Epidemiology of chronic kidney disease of undetermined aetiology in Taiwanese farmers: a cross-sectional study from Changhua Community-based Integrated Screening programme

2021 ◽  
pp. oemed-2021-107369
Author(s):  
Jerry Che-Jui Chang ◽  
Hsiao-Yu Yang
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Sex Education ◽  
Screening Programme ◽  
Asian Countries ◽  
Community Based ◽  
Cross Sectional ◽  
Thermal Hazards ◽  
Increased Risk ◽  
Integrated Screening

ObjectivesChronic kidney disease of undetermined or non-traditional aetiology (CKDu or CKDnT) has been reported in Mesoamerica among farmers under heat stress. Epidemiological evidence was lacking in Asian countries with similar climatic conditions. The objective of this study was to investigate the prevalence of CKDu and possible risk factors.MethodsWe used the data from the Changhua Community-based Integrated Screening programme from 2005 to 2014, which is the annual screening for chronic diseases in Taiwan’s largest rice-farming county since 2005. Our study population included farmers and non-farmers aged 15–60 years. CKDu was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2 at age under 60 years without hypertension, diabetes, proteinuria, haematuria or using Chinese herbal medicine. We estimated the adjusted prevalence OR (POR) of CKDu by farmers, age, sex, education, urbanisation, smoking, body mass index, hyperuricaemia, hyperlipidaemia, heart disease and chronic liver disease.Results5555 farmers and 35 761 non-farmers were included in this study. CKDu accounted for 48.9% of all CKD cases. The prevalence of CKDu was 2.3% in the farmers and 0.9% in the non-farmers. The crude POR of CKDu in farmers compared with non-farmers was 2.73 (2.13–3.50), and the adjusted POR was 1.45 (1.10–1.90). Dehydration (blood urea nitrogen-to-creatinine ratio >20) was found in 22% of the farmers and 14% of the non-farmers.ConclusionsFarmers in subtropical Asian countries are at increased risk of CKDu. Governments should take the CKDu epidemics seriously and provide farmers with occupational health education programmes on thermal hazards.

scholarly journals Screening for chronic kidney disease in a community-based diabetes cohort in rural Guatemala: a cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019778 ◽  
Author(s):  
David Flood ◽  
Pablo Garcia ◽  
Kate Douglas ◽  
Jessica Hawkins ◽  
Peter Rohloff
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Low Income ◽  
Haemoglobin A1c ◽  
Ckd Progression ◽  
Community Based ◽  
Cross Sectional ◽  
Resource Limited ◽  
Increased Risk

ObjectiveScreening is a key strategy to address the rising burden of chronic kidney disease (CKD) in low-income and middle-income countries. However, there are few reports regarding the implementation of screening programmes in resource-limited settings. The objectives of this study are to (1) to share programmatic experiences implementing CKD screening in a rural, resource-limited setting and (2) to assess the burden of renal disease in a community-based diabetes programme in rural Guatemala.DesignCross-sectional assessment of glomerular filtration rate (GFR) and urine albumin.SettingCentral Highlands of Guatemala.ParticipantsWe enrolled 144 adults with type 2 diabetes in a community-based CKD screening activity carried out by the sponsoring institution.Outcome measuresPrevalence of renal disease and risk of CKD progression using Kidney Disease: Improving Global Outcomes definitions and classifications.ResultsWe found that 57% of the sample met GFR and/or albuminuria criteria suggestive of CKD. Over half of the sample had moderate or greater increased risk for CKD progression, including nearly 20% who were classified as high or very high risk. Hypertension was common in the sample (42%), and glycaemic control was suboptimal (mean haemoglobin A1c 9.4%±2.5% at programme enrolment and 8.6%±2.3% at time of CKD screening).ConclusionsThe high burden of renal disease in our patient sample suggests an imperative to better understand the burden and risk factors of CKD in Guatemala. The implementation details we share reveal the tension between evidence-based CKD screening versus screening that can feasibly be delivered in resource-limited global settings.

