Prevalence and risk factors of chronic kidney disease and diabetic kidney disease in a central Chinese urban population: a cross-sectional survey

Abstract

Background : This study was conducted to evaluate and update the current prevalence of and risk factors for chronic kidney disease (CKD) and diabetic kidney disease (DKD) in China. Methods : A total of 5231 participants were randomly recruited for this study. CKD and DKD were defined according to the combination of the estimated glomerular filtration rate (eGFR) and the presence of albuminuria and diabetes. 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 prevalence of CKD and DKD was 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. Results : 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%, 95% confidence interval [CI]: 2.5 – 3.2%), whereas albuminuria was found in 858 participants (14.9%, 95% CI: 13.9 – 15.9%). In all participants with diabetes, the prevalence of reduced eGFR was 6.3% (95% CI = 3.9 – 8.6%) and that of albuminuria was 45.3% (95% CI = 40.4 – 50.1%). The overall prevalence of CKD in participants with diabetes was 48.0% (95% CI = 43.1 – 52.9%). The 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, sex, smoking, alcohol consumption, overweight, obesity, diabetes, hypertension, dyslipidemia and hyperuricemia. Conclusions : Our study shows the current prevalence of CKD and DKD in residents of Central China. The high prevalence suggests an urgent need to implement interventions to relieve the high burden of CKD and DKD in China.

Impact of Novel Guidelines on Multifactorial Control and Its Association with Mortality in Adult Patients with Hypertension and Newly Diagnosed Type 2 Diabetes: A 4-Year Prospective Multicenter Study

“…Escalating CKD incidence among diabetic patients, as well as increasing CKD-induced mortality merit careful attention [4,27,28]. Coexistent CKD was noted in 16.8% to 24.4% of the Asian diabetic population, whereas 43.8% of diabetes with microvascular complications reported eGFR below 60 ml/min [29][30][31]. Similarly, our high-risk patients exhibited a soaring prevalence of CKD (41.1%), which elaborated higher baseline prescription of RAAS inhibitor (89.8%) and statin (67.1%) compared to the Vietnamese subpopulation of the DiabCare study (46.8% and 40.3%, respectively) [32].…”

Association between Non-Alcoholic Fatty Liver Disease and Chronic Kidney Disease: A Cross-Sectional Study

“…Additionally, when uric acid is present in the cytoplasm of cells or in the acidic/hydrophobic environment of atherosclerotic plaques, it is converted to a pro-oxidant, and it promotes oxidative stress, including cardiovascular disease through this mechanism, participating in the pathophysiology of human disease [ 21 ]. Recent studies reported that hyperuricemia is an independent predictor of CKD [ 22 , 23 ]. Uric acid concentration is an independent risk factor for kidney failure in earlier stages of CKD and has a J-shaped relationship with all-cause mortality in CKD [ 24 ].…”

Poor Control of Plasma Triglycerides Is Associated with Early Decline of Estimated Glomerular Filtration Rates in New-Onset Type 2 Diabetes in China: Results from a 3-Year Follow-Up Study

“…DKD has been the most common cause of ESRD in Western countries, and numerous risk factors have been identified for its progression, including but not limited to older age, smoking, alcohol consumption, overweight/obesity, hyperglycemia, hypertension, dyslipidemia, and hyperuricemia [ 4 , 17 , 18 ]. However, even under strict control of body weight, blood glucose, and blood pressure, some patients still progress to ESRD.…”

“…Previous studies had shown that dyslipidemia was a well-established risk factor for the renal impairment in diabetes; it is not only associated with the occurrence [ 2 , 10 , 19 ] but also the deterioration [ 4 , 11 ] of DKD. A cross-sectional study published in 2014 involving 13 countries reported the plasma lipid's contribution to the occurrence of DKD; hypertriglyceridemia significantly increased the risk of DKD, and high HDL-C was a protective factor [ 10 ].…”

“…Diabetic kidney disease (DKD) is one major microvascular complication of type 2 diabetes mellitus (T2DM) and has been the most common cause of end-stage renal disease (ESRD) in Western countries [ 1 ], which ranks the second in China [ 2 ]. From 2009 to 2012, the prevalence of DKD in China was 30%-50% in community diabetic patients and about 40% in hospitalized patients [ 3 ], while in 2017 to 2018, the overall prevalence of CKD in patients with diabetes was 48.0% [ 4 ]. The progression of renal function decline in DKD is insidious and rapid, and lacking effective treatment for ESRD makes it very important to find and control risk factors for DKD at a stage as early as possible [ 5 ].…”