Prevalence of chronic kidney disease in two major Indian cities and projections for associated cardiovascular disease

• Published in: Kidney international Vol. 88; no. 1; pp. 178 - 185
• Main Authors: Anand, Shuchi, Shivashankar, Roopa, Ali, Mohammed K., Kondal, Dimple, Binukumar, B., Montez-Rath, Maria E., Ajay, Vamadevan S., Pradeepa, R., Deepa, M., Gupta, Ruby, Mohan, Viswanathan, Venkat Narayan, K.M., Tandon, Nikhil, Chertow, Glenn M., Prabhakaran, Dorairaj
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2015; Elsevier Limited
• Subjects: Adult; Age Factors; Aged; albuminuria; Albuminuria - epidemiology; cardiovascular disease; Cardiovascular Diseases - epidemiology; chronic kidney disease; Diabetes Mellitus - epidemiology; epidemiology; Female; Glycated Hemoglobin A - metabolism; Humans; India - epidemiology; Male; Middle Aged; Practice Guidelines as Topic; Prevalence; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - epidemiology; resource-poor settings; Risk Assessment; Sex Factors; South Asians; Urban Population - statistics & numerical data; Young Adult; albuminuria; cardiovascular disease; epidemiology; chronic kidney disease; resource-poor settings; South Asians
• ISSN: 0085-2538; 1523-1755
• DOI: 10.1038/ki.2015.58

India is experiencing an alarming rise in the burden of noncommunicable diseases, but data on the incidence of chronic kidney disease (CKD) are sparse. Using the Center for Cardiometabolic Risk Reduction in South Asia surveillance study (a population-based survey of Delhi and Chennai, India) we estimated overall, and age-, sex-, city-, and diabetes-specific prevalence of CKD, and defined the distribution of the study population by the Kidney Disease Improving Global Outcomes (KDIGO) classification scheme. The likelihood of cardiovascular events in participants with and without CKD was estimated by the Framingham and Interheart Modifiable Risk Scores. Of the 12,271 participants, 80% had complete data on serum creatinine and albuminuria. The prevalence of CKD and albuminuria, age standardized to the World Bank 2010 world population, was 8.7% (95% confidence interval: 7.9–9.4%) and 7.1% (6.4–7.7%), respectively. Nearly 80% of patients with CKD had an abnormally high hemoglobin A1c (5.7 and above). Based on KDIGO guidelines, 6.0, 1.0, and 0.5% of study participants are at moderate, high, or very high risk for experiencing CKD-associated adverse outcomes. The cardiovascular risk scores placed a greater proportion of patients with CKD in the high-risk categories for experiencing cardiovascular events when compared with participants without CKD. Thus, 1 in 12 individuals living in two of India’s largest cities have evidence of CKD, with features that put them at high risk for adverse outcomes.