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A Population-Based Study on the Prevalence and Risk Factors of Chronic Kidney Disease in Adult Population of Shiraz, Southern Iran

Marzieh Bakhshayeshkaram, Jamshid Roozbeh, Sayed Taghi Heydari, Behnam Honarvar, Mohammad Hossein Dabbaghmanesh, Maryam Ghoreyshi, Kamran Bagheri Lankarani

Background: Currently we face a significant increase in the new cases of end-stage renal disease in developing countries. Hence it seems vital to work on strategies and reduce its development and progression. Determining the related risk factors can provide insight into achieving these policy-making goals. Therefore, this study was conducted in order to identify risk factors associated with chronic kidney disease in Iranian adult population. Material and Methods: This cross-sectional study was performed in Shiraz, through a random cluster sampling in 819 including 340 male and 479 female adult participants. Body mass indexes, waist circumference, blood pressure and biochemical profile were assessed. We evaluated the prevalence of CKD according to glomerular filtration rate (GFR) as well as possible risk factors. GFR was calculated based on “Chronic Kidney Disease Epidemiology Collaboration” creatinine equation. Result:  Mean age of our participants were 43.0± 14.0 years, and 58.5% were female. Our results showed 16.6% of patients with GFR less than 60 mL/min per 1.73. The proportion of participants having hypertension, obesity, high waist circumference, diabetes mellitus and history of cardiovascular disease were 17.3%,19.3%, 35%,9.4% and 5.3 %, respectively. Multiple regression analysis indicated an independent correlation between age, sex, dyslipidemia, and hypertension with CKD. Conclusion: This study indicates that CKD is a substantial health burden in Iranian adult population. Additionally, the results of this study addressed the importance of integrated strategies that aimed to identify, prevent, and treat non-communicable diseases fueling the development of CKD. [GMJ. 2019;8:e935]

Prevalence; Risk Factors; Chronic Kidney Disease

Eckardt K-U, Coresh J, Devuyst O, Johnson RJ, Köttgen A, Levey AS, et al. Evolving importance of kidney disease: from subspecialty to global health burden. The Lancet. 2013; 382(9887):158-69.

https://doi.org/10.1016/S0140-6736(13)60439-0

Nugent RA, Fathima SF, Feigl AB, Chyung D. The burden of chronic kidney disease on developing nations: a 21st century challenge in global health. Nephron Clin Pract. 2011; 118(3):c269-77. https://doi.org/10.1159/000321382

PMid:21212690

Earley A, Miskulin D, Lamb EJ, Levey AS, Uhlig K. Estimating equations for glomerular filtration rate in the era of creatinine standardization: a systematic review. Ann Intern Med. 2012 Jun 5; 156(11):785-95.

https://doi.org/10.7326/0003-4819-156-11-201203200-00391. PMid:22312131

Zabell JR, Larson G, Koffel J, Li D, Anderson JK, Weight CJ. Use of the Modification of Diet in Renal Disease Equation for Estimating Glomerular Filtration Rate in the Urologic Literature. J Endourol. 2016 Aug; 30(8):930-3.

https://doi.org/10.1089/end.2016.0143

PMid:27150489

Chudleigh RA, Dunseath G, Evans W, Harvey JN, Evans P, Ollerton R, et al. How reliable is estimation of glomerular filtration rate at diagnosis of type 2 diabetes? Diabetes care. 2007;30(2):300-5.https://doi.org/10.2337/dc06-1688

PMid:17259498

Booysen HL, Woodiwiss AJ, Raymond A, Sareli P, Hsu H-C, Dessein PH, et al. Chronic kidney disease epidemiology collaboration-derived glomerular filtration rate performs better at detecting preclinical end-organ changes than alternative equations in black Africans. J Hypertension. 2016;34(6):1178-85

https://doi.org/10.1097/HJH.0000000000000924

PMid:27035736

Vos T, Barber R, Bell B. Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(9995):743-800.

https://doi.org/10.1016/S0140-6736(15)60692-4

Saran R, Li Y, Robinson B, Abbott KC, Agodoa L, Ayanian J, et al. US Renal Data System 2015 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2016 Mar;67(3 Suppl 1): Svii, S1-305

Jha V, Garcia-Garcia G, Iseki K, Li Z, Naicker S, Plattner B, et al. Chronic kidney disease: global dimension and perspectives. The Lancet. 2013; 382(9888):260-72.

https://doi.org/10.1016/S0140-6736(13)60687-X

Gansevoort RT, Correa-Rotter R, Hemmelgarn BR, Jafar TH, Heerspink HJL, Mann JF, et al. Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention. The Lancet. 2013; 382(9889):339-52.

https://doi.org/10.1016/S0140-6736(13)60595-4

Shaheen F, Souqiyyeh M. Kidney health in the Middle East. Clin Nephrol. 2010; 74 Suppl 1:S85-8.

