engleski

Surprisingly high prevalence of chronic kidney disease not only in Croatian endemic nephropathy area but also in non endemic villages

Introduction and Aims:Despite increasing awareness of chronic kidney disease (CKD) burden, epidemiological data from many regions are still lacking. There are no data on CKD prevalence in Croatia, and our aim was to analyze it in Croatian rural area including endemic nephropathy (EN) villages using 4 different formulas to estimate GFR. Methods:In this cross sectional survey we have enrolled 1573 subjects (consecutive sample, participation rate 91%, mean age 51.80+17.09). Subjects were from EN villages (N=1226) and from non-EN area (N=347). GFR was estimated using 4 formulas (C-G, MDRD, MCQE, CKD- EPI), and albumin/creatinine ratio (ACR) was determined from the first morning urine sample. Blood pressure (BP) was measured following ESH/ESC guidelines, hypertension was defined as BP ≥ 140/90 mmHg and/or taking antihypertensive drugs, diabetes was diagnosed if fasting blood glucose ≥ 7 mmol/l and/or taking antidiabetic drugs. CKD was diagnosed and classified according to the KDIGO 2009 classification. Results:There were no differences in gender distribution (p=0.698) and age between EN and non-EN areas (51.41+17.27 vs. 53.24+16.42 ; p=0.25). Using C- G, MDRD and CKD- EPI formulas we have observed surprisingly high overall prevalence of CKD in Croatian rural area (19.8%, 18.9%, 19.4%, respectively). Prevalence was significantly lower when we used MCQE formula (13.2% ; p<0.00005 ; p<0.00005 ; p<0.00005, respectively) vs. other formulas (C-G ; MDRD ; CKD-EPI)). Surprisingly, prevalence of CKD was higher in women than in men (MDRD 20.7%vs.15.9%, CKD-EPI 20.8%vs.17.8% ; p<0.00005 ; p<0.00005, respectively). Using all 4 formulas we observed significantly higher prevalence of CKD in endemic vs. non-endemic villages (p<0.00005 ; p<0.00005). Conclusions:Overall prevalence in Croatian rural area is very high. As it might be expected prevalence was higher in EN than in non EN area. High prevalence could be explained with high prevalence and poor control of hypertension, high prevalence of obesity and low socio-economic status what was particularly emphasized in women. Observed differences in CKD prevalence should be considered when using different formulas

chronic kidney disease ; endemic nephropathy

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