Prevalence and determinants of chronic kidney disease in northeast of Iran: Results of the Golestan cohort study

• Published in: PloS one Vol. 12; no. 5; p. e0176540
• Main Authors: Sepanlou, Sadaf G, Barahimi, Hamid, Najafi, Iraj, Kamangar, Farin, Poustchi, Hossein, Shakeri, Ramin, Hakemi, Monir Sadat, Pourshams, Akram, Khoshnia, Masoud, Gharravi, Abdolsamad, Broumand, Behrooz, Nobakht-Haghighi, Ali, Kalantar-Zadeh, Kamyar, Malekzadeh, Reza
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 03-05-2017; Public Library of Science (PLoS)
• Subjects: Anthropometry; Biology and Life Sciences; Biomarkers; Blood; Blood pressure; Body fat; Body mass; Body measurements; Body weight; Cardiovascular diseases; Cohort analysis; Cohort Studies; Coronary artery disease; Diabetes; Diabetes mellitus; Drug use; Dyslipidemia; Epidermal growth factor receptors; Female; Health aspects; Health risks; Heart diseases; Hospitals; Humans; Hypertension; Internal medicine; Iran - epidemiology; Kidney diseases; Kidney Failure, Chronic - epidemiology; Kidney Failure, Chronic - physiopathology; Kidneys; Male; Medicine; Medicine and Health Sciences; Men; Middle Aged; Mortality; Nephrology; Obesity; Observational studies; Overweight; People and Places; Population; Population studies; Prevalence; Public health; Risk analysis; Risk factors; Sex; Smoking; Studies; Iran; United States > US; California
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0176540

The burden of chronic kidney disease (CKD) is increasing globally in particular in fast emerging economies such as Iran. Population-based studies on prevalence of CKD in Iran are scarce. The objective of the current study was to explore the prevalence and determinants of CKD in the setting of Golestan Cohort Study (GCS), the largest prospective cohort in the Middle East.
In this observational study, 11,409 participants enrolled in the second phase of GCS were included. Sex, age, literacy, residence, anthropometric measurements, smoking, opium use, self-reported history of cardiovascular diseases (heart disease and/or stroke), hypertension, diabetes, and lipid profile were the predictors of interest. The outcomes of interest were eGFR and CKD defined as eGFR< 60 ml/min/1.73m2.
Mean (SD) of GFR was 70.0 ± 14.7 ml/min/1.73m2 among all participants, 68.2 ± 14.2 among women, and 72.0 ± 15.0 among men. Prevalence of CKD was 23.7% (26.6% in women, 20.6% in men). The prevalence of CKD stages 3a, 3b, 4, and 5 were 20.0%, 3.3%, 0.4% and 0.1%, respectively. Female sex, older age, urban residence, history of CVD, hypertension or diabetes, larger body mass and surrogates of body fat and opium use were all associated with CKD. Opium had a significant positive association with CKD in adjusted model. All anthropometric measurements had positive linear association with CKD. Being literate had inverse association. Sex had significant interaction with anthropometric indices, with higher odds ratios among men compared with women. A significantly high association was observed between the rate of change in waist circumference and systolic blood pressure with risk of CKD.
One in four people in this cohort had low eGFR. Obesity and overweight, diabetes, hypertension, and dyslipidemia are major risk factors for CKD. Halting the increase in waist circumference and blood pressure may be as important as reducing the current levels.