Background
Methods
Study design and setting
Study participants
Sources of participants
Eligibility criteria
Selection of participants
Variables of interest
Data sources and measurement
Definitions and calculations
Study size
Handling of quantitative variables
Statistical analysis
Results
Baseline characteristics of the study population
Characteristics | Overall | Rural | Urban | p | p sex*residence |
---|---|---|---|---|---|
n (%) | 439 (100) | 320 (72.9) | 119 (27.1) | ||
Mean age, years (95 % CI) | 47.0 (42.5-51.6) | 51.0 (49.1-52.9) | 36.5 (32.6-40.3) | <0.0001 | 0.007 |
Men, n; % (95 % CI) | 185; 42.1 (35.6-48.7) | 127; 39.7 (33.0-46.4) | 58; 48.7 (37.3-60.2) | 0.154 | NA |
History of renal disease, n; % (95 % CI) | <0.0001 | 0.640 | |||
Yes | 1; 0.2 (0.0-0.7) | 0 | 1; 0.8 (0.0-1.7) | ||
No | 83; 18.9 (0.0-38.1) | 12; 3.8 (1.9-5.6) | 71; 59.7 (38.7-80.6) | ||
Don’t know | 355; 80.9 (61.3-100.0) | 308; 96.2 (94.4-98.1) | 47; 39.5 (17.8-61.1) | ||
History of hypertension, n; % (95 % CI) | <0.0001 | 0.712 | |||
Yes | 47; 10.7 (8.3-13.1) | 33; 10.3 (7.3-13.3) | 14; 11.8 (9.7-13.8) | ||
No | 247; 56.3 (46.5-66.1) | 148; 46.3 (43.9-48.5) | 99; 83.2 (76.6-89.7) | ||
Don’t know | 145; 33.0 (22.4-43.6) | 139; 43.4 (40.4-46.4) | 6; 5.0 (0.0-11.8) | ||
History of diabetes, n; % (95 % CI) | <0.001 | 0.835 | |||
Yes | 26; 5.9 (2.7-9.1) | 23; 7.2 (3.8-10.5) | 3; 2.5 (0.0-6.6) | ||
No | 226; 51.5 (38.3-64.7) | 122; 38.1 (35.0-41.3) | 104; 87.4 (81.2-93.6) | ||
Don’t know | 187; 42.6 (31.1-54.1) | 175; 54.7 (51.6-57.8) | 12; 10.1 (6.0-14.2) | ||
History of gout, n; % (95 % CI) | <0.001 | 0.063 | |||
Yes | 5; 1.1 (0.6-1.7) | 4; 1.3 (0.6-1.9) | 1; 0.8 (0.0-1.7) | ||
No | 187; 42.6 (26.6-58.6) | 84; 26.3 (22.8-29.7) | 103; 86.6 (80.5-92.6) | ||
Don’t know | 247; 56.3 (40.2-72.3) | 232; 72.5 (69.0-76.0) | 15; 12.6 (6.2-19.0) | ||
Tobacco use currently or formerly, n; % (95 % CI) | 41; 9.3 (7.5-11.2) | 34; 10.6 (8.5-12.7) | 7; 5.9 (4.5-7.3) | <0.0001 | 0.009 |
Alcohol use currently or formerly, n; % (95 % CI) | 262; 59.7 (51.3-68.1) | 211; 65.9 (60.7-71.1) | 51; 42.9 (27.6-58.1) | 0.003 | 0.001 |
Longstanding use of herbal medicine, n; % (95 % CI) | 399; 90.9 (83.8-97.9) | 312; 97.5 (96.1-98.9) | 87; 73.1 (65.6-80.6) | <0.0001 | 0.090 |
Longstanding use of street medications, n; % (95 % CI) | 384; 87.5 (77.3-97.7) | 306; 95.6 (93.9-97.4) | 78; 65.5 (51.6-79.4) | <0.0001 | 0.064 |
