A Cross-Sectional Study on the Prevalence and Risk Stratification of Chronic Kidney Disease in Cardiological Patients in São Paulo, Brazil

Background Chronic kidney disease (CKD) is associated with increased cardiovascular disease (CVD) risk factors and morbidity in the elderly population. This study aimed to examine the association between CKD and CVD risk factors in the elderly population of Fasa and Yazd (Shahdieh), Iran, using the data from the enrolment phase of Fasa and Shahedieh cohort studies. Methods We conducted a cross-sectional analytical study using data from Fasa and Shahedieh cohort studies, which enrolled 1487 and 1507 participants aged over 60 years, respectively. We collected data on demographic and clinical variables, kidney problems, and CVD from the two studies. We estimated the glomerular filtration rate (eGFR) using the modification of diet in renal disease (MDRD) formula and considered values less than 60 ml/min/1.73 m2 as CKD. We used independent t-tests, Spearman’s correlation coefficient, chi-square, one-way analysis of variance, and logistic regression to analyze the data. We performed the analyses using SPSS V. 22.0 software and set the significance level at 0.05. Results The overall prevalence of CKD was 41.9%; 25.7% in women and 16.2% in men. The prevalence of CKD based on reported kidney problems was 1.7%, of which 54.7% were in stage 3 of CKD. Compared to participants in the early stages of CKD, participants in advanced stages had a higher prevalence of diabetes ( p < 0.001), hypertension ( p < 0.001), ischemic heart disease (IHD) ( p < 0.001), and myocardial infarction ( p < 0.001). In addition, participants in higher stages of CKD were more obese, had lower physical activity, smoked more, and consumed more opium ( p < 0.001). Conclusion Our study showed that more than half of the patients were in stage three CKD, which is an advanced stage of this disease. Diabetes Melitus, hypertension, dyslipidemia, IHD, and myocardial infarction were more prevalent in patients than others. These findings demonstrate the importance of screening for CKD in patients with diabetes mellitus and hypertension. The results also suggest that lifestyle modification and prevention strategies are needed to reduce the burden of CKD and CVD in this population.

Association between chronic kidney disease and cardiovascular disease risk factors in elderly: results from the first phase of Fasa and Shahedieh cohort studies

Zarshenas,

Dehghan,

Mirzaei

2024

Prevalence of hypertension and diabetes mellitus in Peruvian patients with chronic kidney disease: a systematic review and meta-analysis

León-Figueroa,

Aguirre-Milachay,

Barboza

et al. 2024

Background Chronic Kidney Disease (CKD) represents a major challenge for public health, with hypertension and diabetes being the main causes of its occurrence. Therefore, this study aims to determine the prevalence of hypertension (HTN) and diabetes mellitus (DM) in Peruvian patients with CKD. Methods A systematic search for studies about CKD in Peru was carried out in PubMed, Scopus, Embase, Web of Science, ScienceDirect, Google Scholar, Virtual Health Library (VHL), and Scielo from 2011 to December 2023. The protocol of this research was registered in the international registry of systematic reviews, the Prospective International Registry of Systematic Reviews (PROSPERO), with registration number CRD42023425118. Study selection, quality assessment, and data extraction were performed independently by two authors. Study quality was assessed using the Joanna Briggs Institute Statistical Meta-Analysis Assessment and Review Instrument. A random-effects model with inverse variance weighting was used to estimate the combined prevalence of HTN and DM in Peruvian patients with CKD. To analyze data heterogeneity, the I2 statistical test was used. Statistical analysis was performed with R version 4.2.3. Results A total of 1425 studies were retrieved, of which 23 were included in the final meta-analysis. A total of 43,321 patients with CKD were evaluated, of whom 52.22% were male and 47.78% were female. The combined prevalence of HTN in Peruvian patients with CKD was 38% (95% CI: 30–46%; 41,131 participants; 21 studies, I2 = 99%, p = 0), while the combined prevalence of DM in Peruvian patients with CKD was 33% (95% CI: 26–40%; 43,321 participants; 23 studies, I2 = 99%, p = 0). Conclusion Approximately one-third of Peruvian patients with CKD have HTN and DM. These findings highlight the importance of implementing prevention and control measures for these chronic noncommunicable diseases in the Peruvian population, such as promoting healthy lifestyles, encouraging early detection and proper management of hypertension and diabetes, and improving access to medical care and health services.

Laboratory-based surveillance of chronic kidney disease in people with private health coverage in Brazil

Samaan,

Silveira,

Mouro

et al. 2024

Background Although approximately 25% of Brazilians have private health coverage (PHC), studies on the surveillance of chronic kidney disease (CKD) in this population are scarce. The objective of this study was to estimate the prevalence of CKD in individuals under two PHC regimes in Brazil, who total 8,335,724 beneficiaries. Methods Outpatient serum creatinine and proteinuria results of individuals from all five regions of Brazil, ≥ 18 years of age, and performed between 10/01/2021 and 10/31/2022, were analyzed through the own laboratory network database. People with serum creatinine measurements were evaluated for the prevalence and staging of CKD, and those with simultaneous measurements of serum creatinine and proteinuria were evaluated for the risk category of the disease. CKD was classified according to current guidelines and was defined as a glomerular filtration rate (GFR) < 60 ml/min/1.73 m² estimated by the 2021 CKD-EPI equation. Results The number of adults with serum creatinine results was 1,508,766 (age 44.0 [IQR, 33.9–56.8] years, 62.3% female). The estimated prevalence of CKD was 3.8% (2.6%, 0.8%, 0.2% and 0.2% in CKD stages 3a, 3b, 4 and 5, respectively), and it was higher in males than females (4.0% vs. 3.7%, p < 0.001, respectively) and in older age groups (0.2% among 18-29-year-olds, 0.5% among 30-44-year-olds, 2.0% among 45-59-year-olds, 9.4% among 60-74-year-olds, and 32.4% among ≥ 75-year-olds, p < 0.001) Adults with simultaneous results of creatinine and proteinuria were 64,178 (age 57.0 [IQR, 44.8–67.3] years, 58.1% female). After adjusting for age and gender, 70.1% were in the low-risk category of CKD, 20.0% were in the moderate-risk category, 5.8% were in the high-risk category, and 4.1% were in the very high-risk category. Conclusion The estimated prevalence of CKD was 3.8%, and approximately 10% of the participants were in the categories of high or very high-risk of the disease. While almost 20% of beneficiaries with PHC had serum creatinine data, fewer than 1% underwent tests for proteinuria. This study was one of the largest ever conducted in Brazil and the first one to use the 2021 CKD-EPI equation to estimate the prevalence of CKD.