men and 1.7-17.1% of women age from 40 to 74years in the main cohort. The estimated prevalence of reduced eGFR and/or proteinuria in the baseline year alone was 15.7% in men and 13.6% in women; the prevalence of definitive CKD was 10.9% in men and 9.2% in women. The number of CKD cases based on a single-year test in Japanese adults over 20years of age increased from 13.3 million to 14.8 million between 2005 and 2015. Recent changes in prevalence of CKD seem to be mainly caused by an increase in Japan's elderly population. Although past reports may lead to overdiagnosis of CKD by a single-year test, the estimated number of definitive CKD was 10.2 million in 2015.

POS-320 INSIDE ANEMIA OF CKD: QUANTIFYING THE EPIDEMIOLOGICAL BURDEN OF ANEMIA OF CKD IN CANADA VIA MICROSIMULATION MODELLING

Chronic kidney disease (CKD) is associated with adverse cardiovascular outcomes, premature mortality and reduced quality of life. Anemia is a common complication of CKD that may occur with, and increases with, disease progression. Mathematical models based on robust epidemiological and clinical data are a useful way to predict the future burden of disease; this is important for the planning of health services. This study reports a microsimulation model, Inside ANEMIA of CKD, that projects the epidemiological burden of anemia of CKD up to 2025 in Canada. A virtual cohort representing the Canadian population was created, using national demographic statistics, within the Inside ANEMIA of CKD microsimulation model framework. Virtual individuals were ascribed an age-sex stratified CKD status (defined by estimated glomerular filtration rate and albuminuria levels, in accordance with international guidelines) and anemia status (defined by hemoglobin level as mild, moderate or severe, in accordance with WHO criteria). Key co-morbidities were also assigned, reflecting country-specific population statistics. Canadian demographics and epidemiological data were drawn from Statistics Canada and a provincial renal database. Incidence rates for cardiovascular complications were drawn from the literature. Preliminary results indicate that the overall prevalence of CKD in Canada is projected to increase by an absolute rate of 1% from 2020 to 2025, irrespective of population growth. The number of individuals with anemia of CKD is estimated to increase from 1.8 to 2.7 million cases by 2025. A 16% increase is projected for patients with moderate to severe anemia of CKD by 2025. The incidence of cardiovascular complications in patients with all levels of anemia of CKD is expected to increase by 2025 as follows: 28% increase in heart failure and a 20% increase in myocardial infarction events. Inside ANEMIA of CKD is the first microsimulation model to project the epidemiological burden of anemia attributable to CKD in Canada. As more individuals are affected by anemia of CKD over the next five years, co-morbidities such as cardiovascular disease will increase in parallel. Implementing healthcare policies that are aimed at identifying and proactively managing patients with anemia of CKD may reduce this substantial healthcare burden.