Mean systolic blood pressure, mmHg (95 % CI) | 119.5 (117.0-122.1) | 121.2 (119.5-122.9) | 115.0 (111.6-118.5) | 0.015 | 0.163 |
Mean diastolic blood pressure, mmHg (95 % CI) | 77.9 (77.0-78.9) | 78.1 (77.0-79.3) | 77.4 (76.0-78.8) | 0.543 | 0.253 |
Any hypertension, n (%) | 112; 25.5 (22.3-28.7) | 92; 28.8 (25.7-31.8) | 20; 16.8 (13.0-20.6) | <0.0001 | 0.077 |
Mean body mass index, kg/m2 (95 % CI) | 26.0 (25.7-26.4) | 26.0 (25.6-26.4) | 26.2 (25.5-26.8) | 0.711 | 0.004 |
BMI ≥ 25, n; % (95 % CI) | 234; 53.3 (49.5-57.1) | 169; 52.8 (49.5-56.1) | 65; 54.6 (45.6-63.6) | 0.696 | 0.102 |
Mean waist girth, cm (95 % CI) | 88.4 (87.2-89.7) | 89.2 (88.0-90.4) | 86.3 (84.8-87.9) | 0.021 | 0.277 |
Mean fasting glycemia, g/l (95 % CI) | 0.92 (0.88-0.96) | 0.93 (0.88-0.97) | 0.91 (0.87-0.95) | 0.539 | 0.387 |
Any diabetes, n; % (95 % CI) | 43; 9.8 (6.6-13.0) | 34; 10.6 (7.2-14.0) | 9; 7.6 (2.1-13.1) | 0.370 | 0.976 |
Characteristics | Overall | Rural | Urban | p | p sex*residence |
---|---|---|---|---|---|
n (%) | 439 (100) | 320 (72.9) | 119 (27.1) | ||
Dipstick abnormalities, n; % (95 % CI) | |||||
Proteinuria | 86; 19.6 (13.5-25.6) | 76; 23.8 (18.5-29.0) | 10; 8.4 (3.3-13.5) | 0.0005 | 0.155 |
Leucocyturia | 22; 5.0 (2.4-7.6) | 10; 3.1 (1.6-4.7) | 12; 10.1 (0.0-20.1) | 0.034 | 0.807 |
Hematuria | 2; 0.5 (0.0-1.1) | 0 | 2; 1.7 (0.2-3.2) | <0.0001 | 0.984 |
Albuminuria, mg/g, n; % (95 % CI) | 0.0004 | 0.148 | |||
<30 | 353; 80.4 (74.3-86.5) | 244; 76.3 (71.0-81.5) | 109; 91.6 (86.5-96.7) | ||
30-300 | 70; 15.9 (10.0-21.8) | 64; 20.0 (15.6-24.3) | 6; 5.0 (0.0-11.1) | ||
>300 | 16; 3.6 (2.1-5.2) | 12; 3.8 (1.9-5.6) | 4; 3.4 (1.1-5.6) | ||
Mean serum creatinine, mg/l (95 % CI) | 10.6 (10.0-11.2) | 10.3; 4.9 (9.6-10.9) | 11.6; 3.9 (10.5-12.8) | 0.065 | 0.037 |
Mean eGFR, ml/min (95 % CI) | |||||
MDRD | 109.5 (104.0-115.0) | 110.9; 38.2 (105.2-116.5) | 105.8; 48.1 (91.7-119.8) | 0.522 | 0.0005 |
CKD-EPI | 106.4 (101.3-111.5) | 107.2; 30.1 (102.6-111.8) | 104.2; 38.6 (90.1-118.3) | 0.622 | 0.0003 |
CG | 89.1 (83.2-95.0) | 88.2; 35.5 (83.1-93.2) | 91.8; 35.4 (78.4-105.1) | 0.691 | 0.0002 |
Stages of kidney function by eGFR, n; % (95 % CI) | |||||
MDRD (ml/min/1.73 m2) >90 | 303; 69.0 (63.3-74.7) | 238; 74.4 (70.4-78.3) | 65; 54.6 (38.3-70.9) | 0.2681 | 0.711 |
60-90 | 89; 20.3 (15.0-25.5) | 53; 16.6 (13.1-20.0) | 36; 30.3 (16.7-43.8) | ||
<60 | 47; 10.7 (5.4-16.0) | 29; 9.1 (3.0-15.1) | 18; 15.1 (4.5-25.8) | ||
CG (ml/min) >90 | 197; 44.9 (39.7-50.1) | 142; 44.4 (40.6-48.2) | 55; 46.2 (32.2-60.2) | 0.757 | 0.090 |
