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      Burden of chronic kidney disease in resource-limited settings from Peru: a population-based study

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          Abstract

          Background

          The silent progression of chronic kidney diseases (CKD) and its association with other chronic diseases, and high treatment costs make it a great public health concern worldwide. The population burden of CKD in Peru has yet to be fully described.

          Methods

          We completed a cross sectional study of CKD prevalence among 404 participants (total study population median age 54.8 years, 50.2 % male) from two sites, highly-urbanized Lima and less urbanized Tumbes, who were enrolled in the population-based CRONICAS Cohort Study of cardiopulmonary health in Peru. Factors potentially associated with the presence of CKD were explored using Poisson regression, a statistical methodology used to determine prevalence ratios.

          Results

          In total, 68 participants (16.8 %, 95 % CI 13.5–20.9 %) met criteria for CKD: 60 (14.9%) with proteinuria, four (1%) with eGFR <60mL/min/1.73m2 , and four (1%) with both. CKD prevalence was higher in Lima (20.7 %, 95 % CI 15.8–27.1) than Tumbes (12.9 %, 95 % CI 9.0–18.5). Among participants with CKD, the prevalence of diabetes and hypertension was 19.1 % and 42.7 %, respectively. After multivariable adjustment, CKD was associated with older age, female sex, greater wealth tertile (although all wealth strata were below the poverty line), residence in Lima, and presence of diabetes and hypertension.

          Conclusions

          The high prevalence rates of CKD identified in Lima and Tumbes are similar to estimates from high-income settings. These findings highlight the need to identify occult CKD and implement strategies to prevent disease progression and secondary morbidity.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12882-015-0104-7) contains supplementary material, which is available to authorized users.

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          Author and article information

          Contributors
          ebf111@gmail.com
          ckuojhsph@gmail.com
          antonio.bernabe@upch.pe
          nessel@mail.med.upenn.edu
          gilmanbob@gmail.com
          wcheckl1@jhmi.edu
          jaime.miranda@upch.pe
          hfeldman@mail.med.upenn.edu
          Journal
          BMC Nephrol
          BMC Nephrol
          BMC Nephrology
          BioMed Central (London )
          1471-2369
          24 July 2015
          24 July 2015
          2015
          : 16
          : 114
          Affiliations
          [ ]Penn State College of Medicine, Hershey, PA USA
          [ ]Office of Global Health Education, Weill Cornell Medical College, New York, NY USA
          [ ]Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
          [ ]CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendáriz 497, Miraflores, Lima 18, Peru
          [ ]Kidney Institute and Division of Nephrology, Department of Internal Medicine, China Medical University Hospital and College of Medicine, China Medical University, Taichung, Taiwan
          [ ]School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
          [ ]Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
          [ ]Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
          [ ]Área de Investigación y Desarrollo, Asociación Beneficia PRISMA, Lima, Peru
          [ ]Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD USA
          [ ]Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
          [ ]Departments of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
          [ ]Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
          Article
          104
          10.1186/s12882-015-0104-7
          4512019
          26205002
          f8379d5b-a86b-4e45-990e-ee4eea183772
          © Francis et al. 2015

          This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

          History
          : 12 February 2015
          : 30 June 2015
          Categories
          Research Article
          Custom metadata
          © The Author(s) 2015

          Nephrology
          chronic kidney disease,prevalence,chronic diseases
          Nephrology
          chronic kidney disease, prevalence, chronic diseases

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