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Original research
Chronic kidney disease in adults aged 18 years and older in Chile: findings from the cross-sectional Chilean National Health Surveys 2009–2010 and 2016–2017
  1. Magdalena Walbaum1,
  2. Shaun Scholes1,
  3. Elena Pizzo2,
  4. Melanie Paccot3,
  5. Jennifer S Mindell1
  1. 1Department of Epidemiology and Public Health, University College London Research, London, UK
  2. 2Applied Health Research, University College London, London, UK
  3. 3Non-communicable Diseases, Government of Chile Ministry of Health, Santiago, Chile
  1. Correspondence to Jennifer S Mindell; j.mindell{at}ucl.ac.uk

Abstract

Objectives This study estimates the prevalence of chronic kidney disease (CKD) among Chilean adults and examines its associations with sociodemographic characteristics, health behaviours and comorbidities.

Design Analysis of cross-sectional data from the two most recent large nationally representative Chilean Health Surveys (Encuesta Nacional de Salud, ENS) 2009–2010 and 2016–2017.

Participants Adults aged 18+ years with serum creatine data (ENS 2009–2010: n=4583; ENS 2016–2017: n=5084).

Primary and secondary outcome measures Reduced kidney function (CKD stages 3a–5) based on the estimated glomerular filtration rate (eGFR <60 mL/min/1.73 m2) was the primary outcome measure. Using the urine albumin-to-creatinine ratio (ACR ≥30 mg/g), increased albuminuria was ascertained among adults aged 40+ years with diabetes and/or hypertension. Both outcomes were analysed using logistic regression with results summarised using OR. CKD prevalence (stages 1–5) among adults aged 40+ years was estimated including participants with an eGFR of >60 mL/min/1.73 m2 but with increased albuminuria (stages 1–2).

Results Overall, 3.2% (95% CI: 2.4% to 3.8%) of adults aged 18+ in ENS 2016–2017 had reduced kidney function. After full adjustment, participants with hypertension (OR: 2.37; 95% CI: 1.19 to 4.74) and those with diabetes (OR: 1.66; 95% CI: 1.03 to 2.66) had significantly higher odds of reduced kidney function. In ENS 2016–2017, 15.5% (13.5% to 17.8%) of adults aged 40+ years with diabetes and/or hypertension had increased albuminuria. Being obese versus normal-weight (OR: 1.66; 95% CI: 1.08 to 2.54) and having both diabetes and hypertension versus having diabetes alone (OR: 2.30; 95% CI: 1.34 to 3.95) were significantly associated with higher odds of increased albuminuria in fully-adjusted analyses. At least 15.4% of adults aged 40+ years in ENS 2016–2017 had CKD (stages 1–5), including the 9.6% of adults at CKD stages 1–2.

Conclusions Prevention strategies and Chilean guidelines should consider the high percentage of adults aged 40 years and older at CKD stages 1–2.

  • chronic renal failure
  • epidemiology
  • public health
  • nephrology
http://creativecommons.org/licenses/by-nc/4.0/

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, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Twitter @j_mindell

  • Contributors MW, SS and JSM contributed to the study design, were involved in analysis and interpretation of data and preparation of the manuscript. EP and MP were involved in the preparation of the manuscript.

  • Funding This work was supported by Chilean Scholarship 'Becas Chile, CONICYT'. EP was funded by the United Kingdom National Institute for Health Research (NIHR) Applied Research Collaboration North Thame (ARC North Thames) at Barts Health NHS Trust.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Both Health Surveys were approved by the Ethics Research Committee of the Faculty of Medicine at the Pontificia Universidad Católica de Chile.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. The full data sets can be accessed in through the Ministry of Health of Chile website found at: http://epi.minsal.cl/encuestas-poblacionales/

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