CKD and CKDu in northern Peru: a cross-sectional analysis under the DEGREE protocol

Abstract

Background This study estimated the prevalence and risk factors for decreased estimated glomerular filtration rate (eGFR) in those without known hypertension, type 2 diabetes mellitus, or heavy proteinuria as a surrogate marker for chronic kidney disease of unknown cause (CKDu) among adults in the North of Peru. Methods A cross-sectional study was conducted following the Disadvantaged Populations eGFR Epidemiology (DEGREE) Study protocol. Low eGFR was defined based on a single eGFR ≤60 mL/min/1.7m2 estimated using the CKD-EPI equation. Environmental conditions related to CKDu (i.e., work in agriculture or sugarcane, water source, heat intolerance, and pesticide exposure) were evaluated, in addition to traditional risk factors for CKD (i.e., smoking, heavy drinking, physical activity, hypertension, type 2 diabetes mellitus, urolithiasis, among others). Results A total of 1514 subjects were included in the study, mean age 45.1 (SD: 16.4), and 55.2% were females. Overall, only 26 cases (1.7%; 95%CI: 1.1–2.5%) had an eGFR < 60 mL/min/1.7m2 compatible with CKD definition; when those with hypertension and type-2 diabetes or heavy proteinuria were excluded, according to the DEGREE protocol, the estimate fell to 0.9% (95%CI: 0.4–1.5%). Low physical activity levels (OR = 1.99; 95%CI: 1.18–3.34), hypertension (OR = 2.07; 1.26–3.41), and urolithiasis (OR = 1.97; 95%CI: 1.18–3.27) were factors associated with low eGFR. Conclusions A low population-based prevalence of low eGFR (as a surrogate for CKDu), both in rural and urban settings areas, in the Northern Peru, was found. Low physical activity levels, hypertension and urolithiasis were factors associated with low eGFR. Interventions to prevent CKD cases may be focused on well-known CV risk factors and urolithiasis.

Prevalence and predictors of chronic kidney disease of undetermined causes (CKDu) in Western Kenya’s “sugar belt”: a cross-sectional study

“…Increasing age and a non-normal BMI were significant predictors of reduced eGFR Kenya . Table 6 summarizes other study findings that utilized DEGREE methods [ 32 , 42 , 47 , 48 ]. The estimated prevalence of reduced eGFR DEGREE appears to be greater in Sri Lanka and the Southern region of India compared to Peru, Malawi, and the present study [ 32 , 42 , 47 , 48 ].…”

“…Table 6 summarizes other study findings that utilized DEGREE methods [ 32 , 42 , 47 , 48 ]. The estimated prevalence of reduced eGFR DEGREE appears to be greater in Sri Lanka and the Southern region of India compared to Peru, Malawi, and the present study [ 32 , 42 , 47 , 48 ]. This suggests that local factors not present in Kenya, Malawi, or Peru may be present in locations with epidemics of CKDu.…”

“…The DEGREE definition of CKDu is an eGFR of < 60 mL/min/1.73m 2 based on a single serum creatinine measurement in individuals without diabetes, hypertension, or heavy proteinuria [ 30 , 31 ]. We followed the convention of prior studies that utilized the DEGREE protocol and also assessed eGFR < 90 as an endpoint because of low observed prevalence of eGFR < 60 [ 32 , 42 ]. Table 1 defines the terms used for renal function categories.…”

Chronic Kidney Disease of Unknown Origin: Think Beyond Common Etiologies

“…According to a cross-sectional analysis under the DEGREE protocol conducted in Peru, along with the standard danger aspects for CKD, environmental situations for CKDu (such as working in farms, water sources, hot flashes, and pesticide susceptibility) were assessed. In both villages and urban sectors of Northern Peru, a minimal community prevalence of reduced eGFR (as a stand-in for CKDu) was discovered [ 17 ].…”

Revisión Literaria del Convenio Internacional Puyango – Tumbes bajo una mirada socio – económica

“…Así, se supo que las actividades mineras en dicha zona fronteriza provocaron la contaminación por metales pesados del río Puyango (Mora et al, 2016), que representa la principal fuente de agua para los habitantes de Tumbes; y casi el 60% y el 90% de los habitantes varones de las zonas rurales del estudio informaron exposición previa a plaguicidas y haber trabajado en la agricultura, respectivamente (Ruiz-Alejos et al, 2021).…”