Prevalence and Associated Factors of Kidney Dysfunction in Patients with Hypertension and/or Diabetes Mellitus from a Primary Care Population in Northwest China

Figures & data

Table 1 Prevalence of Kidney Dysfunction in the Study Population

Characteristics		Hypertension and DM		Hypertension Only		DM Only
		Prevalence 1	Prevalence 2	Prevalence 1	Prevalence 2	Prevalence 1	Prevalence 2
Sex	Female	11.46 (9.36–13.84)	17.93 (15.36–20.73)	4.88 (4.13–5.73)	8.70 (7.70–9.79)	5.58 (3.96–7.61)	10.25 (8.05–12.82)
	Male	5.73 (4.47–7.80)	7.41 (5.73–9.40)	1.87 (1.42–2.42)	2.14 (1.65–2.72)	4.87 (3.37–6.77)	5.46 (3.87–7.44)
	P-value	<0.001	<0.001	<0.001	<0.001	0.557	0.001
Age	< 30	0	0	1.87 (0.23–6.59)	0.93 (0.02–5.10)	3.51 (0.43–12.11)	3.51 (0.43–12.11)
	30–59	5.14 (3.62–7.04)	5.85 (4.23–7.85)	2.15 (1.69–2.69)	3.02 (2.47–3.64)	4.15 (2.97–5.63)	5.11 (3.79–6.71)
	≥ 60	11.36 (9.41–13.55)	17.67 (15.29–20.24)	5.20 (4.34–6.18)	9.04 (7.91–10.27)	8.43 (5.72–11.88)	15.99 (12.28–20.29)
	P-value	<0.001	<0.001	<0.001	<0.001	0.008	<0.001
Living region	Urban	11.18 (9.07–13.59)	14.76 (12.33–17.41)	5.38 (4.35–6.56)	7.27 (6.07–8.61)	8.63 (6.32–11.45)	12.85 (10.04–16.12)
	Stock-raising	4.82 (1.33–11.88)	6.02 (1.98–13.5)	1.98 (1.14–3.19)	3.71 (2.52–5.26)	3.26 (0.68–9.23)	5.43 (1.79–12.23)
	Agriculture	6.61 (4.97–8.57)	11.18 (9.07–13.59)	2.68 (2.16–3.28)	4.82 (4.13–5.60)	3.20 (2.06–4.72)	4.79 (3.38–6.57)
	P-value	0.002	0.019	<0.001	<0.001	<0.001	<0.001
Ethnicity	Han	9.61 (7.95–11.48)	14.32 (12.33–16.51)	3.76 (3.06–4.57)	5.97 (5.09–6.96)	5.65 (4.21–7.40)	8.88 (7.07–10.98)
	Kazakh	7.17 (4.37–10.97)	9.06 (5.89–13.18)	2.84 (2.20–3.59)	4.70 (3.88–5.63)	4.42 (2.23–7.77)	5.62 (3.11–9.25)
	Others	6.34 (3.74–9.96)	8.96 (5.82–13.03)	3.55 (2.47–4.92)	5.42 (4.06–7.05)	4.44 (2.15–8.02)	6.22 (3.44–10.22)
	P-value	0.148	0.010	0.184	0.139	0.630	0.148
Educational status	Primary and lower	9.14 (7.15–11.46)	14.73 (12.25–17.51)	3.38 (2.73–4.14)	6.35 (5.45–7.34)	5.66 (3.76–8.13)	9.22 (6.78–12.19)
	Junior high	8.21 (6.08–10.80)	11.43 (8.91–14.36)	3.34 (2.59–4.23)	4.70 (3.81–5.73)	4.28 (2.73–6.35)	5.95 (4.10–8.29)
	Senior high and higher	8.52 (5.86–11.87)	10.16 (7.26–13.74)	3.33 (2.41–4.48)	4.36 (3.30–5.64)	6.13 (3.79–9.32)	8.90 (6.04–12.53)
	P-value	0.835	0.058	0.955	0.010	0.425	0.109

Notes: Data was showed as percentage and 95% confidence interval. Prevalence 1: defined as eGFR <60 calculated by MDRD equation; prevalence 2: defined as eGFR <60 calculated by CKD-EPI equation.

Abbreviation: DM, diabetes mellitus.

Figure 1 Flow chart of screening and including subjects.

