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Epidemiology
Research
Change in prevalence of chronic kidney disease in England over time: comparison of nationally representative cross-sectional surveys from 2003 to 2010
  1. Grant R Aitken1,
  2. Paul J Roderick2,
  3. Simon Fraser2,
  4. Jennifer S Mindell3,
  5. Donal O'Donoghue4,
  6. Julie Day5,
  7. Graham Moon1
  1. 1Faculty of Social and Human Sciences, Department of Geography, University of Southampton, Southampton, UK
  2. 2Faculty of Medicine, Academic Unit of Primary Care and Population Sciences, University of Southampton, Southampton, UK
  3. 3Research Department of Epidemiology and Public Health, University College London, London, UK
  4. 4Renal Unit, Salford Royal NHS Foundation Trust, Salford, UK
  5. 5Department of Clinical Biochemistry, Royal Victoria Infirmary, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
  1. Correspondence to Professor Paul J Roderick; pjr{at}soton.ac.uk

Abstract

Objectives To determine whether the prevalence of chronic kidney disease (CKD) in England has changed over time.

Design Cross-sectional analysis of nationally representative Health Survey for England (HSE) random samples.

Setting England 2003 and 2009/2010.

Survey participants 13 896 adults aged 16+ participating in HSE, adjusted for sampling and non-response, 2009/2010 surveys combined.

Main outcome measure Change in prevalence of estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 (as proxy for stage 3–5 CKD), from 2003 to 2009/2010 based on a single serum creatinine measure using an isotope dilution mass spectrometry traceable enzymatic assay in a single laboratory; eGFR derived using Modified Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKDEPI) eGFR formulae.

Analysis Multivariate logistic regression modelling to adjust time changes for sociodemographic and clinical factors (body mass index, hypertension, diabetes, lipids). A correction factor was applied to the 2003 HSE serum creatinine to account for a storage effect.

Results National prevalence of low eGFR (<60) decreased within each age and gender group for both formulae except in men aged 65–74. Prevalence of obesity and diabetes increased in this period, while there was a decrease in hypertension. Adjustment for demographic and clinical factors led to a significant decrease in CKD between the surveyed periods. The fully adjusted OR for eGFR <60 mL/min/1.73 m2 was 0.75 (0.61 to 0.92) comparing 2009/2010 with 2003 using the MDRD equation, and was similar using the CKDEPI equation 0.73 (0.57 to 0.93).

Conclusions The prevalence of a low eGFR indicative of CKD in England appeared to decrease over this 7-year period, despite the rising prevalence of obesity and diabetes, two key causes of CKD. Hypertension prevalence declined and blood pressure control improved but this did not appear to explain the fall. Periodic assessment of eGFR and albuminuria in future HSEs is needed to evaluate trends in CKD.

  • EPIDEMIOLOGY
  • PUBLIC HEALTH

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2014-005480

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