60-90 | 146; 33.3 (30.6-35.9) | 106; 33.1 (29.9-36.3) | 40; 33.6 (29.5-37.7) | ||
<60 | 96; 21.9 (16.3-27.4) | 72; 22.5 (18.2-26.8) | 24; 20.2 (5.7-34.6) | ||
CKD-EPI (ml/min/1.73 m2) >90 | 309; 70.4 (64.7-76.0) | 243; 75.9 (72.3-79.6) | 66; 55.5 (38.4-72.5) | 0.242 | 0.543 |
60-90 | 82; 18.7 (13.6-23.7) | 48; 15.0 (11.9-18.1) | 34; 28.6 (15.2-41.9) | ||
<60 | 48; 10.9 (5.4-16.4) | 29; 9.1 (3.0-15.1) | 19; 16.0 (3.9-28.0) | ||
Albuminuria (≥30) and/or eGFR (<60) MDRD | 120; 27.3 (20.6-34.5) | 96; 30.0 (24.3-35.7) | 24; 20.2 (8.3-32.0) | 0.162 | <0.0001 |
Albuminuria (≥30) and/or eGFR (<60) CG | 157; 35.8 (27.3-44.2) | 129; 40.3 (34.5-46.1) | 28; 23.5 (7.8-39.3) | 0.072 | 0.022 |
Albuminuria(≥30) and/or eGFR(<60)CKD-EPI | 121; 27.6 (20.6-34.5) | 96; 30.0 (24.3-35.7) | 25; 21.0 (7.5-34.6) | 0.252 | <0.0001 |
Prevalence and correlates of albuminuria and chronic kidney disease
Variables | CKD | GFR based CKD stages | Albuminuria based CKD stages | ||||||
---|---|---|---|---|---|---|---|---|---|
No | Yes | p | G1-G2 | G3-G4 | p | A1 | A2-A3 | p | |
n (%) | 381 (86.8) | 58 (13.2) | 428 (97.5) | 11 (2.5) | 386 (87.9) | 53 (12.1) | |||
Sex (Men), n; % (95 % CI) | 166; 43.6 (36.7-50.5) | 19; 32.8 (20.5-45.0) | 0.094 | 185; 43.2 (36.9-49.5) | 0 | <0.0001 | 166 (36.2-49.8) | 19; 35.8 (23.7-48.0) | 0.230 |
Rural residence, n; % (95 % CI) | 275; 72.2 (47.8-96.6) | 45; 77.6 (56.7-98.5) | 0.432 | 315; 73.6 (50.2-97.0) | 5; 45.5 (0.0-92.3) | 0.077 | 275; 71.2 (46.5-96.0) | 45; 84.9 (70.81-99.0) | 0.047 |
Mean age, years (95 % CI) | 46.5 (41.5-51.5) | 50.2 (46.7-53.8) | 0.191 | 46.9 (42.4-51.5) | 50.6 (40.9-60.3) | 0.413 | 46.5 (41.5-51.5) | 50.7 (46.8-54.5) | 0.193 |
History of hypertension, n; % (95 % CI) | 0.001 | 0.766 | <0.0001 | ||||||
Yes | 34; 8.9 (6.1-11.7) | 13; 22.4 (12.7-32.1) | 42; 9.8 (7.4-12.2) | 5; 45.5 (16.6-74.3) | 35; 9.1 (6.4-11.7) | 12; 22.6 (12.2-33.1) | |||
No | 226; 59.3 (49.7-69.0) | 21; 36.2 (26.3-46.1) | 242; 56.5 (47.0-66.1) | 5; 45.5 (17.7-73.2) | 230; 59.6 (49.6-69.5) | 17; 32.1 (24.0-40.1) | |||
Don’t know | 121; 31.8 (21.1-42.4) | 24; 41.4 (27.1-55.6) | 144; 33.6 (23.0-44.3) | 1; 9.1 (0.0-28.2) | 121; 31.3 (20.6-42.1) | 24; 45.3 (31.4-59.1) | |||
History of diabetes, n; % (95 % CI) | 0.017 | 0.662 | 0.003 | ||||||
Yes | 16; 4.2 (0.9-7.5) | 10; 17.2 (6.5-27.9) | 23; 5.4 (2.4-8.4) | 3; 27.3 (0.0-60.1) | 16; 4.1 (0.8-7.5) | 10; 18.9 (8.0-29.7) | |||
