Prevalence and risk factors of kidney disease in urban Karachi: baseline findings from a community cohort study

BMC Research Notes

Faisal S Khan²  Ismat Lotia-Farrukh²  Naila Baig-Ansari²  Farhana Amanullah²  Ashar Alam¹ 

[1] Department of Nephrology, The Indus Hospital, Korangi Crossing, Karachi 75190, Pakistan;Interactive Research & Development, Suite 508, Ibrahim Trade Tower, Main Shahrah-e-Faisal, Karachi 75350, Pakistan

关键词: South Asia;    Prevalence;    Pakistan;    Chronic kidney disease;   

Others  :  1134167
DOI  :  10.1186/1756-0500-7-179

 received in 2013-12-17, accepted in 2014-03-20,  发布年份 2014

【 摘 要 】

Background

Chronic kidney disease (CKD) is being increasingly recognized as a leading public health problem. However, there are limited data available with respect to prevalence of CKD in Pakistan, a developing South Asian country. The study presents the baseline findings of prevalence and risk factors for adult kidney disease in a Pakistani community cohort.

Methods

A total of 667 households were enrolled between March 2010 and August 2011 including 461 adults, aged 15 and older. Mild kidney disease was defined as estimated Glomerular Filtration Rate (eGFR) ≥60 ml/min with microalbuminuria ≥ 30 mg/dl and moderate kidney disease was defined as eGFR <60 ml/min (with or without microalbuminuria).

Results

The overall prevalence of kidney disease was 16.6% with 8.6% participants having mild kidney disease and 8% having moderate kidney disease. Age was significantly associated with kidney disease (p < 0.0001). The frequency of diabetes, hypertension and smoking differed significantly among the three groups, i.e., no kidney disease, mild kidney disease and moderate kidney disease.

Conclusion

Our study results suggest that the burden of kidney disease in this population is found considerable and comparable to neighboring developing countries. We believe that these results have critical implications on health and economics of these countries and due to the epidemic of diabetes, hypertension, cardiovascular disease, smoking and association with worsening poverty, further rapid growth is expected. There is an urgent need for early recognition and prevention strategies based on risk factors and disease trends determined through longitudinal research.

