Abstract: FR-PO414

Factors Associated with Clinically Significant CKD and Their Clinical Utility in Primary Care Clinics in Singapore

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 301 CKD: Risk Factors for Incidence and Progression

Authors

  • Lew, Quan Lan J., Singhealth Polyclinic, Singapore, Singapore
  • Nguyen, Francis Ngoc hoang long, SingHealth, Singapore, Singapore
  • Allen, John C., Duke-NUS Graduate Medical School, Singapore, Singapore
  • Tan, Ngiap chuan, SingHealth Polyclinics, Singapore, Singapore
  • Jafar, Tazeen H., Duke-NUS Graduate Medical School, Singapore, Singapore
Background

Chronic kidney disease (CKD) is a major global public health challenge, including Southeast Asia. Factors associated with CKD in Singapore were determined by analyzing historical data on all individuals > 40 years visiting 4 government polyclinics in Singapore from 1st Jan 2012 to 31st Dec 2015.

Methods

Clinically significant CKD patients had CKD-EPI serum creatinine-based estimated glomerular filtration rate < 60ml/min/1.73m2 or 1+ dipstick proteinuria sustained > 3 months. Multivariable and stepwise logistic regression analysis and receiver operator characteristic curve analysis were conducted for the outcome of clinically significant CKD.

Results

About 25.9% (95% CI: 25.6-26.2%) of the 88,765 individuals screened at Singapore Polyclinics (mean (SD) age of 65.9 (+11.1) years, and 53.3% women) had clinically significant CKD. Age [OR=1.06; 95% CI: (1.06-1.07) / year]; body mass index [1.02 (1.02-1.03) / kg/m2]; male vs female [1.23 (1.17-1.27)]; Malay [1.31 (1.24-1.38)] and Indian [(0.80 (0.74-0.87)] vs Chinese; public vs private housing [1.25 (1.18-1.34)]; ever vs never smoker [1.08 (1.01-1.15)]; presence of hypertension [2.89 (2.69-3.11)], diabetes [7.23 (6.95-7.52)], or stroke [1.36 (1.27-1.45)] vs none were independently associated with clinically significant CKD. However, only age, presence of diabetes and hypertension incrementally added to the area under the curve of 0.808 (95% CI: 0.805-0.811) for clinically significant CKD.

Conclusion

Clinically significant CKD prevalence is high in primary care clinics in Singapore. Our results highlight the factors associated with clinically significant CKD and underscore the need for targeted screening of CKD in Southeast Asia.

Probability of CKD increases with age, and presence of hypertension and diabetes.

Funding

  • Clinical Revenue Support