Chronic Kidney Disease in Rural Population

The aims of the study were to provide data on chronic kidney disease (CKD) prevalence in rural population and to analyze the association with cardiovascular risk factors and aging. A random sample of 2193 farmers (1333 female (F) and 860 male (M), mean age 50.61±17.12) were enrolled. Questionnaire and clinical examination were conducted. Participants provided a spot urine and fasting blood sample. Estimated glomerular filtration rate (eGFR) was estimated using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Subjects were classified according to the KDIGO guidelines. The overall prevalence of CKD (eGFR <60 mL/min/1.73 m2) was 8.83% (F vs. M 9.9% vs. 6.3%; p<0.001). Albuminuria (albumin-to-creatinine ratio >30 mg/g) was found in 8.45% (F vs. M p>0.05). Sharp increase in CKD prevalence was found to begin after the sixth decade (29.44% in subjects older than 65 years; F vs. M 30.9% vs. 26.8%; p<0.01). The strongest predictor factors for CKD were age >65 years (OR 22.12), hypertension (OR 6.53), albuminuria (OR 5.71), fasting blood glucose >7 mmol/L (OR 5.49), diabetes (OR 3.07), abdominal obesity (OR 2.05) and non-smoking (OR 0.41). In multivariate analysis, age (OR 1.13), female gender (OR 0.60) and diabetes (OR 1.75) were the independent predictor factors for CKD. In conclusion, CKD prevalence is high in rural population, being higher in women than in men. In both genders, eGFR significantly decreased with aging. Aging is a significant independent predictor of CKD.
Cilj ove studije bio je istražiti učestalost kronične bubrežne bolesti (KBB) kod seoskog stanovništva i analizirati povezanost s čimbenicima kardiovaskularnoga rizika i starenjem. U studiju je bilo uključeno 2193 ispitanika (1333 žena, 860 muškaraca, srednja dob 50,61±17,12 godina). Svi ispitanici su ispunili opsežan upitnik i klinički su pregledani. Uzet im je uzorak krvi natašte i drugi jutarnji uzorak mokraće. Procijenjena stopa glomerularne filtracije (eGFR) utvrđena je pomoću jednadžbe CKD-EPI. Ispitanici su klasificirani prema smjernicama KDIGO. Sveukupna učestalost KBB (eGFR <60 mL/ min/1,73 m2) bila je 8,83% (žene prema muškarcima 9,9% prema 6,3%; p<0,001). Albuminurija je potvrđena (omjer albumina i kreatinina (ACR) >30 mg/g) u 8,45% ispitanika bez razlike među spolovima. Učestalost KBB bila je značajno veća kod ispitanika starijih od 65 godina u oba spola (29,44%; žene prema muškarcima 30,9% prema 26,6%; p<0,01). Najjači prediktorski čimbenici za KBB bili su dob >65 godina (OR 22,12), hipertenzija (OR 6,53), albuminurija (OR 5,71), glukoza u krvi natašte >7 mmol/L (OR 5,49), dijabetes (OR 3,07), trbušna pretilost (OR 2,05) i nepušenje (OR 0,41). U multivarijatnoj analizi (OR 1,13) su ženski spol (OR 0,60) i dijabetes (OR 1,75) bili nezavisni prediktorski čimbenici za KBB. U zaključku, učestalost KBB je velika u ruralnoj populaciji. U oba spola eGFR se značajno smanjila starenjem, koje se pokazalo kao značajan nezavisni prediktor za KBB.