Renal Function and Risk Factors of Moderate to Severe Chronic Kidney Disease in Golestan Province, Northeast of Iran

Abstract

IntroductionThe incidence of end-stage renal disease is increasing worldwide. Earlier studies reported high prevalence rates of obesity and hypertension, two major risk factors of chronic kidney disease (CKD), in Golestan Province, Iran. We aimed to investigate prevalence of moderate to severe CKD and its risk factors in the region.MethodsQuestionnaire data and blood samples were collected from 3591 participants (≥18 years old) from the general population. Based on serum creatinine levels, glomerular filtration rate (GFR) was estimated.ResultsHigh body mass index (BMI) was common: 35.0% of participants were overweight (BMI 25–29.9) and 24.5% were obese (BMI ≥30). Prevalence of CKD stages 3 to 5 (CKD–S3-5), i.e., GFR <60 mL/min/1.73 m2, was 4.6%. The odds ratio (OR) and 95% confidence interval (95% CI) for the risk of CKD–S3-5 associated with every year increase in age was 1.13 (1.11–1.15). Men were at lower risk of CKD–S3-5 than women (OR = 0.28; 95% CI 0.18–0.45). Obesity (OR = 1.78; 95% CI 1.04–3.05) and self-reported diabetes (OR = 1.70; 95% CI 1.00–2.86), hypertension (OR = 3.16; 95% CI 2.02–4.95), ischemic heart disease (OR = 2.73; 95% CI 1.55–4.81), and myocardial infarction (OR = 2.69; 95% CI 1.14–6.32) were associated with increased risk of CKD–S3-5 in the models adjusted for age and sex. The association persisted for self-reported hypertension even after adjustments for BMI and history of diabetes (OR = 2.85; 95% CI 1.77–4.59).ConclusionA considerable proportion of inhabitants in Golestan have CKD–S3-5. Screening of individuals with major risk factors of CKD, in order to early detection and treatment of impaired renal function, may be plausible. Further studies on optimal risk prediction of future end-stage renal disease and effectiveness of any screening program are warranted.

Risk factors associated with disease progression and mortality in chronic kidney disease of uncertain etiology: a cohort study in Medawachchiya, Sri Lanka

“…A similar age-structure pyramid in the CKD population has been reported from another Asian country, Iran, where 23.6% are aged \30 years, and only 6.0% are [70 years old [4]. In the present cohort, 37% of stage 3-5 CKDu patients were older than 60 years.…”

“…A similar association has been reported in a study in Taiwan [15], where 62% of the affected population was male. However, the majority of published studies have shown female-dominant CKD cohorts [4,22,23]. Further research is needed to determine the reasons for male dominance in our study area.…”

“…Patients with CKD constitute a significant economic burden, both directly in terms of resource utilization, and indirectly through loss of productivity and impaired quality of life [3]. In the past decade, 1.1 trillion dollars have been spent on dialysis worldwide [4]. Therefore, early detection of asymptomatic CKD patients is important because early intervention has a reasonable chance of making a positive impact on outcome [5].…”

“…Therefore, early detection of asymptomatic CKD patients is important because early intervention has a reasonable chance of making a positive impact on outcome [5]. Similarly, it is important to prevent or delay disease progression from mild to severe stages [4]. The global increase in the prevalence of CKD and its disproportionate burden on economically developing countries is being driven by an increase in the prevalence of the main risk factors for CKD; namely, diabetes, hypertension, obesity, and aging of the population [6].…”

Prevalence and determinants of chronic kidney disease in northeast of Iran: Results of the Golestan cohort study

“…Literacy proved to be inversely associated with CKD while urbanization was associated with higher odds of CKD, and both associations remained statistically significant in multivariate analyses, which is consistent with previous reports. [7,8] Socio-economic status and ethnicity remained non-significant, neither in crude nor in adjusted models.…”