Abbreviation: DM, diabetes mellitus.

Figure 2 Prevalence of kidney dysfunction in patients with hypertension and/or diabetes based on MDRD equation. *Indicates P<0.01.

Abbreviations: HTN, hypertension; DM, diabetes mellitus.

Table 2 Characteristics of Participants with Hypertension and/or Diabetes

Characteristics	Total (n=8899)	eGFR ≥60 (n=8487)	eGFR <60 (n=412)	P-value
Age (years)	56.61±12.11	56.34±12.09	62.22±11.12	<0.001
BMI (kg/m^2)	27.22±4.33	27.21±4.34	27.46±4.21	0.250
Female	4390 (49.3)	4117 (48.5)	273 (66.3)	<0.001
Systolic BP (mmHg)	143.7±21.5	143.8±21.4	141.2±23.4	0.024
Diastolic BP (mmHg)	87.5±13.1	87.7±13.0	83.9±13.9	<0.001
Waist circumference (cm)	92.0±11.4	92.0±11.4	92.4±11.2	0.464
Central obesity, n (%)	5795 (65.1)	5509 (64.9)	286 (69.4)	0.061
Hypertension, n (%)	7558 (84.9)	7216 (85.0)	342 (83.0)	0.264
Diabetes, n (%)	2998 (33.7)	2784 (32.8)	214 (51.9)	<0.001
Hypertension and DM, n (%)	1657 (18.6)	1513 (17.8)	144 (34.9)	<0.001
CVD, n (%)	881 (9.9)	810 (9.5)	71 (17.2)	<0.001
Region, n (%)				<0.001
Urban	2978 (33.5)	2756 (32.5)	222 (53.9)
Stock-raising	983 (11.0)	960 (11.3)	23 (5.6)
Agriculture	4938 (55.5)	4771 (56.2)	167 (40.5)
Educational status, n (%)				0.734
Primary and lower	3872 (43.5)	3688 (43.5)	184 (44.7)
Junior high	3076 (34.6)	2941 (34.7)	135 (32.8)
Senior high and higher	1951 (21.9)	1858 (21.9)	93 (22.6)
Occupation, n (%)				0.008
Manual	7650 (86.0)	7314 (86.2)	336 (81.6)
Intelligent	1249 (14.0)	1173 (13.8)	76 (18.4)
Ethnicity, n (%)				<0.001
Han	4570 (51.4)	4316 (50.9)	254 (61.7)
Kazakh	2877 (32.3)	2780 (32.8)	97 (23.5)
Others	1452 (16.3)	1391 (16.4)	61 (14.8)
Marital status, n (%)				0.004
Single	249 (2.8)	243 (2.9)	6 (1.5)
Married	7461 (83.8)	7130 (84.0)	331 (80.3)
Separated	1189 (13.4)	1114 (13.1)	75 (18.2)
Smoke, n (%)	3060 (34.4)	2959 (34.9)	101 (24.5)	<0.001
Alcohol intake, n (%)	2888 (32.5)	2790 (32.9)	98 (23.8)	<0.001
Physical activity, n (%)				0.001
Low	1434 (16.1)	1347 (15.9)	87 (21.1)
Median	4997 (56.2)	4759 (56.1)	238 (57.8)
High	2468 (27.7)	2381 (28.1)	87 (21.1)
Sleep quality, n (%)				<0.001
Very good	4515 (50.7)	4346 (51.2)	169 (41.0)
Fair good	2992 (33.6)	2836 (33.4)	156 (37.9)
Fair bad	1138 (12.8)	1063 (12.5)	75 (18.2)
Very bad	254 (2.9)	242 (2.9)	12 (2.9)
Hemoglobin (g/L)	139.5±20.6	139.7±20.6	136.4±20.3	0.001
Anemia, n (%)	570 (6.4)	535 (6.3)	35 (8.5)	0.076
Dyslipidemia, n (%)	3958 (44.5)	3729 (43.9)	229 (55.6)	<0.001
FPG (mmol/L)	6.44±2.80	6.38±2.75	7.54±3.59	<0.001
TC (mmol/L)	5.08±1.29	5.08±1.30	5.14±1.22	0.352
TG (mmol/L)	1.40 (0.99–2.00)	1.36 (0.93–1.94)	1.70 (1.18–2.40)	<0.001

Abbreviations: eGFR, estimated glomerular filtration rate; BP, blood pressure; DM, diabetes mellitus; CVD, cardiovascular disease; FPG, fasting plasma glucose; TC, total cholesterol; TG, triglyceride.