scholarly journals Association between betel-nut chewing and chronic kidney disease in men

2009 ◽  
Vol 12 (5) ◽  
pp. 723-727 ◽  
Author(s):  
Che-Yi Chou ◽  
Shi-Yann Cheng ◽  
Jiung-Hsiun Liu ◽  
Wen-Chun Cheng ◽  
I-Min Kang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Alcohol Consumption ◽  
Kidney Disease ◽  
Estimated Glomerular Filtration Rate ◽  
Screening Programme ◽  
Multivariate Logistic Regression Analysis ◽  
Betel Nut ◽  
Cross Sectional ◽  
History Of ◽  
Betel Nut Chewing

AbstractBackgroundBetel-nut use is associated with metabolic syndrome and obesity. However, the association between betel-nut chewing and risk for chronic kidney disease (CKD) is unknown. The present study was conducted to determine the association between betel-nut chewing and CKD in men.MethodsWe retrospectively reviewed health-check records of 3264 men in a hospital-based cross-sectional screening programme from 2003 to 2006. CKD was defined as estimated glomerular filtration rate less than 60 ml/min/1·73 m2 calculated by the Modification of Diet in Renal Disease formula. Risk factors for CKD including diabetes, hypertension, BMI, smoking, alcohol consumption and age were also considered.ResultsA total of 677 (20·7 %) men were found to have CKD and 427 (13·1 %) participants reported a history of betel-nut use. The prevalence (24·8 %) of CKD in betel-nut users was significantly higher than that (11·3 %) of participants without betel-nut use (P = 0·026). In multivariate logistic regression analysis with adjustments for age, hypertension, diabetes and hyperlipidaemia, betel-nut use was independently associated with CKD (P < 0·001). The adjusted odds ratio for betel-nut use was 2·572 (95 % CI 1·917, 3·451).ConclusionsBetel-nut use is associated with CKD in men. The association between betel-nut use and CKD is independent of age, BMI, smoking, alcohol consumption, hypertension, diabetes and hyperlipidaemia.

Prevalence of Impaired Kidney Function in the German Elderly: Results from the Berlin Aging Study II (BASE-II)

Gerontology ◽  
2017 ◽  
Vol 63 (3) ◽  
pp. 201-209 ◽  
Author(s):  
Maximilian König ◽  
Maik Gollasch ◽  
Ilja Demuth ◽  
Elisabeth Steinhagen-Thiessen
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
The Elderly ◽  
Community Dwelling ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Increased Risk ◽  
Aging Study

Background: In aging populations with an ever-growing burden of risk factors such as obesity, diabetes, and hypertension, chronic kidney disease (CKD) is on the rise. However, little is known about its exact prevalence among elderly adults, and often albuminuria is not included in the definition of CKD. Moreover, novel equations for the estimated glomerular filtration rate (eGFR) have recently emerged, which have not been applied comprehensively to older adults. Data on CKD awareness among the elderly are sparse. Objectives: To determine the prevalence of CKD among older adults by eGFR and albumin/creatinine ratio (ACR), compare the performance of 6 established and novel eGFR formulas, explore risk factors, and determine the awareness of CKD in a large cohort of community-dwelling elderly from Germany. Methods: A total of 1,628 subjects from the Berlin Aging Study II (BASE-II) were included in this analysis (mean age 68.7 years; 51.2% female). Extensive cross-sectional data on sociodemographics, lifestyle, medication, and diagnoses were inquired during structured interviews and a medical examination, and blood and urine parameters were measured. Results: In all, 77.1% of the subjects had hypertension, 12.4% had diabetes, and 18.3% were obese. The prevalence of CKD strongly depended on the eGFR equations used: 25.4% (full age spectrum [FAS] equation), 24.6% (Berlin Initiative Study), 23.1% (Lund-Malmö revised), 19.3% (Cockcroft-Gault), 16.4% (Chronic Kidney Disease-Epidemiology Collaboration [CKD-EPI]), and 14.7% (Modification of Diet in Renal Disease [MDRD]). Of the subjects with an eGFRFAS <60 mL/min/1.73 m2 and/or an ACR >30 mg/g, only 3.9% were aware of having CKD. Polypharmacy, age, BMI, coronary artery disease, non-HDL cholesterol, and female sex were independently associated with CKD. Conclusions: CKD is prevalent among older adults in Germany, but awareness is low. The FAS equation detects higher rates of CKD than MDRD and CKD-EPI, which are most widely used at present. Also, when CKD is defined based on eGFR and albuminuria, considerably more people are identified than by eGFR alone. Finally, polypharmacy is associated with an increased risk for CKD in the elderly.

