Community-based screening to determine the prevalence, health and nutritional status of patients with CKD in rural and peri-urban Bangladesh

Abstract

Background: Studies have labelled chronic kidney disease (CKD) among the adult population in urban Bangladesh. To address knowledge gaps on CKD, we aimed to generate data on prevalence, health and nutrition of CKD individuals living in rural and peri-urban Bangladesh. Methods: Participants were recruited from the Mirzapur Demographic Surveillance System by age-stratified random sampling. We screened participants by measuring serum creatinine and urine albumin to creatinine ratio, and collected socio-demographic, lifestyles and health information (phase I). After 3 months (phase II), we repeated the urine and blood tests as per the Kidney Disease Outcomes Quality Initiative guidelines. The glomerular filtration rate was calculated using the CKD Epidemiology Collaboration equation. Results: Among 928 participants, 872 completed the study. In phase I, probable CKD cases were 281 (32.2%); in phase II, confirmed cases were 192 (22.0%) (stage 1, 4.0%; stage 2, 11.8%; stage 3, 5.5%; stage 4, 0.6%; stage 5, 0.1%). In multivariable analysis, associated factors for prevalent CKD included aged ⩾60 years [adjusted odds ratio (aOR) 5.02; 95% confidence interval (CI) 1.85–13.65], hypertension (aOR 3.08; 95% CI 2.07–4.59), diabetes (aOR 2.52; 95% CI 1.60–3.96), presence of red blood cell in urine (aOR 3.20; 95% CI 1.71–5.98) and anemia (aOR 2.50; 95% CI 1.63–3.84). Conclusions: This is the first ever research on CKD prevalence in rural and peri-urban Bangladesh and recorded about 22%, which is higher than urban settings. Monitoring systems are needed to evaluate the overall burden and to mitigate risk factors with an emphasis on the rural and peri-urban population.

Health Education Through a Campaign and mHealth to Enhance Knowledge and Quality of Life Among Patients With Chronic Kidney Disease in Bangladesh: Protocol for a Randomized Controlled Trial

“…This study was conducted in the demographic surveillance system (DSS) area of the Mirzapur subdistrict within the Tangail district, which is located about 60 km north of Dhaka, the capital city of Bangladesh. It has a mixed rural and periurban population [ 20 ]. The subdistrict has 13 unions—it is the smallest administrative unit—and 219 villages.…”

Chronic Kidney Disease Awareness Campaign and Mobile Health Education to Improve Knowledge, Quality of Life, and Motivation for a Healthy Lifestyle Among Patients With Chronic Kidney Disease in Bangladesh: Randomized Controlled Trial

“…This study was conducted in the demographic surveillance system (DSS) area of the Mirzapur subdistrict under the Tangail district, which is 60 km north of Dhaka, the capital city of Bangladesh. The details of the Mirzapur DSS have been described in a previous publication [5]. The research team completed a CKD prevalence study before implementing this RCT [5].…”

“…The details of the Mirzapur DSS have been described in a previous publication [5]. The research team completed a CKD prevalence study before implementing this RCT [5]. The Chronic Kidney Disease Epidemiology Collaboration equation was used to estimate glomerular filtration rate [22], and the National Kidney Foundation Kidney Disease Outcomes Quality Initiative guidelines were used to define and indicate the stages of CKD [23].…”

“…Globally, the rising trend of CKD is being recognized as a future public health threat [2]. The prevalence of CKD in stages 1-3 has been documented at 8.9% of the global population [3], with rates higher in low-income nations such as India (15.6%) [4] and Bangladesh (21.33%) [5]. Early stage CKD is generally asymptomatic, and diagnosis is usually made through serum creatinine and albumin-to-creatinine ratio tests [6].…”

“…The education of patients with CKD may increase perceived kidney disease knowledge among patients, improve QOL, and delay the progression of kidney disease [18,19]. A community-based screening revealed a high prevalence of CKD in stages 1-3, with only around 7% of the people being aware of their condition prior to the study; however, no health education intervention for these stages was investigated [5]. Most studies on the education of patients with CKD have focused on individuals with end-stage disease and shown improved outcomes [11].…”