Table 3 Factors Associated with Kidney Dysfunction Among Patients with Hypertension and Diabetes

Factors	Adjusted OR	95%CI	P-value
Age	1.037	1.016–1.059	0.001
Female	2.086	1.408–3.090	<0.001
BMI (vs <24.0)
24.0–27.9	0.645	0.378–1.098	0.106
≥28.0	0.937	0.559–1.570	0.805
Region (vs urban)
Stock-raising	0.608	0.206–1.791	0.366
Agriculture	0.731	0.483–1.105	0.137
Ethnicity (vs Han)
Kazakh	0.985	0.551–1.664	0.879
Others	0.620	0.356–1.078	0.090
Marital status (vs married)
Single	1.298	0.164–10.25	0.805
Separated	1.058	0.655–1.709	0.819
Occupation (vs manual)
Intelligent	1.463	0.929–2.302	0.100
CVD	1.326	0.858–2.049	0.204
Physical activity (vs high)
Median	1.268	0.757–2.123	0.366
Low	1.188	0.650–2.173	0.576
Control of hypertension	1.093	0.726–1.645	0.641
Duration of hypertension	1.022	1.001–1.042	0.036
Anemia	2.621	1.296–5.299	0.007
FPG	1.056	1.005–1.110	0.031
TC	0.908	0.782–1.055	0.208
TG	1.146	1.049–1.251	0.002

Abbreviations: BMI, body mass index; CVD, cardiovascular disease; FPG, fasting plasma glucose; TC, total cholesterol; TG, triglyceride. OR, odds ratio; CI, confidence interval.

Table 4 Factors Associated with Kidney Dysfunction Among Patients with Only Hypertension

Factors	Adjusted OR	95%CI	P-value
Age	1.042	1.026–1.059	<0.001
Female	3.016	1.991–4.569	<0.001
BMI (vs <24.0)
24.0–27.9	0.825	0.556–1.226	0.341
≥28.0	0.926	0.627–1.366	0.697
Systolic blood pressure	0.995	0.984–1.006	0.373
Diastolic blood pressure	0.999	0.984–1.015	0.932
Region (vs urban)
Stock-raising	0.437	0.247–0.776	0.005
Agriculture	0.506	0.361–0.709	<0.001
Education (vs senior high and higher)
Junior high	1.328	0.876–2.014	0.181
Primary and lower	1.020	0.666–1.563	0.928
Physical activity (vs high)
Median	0.650	0.460–0.917	0.014
Low	1.056	0.693–1.609	0.800
Sleep quality (vs very good)
Fair good	1.162	0.835–1.617	0.373
Fair bad	1.164	0.762–1.779	0.482
Very bad	0.567	0.221–1.455	0.238
Control of hypertension	1.253	0.797–1.968	0.328
Duration of hypertension	1.028	1.009–1.048	0.005
Alcohol	1.379	0.897–2.120	0.143
Anemia	1.854	1.147–2.996	0.012
Dyslipidemia	1.281	0.920–1.783	0.142
FPG	1.409	1.057–1.877	0.019
TC	0.987	0.868–1.122	0.842
TG	1.078	0.964–1.205	0.187

Abbreviations: BMI, body mass index; FPG, fasting plasma glucose; TC, total cholesterol; TG, triglyceride. OR, odds ratio; CI, confidence interval.

Table 5 Factors Associated with Kidney Dysfunction Among Patients with Only Diabetes

Factors	Adjusted OR	95%CI	P-value
Age	1.023	0.999–1.048	0.064
Female	1.220	0.740–2.012	0.436
Duration of diabetes	1.040	1.001–1.081	0.047
Region (vs urban)
Stock-raising	0.427	0.127–1.438	0.169
Agriculture	0.423	0.250–0.715	0.001
Marital status (vs married)
Single	1.424	0.307–6.616	0.652
Separated	0.798	0.325–1.958	0.798
Physical activity (vs high)
Median	2.409	1.115–5.207	0.025
Low	2.000	0.805–4.966	0.135

Abbreviations: OR, odds ratio; CI, confidence interval.