Kidney Week

Abstract: TH-PO1067

Prevalence of CKD in the Punjab, Northern India: A Comparison with the United States

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

• Bragg-Gresham, Jennifer L., University of Michigan, Ann Arbor, Michigan, United States

Jennifer L. Bragg-Gresham,

• Thakur, Jarnail Singh, PGIMER, Chandigarh, Chadigarh, India

Jarnail Singh Thakur,

• Jain, Sanjay, PGIMER, Chandigarh, India

Sanjay Jain,

• Pennathur, Subramaniam, University of Michigan, Ann Arbor, Michigan, United States

Subramaniam Pennathur,

• Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States

Rajiv Saran,

Background

India is witnessing a disturbing growth in non-communicable diseases (NCDs), including CKD. Recently, a WHO STEPS survey was conducted in the state of Punjab in northern India to collect data from the adult population on NCD risk factors (2014-2015). We sought to compare the prevalence of CKD and its risk factors between this large state in northern India and the US.

Methods

Data from 1,928 participants in the Punjab survey and 5,588 in the US (National Health and Nutrition Examination Survey- NHANES, 2013-2014) with complete information on estimated glomerular filtration rate and albuminuria were examined. Both regions used multi-stage stratified sampling designs to collect data representative of the general population. All analyses used sampling weights.

Results

The average age in the Punjab sample of adults (age 20 years+) was significantly lower than the US (39.2 vs. 47.5 years, p<0.0001) and had a higher proportion of males (57.8% vs. 48.1%, p<0.0001). The US had a much higher percentage of high school or higher education and private health insurance coverage (p<0.0001). In the US body size was much larger in terms of height, weight, BMI, and waist circumference. While smoking and obesity were higher in the US, diabetes and hypertension were much more common in Punjab (39.6% vs. 10.7% and 49.5% vs. 39.8%, respectively, p<0.0001). No differences were seen in the prevalence of cardiovascular disease or triglyceride levels, although the US had higher total cholesterol. Significant differences were seen in the prevalence of CKD markers, with lower prevalence of eGFR < 60 ml/min/1.73m², but markedly higher albuminuria (see Table).

Conclusion

We report a strikingly high prevalence of albuminuria in the Punjab (with well over a third of the adult population being affected!), and much higher prevalence of both DM and HT compared with the US. In contrast, the prevalence of eGFR <60 was relatively low. These findings need to be further confirmed, and if true have enormous public health and resource implications for a low-middle income country such as India, specifically in the realm of CKD, cardiovascular disease and other NCDs.