Burden of CKD, proteinuria, and cardiovascular risk among Chinese, Mongolian, and Nepalese participants in the International Society of Nephrology screening programs.
BACKGROUND
In 2007, the International Society of Nephrology funded the Kidney Disease Data Center database to house data from sponsored programs aimed at preventing chronic kidney disease and its complications in developing nations. This study compares baseline characteristics and burden of illness among participants from centers in China, Mongolia, and Nepal. An important secondary objective is to show the feasibility of screening for chronic kidney disease and its major risk factors in a diverse group of lower income settings.


METHODS
Cross-sectional screening study.


METHODS
Participants from Nepal (n = 8,398), China (n = 1,999), and Mongolia (n = 997). Screening was open to the public for participants in China and Nepal; referral from a general practitioner was required for participants in Mongolia.


RESULTS
Estimated glomerular filtration rate (eGFR), proteinuria, hypertension, diabetes, obesity, cardiovascular risk.


METHODS
Demographic and clinical data were collected prospectively using a standard format. Blood and urine specimens were provided according to local protocol.


RESULTS
Of 11,394 participants, decreased eGFR (<60 mL/min/1.73 m(2)) was present in 7.3%-14% of participants across centers; proteinuria (≥1+) on dipstick (2.4%-10%), hypertension (26%-36%), diabetes (3%-8%), and obesity (body mass index ≥30 kg/m(2); 2%-20%) were all common. Predicted 5-year cardiovascular risk ≥10% ranged from 20%-89%. Numbers needed to screen to detect a new case of eGFR <60 mL/min/1.73 m(2), hypertension, or diabetes were 2.6 (95% CI, 2.5-2.7), 3.4 (95% CI, 3.1-3.7), and 4.7 (95% CI, 3.3-8.0) for Nepal, China, and Mongolia, respectively.


CONCLUSIONS
May not be representative of the general population.


CONCLUSIONS
The acceptable diagnostic yield of abnormalities across these 3 diverse settings suggests that trials of targeted screening and intervention are feasible and warranted in such countries.
Sharma
Sanjib Kumar
SK
Department of Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal.
Zou
Hequn
H
Togtokh
Ariunaa
A
Ene-Iordache
Bogdan
B
Carminati
Sergio
S
Remuzzi
Andrea
A
Wiebe
Natasha
N
Ayyalasomayajula
Bharati
B
Perico
Norberto
N
Remuzzi
Giuseppe
G
Tonelli
Marcello
M
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D002681:China / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D008986:Mongolia / Q000453:epidemiology; D009390:Nepal / Q000453:epidemiology; D015397:Program Evaluation; D011446:Prospective Studies; D011507:Proteinuria / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D012955:Societies, Medical