Prevalence and determinants of chronic kidney disease in northeast of Iran: Results of the Golestan cohort study.

BackgroundThe burden of chronic kidney disease (CKD) is increasing globally in particular in fast emerging economies such as Iran. Population-based studies on prevalence of CKD in Iran are scarce. The objective of the current study was to explore the prevalence and determinants of CKD in the setting of Golestan Cohort Study (GCS), the largest prospective cohort in the Middle East.MethodsIn this observational study, 11,409 participants enrolled in the second phase of GCS were included. Sex, age, literacy, residence, anthropometric measurements, smoking, opium use, self-reported history of cardiovascular diseases (heart disease and/or stroke), hypertension, diabetes, and lipid profile were the predictors of interest. The outcomes of interest were eGFR and CKD defined as eGFR< 60 ml/min/1.73m2.ResultsMean (SD) of GFR was 70.0 ± 14.7 ml/min/1.73m2 among all participants, 68.2 ± 14.2 among women, and 72.0 ± 15.0 among men. Prevalence of CKD was 23.7% (26.6% in women, 20.6% in men). The prevalence of CKD stages 3a, 3b, 4, and 5 were 20.0%, 3.3%, 0.4% and 0.1%, respectively. Female sex, older age, urban residence, history of CVD, hypertension or diabetes, larger body mass and surrogates of body fat and opium use were all associated with CKD. Opium had a significant positive association with CKD in adjusted model. All anthropometric measurements had positive linear association with CKD. Being literate had inverse association. Sex had significant interaction with anthropometric indices, with higher odds ratios among men compared with women. A significantly high association was observed between the rate of change in waist circumference and systolic blood pressure with risk of CKD.ConclusionOne in four people in this cohort had low eGFR. Obesity and overweight, diabetes, hypertension, and dyslipidemia are major risk factors for CKD. Halting the increase in waist circumference and blood pressure may be as important as reducing the current levels

Comparing adjusted ORs for deciles of anthropometric measurements.

<p>The fifth decile serves as the reference group. Each decile includes approximately 1,100 participants. BMI: Body Mass Index, WHR: Waist to Hip Ratio, WHT: Waist to Height Ratio.</p

Association of systolic blood pressure and high density lipoprotein with chronic kidney disease.

<p>(A) Association of systolic blood pressure measurements with Chronic Kidney Disease using restricted cubic splines, with knots from 60 to 240 mmHg by 20 mmHg unit intervals and the reference point of 120 mmHg. (B) Association of High Density Lipoprotein (HDL) with Chronic Kidney Disease using restricted cubic splines, with knots from 20 to 140 mg/dL by 10 unit intervals and the reference point of 50 mg/dL.</p

Association of anthropometric measurements with chronic kidney disease stratified by sex.

<p>Association of anthropometric measurements with chronic kidney disease stratified by sex.</p

Association of anthropometric measurements with chronic kidney disease (CKD) defined as eGFR<60 ml/min/1.73m² using restricted cubic splines.

<p>(A) Body Mass Index: using knots from 15 to 45 by 2.5 unit intervals and the reference point of 22.5 kg/m². (B) Waist Circumference (cm) with knots ranging from 60 to 140 by 10 unit intervals and the reference point of 90 cm. (C) Waist to hip ratio (WHR): using knots ranging from 0.7 to 1.4 with 0.1 unit intervals and the reference point of 0.9. (D) Waist to height ratio (WHT): using knots ranging from 0.4 to 0.9 with 0.1 unit intervals and the reference point of 0.6.</p

Comparing adjusted ORs for deciles of anthropometric measurements.

<p>The fifth decile serves as the reference group. Each decile includes approximately 1,100 participants. BMI: Body Mass Index, WHR: Waist to Hip Ratio, WHT: Waist to Height Ratio.</p

Association of systolic blood pressure, body mass index, and waist circumference in main phase and the rate of their change from main phase to repeated measurement with chronic kidney disease defined as eGFR < 60 ml/min/1.73m².

<p>Association of systolic blood pressure, body mass index, and waist circumference in main phase and the rate of their change from main phase to repeated measurement with chronic kidney disease defined as eGFR < 60 ml/min/1.73m².</p

Summary statistics of 11,409 GCS participants.

<p>Summary statistics of 11,409 GCS participants.</p