No | 206; 54.1 (40.8-67.3) | 20; 48.3 (19.1-49.8) | 219; 51.2 (38.2-64.1) | 7; 63.6 (28.4-98.8) | 211; 54.7 (41.1-68.2) | 15; 28.3 (17.1-39.5) | |||
Don’t know | 159; 41.7 (29.6-53.9) | 28; 48.3 (34.6-61.9) | 186; 43.5 (31.9-55.0) | 1; 9.1 (0.0-28.2) | 159; 41.2 (28.8-53.6) | 28; 52.8 (40.1-65.6) | |||
History of gout, n; % (95 % CI) | 0.009 | 0.566 | 0.0002 | ||||||
Yes | 4; 1.0 (0.4-1.7) | 1; 1.7 (1.0-2.4) | 5; 1.2 (0.6-1.7) | 0 | 4; 1.0 (0.4-1.7) | 1; 1.9 (1.2-2.6) | |||
No | 169; 44.4 (28.2-60.5) | 18; 31.0 (14.9-47.2) | 181; 42.3 (26.6-58.0) | 6; 54.5 (7.7-100) | 174; 45.1 (28.5-61.6) | 13; 24.5 (12.9-36.2) | |||
Don’t know | 208; 54.6 (38.2-71.0) | 39; 67.2 (51.4-83.1) | 242; 56.5 (40.7-72.3) | 5; 45.5 (0.0-92.3) | 208; 53.9 (37.2-70.6) | 39; 73.6 (62.1-85.1) | |||
Tobacco use, n; % (95 % CI) | 38; 10.0 (8.0-12.0) | 3; 5.2 (0.8-9.5) | 0.071 | 41; 9.6 (7.7-11.5) | 0 | <0.0001 | 38; 9.8 (7.8-11.9) | 3; 5.7 (1.0-10.3) | 0.129 |
Alcohol use, n; % (95 % CI) | 231; 60.6 (51.5-69.8) | 31; 53.4 (39.5-67.4) | 0.310 | 259; 60.5 (51.9-69.1) | 3; 27.3 (0.0-57.0) | 0.068 | 234; 60.6 (51.3-70.0) | 28; 52.8 (38.6-67.1) | 0.300 |
Longstanding use of herbal medicine, n; % (95 % CI) | 341; 89.5 (81.5-97.5) | 58; 100 (100–100) | <0.0001 | 388; 90.7 (83.4-97.9) | 11; 100 (100–100) | <0.0001 | 346; 89.6 (81.8-97.4) | 53; 100 (100–100) | <0.0001 |
Longstanding use of street medications, n; % (95 % CI) | 330; 86.6 (81.5-97.5) | 54; 93.1 (85.7-100.0) | 0.007 | 373; 87.1 (76.7-97.6) | 11; 100 (100–100) | <0.0001 | 335; 86.8 (76.4-97.2) | 49; 92.5 (84.1-100.0) | 0.025 |
Mean systolic blood pressure, mmHg (95 % CI) | 118.6 (116.6-120.6) | 125.6 (118.3-133.0) | 0.053 | 119.3 (117.1-121.5) | 128.3 (103.0-153.5) | 0.457 | 118.5 (116.2-120.7) | 127.2 (120.7-133.7) | 0.019 |
Mean diastolic blood pressure, mmHg (95 % CI) | 77.7 (76.8-78.5) | 79.8 (76.0-83.5) | 0.294 | 77.9 (76.8-78.9) | 81.5 (70.4-92.6) | 0.511 | 77.6 (76.8-78.4) | 80.3 (76.8-83.8) | 0.164 |
Any hypertension, n; % (95 % CI) | 89; 23.4 (19.7-27.0) | 23; 39.7 (31.9-47.4) | <0.0001 | 107; 25.0 (21.7-28.3) | 5; 45.5 (16.6-74.3) | 0.107 | 90; 23.3 (19.6-27.0) | 22; 41.5 (32.7-50.3) | <0.0001 |
Body mass index ≥ 25, n; % (95 % CI) | 200; 52.5 (48.7-56.3) | 34; 58.6 (48.1-69.2) | 0.196 | 227; 53.0 (48.8-57.3) | 7; 63.6 (39.8-100) | 0.526 | 204; 52.8 (49.3-56.4) | 30; 56.6 (46.2-67.0) | 0.374 |
