Prevalence and factors associated to chronic kidney disease in older adults

Amaral, Thatiana Lameira Maciel; Amaral, Cledir de Araújo; Vasconcellos, Maurício Teixeira Leite de; Monteiro, Gina Torres Rego

doi:10.11606/S1518-8787.2019053000727

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Original Article • Rev. Saúde Pública 53 • 2019 • https://doi.org/10.11606/S1518-8787.2019053000727 copy

Prevalence and factors associated to chronic kidney disease in older adults

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To verify the prevalence of chronic kidney disease and the factors associated to it in older adults (≥ 60 years).

METHODS

This is a population-based research conducted in 2014, involving 1,016 older adults living in urban and rural areas of the municipality of Rio Branco, Acre. Chronic kidney disease was defined by glomerular filtration rate < 60 ml/min/1.73 m ² , estimated by the equations of the Chronic Kidney Disease Epidemiology Collaboration, and the presence of albuminuria > 29 mg/g. Association measure were estimated by gross and adjusted odds ratio (OR), with a confidence level of 95% (95%CI).

RESULTS

The overall prevalence of chronic kidney disease was 21.4% in older adults, with the associated factors age, diabetes (OR = 3.39; 95%CI 2.13–5.40), metabolic syndrome (OR = 2.49; 95%CI 1.71–3.63), self-assessment of poor health (OR = 1.79; 95%CI 1.10–2.91), arterial hypertension (OR = 1.82; 95%CI 1.04–3.19) and obesity (OR = 1.69; 95%CI 1.02–2.80).

CONCLUSIONS

The prevalence of chronic kidney disease was high in older adults, being associated with age, self-assessment of health as bad or very bad, obesity, diabetes and metabolic syndrome.

Aged; Renal Insufficiency, Chronic, epidemiology; Risk Factors; Comorbidity; Health Surveys

Categories of risk of CKD		Total		Albuminuria						CKD (GFR* and albuminuria)

				A1 (< 30)		A2 (30–299)		A3 (≥ 300)

		n	N (%)	n	N (%)	n	Exp N (%)	n	N (%)	n	N (%)
1	≥ 90	296	7,982 (34.0)	270 ^a	7,252 (31.2) ^a	19 ^b	518 (2.2) ^b	4 ^c	116 (0.5) ^c	23	634 (2.7)
2	60–89	547	12,407 (53.0)	486 ^a	10,982 (47.3) ^a	45 ^b	1,059 (4.6) ^b	11 ^c	260 (1.1) ^c	56	1,319 (5.7)
3a	45–59	106	2,271 (9.7)	85 ^b	1,778 (7.7)	15 ^c	358 (1.6) ^c	6 ^d	135 (0.6) ^d	106	2,217 (9.7)
3b	30–44	26	552 (2.4)	19 ^c	385 (1.7) ^c	4 ^d	93 (0.4) ^d	3 ^d	73 (0.3) ^d	26	552 (2.4)
4	15–29	4	93 (0.4)	4 ^d	93 (0.4) ^d	-	-	-	-	4	93 (0.4)
5	< 15	4	111 (0.5)	1 ^d	24 (0.1) ^d	2 ^d	54 (0.2) ^d	1 ^d	33 (0.1) ^d	4	111 (0.5)
Total		983	23,416 (100.0)	865	20,514 (88.4)	85	2,082 (9.0)	25	617 (2.6)	219	4,979 (21.4)