PMid:20979970

Sepanlou SG, Barahimi H, Najafi I, Kamangar F, Poustchi H, Shakeri R, et al. Prevalence and determinants of chronic kidney disease in northeast of Iran: Results of the Golestan cohort study. PLoS One. 2017; 12(5):e0176540.

https://doi.org/10.1371/journal.pone.0176540

PMid:28467510 PMCid:PMC5414986

Hill NR, Fatoba ST, Oke JL, Hirst JA, O'Callaghan CA, Lasserson DS, et al. Global Prevalence of Chronic Kidney Disease–A Systematic Review and Meta-Analysis. PLoS One. 2016; 11(7):e0158765.

https://doi.org/10.1371/journal.pone.0158765

PMid:27383068 PMCid:PMC4934905

Kooman JP, van der Sande FM, Leunissen KM. Kidney disease and aging: a reciprocal relation. Exp Gerontol. 2017; 87(Pt B):156-159

Collins AJ, Foley RN, Gilbertson DT, Chen S-C. United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease. Kidney Int Suppl (2011). 2015; 5(1):2-7.

https://doi.org/10.1038/kisup.2015.2

PMid:26097778 PMCid:PMC4455192

Cobo G, Hecking M, Port FK, Exner I, Lindholm B, Stenvinkel P, et al. Sex and gender differences in chronic kidney disease: progression to end-stage renal disease and haemodialysis. Clin Sci (Lond). 2016; 130(14):1147-63.

https://doi.org/10.1042/CS20160047

PMid:27252402

Jungers P, Chauveau P, Descamps-Latscha B, Labrunie M, Giraud E, Man N, et al. Age and gender-related incidence of chronic renal failure in a French urban area: a prospective epidemiologic study. Nephrol Dial Transplant. 1996; 11(8):1542-6.

https://doi.org/10.1093/ndt/11.8.1542

PMid:8856208

Zhang L, Zhang P, Wang F, Zuo L, Zhou Y, Shi Y, et al. Prevalence and factors associated with CKD: a population study from Beijing. Am J Kidney Dis. 2008; 51(3):373-84

https://doi.org/10.1053/j.ajkd.2007.11.009

PMid:18295053

Inaguma D, Imai E, Takeuchi A, Ohashi Y, Watanabe T, Nitta K, et al. Risk factors for CKD progression in Japanese patients: findings from the Chronic Kidney Disease Japan Cohort (CKD-JAC) study. Clin Exp Nephrol. 2017; 21(3):446-456. https://doi.org/10.1007/s10157-016-1309-1

PMid:27412450 PMCid:PMC5486452

Franceschini N, Gouskova NA, Reiner AP, Bostom A, Howard BV, Pettinger M, et al. Adiposity patterns and the risk for ESRD in postmenopausal women. Clin J Am Soc Nephrol. 2015; 10(2):241-50. 0.

Lu JL, Kalantar-Zadeh K, Ma JZ, Quarles LD, Kovesdy CP. Association of body mass index with outcomes in patients with CKD. J Am Soc Nephrol. 2014; 25(9):2088-96

https://doi.org/10.1681/ASN.2013070754

PMid:24652789 PMCid:PMC4147974

Kramer H, Gutiérrez OM, Judd SE, Muntner P, Warnock DG, Tanner RM, et al. Waist Circumference, Body Mass Index, and ESRD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study. Am J Kidney Dis. 2016; 67(1):62-9.

https://doi.org/10.1053/j.ajkd.2015.05.023

PMid:26187471 PMCid:PMC5628031

D'Agati VD, Chagnac A, de Vries AP, Levi M, Porrini E, Herman-Edelstein M, et al. Obesity-related glomerulopathy: clinical and pathologic characteristics and pathogenesis. Nat Rev Nephrol. 2016; 12(8):453-71

https://doi.org/10.1038/nrneph.2016.75

PMid:27263398

Wang Y, Rimm EB, Stampfer MJ, Willett WC, Hu FB. Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men. Am J Clin Nutr. 2005; 81(3):555-63.

https://doi.org/10.1093/ajcn/81.3.555

PMid:15755822

Zoungas S, Woodward M, Li Q, Cooper ME, Hamet P, Harrap S, et al. Impact of age, age at diagnosis and duration of diabetes on the risk of macrovascular and microvascular complications and death in type 2 diabetes. Diabetologia. 2014; 57(12):2465-74.

https://doi.org/10.1007/s00125-014-3369-7

PMid:25226881

Kuznik A, Mardekian J, Tarasenko L. Evaluation of cardiovascular disease burden and therapeutic goal attainment in US adults with chronic kidney disease: an analysis of national health and nutritional examination survey data, 2001–2010. BMC Nephrol. 2013; 14:132

https://doi.org/10.1186/1471-2369-14-132

PMid:23802885 PMCid:PMC3701605

Vaziri ND, Norris K. Lipid disorders and their relevance to outcomes in chronic kidney disease. Blood Purif. 2011; 31(1-3):189-96. https://doi.org/10.1159/000321845

PMid:21228589

Kaysen GA. Lipid and lipoprotein metabolism in chronic kidney disease. J Ren Nutr. 2009; 19(1):73-7

https://doi.org/10.1053/j.jrn.2008.10.011

PMid:19121776

Reis A, Rudnitskaya A, Chariyavilaskul P, Dhaun N, Melville V, Goddard J, et al. Top-down lipidomics of low density lipoprotein reveal altered lipid profiles in advanced chronic kidney disease. J Lipid Res. 2015; 56(2):413-22.

https://doi.org/10.1194/jlr.M055624

PMid:25424003 PMCid:PMC4306694

Tsuruya K, Yoshida H, Nagata M, Kitazono T, Iseki K, Iseki C, et al. Impact of the triglycerides to high-density lipoprotein cholesterol ratio on the incidence and progression of CKD: a longitudinal study in a large Japanese population. Am J Kidney Dis. 2015; 66(6):972-83

https://doi.org/10.1053/j.ajkd.2015.05.011

PMid:26145254

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