Prevalence and risk factors associated with chronic kidney disease in Nepal: evidence from a nationally representative population-based cross-sectional study

Abstract

ObjectiveThis study aimed to determine population-based prevalence of chronic kidney disease (CKD) and its associated factors in Nepal.Study designThe study was a nationwide population-based cross-sectional study.Setting and participantsCross-sectional survey conducted in a nationally representative sample of 12 109 Nepalese adult from 2016 to 2018 on selected chronic non-communicable diseases was examined. Multistage cluster sampling with a mix of probability proportionate to size and systematic random sampling was used for the selection of individuals aged 20 years and above.Primary and secondary outcome measuresPrimary outcome in this study was population-based prevalence of CKD in Nepal. A participant was considered to have CKD if the urine albumin-to-creatinine ratio was greater than or equal to 30 mg/g and/or estimated glomerular filtration rate is less than 60 mL/min/1.73 m2 at baseline and in follow-up using modification of diet in renal disease study equations. The secondary outcome measure was factors associated with CKD in Nepal. The covariate adjusted association of risk factors and CKD was calculated using multivariable binary logistic regression.ResultsThe overall prevalence of CKD in Nepal was 6.0% (95% CI 5.5 to 6.6). Factors independently associated with CKD included older age (adjusted OR (AOR) 2.6, 95% CI 1.9 to 3.6), Dalit caste (AOR 1.6, 95% CI 1.1 to 2.3), hypertension (AOR 2.4, 95% CI 2.0 to 3.0), diabetes mellitus (AOR 3.2, 95% CI 2.5 to 4.1), raised total cholesterol (AOR 1.3, 95% CI 1.0 to 1.6) and increased waist-to-hip ratio (AOR 1.6, 95% CI 1.2 to 2.3).ConclusionThis nationally representative study shows that the prevalence of CKD in the adult population of Nepal is substantial, and it is independently associated with several cardiometabolic traits. These findings warrant longitudinal studies to identify the causes of CKD in Nepal and effective strategies to prevent it.

Prevalence and factors associated with chronic kidney disease in selected hospitals in Kigali, Rwanda - A cross-sectional study

“…This study results showed that the old age was not associated with chronic kidney disease while the study done by Poudyal in Nepal showed that the older age was associated with chronic kidney disease with AOR: 2.6, 95% CI (1.9 to 3.6) (Poudyal, 2022). Around 36.8% of the study participants had anemia as a comorbidity with CKD.…”

“…The ndings of this study showed that diabetes was 11 times and hypertension was 6 times signi cantly associated with chronic kidney disease which was also supported by other studies but with low Adjusted Odd ratios. This showed that hypertension and diabetes AORs were 2.4, 95% CI 2.0 to 3.0), diabetes mellitus (AOR 3.2, 95% CI 2.5 to 4.1), p < 0.05, (Poudyal, 2022;Joshi, 2022). The astonishing results and the difference of this study's high AOR levels may be justi ed by the study settings of both studies where the Nepal study was carried out on a nationally representative sample while this study was limited on inpatients.…”

Clinical Profile of End Stage Renal Disease Patients Undergoing Hemodialysis in a Tertiary Hospital of Lumbini Province, Nepal

“…Although it is largely preventable, over 9% of the population worldwide is estimated to be affected by the condition, particularly developing countries and it is associated with diabetes type II, hypertension and obesity, which are also growing at an alarming rate. 3 An eGFR level of less than 15 mL/min/1.73 m2 was defined as the final stage of CKD. 2 The present study was conducted to find out the demographic, clinical and etiological profile of the CKD patients on hemodialysis attending to a tertiary care hospital in Nepalguj, Nepal.…”

Role of female community health volunteers in the prevention and early detection of chronic kidney disease in Nepal

“…The overall prevalence of CKD in the general population in South Asia is 14% [4] . A nationwide population-based cross-sectional study conducted in Nepal showed that the overall prevalence of CKD in the country is 6% [5] . Despite the high prevalence of the disease, only 6% of the general population and 10% of the high-risk population are aware of their CKD status [6] .…”

“…A nationally representative study has shown that older age [adjusted odds ratio (aOR): 2.6, 95% CI: 1.9-3.6), hypertension (aOR: 2.4, 95% CI: 2.0-3.0) and diabetes mellitus (aOR: 3.2, 95% CI: 2.5-4.1) are the common prevalent risk factors of CKD in Nepal [5] . Early identification of patients with CKD is desirable because interventions can then be implemented to reduce the progression to ESKD and cardiovascular events [2] .…”