scholarly journals Prevalence of Chronic Kidney Disease and Poor Diagnostic Accuracy of Dipstick Proteinuria in Human Immunodeficiency Virus-Infected Individuals: A Multicenter Study in Japan

2018 ◽  
Vol 5 (10) ◽  
Author(s):  
Naoki Yanagisawa ◽  
Takashi Muramatsu ◽  
Tomohiko Koibuchi ◽  
Akihiro Inui ◽  
Yusuke Ainoda ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Human Immunodeficiency Virus ◽  
Kidney Disease ◽  
Total Cholesterol Level ◽  
Hepatitis C Infection ◽  
Dipstick Test ◽  
Cross Sectional ◽  
Increased Risk ◽  
Immunodeficiency Virus ◽  
Kdigo Guidelines

Abstract Background Chronic kidney disease (CKD) has become one of the common comorbid conditions affecting the human immunodeficiency virus (HIV) population. Human immunodeficiency virus-infected individuals are at increased risk of developing CKD, and they are likely to experience faster progression of renal dysfunction compared with HIV-uninfected individuals. Albuminuria represents not only kidney damage but also manifests metabolic syndrome and vascular dysfunction. Methods We conducted a multicenter, cross-sectional study involving 2135 HIV-infected individuals in Japan to test the prevalence of CKD and proteinuria/albuminuria. Urine sample was analyzed by both dipstick test and albumin-to-creatinine ratio (ACR) assay. Chronic kidney disease was classified according to the Kidney Disease Outcomes Quality Initiative (K/DOQI) and Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. The diagnostic performance of dipstick test to detect albuminuria (ACR ≥30 mg/g) was evaluated. Results The prevalence of CKD, evaluated by K/DOQI and KDIGO guidelines, was 15.8% and 20.4%, respectively. Age, total cholesterol level, prevalence of hypertension, diabetes mellitus, and hepatitis C infection tended to increase, whereas levels of hemoglobin, serum albumin, and CD4 cell count tended to decrease as CKD risk grades progressed. Proteinuria and albuminuria were present in 8.9% and 14.5% of individuals, respectively. Dipstick test ≥1+ to detect albuminuria had an overall sensitivity of 44.9% and specificity of 97.2%. Conclusions The KDIGO guideline may enable physicians to capture HIV-infected patients at increased risk more effectively. The sensitivity of dipstick proteinuria to detect albuminuria is so poor that it may not serve as an alternative in HIV-infected individuals.

scholarly journals Liver Stiffness, Albuminuria and Chronic Kidney Disease in Patients with NAFLD: A Systematic Review and Meta-Analysis

Biomolecules ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 105
Author(s):  
Stefano Ciardullo ◽  
Cinzia Ballabeni ◽  
Roberto Trevisan ◽  
Gianluca Perseghin
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Liver Fibrosis ◽  
Statistical Power ◽  
Transient Elastography ◽  
Meta Analysis ◽  
Liver Stiffness ◽  
Significant Heterogeneity ◽  
Cross Sectional ◽  
Increased Risk