【 授权许可】

   
2014 Alam et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]WHO: Preventing chronic diseases: a vital investment. Geneva: World Health Organization; 2005.
• [2]WHO: 2008-2013 action plan for the global strategy for the prevention and control of noncommunicable diseases: prevent and control cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. Geneva: World Health Organization; 2008.
• [3]Zhang QL, Rothenbacher D: Prevalence of chronic kidney disease in population-based studies: systematic review. BMC Public Health 2008, 8:117. BioMed Central Full Text
• [4]Couser WG, Remuzzi G, Mendis S, Tonelli M: The contribution of chronic kidney disease to the global burden of major noncommunicable diseases. Kidney Int 2011, 80:1258-1270.
• [5]Alebiosu CO, Ayodele OE: The global burden of chronic kidney disease and the way forward. Ethn Dis 2005, 15:418-423.
• [6]Martins D, Tareen N, Zadshir A, Pan D, Vargas R, Nissenson A, Norris K: The association of poverty with the prevalence of albuminuria: data from the Third National Health and Nutrition Examination Survey (NHANES III). Am J Kidney Dis 2006, 47:965-971.
• [7]Jha V: Current status of end-stage renal disease care in South Asia. Ethn Dis 2009, 19:S1-27-32.
• [8]Modi G, Jha V: Incidence of ESRD in India. Kidney Int 2011, 79:573.
• [9]Modi GK, Jha V: The incidence of end-stage renal disease in India: a population-based study. Kidney Int 2006, 70:2131-2133.
• [10]Saeed ZI, Hussain SA: Chronic kidney disease in Pakistan: an under-recognized public health problem. Kidney Int 2012, 81:1151. author reply 1151–1152
• [11]Jafar TH, Schmid CH, Levey AS: Serum creatinine as marker of kidney function in South Asians: a study of reduced GFR in adults in Pakistan. J Am Soc Nephrol 2005, 16:1413-1419.
• [12]Jafar TH: The growing burden of chronic kidney disease in Pakistan. N Engl J Med 2006, 354:995-997.
• [13]NHLBI, Boston University: Epidemiological background and design: the Framingham study. 2013. Available at: http://www.framinghamheartstudy.org/about-fhs/background.php webcite. Accessed Apr 2, 2014
• [14]Khan FS, Lotia-Farrukh I, Khan AJ, Siddiqui ST, Sajun SZ, Malik AA, Burfat A, Arshad MH, Codlin AJ, Reininger BM, McCormick JB, Afridi N, Fisher-Hoch SP: The burden of non-communicable disease in transition communities in an Asian megacity: baseline findings from a cohort study in Karachi, Pakistan. PLoS One 2013, 8(2):e56008.
• [15]American Diabetes A: Diagnosis and classification of diabetes mellitus. Diabetes Care 2010, 33(Suppl 1):S62-S69.
• [16]Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, Roccella EJ: Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension 2003, 42:1206-1252.
• [17]Huda MN, Alam KS, Harun UR: Prevalence of chronic kidney disease and its association with risk factors in disadvantageous population. Int J Nephrol 2012, 2012:267329.
• [18]Najafi I, Shakeri R, Islami F, Malekzadeh F, Salahi R, Yapan-Gharavi M, Hosseini M, Hakemi M, Alatab S, Rahmati A, Broumand B, Nobakht-Haghighi A, Larijani B, Malekzadeh R: Prevalence of chronic kidney disease and its associated risk factors: the first report from Iran using both microalbuminuria and urine sediment. Arch Iran Med 2012, 15(22292573):70-75.
• [19]Ingsathit A, Thakkinstian A, Chaiprasert A, Sangthawan P, Gojaseni P, Kiattisunthorn K, Ongaiyooth L, Vanavanan S, Sirivongs D, Thirakhupt P, Mittal B, Singh AK, Thai Seek Group: Prevalence and risk factors of chronic kidney disease in the Thai adult population: Thai SEEK study. Nephrol Dial Transplant 2010, 25(5):1567-1575.
• [20]Takamatsu N, Abe H, Tominaga T, Nakahara K, Ito Y, Okumoto Y, Kim J, Kitakaze M, Doi T: Risk factors for chronic kidney disease in Japan: a community-based study. BMC Nephrol 2009, 10:34. BioMed Central Full Text
• [21]Alsuwaida AO, Farag YM, Al Sayyari AA, Mousa D, Alhejaili F, Al-Harbi A, Housawi A, Mittal BV, Singh AK: Epidemiology of chronic kidney disease in the Kingdom of Saudi Arabia (SEEK-Saudi investigators) - a pilot study. Saudi J Kidney Dis Transpl 2010, 21:1066-1072.
• [22]Domrongkitchaiporn S, Sritara P, Kitiyakara C, Stitchantrakul W, Krittaphol V, Lolekha P, Cheepudomwit S, Yipintsoi T: Risk factors for development of decreased kidney function in a Southeast Asian population: a 12-year cohort study. J Am Soc Nephrol 2005, 16:791-799.
• [23]Nagata M, Ninomiya T, Doi Y, Yonemoto K, Kubo M, Hata J, Tsuruya K, Iida M, Kiyohara Y: Trends in the prevalence of chronic kidney disease and its risk factors in a general Japanese population: the Hisayama Study. Nephrol Dial Transplant 2010, 25:2557-2564.
• [24]Kuo HW, Tsai SS, Tiao MM, Yang CY: Epidemiological features of CKD in Taiwan. Am J Kidney Dis 2007, 49:46-55.
• [25]Yu MK, Lyles CR, Bent-Shaw LA, Young BA: Risk factor, age and sex differences in chronic kidney disease prevalence in a diabetic cohort: the pathways study. Am J Nephrol 2012, 36:245-251.
• [26]Hosseinpanah F, Kasraei F, Nassiri AA, Azizi F: High prevalence of chronic kidney disease in Iran: a large population-based study. BMC Public Health 2009, 9:44. BioMed Central Full Text
• [27]Silbiger SR, Neugarten J: The role of gender in the progression of renal disease. Adv Ren Replace Ther 2003, 10:3-14.
• [28]Garg AX, Papaioannou A, Ferko N, Campbell G, Clarke JA, Ray JG: Estimating the prevalence of renal insufficiency in seniors requiring long-term care. Kidney Int 2004, 65:649-653.
• [29]Hemmelgarn BR, Zhang J, Manns BJ, Tonelli M, Larsen E, Ghali WA, Southern DA, McLaughlin K, Mortis G, Culleton BF: Progression of kidney dysfunction in the community-dwelling elderly. Kidney Int 2006, 69:2155-2161.
• [30]Manjunath G, Tighiouart H, Coresh J, Macleod B, Salem DN, Griffith JL, Levey AS, Sarnak MJ: Level of kidney function as a risk factor for cardiovascular outcomes in the elderly. Kidney Int 2003, 63:1121-1129.
• [31]Wasen E, Isoaho R, Mattila K, Vahlberg T, Kivela SL, Irjala K: Estimation of glomerular filtration rate in the elderly: a comparison of creatinine-based formulae with serum cystatin C. J Intern Med 2004, 256:70-78.
• [32]Lamb EJ, O’Riordan SE, Delaney MP: Kidney function in older people: pathology, assessment and management. Clin Chim Acta 2003, 334:25-40.
• [33]National Kidney F: K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002, 39:S1-S266.
• [34]Levey AS, de Jong PE, Coresh J, El Nahas M, Astor BC, Matsushita K, Gansevoort RT, Kasiske BL, Eckardt KU: The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int 2011, 80:17-28.
• [35]Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J, De Zeeuw D, Hostetter TH, Lameire N, Eknoyan G: Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 2005, 67:2089-2100.
• [36]Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D: A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999, 130:461-470.
• [37]Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group: KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int 2013, 2013(Suppl):1-150.