Variable	Total		CKD						p

			Yes			No

	n	N	n	N	%	n	N	%
Sex									0.519
Female	577	12,496	123	2,570	20.6	454	9,926	79.4
Male	406	10,920	96	2,409	22.1	310	8,511	77.9
Age group (years)									< 0.001
60–69	475	13,394	75	2,134	15.9	400	11,260	84.1
70–79	339	6,687	80	1,586	23.7	259	5,101	76.3
80 and more	169	3,335	64	1,259	37.8	105	2,076	62.2
Skin color									0.158
White	241	5,601	62	1,374	24.5	179	4,227	75.5
Brown	634	15,221	140	3,217	21.1	494	12,004	78.9
Other	108	2,594	17	388	15.0	91	2,206	85.0
Education level*									0.804
Higher education	38	954	10	231	24.2	28	723	75.8
High school	112	2,828	21	528	18.7	91	2,300	81.3
Elementary school	360	8,721	76	1,807	20.7	284	6,914	79.3
Illiterate/Literate	465	10,712	109	2,344	21.9	356	8,368	78.1
Marital status*									0.011
Married	365	9,144	80	1,994	21.8	285	7,150	78.2
Single	178	4,356	28	591	13.6	150	3,765	86.4
Widow/Widower	317	6,793	85	1,754	25.8	232	5,039	74.2
Separated/Divorced	117	2,980	25	616	20.7	92	2,365	79.3
Physical activity									0.153
Yes	149	3,654	26	593	16.2	123	3,061	83.8
No	834	19,762	193	4,386	22.2	641	15,376	77.8
Smoking									0.148
Non-smoker	282	6,696	71	1,618	24.2	211	5,078	75.8
Ex-smoker	537	12,541	119	2,689	21.4	418	9,852	78.6
Smoker	164	4,179	29	672	16.1	135	3,507	83.9
Consumption of alcoholic beverage									0.149
No	857	20,138	185	4,131	20.5	672	16,007	79.5
Yes	80	2,175	23	600	27.6	57	1,575	72.4

Variable	Total		CKD						p

			Yes			No

	n	N	n	N	%	n	N	%
Self-assessment of health									0.014
Very good/Regular	824	19,774	170	3,906	19.8	654	15,868	80.2
Bad/Very bad	159	3,642	49	1,073	29.5	110	2,569	70.5
BMI (kg/m ² )*									0.031
< 25.0	333	7,844	59	1,275	16.3	274	6,569	83.7
25.0–29.9	367	8,816	83	1,944	22.1	284	6,872	77.9
≥ 30.0	248	5,932	69	1,565	26.4	179	4,367	73.6
Hypertension*									0.008
No	231	5.571	32	728	13.1	199	4,843	86.9
Yes	744	17,618	186	4,231	24.0	558	13,387	76.0
Diabetes*									< 0.001
No	820	19,501	152	3,381	17.3	668	16,120	82.7
Yes	161	3,848	67	1,599	41.5	94	2,249	58.5
Dyslipidemia*									0.032
No	198	4,753	32	743	15.6	166	4,010	84.4
Yes	784	18,629	187	4,236	22.7	597	14,393	77.3
Metabolic syndrome*									< 0.001
No	618	14,842	105	2,385	16.1	513	12,458	83.9
Yes	356	8,363	111	2,536	30.3	245	5,827	69.7
Other self-reported CVD (CHF, MI, CVA, arrhythmia)*									0.462
No	830	19,834	182	4,132	20.8	648	15,702	79.2
Yes	138	3,219	34	766	23.8	104	2,453	76.2
Use of medicines									0.034
No	231	5,934	42	1,020	17.2	189	4,914	82.8
Yes	752	17,482	177	3,960	22.6	575	13,522	77.4
Hospitalization in the past 12 months*									0.055
No	791	18,869	167	3,843	20.4	624	15,026	79.6
Yes	158	3,769	49	1,077	28.6	109	2,692	71.4

Variable	OR _crude (95%CI)	OR _adjusted (95%CI)
Age group (years)
60–69	1	1
70–79	1.64 (1.12–2.40)	1.83 (1.25–2.68)
80 and more	3.20 (2.24–4.57)	3.99 (2.70–5.91)
Self-assessment of health
Very good/Regular	1	1
Bad/Very bad	1.70 (1.12–1.58)	1.79 (1.10–2.91)
BMI (kg/m ² )
< 25.0	1	1
25.0–29.9	1.46 (0.95–2.24)	1.37 (0.90–2.08)
≥ 30.0	1.85 (1.11–3.08)	1.69 (1.02–2.80)
Use of medicines
No	1	1
Yes	1.41 (1.03–1.94)	0.70 (0.43–1.14)
Arterial hypertension
No	1	1
Yes	2.10 (1.22–3.63)	1.82 (1.04–3.19)
Diabetes
No	1	1
Yes	3.39 (2.34–4.91)	3.39 (2.13–5.40)
Dyslipidemia
No	1	1
Yes	1.59 (1.04–2.43)	1.43 (0.87–2.37)
Metabolic syndrome*
No	1	1
Yes	2.27 (1.61–3.21)	2.49 (1.71–3.63)

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[1] Correspondence: Thatiana Lameira Maciel Amaral Campus Universitário Centro de Ciências da Saúde e do Desporto BR 364 km 4 Distrito Industrial Caixa postal 500 69920-900 Rio Branco, AC, Brasil E-mail: thatianalameira27@gmail.com