Mean fasting glycemia, g/l (SD) | 0.91 (0.87-0.94) | 1.02 (0.86-1.18) | 0.167 | 0.91 (0.88-0.95) | 1.25 (0.73-1.76) | 0.200 | 0.91 (0.87-0.94) | 1.02 (0.85-1.20) | 0.191 |
Any diabetes, n; % (95 % CI) | 32; 8.4 (4.7-12.1) | 11; 19.0 (8.9-29.0) | 0.017 | 40; 9.3 (6.2-12.5) | 3; 27.3 (0.0-0.60) | 0.102 | 32; 8.3 (4.6-12.0) | 11; 20.8 (10.3-31.2) | 0.008 |
Predictors of albuminuria and chronic kidney disease in age, sex and residency adjusted logistic regressions
Variables | CKD | CKD Stages G3-G4 | Albuminuria | |||
---|---|---|---|---|---|---|
OR (95 % CI) |
p
| OR (95 % CI) |
p
| OR (95 % CI) |
p
| |
Sex (men) | 0.63 (0.36-1.08) | 0.095 | <0.001 (<0.001- < 0.001) | <0.0001 | 0.76 (0.46-1.25) | 0.283 |
Residence (rural) | 1.06 (0.52-2.16) | 0.880 | 0.16 (0.04-0.69) | 0.008 | 1.92 (1.06-3.48) | 0.031 |
Age, per years | 1.01 (0.99-1.03) | 0.178 | 1.03 (1.00-1.07) | 0.066 | 1.01 (0.99-1.03) | 0.293 |
History of hypertension | <0.0001 | 0.056 | <0.0001 | |||
No | 1 (reference) | 1 (reference) | 1 (reference) | |||
Yes | 3.95 (2.09-7.46) | 4.74 (0.84-26.58) | 4.67 (2.63-8.29) | |||
Don’t know | 2.16 (1.29-3.63) | 0.50 (0.03-8.66) | 2.38 (1.40-4.03) | |||
History of diabetes | <0.0001 | 0.004 | <0.0001 | |||
No | 1 (reference) | 1 (reference) | 1 (reference) | |||
Yes | 6.64 (2.63-16.75) | 4.49 (1.55-13.03) | 8.13 (3.17-20.84) | |||
Don’t know | 1.89 (1.09-3.26) | 0.17 (0.01-3.11) | 2.25 (1.26-4.01) | |||
History of gout | 0.131 | <0.0001 | 0.064 | |||
No | 1 (reference) | 1 (reference) | 1 (reference) | |||
Yes | 2.58 (0.96-6.94) | <0.001 (<0.001- < 0.001) | 3.13 (1.14-8.59) | |||
Don’t know | 1.74 (0.94-3.23) | 1.38 (0.32-5.94) | 2.12 (1.04-4.31) | |||
Tobacco use | 0.50 (0.24-1.05) | 0.066 | <0.001 (<0.001- < 0.001) | <0.0001 | 0.52 (0.25-1.07) | 0.077 |
Alcohol use | 0.75 (0.40-1.39) | 0.362 | 0.32 (0.07-1.41) | 0.133 | 0.65 (0.35-1.19) | 0.160 |
Longstanding use of street medications | 1.77 (0.87-3.60) | 0.113 | Few events | 1.17 (0.52-2.63) | 0.713 | |
Systolic blood pressure, mmHg | 1.01 (1.00-1.02) | 0.018 | 1.02 (0.99-1.05) | 0.158 | 1.01 (1.00-1.02) | 0.002 |
Diastolic blood pressure, mmHg | 1.01 (0.99-1.03) | 0.175 | 1.02 (0.97-1.08) | 0.342 | 1.01 (1.00-1.03) | 0.038 |
Any hypertension | 2.07 (1.38-3.11) | 0.0004 | 2.85 (0.65-12.45) | 0.163 | 2.19 (1.47-3.25) | 0.0001 |
Body mass index ≥ 25 kg/m2 | 1.34 (0.89-2.02) | 0.157 | 1.55 (0.35-6.83) | 0.564 | 1.22 (0.84-1.78) | 0.288 |
Any diabetes | 2.43 (1.15-5.16) | 0.021 | 3.88 (0.75-20.19) | 0.107 | 2.74 (1.26-5.98) | 0.011 |