Factors associated with chronic kidney disease, according to laboratory criteria of the National Health Survey

Aguiar, Lilian Kelen de; Ladeira, Roberto Marini; Machado, Ísis Eloah; Bernal, Regina Tomei Ivata; Moura, Lenildo de; Malta, Deborah Carvalho

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ORIGINAL ARTICLE • Rev. bras. epidemiol. 23 • 2020 • https://doi.org/10.1590/1980-549720200101 copy

Factors associated with chronic kidney disease, according to laboratory criteria of the National Health Survey

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT:

Objective:

To identify the prevalence of glomerular filtration rate (GFR) less than 60 mL/min/1.73 m² in Brazil and the associated factors.

Methods:

This is a cross-sectional household-based epidemiological survey. Data were collected from the National Health Survey (PNS), conducted in 2013, by carrying out creatinine blood test and GFR calculation (n = 7,457). The groups of explanatory variables were: sociodemographic characteristics, lifestyles, chronic diseases, anthropometry, and health assessment. The prevalence of GFR < 60 mL/min/1.73 m² and the respective 95% confidence intervals were estimated using the Poisson regression to calculate the crude and adjusted prevalence ratio (PR and adjPR) by age, sex, education level, and region.

Results:

The prevalence of GFR < 60 mL/min/1.73 m² was 6.48% (95%CI 5.88 - 7.09). After the adjustment, the following aspects remained associated: women (PR = 1.40; 95%CI 1.16 - 1.68), age of 45-59 years (adjPR = 7.27; 95%CI 3.8 - 14.1), 60 years or older (adjPR = 33.55; 95%CI 17.8 - 63.4), obesity (PR = 1.32 (95%CI 1.1 - 1.7), diabetes (PR = 1.44; 95%CI 1.2 - 1.8), poor/very poor self-rated health (PR = 1.50; 95%CI 1.2 - 1.9); and the lowest adjPR was found for the Northeast and Southeast regions, among smokers with high salt intake.

Conclusion:

GFR < 60 mL/min/1.73 m² was higher in women, increased with age, in addition to being associated with obesity, diabetes, and poor self-rated health. Knowing the prevalence of chronic kidney disease through biochemical tests and risk and protective factors are paramount to support public health policies.

Keywords:
Renal insufficiency; chronic. Chronic disease. Risk factors. Health surveys. Public health nursing. Health planning

Variables/Glomerular Filtration < 60*	%	95%CI
Total (n = 7,457)	6.48	5.88	7.09
Men	5.05	4.24	5.86
Women	7.76	6.87	8.65
18 to 29 years	0.74	0.28	1.20
30 to 44 years	1.20	0.70	1.69
45 to 59 years	5.40	4.29	6.51
60 years or older	25.25	22.78	27.73
No education	11.14	9.94	12.34
Elementary school	3.65	2.52	4.79
High school	3.45	2.72	4.17
Afro-descendant	5.63	4.93	6.34
Non-Afro-descendant	7.39	6.38	8.39
North region	6.39	5.37	7.42
Northeast region	5.32	4.55	6.08
Southeast region	6.44	5.29	7.58
South region	8.72	7.07	10.36
Midwest region	6.62	5.07	8.18
Low weight/Normal**	5.10	4.27	5.94
Overweight**	6.89	5.86	7.92
Obesity**	8.71	7.16	10.26

Variables/Glomerular Filtration < 60*	%	95%CI
Smoker	4.76	3.52	6.00
Nonsmoker	6.78	6.10	7.46
Consumption of soft drinks > 5 glasses/week	4.21	3.08	5.34
Consumption of soft drinks < 5 glasses/week	7.16	6.44	7.87
Red meat with visible fat	4.21	3.34	5.09
Red meat with no visible fat	7.22	6.42	8.03
High salt intake	4.21	3.15	5.26
Low salt intake	7.04	6.26	7.82
Abusive consumption of alcoholic beverages	7.54	6.80	8.29
Non-abusive consumption of alcoholic beverages	3.21	2.30	4.13
Arterial hypertension	9.05	6.87	11.24
Absence of arterial hypertension	6.18	5.55	6.81
Diabetes mellitus**	17.06	13.40	20.73
Non-diabetic	5.75	5.14	6.36
High cholesterol	7.92	6.79	9.04
Normal cholesterol	6.06	5.31	6.81
Very good/good self-rated health	4.47	3.82	5.13
Fair self-rated health	8.85	7.58	10.12
Very poor/poor self-rated health	16.60	13.16	20.03

Variables	PR_crude*	95%CI		adjPR*	95%CI
Men	1.00			1.00
Women	1.54	1.26	1.87	1.40	1.16	1.68
18 to 29 years	1.00			1.00
30 to 44 years	1.62	0.77	3.44	1.61	0.76	3.41
45 to 59 years	7.32	3.78	14.16	7.27	3.76	14.06
60 years or older	34.22	18.14	64.57	33.55	17.77	63.36
No education	1.00			1.00
Elementary school	0.33	0.24	0.46	0.79	0.58	1.09
High school	0.31	0.24	0.39	0.79	0.63	1.00
Afro-descendant	0.76	0.63	0.92	0.93	0.78	1.10
Non-Afro-descendant	1.00			1.00
North region	1.00			1.00
Northeast region	0.83	0.67	1.03	0.67	0.54	0.83
Southeast region	1.01	0.79	1.28	0.72	0.57	0.90
South region	1.36	1.06	1.75	1.02	0.81	1.29
Midwest region	1.04	0.78	1.38	0.88	0.68	1.14
Low weight/Normal**	1.00			1.00
Overweight**	1.35	1.08	1.68	1.12	0.92	1.37
Obesity**	1.71	1.34	2.17	1.32	1.05	1.65

Variables/Glomerular Filtration < 60*	PR_crude	95%CI		adjPR	95%CI
Smoker	0.70	0.53	0.93	0.71	0.55	0.93
Consumption of soft drinks > 5 glasses	0.59	0.44	0.78	1.06	0.82	1.38
Red meat: visible fat	0.58	0.46	0.74	0.86	0.68	1.08
High salt intake	0.60	0.45	0.79	0.68	0.53	0.88
Abusive consumption of alcoholic beverages	2.35	1.74	3.17	1.24	0.92	1.68
Arterial hypertension	1.46	1.13	1.90	1.06	0.82	1.37
Diabetes mellitus (**)	2.97	2.33	3.77	1.44	1.15	1.80
High cholesterol	0.13	1.58		0.88	0.74	1.05
Fair self-rated health	1,98	1.61	2.43	1.06	0.87	1.29
Very poor/poor self-rated health	3.71	2.88	4.78	1.50	1.19	1.90

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[1] Corresponding author: Lilian Kelen de Aguiar. Avenida Amazonas, 3.217, ap. 1, Gutierrez, CEP: 30410-000, Belo Horizonte (MG), Brazil. E-mail: lilian.uea@gmail.com