Prevalence of and risk factors for chronic kidney disease in ten metropolitan areas of China: a cross-sectional study using three kidney damage markers

Abstract

Introduction

To estimate the up-to-date prevalence of chronic kidney disease among the health check-up population in economically developed areas of China using estimated glomerular filtration rate, urinary albumin creatinine ratio, and kidney ultrasound.

Methods

Healthcare data from 38,093 subjects in 10 megalopolises of China who had an annual health check-up in 2021 were used. The overall and stratified prevalence of chronic kidney disease by sex, age, region and comorbidity group was reported. The association between chronic kidney disease and covariates of demographics, and comorbidities were analyzed in the multivariable-adjusted logistic regression model.

Results

A total of 3837 CKD cases were detected meeting any of the three CKD diagnostic criteria, with a crude prevalence of 10.1% in the study population. Using one criterion of decreased glomerular filtration rate, albuminuria and kidney structural abnormalities alone detected 204 (5.3%), 3289 (85.7%) and 563 (14.7%) cases, respectively. The addition of kidney ultrasound detected 427 (11.1%) structural abnormality cases without decreased GFR and albuminuria. The most common abnormalities were renal masses, hydronephrosis due to obstruction and congenital anomalies of kidney and urinary tract. Female, older age, low city-tier, hypertension, diabetes, obesity, hypertriglyceridemia as well as early disease stages such as pre-hypertension, impaired fasting glucose and overweight were significantly associated with chronic kidney disease.

Conclusion

Kidney ultrasound helps to amplify the detection of CKD patients, which is a supplement to kidney function and urine protein.

Keywords:

• Chronic kidney disease
• prevalence
• risk factor
• Chinese
• health checkup
• kidney ultrasound

Acknowledgements

The authors acknowledge Mr. Haoze Fang from Rici Healthcare Holdings Limited, China for supporting this study, Mr Liucheng Wang from Rici Healthcare Holdings Limited, China for deriving data contained in the database of Rici Healthcare, Dr. Hui Wang and Dr. Xiaoguang Li from School of Public Health, Shanghai Jiao Tong University School of Medicine for providing writing and statistic assistance.

Authors’ contributions

YJW conceptualized the study. ZJL and XYQ designed the study and suggested the statistical method. WYL and ZHY took responsibility for the integrity of the data. FTX and WXX performed the data analysis. FTX wrote the first and subsequent drafts of the manuscript. ZBL and ZL provided administrative support. YJW and LYS supervised this study. All authors critically revised the manuscript for intellectual content and approved the final draft for submission.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.