title: Chronic kidney disease and risk factor prevalence in Saint Kitts and Nevis: a cross-sectional study.
abstract: BACKGROUND
  The prevalence of chronic kidney disease (CKD) in St. Kitts and Nevis, islands of the West Indies, is unknown. We sought to determine estimates of CKD and its risk factors (e.g. diabetes, hypertension and obesity) in St. Kitts and Nevis.
  
  
  METHODS
  This was a chronic disease screening program. Three community-based locations in St. Kitts and Nevis were included in the program. Participants were adult community residents aged ≥18 years. The main outcome measures were estimated CKD prevalence (by serum creatinine-based estimated glomerular filtration rate (eGFR) and dipstick urine albumin); and estimated prevalence of CKD risk factors (diabetes, hypertension and obesity). Logistic regression was used to determine independent predictors of CKD.
  
  
  RESULTS
  One thousand nine hundred seventy eight persons, from Nevis (n = 950) and St. Kitts (n = 1028) were screened by the Caribbean Health and Education Foundation. Participants' mean age was 49 ± 15 years, 65% were female, and 99% were black. Fully, 21.5% had diabetes and 53.1% had hypertension; and 40.3% were obese. Mean estimated eGFR was 98 ml/min/1.73 m2(standard deviation = 30) and 4.7% had an eGFR <60 ml/min/1.73 m2, indicating CKD. Age [Odds Ratio (OR) = 1.08, 95% Confidence Interval (CI) 1.05-1.11], hypertension (OR = 2.89, 95% CI 1.18-7.07) and diabetes (OR = 3.12, 95% CI 1.80-5.43) were independent predictors of reduced eGFR in models adjusted for age, gender and obesity status. Of those with urine testing in Nevis (n = 929), 13.5% had urine albumin ≥30 mg/dL, and diabetes was an independent predictor of this finding (OR = 2.43, 95% CI 1.53-3.87).
  
  
  CONCLUSIONS
  CKD and its risk factors were prevalent among adults in St. Kitts and Nevis. Public policy strategies for prevention and treatment of these conditions may be needed to reduce their associated morbidity, mortality and costs.
authors.affiliation: Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, 301 Mason F. Lord Drive, Suite 2500, Baltimore, MD, 21224, USA. dcrews1@jhmi.edu.|Welch Center for Prevention Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA. dcrews1@jhmi.edu.
authors.forename: Deidra C
authors.initials: DC
authors.lastname: Crews
authors.affiliation: Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Kirk N
authors.initials: KN
authors.lastname: Campbell
authors.affiliation: Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, 301 Mason F. Lord Drive, Suite 2500, Baltimore, MD, 21224, USA.|Welch Center for Prevention Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Caribbean Health and Education Foundation, Takoma Park, MD, USA.
authors.forename: Odell
authors.initials: O
authors.lastname: Bussue
authors.affiliation: Caribbean Health and Education Foundation, Takoma Park, MD, USA.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Dawkins
authors.affiliation: Division of Nephrology, Department of Medicine, Seattle Puget Sound Veterans Affairs, Kidney Research Institute, University of Washington at Seattle, Seattle, WA, USA.
authors.forename: Bessie A
authors.initials: BA
authors.lastname: Young
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology*; D012307:Risk Factors; D019437:Saint Kitts and Nevis / Q000453:epidemiology; D055815:Young Adult
keywords: Chronic kidney disease; Diabetes; Epidemiology; Hypertension; Risk factors