Abstract: FR-PO471

Incidence and Risk Factors of CKD in Thailand: Thai-SEEK Project

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 301 CKD: Risk Factors for Incidence and Progression

Authors

  • Kiattisunthorn, Kraiwiporn, Siriraj Medical School, Mahidol University, Bangkok, Thailand
  • Gojaseni, Pongsathorn, Bhumibol Adulyadej hospital, Bangkok, Thailand
  • Sangthawan, Pornpen, Prince of Songkla University Hospital, Songkhla, Thailand
  • Ingsathit, Atiporn, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Group or Team Name

  • Thai-SEEK Steering Committee, Nephrology Society of Thailand
Background

Chronic kidney disease is one of the major public health problems which, in majority, can be preventable for progression to ESRD. Data from the first Thai-SEEK (Screening and Early Evaluation of Kidney Disease) survey completed in 2008, demonstrated prevalence of CKD for 17.5%. Data of incidence and etiologies of CKD in Thailand is scarce but is seriously concerned by policy makers of national health program for CKD prevention and slow progression. Therefore, we analyzed the data from the second survey to evaluate incidence and risk factors of CKD in Thailand.

Methods

A prospective cohort study was run from June 16, 2015 to December 15, 2016 by using subjects of the first survey. Data from history taking and physical examination, serum creatinine, urinalysis, and urine albumin creatinine ratio (UACR) were done in 2,396 subjects (70%) who gave responses for participating follow up program. One thousand, nine hundred and thirty-four subjects (71% of CKD-free in the first survey) were analyzed for CKD incidence and risk factors of new diagnosed CKD. Serum creatinine standardized with SRM967a (National Institute of Standards and Technology, MD, USA) was put in GFR calculation using CKD-EPI formula. Diagnosis and staging of CKD was based on KDIGO 2012 criteria, and rapid CKD progression was defined as a change in CKD staging plus a decline in GFR >25% or >5 ml/min/1.73m2/year or renal replacement therapy was initiated.

Results

Mean age was 46.7+13.8 years old and 41% were male. Median follow-up time was 7.9 year (min-max 7.7, 9.1). The estimated incident CKD was 0.28 (95% CI: 0.26, 0.30) presented in 15.4%, 8.4%, 3.1%, 0.7% and 0.05%, for stage G1, G2, G3a, G3b and G4, respectively. The majority of CKD etiologies were hypertensive nephropathy (30.7%), diabetic nephropathy (19.2%), and tubulointerstitial nephritis (10.3%). Promoting factors of incident CKD were diabetes mellitus (RR 1.41; 95% CI: 1.15, 1.73), hypertension (RR 1.19; 95% CI: 1.01,1.41), and low socioeconomic status (<5,000 baht/month) (RR 1.54; 95% CI: 1.28,1.86).

Conclusion

Incidence of CKD was 28% in the 8-year cohort. Hypertension and diabetes mellitus were the most etiologies of CKD. Promoting primary prevention program for hypertension and diabetes mellitus, also effective screening in whom diagnosed hypertension and/or diabetes would be powerful in national CKD prevention policy.

Funding

  • Commercial Support