Kidney Week

Abstract: TH-PO1017

International Patterns of Low eGFR in Population-Based Surveys of Working-Age Adults: Disadvantaged Populations eGFR Epidemiology (DEGREE) Study

Session Information

• CKD: Epidemiology, Risk Factors, and Prevention - 1
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Caplin, Ben, University College London Research Department of Renal Medicine, London, United Kingdom

Ben Caplin, MBChB, PhD

• Rutter, Charlotte E., London School of Hygiene & Tropical Medicine, London, United Kingdom

Charlotte E. Rutter, MSc, PhD

• Pearce, Neil, London School of Hygiene & Tropical Medicine, London, United Kingdom

Neil Pearce, PhD

Group or Team Name

• DEGREE Study Group.

Background

The Disadvantaged Populations eGFR Epidemiology study was designed to gain insight into the burden of chronic kidney disease (CKD) of undetermined cause (CKDu) by using standard protocols to estimate the general-population prevalence of low estimated glomerular filtration rate (eGFR).

Methods

We estimated the age-standardised prevalence of eGFR<60mL/min/1.73m² not due to common, known causes of CKD (eGFR<60_{[absent HT, DM, high ACR]}) by excluding participants with self-reported or measured hypertension or diabetes, or an ACR>300mg/g or equivalent in population-representative surveys of working-age adults, stratified by sex and rural-urban classification. Included studies either were designed to estimate CKDu burden or were re-analyses of regional or national surveys and were conducted either in areas where CKDu was reported to be endemic or in areas with proposed CKDu risk factors, alongside two high-income reference datasets.

Results

There were 61306 participants from 43 areas across 14 countries. A high prevalence (>5%) of eGFR<60_{[absent HT, DM, high ACR]} was generally only observed in rural men. Rates were highest in Andhra Pradesh, India, and Northwest Nicaragua. Of the areas considered, prevalence in rural men was low outside of Central America and South Asia; including areas of Kenya, Italy, Malawi, Peru, Chile, Ecuador, and Thailand (as well as England and the USA).

Conclusion

Although there are limitations in terms of comparability of study populations, study timing, lack of individual-level exposures, and absent data in many regions, this work is the first attempt to estimate the burden of CKDu around the world. Clusters of disease may exist elsewhere, but to date there is evidence consistent with a high general-population burden of CKDu in Central America and South Asia.

eGFR<60: Age-standardised rural male prevalence of eGFR<60_{[absent HT, DM, high ACR]} in mL/min/1.73m². NB: USA includes both rural and urban. The authors take a neutral position with respect to territorial clams on the map.

Funding

• Government Support – Non-U.S.