title: Regional variation of chronic kidney disease in Germany: results from two population-based surveys.
abstract: OBJECTIVE
  Due to the increasing prevalence of risk factors for chronic kidney disease (CKD), kidney dysfunction becomes a major public health problem. We investigated the CKD prevalence and determined to what extent the variation of risk factors explains the different CKD prevalence in Germany.
  
  
  METHODS
  We analyzed data from 6,054 participants, aged 31 to 82 years, from the Study of Health in Pomerania (SHIP-1) in Northeast Germany and the Cooperative Health Research in the Region of Augsburg (KORA F4) Study in Southern Germany. Regional differences in selected percentiles corresponding to the cutpoints for estimated glomerular filtration rate (eGFR, <60 ml/min per 1.73 m(2)) and albumin-to-creatinine ratio (ACR, ≥30 mg/g) were tested using quantile regression models that adjusted for CKD risk factors.
  
  
  RESULTS
  The prevalence of decreased eGFRcreatinine-cystatinC (5.9 vs. 3.1 %, p <0.001) and albuminuria (20.2 vs. 8.8 %, p<0.001) were higher in SHIP-1 than in KORA F4. The differential distribution of risk factors explained 18-21% of the regional differences of decreased eGFRcreatinine-cystatinC and high ACR.
  
  
  CONCLUSIONS
  The CKD prevalence is higher in Northeast than in Southern Germany. Differences in the prevalence of risk factors partly explain the higher disease burden of CKD in Northeast than in Southern Germany.
authors.affiliation: Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Aumann
authors.forename: Sebastian E
authors.initials: SE
authors.lastname: Baumeister
authors.forename: Rainer
authors.initials: R
authors.lastname: Rettig
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lieb
authors.forename: André
authors.initials: A
authors.lastname: Werner
authors.forename: Angela
authors.initials: A
authors.lastname: Döring
authors.forename: Annette
authors.initials: A
authors.lastname: Peters
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Koenig
authors.forename: Anke
authors.initials: A
authors.lastname: Hannemann
authors.forename: Henri
authors.initials: H
authors.lastname: Wallaschofski
authors.forename: Matthias
authors.initials: M
authors.lastname: Nauck
authors.forename: Sylvia
authors.initials: S
authors.lastname: Stracke
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.forename: Christa
authors.initials: C
authors.lastname: Meisinger
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005843:Geography; D005858:Germany / Q000453:epidemiology; D005919:Glomerular Filtration Rate; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011153:Population; D012016:Reference Values; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D012959:Socioeconomic Factors
chemical_list: D012709:Serum Albumin; D003404:Creatinine