Kidney Week

Abstract: TH-PO1069

Population Estimates of Predicted Risk of Kidney Failure Among Individuals with Hypertension in Rural Bangladesh, Pakistan, and Sri Lanka - Health Systems Perspective

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - I
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Feng, Liang, Duke-NUS Medical School, Singapore, Singapore

Liang Feng,

• Jafar, Tazeen H., Duke-NUS Medical School, Singapore, Singapore

Tazeen H. Jafar,

Background

South Asia is suffering an increasing burden of hypertension, chronic kidney disease (CKD) and end-stage kidney disease (ESKD). We estimated the proportion and number of individuals aged≥40 years with hypertension and CKD carrying a high risk for ESKD in rural Bangladesh, Pakistan, and Sri Lanka.

Methods

We analyzed baseline data from ongoing Control of Blood Pressure and Risk Attenuation (COBRA) study on 2643 hypertensives aged≥40 years recruited via door-to-door sampling in 30 rural communities in Bangladesh, Pakistan, and Sri Lanka. Serum creatinine was measured, and CKD-EPI eGFR was computed. Predicted risk of kidney failure at five years was computed using 4-variable (age, sex, albuminuria, eGFR) Kidney Failure Risk Equation (KFRE) in hypertensives with CKD Stage 3 or worse (eGFR <60 ml/min/1.73 m²). Country-level population statistics from 2016 World Bank Data were used to project population estimates of these conditions.

Results

See attached table

Conclusion

There is a high burden of CKD progressive to ESKD in hypertensive individuals in rural South Asia. There is noticeable cross-country heterogeneity in the proportion and number of hypertensive individuals with CKD Stage 3 or worse (highest in Sri Lanka), proportion at high risk of ESKD (highest in Pakistan), and the absolute number at high risk of ESKD (highest in Bangladesh). Countries in South Asia, need immediate public health measures to prevent onset and progression of CKD including establishing timely referrals to nephrologists, and accessible renal replacement therapy programs.
Limitations: KFRE has not been validated for use in South Asian rural health systems. Our population estimates of CKD are limited to individuals with hypertension.

Hypertensive individuals with chronic kidney disease(CKD) at high risk for end-stage kidney failure (ESKD) in rural communities in Bangladesh,Pakistan and Sri Lanka

Funding

• Government Support - Non-U.S.