An association between liver stiffness, a surrogate measure of liver fibrosis, and chronic kidney disease (CKD) in patients with nonalcoholic fatty liver disease (NAFLD) has been proposed. However, most studies were small and had low statistical power. We systematically searched PubMed-MEDLINE and Scopus from inception to August 2021 for cross-sectional or cohort studies reporting the association between liver stiffness diagnosed by vibration controlled transient elastography (VCTE) and renal dysfunction. The primary outcome was CKD, defined as a composite of urinary albumin to creatinine ratio (UACR) ≥ 30 mg/g and estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2. Measures of association from individual studies were meta-analyzed using random effects models. Of the 526 titles initially scrutinized, 7 cross-sectional studies fulfilled the criteria and were included. For CKD, risk was higher in patients with liver fibrosis assessed by VCTE, compared with patients without (n = 5 studies: OR 2.49, 95% CI 1.89–3.29; test for overall effect z = 6.475, p < 0.001). When increased UACR was considered as an outcome, elevated liver stiffness was associated with a significantly increased risk as well (n = 3 studies: OR 1. 98 95% CI 1.29–3.05; test for overall effect z = 3.113, p = 0.002). Neither analysis showed significant heterogeneity (I2 = 0% and I2 = 46.5%, respectively for the two outcomes). This meta-analysis indicates that elevated liver stiffness is associated with increased odds of kidney outcomes among patients with NAFLD. Wider use of VCTE to screen for advanced fibrosis might help identify patients at risk of end-stage renal disease.

scholarly journals Associations of Chronic Kidney Disease With Dementia Before and After Transient Ischemic Attack and Stroke: Population-Based Cohort Study

Neurology ◽  
2022 ◽  
pp. 10.1212/WNL.0000000000013205
Author(s):  
Dearbhla M. Kelly ◽  
Sarah T. Pendlebury ◽  
peter M. rothwell
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Sex Education ◽  
Population Based ◽  
Competing Risk ◽  
Minor Stroke ◽  
Stroke Severity ◽  
Increased Risk ◽  
Before And After

Objective:Individuals with chronic kidney disease (CKD) appear to be at increased risk of cognitive impairment, with both vascular and neurodegenerative mechanisms postulated. To explore the vascular hypothesis, we studied the association between CKD and dementia before and after transient ischaemic attack (TIA) and stroke.Methods:In a prospective, population-based cohort study of TIA and stroke (Oxford Vascular Study; 2002-2012), pre-event and new post-event dementia were ascertained through direct patient assessment and follow-up for 5 years, supplemented by review of hospital/primary care records. Associations between pre-event dementia and CKD (defined as an estimated glomerular filtration rate [eGFR] < 60 ml/min/1.73m2) were examined using logistic regression, and between post-event dementia and CKD using Cox and competing risk regression models, adjusted for age, sex, education, stroke severity, prior stroke, white matter disease, diabetes mellitus, and dysphasia.Results:Among 2305 TIA/stroke patients (median [IQR] age, 77 [67-84] years, 1133 [49%] male, 688 [30%] TIA), 1174 (50.9%) had CKD. CKD was associated with both pre-event (odds ratio [OR], 2.04 [95% CI, 1.52–2.72]; P<0.001) and post-event dementia (hazard ratio [HR], 2.01 [95% CI, 1.65–2.44]; P<0.001), but these associations attenuated after adjustment for covariates (OR=0.92 [0.65-1.31]; p=0.65 and HR=1.09 [0.85-1.39]; p=0.50). The results were similar when a competing risk model was used (subdistribution HR [SHR] =1.74 [1.43-2.12; p<0.001, attenuating to 1.01 [0.78-1.33]; p=0.92 with adjustment). CKD was more strongly associated with late (>1 year) post-event dementia (SHR=2.32, 1.70-3.17; p<0.001), particularly after TIA and minor stroke (SHR=3.08, 2.05-4.64; p<0.001), but not significantly so after adjustment (SHR=1.53, 0.90-2.60; p=0.12).Conclusions:In patients with TIA and stroke, CKD was not independently associated with either pre- or post-event dementia, suggesting that renal-specific mechanisms are unlikely to play an important role in aetiology.

Sign in / Sign up

Export Citation Format

Share Document