Prevalence and factors associated with CKD: A population study from Beijing

Background: Chronic kidney disease (CKD) is considered a serious worldwide public health problem, but data from developing countries are extremely limited. Study Design: Cross-sectional study. Setting and Participants: A representative sample of 13,925 adults in Beijing, China. Predictors: Age (18 to 39, 40 to 59, 60 to 69, and >70 years), sex, urban or rural area, history of chronic respiratory infection and cardiovascular disease, hepatitis B virus infection, smoking, family history (diabetes, hypertension, and CKID), nephrotoxic medications, central obesity, diabetic and hypertension status, and dyslipidemia. Outcomes and Measurements: CKID was defined as estimated glomerular filtration rate less than 60 mL/min/1.73 m(2) or markers of kidney damage. Glomerular filtration rate was estimated by using calibrated serum creatinine level and a formula specific for China. Persistent albuminuria and hematuria were considered markers of kidney damage. Results: The prevalence of CKID in adults in Beijing was 13.0% (95% confidence interval [CI], 11.9 to 14.2). It therefore was estimated that the number of adults in Beijing with CKID was 1.43 million. In subjects aged 18 to 39, 40 to 59, 60 to 69, and older than 70 years, prevalences of CKID were 10.0% (95% CI, 8.9 to 11.3),14.2% (95% CI, 13.0 to 15.4),20.8% (95% CI, 18.1 to 23.9), and 30.5% (95% CI, 26.6 to 34.7), respectively. Factors independently associated with decreased kidney function included older age (odds ratio [OR], 1.83; 95% CI, 1.51 to 2.22 per 10-year increase), nephrotoxic medications (OR, 2.19; 95% CI, 1.21 to 3.97), rural area (versus urban area; OR, 0.47; 95% CI, 0.28 to 0.78), history of cardiovascular disease (OR, 2.04; 95% CI, 1.24 to 3.38), high-density lipoprotein cholesterol level less than 40 mg/dL (OR, 3.00; 95% CI, 1.39 to 6.51), and hypertension status (with duration > 10 years; OR, 1.85; 95% CI, 1.19 to 2.88). Limitations: Kidney function and indicators of kidney damage were based on single measurements. Conclusions: CKD is a public health burden in Beijing.