Andrea Ruiz-Alejos1, Ben Caplin2, J Jaime Miranda1,3, Neil Pearce4,5, Antonio Bernabé-Ortiz6. 1. CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendariz 445, Miraflores, Lima, Peru. 2. Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru. 3. Centre for Nephrology, University College London, London, UK. 4. Department of Medical Statistics and Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. 5. Centre for Global Health, London School of Hygiene and Tropical Medicine, London, UK. 6. CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendariz 445, Miraflores, Lima, Peru. Antonio.Bernabe@upch.pe.
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.
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.
Authors: Shuchi Anand; Roopa Shivashankar; Mohammed K Ali; Dimple Kondal; B Binukumar; Maria E Montez-Rath; Vamadevan S Ajay; R Pradeepa; M Deepa; Ruby Gupta; Viswanathan Mohan; K M Venkat Narayan; Nikhil Tandon; Glenn M Chertow; Dorairaj Prabhakaran Journal: Kidney Int Date: 2015-03-18 Impact factor: 10.612
Authors: Elizabeth R Francis; Chin-Chi Kuo; Antonio Bernabe-Ortiz; Lisa Nessel; Robert H Gilman; William Checkley; J Jaime Miranda; Harold I Feldman Journal: BMC Nephrol Date: 2015-07-24 Impact factor: 2.388
Authors: Percy Herrera-Añazco; Alvaro Taype-Rondan; María Lazo-Porras; E Alberto Quintanilla; Victor Manuel Ortiz-Soriano; Adrian V Hernandez Journal: BMC Nephrol Date: 2017-07-19 Impact factor: 2.388
Authors: Liliana A Zúñiga-Venegas; Carly Hyland; María Teresa Muñoz-Quezada; Lesliam Quirós-Alcalá; Mariana Butinof; Rafael Buralli; Andres Cardenas; Ricardo A Fernandez; Claudia Foerster; Nelson Gouveia; Juan P Gutiérrez Jara; Boris A Lucero; María Pía Muñoz; Muriel Ramírez-Santana; Anna R Smith; Noemi Tirado; Berna van Wendel de Joode; Gloria M Calaf; Alexis J Handal; Agnes Soares da Silva; Sandra Cortés; Ana M Mora Journal: Environ Health Perspect Date: 2022-09-29 Impact factor: 11.035