title: Renal function and risk factors of moderate to severe chronic kidney disease in Golestan Province, northeast of Iran.
abstract: BACKGROUND
  The incidence of end-stage renal disease is increasing worldwide. Earlier studies reported high prevalence rates of obesity and hypertension, two major risk factors of chronic kidney disease (CKD), in Golestan Province, Iran. We aimed to investigate prevalence of moderate to severe CKD and its risk factors in the region.
  
  
  METHODS
  Questionnaire data and blood samples were collected from 3591 participants (≥18 years old) from the general population. Based on serum creatinine levels, glomerular filtration rate (GFR) was estimated.
  
  
  RESULTS
  High body mass index (BMI) was common: 35.0% of participants were overweight (BMI 25-29.9) and 24.5% were obese (BMI ≥30). Prevalence of CKD stages 3 to 5 (CKD-S3-5), i.e., GFR <60 mL/min/1.73 m(2), was 4.6%. The odds ratio (OR) and 95% confidence interval (95% CI) for the risk of CKD-S3-5 associated with every year increase in age was 1.13 (1.11-1.15). Men were at lower risk of CKD-S3-5 than women (OR = 0.28; 95% CI 0.18-0.45). Obesity (OR = 1.78; 95% CI 1.04-3.05) and self-reported diabetes (OR = 1.70; 95% CI 1.00-2.86), hypertension (OR = 3.16; 95% CI 2.02-4.95), ischemic heart disease (OR = 2.73; 95% CI 1.55-4.81), and myocardial infarction (OR = 2.69; 95% CI 1.14-6.32) were associated with increased risk of CKD-S3-5 in the models adjusted for age and sex. The association persisted for self-reported hypertension even after adjustments for BMI and history of diabetes (OR = 2.85; 95% CI 1.77-4.59).
  
  
  CONCLUSIONS
  A considerable proportion of inhabitants in Golestan have CKD-S3-5. Screening of individuals with major risk factors of CKD, in order to early detection and treatment of impaired renal function, may be plausible. Further studies on optimal risk prediction of future end-stage renal disease and effectiveness of any screening program are warranted.
authors.affiliation: Nephrology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Iraj
authors.initials: I
authors.lastname: Najafi
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Attari
authors.forename: Farhad
authors.initials: F
authors.lastname: Islami
authors.forename: Ramin
authors.initials: R
authors.lastname: Shakeri
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Malekzadeh
authors.forename: Rasool
authors.initials: R
authors.lastname: Salahi
authors.forename: Mina Yapan
authors.initials: MY
authors.lastname: Gharavi
authors.forename: Mostafa
authors.initials: M
authors.lastname: Hosseini
authors.forename: Behrooz
authors.initials: B
authors.lastname: Broumand
authors.forename: Ali Nobakht
authors.initials: AN
authors.lastname: Haghighi
authors.forename: Bagher
authors.initials: B
authors.lastname: Larijani
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
mesh_terms: D000368:Aged; D000375:Aging; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007492:Iran; D007668:Kidney / Q000502:physiology*; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires