Prevalence of chronic kidney disease in Peruvian ... - BMC Nephrology

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Abstract. Background: Chronic Kidney Disease (CKD) is a worldwide public health problem. There are few studies in Latin. America, especially in primary care ...
Herrera-Añazco et al. BMC Nephrology (2017) 18:246 DOI 10.1186/s12882-017-0655-x

RESEARCH ARTICLE

Open Access

Prevalence of chronic kidney disease in Peruvian primary care setting Percy Herrera-Añazco1,2* , Alvaro Taype-Rondan3,7, María Lazo-Porras3,5,7, E. Alberto Quintanilla4, Victor Manuel Ortiz-Soriano3 and Adrian V. Hernandez6

Abstract Background: Chronic Kidney Disease (CKD) is a worldwide public health problem. There are few studies in Latin America, especially in primary care settings. Our objective was to determine the prevalence, stages, and associated factors of CKD in primary care setting. Methods: We did a retrospective secondary analysis of a database from the Diabetes and Hypertension Primary Care Center of the Peruvian Social Security System (EsSalud) in Lima, Peru. We defined CKD as the presence of eGFR 30 mg/day in 24 h, according to Kidney Disease: Improving Global Outcomes (KDIGO). Factors associated with CKD were evaluated with Poisson Regression models; these factors included age, gender, type 2 diabetes mellitus (DM2), hypertension (HTN), body mass index (BMI), and uric acid. Associations were described as crude and adjusted prevalence ratios (PR) and their 95% confidence intervals (95% CI). Results: We evaluated 1211 patients (women [59%], mean age 65.8 years [SD: 12.7]). Prevalence of CKD was 18%. Using the estimated glomerular filtration rate (eGFR), the prevalence was 9.3% (95% CI 5.3 – 13.3) in patients without HTN or DM2; 20.2% (95% CI 17.6 – 22.8) in patients with HTN, and 23.9% (95% CI 19.4 – 28.4) in patients with DM2. The most common stages were 1 and 2 with 41.5% and 48%, respectively. Factors associated with CKD in the adjusted analysis were: age in years (PR = 1.03, 95% CI 1.01 – 1.04), DM2 (PR = 3.37, 95% CI 1.09 – 10.39), HTN plus DM2 (PR = 3.90, 95% CI 1.54 – 9.88), and uric acid from 5 to 7%, those with fasting serum glucose >126 mg/dL or random serum glucose >200 mg/dL. We defined an HTN patient as the one who previously had this diagnosis, those with a systolic blood pressure > 140 mmHg or diastolic blood pressure > 90 mmHg, and those who were taking antihypertensive medication. We combined HTN and DM2 in the following classification: patients without DM2 or HTN, patients with DM2 without HTN, patients with HTN without DM2, and patients with DM2 and HTN. We use the Body Mass Index (BMI) to define whether the patient had overweight or obesity. We classified them as normal (