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Chronic kidney disease in adults aged 18 years and older in Chile: findings from the cross-sectional Chilean National Health Surveys 2009-2010 and 2016-2017.

ABSTRACT: OBJECTIVES:This study estimates the prevalence of chronic kidney disease (CKD) among Chilean adults and examines its associations with sociodemographic characteristics, health behaviours and comorbidities. DESIGN:Analysis of cross-sectional data from the two most recent large nationally representative Chilean Health Surveys (Encuesta Nacional de Salud, ENS) 2009-2010 and 2016-2017. PARTICIPANTS:Adults aged 18+ years with serum creatine data (ENS 2009-2010: n=4583; ENS 2016-2017: n=5084). PRIMARY AND SECONDARY OUTCOME MEASURES:Reduced kidney function (CKD stages 3a-5) based on the estimated glomerular filtration rate (eGFR <60?mL/min/1.73 m2) was the primary outcome measure. Using the urine albumin-to-creatinine ratio (ACR ?30?mg/g), increased albuminuria was ascertained among adults aged 40+ years with diabetes and/or hypertension. Both outcomes were analysed using logistic regression with results summarised using OR. CKD prevalence (stages 1-5) among adults aged 40+ years was estimated including participants with an eGFR of >60?mL/min/1.73 m2 but with increased albuminuria (stages 1-2). RESULTS:Overall, 3.2% (95% CI: 2.4% to 3.8%) of adults aged 18+ in?ENS 2016-2017 had reduced kidney function. After full adjustment, participants with hypertension (OR: 2.37; 95%?CI: 1.19 to 4.74) and those with diabetes (OR: 1.66; 95% CI: 1.03 to 2.66) had significantly higher odds of reduced kidney function. In ENS 2016-2017, 15.5% (13.5% to 17.8%) of adults aged 40+ years with diabetes and/or hypertension had increased albuminuria. Being obese versus normal-weight (OR: 1.66; 95% CI: 1.08 to 2.54) and having both diabetes and hypertension versus having diabetes alone (OR: 2.30; 95% CI: 1.34 to 3.95) were significantly associated with higher odds of increased albuminuria in fully-adjusted analyses. At least 15.4% of adults aged 40+ years in ENS 2016-2017 had CKD (stages 1-5), including the 9.6% of adults at CKD stages 1-2. CONCLUSIONS:Prevention strategies and Chilean guidelines should consider the high percentage of adults aged 40 years and older at CKD stages 1-2.

SUBMITTER: Walbaum M

PROVIDER: S-EPMC7473630 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Chronic kidney disease in adults aged 18 years and older in Chile: findings from the cross-sectional Chilean National Health Surveys 2009-2010 and 2016-2017.

Walbaum Magdalena M Scholes Shaun S Pizzo Elena E Paccot Melanie M Mindell Jennifer S JS

BMJ open 20200903 9

<h4>Objectives</h4>This study estimates the prevalence of chronic kidney disease (CKD) among Chilean adults and examines its associations with sociodemographic characteristics, health behaviours and comorbidities.<h4>Design</h4>Analysis of cross-sectional data from the two most recent large nationally representative Chilean Health Surveys (Encuesta Nacional de Salud, ENS) 2009-2010 and 2016-2017.<h4>Participants</h4>Adults aged 18+ years with serum creatine data (ENS 2009-2010: n=4583; ENS 2016- ...[more]

PMID: 32883732

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Project description:BACKGROUND:Trend data on hypertension prevalence and attainment indicators at each step of the care cascade (awareness, treatment, control) are required in Chile. This study aims to quantify trends (2003-2017) in prevalence and in the proportion of individuals with hypertension attaining each step of the care cascade among adults aged 17?years or older, and to assess the impact of lowering the blood pressure (BP) thresholds used to define elevated BP on these indicators. METHODS:We used data from 2003, 2010, and 2017 Chilean national health surveys. Each year we assessed levels of (1) mean systolic (SBP) and diastolic (DBP) blood pressure, (2) hypertension prevalence (BP???140/90?mmHg or use of antihypertensive treatment), and (3) awareness, treatment, and control. Logistic regression on pooled data was used to assess trends in binary outcomes; linear regression was used to assess trends in continuous SBP and DBP. We compared levels of hypertension prevalence using two sources to ascertain antihypertensive treatment (self-reported versus medicine inventory). The 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines were used to re-define hypertension using lower thresholds (BP???130/80?mmHg). RESULTS:Hypertension prevalence was 34.0, 32.0 and 30.8% in 2003, 2010 and 2017, respectively. Levels of treated- and controlled-hypertension were significantly higher in 2017 than in 2003 (65% versus 41% for treatment, P?<?0.001; 34% versus 14% for control, P?<?0.001), while levels of awareness were stable (66% versus 59%, P?=?0.130). Awareness, treatment, and control levels were higher among females in 2003, 2010, and 2017 (P?<?0.001). Mean SBP and DBP decreased over the 15-year period, except for SBP among females on treatment. Adopting the 2017 ACC/AHA guidelines would increase hypertension prevalence by 17 and 55% in absolute and relative terms, respectively. CONCLUSIONS:Chile has experienced a positive population-wide lowering in blood pressure distribution which may be explained partly by a significant rise in levels of treated- and controlled-hypertension since 2003. Lowering the thresholds used to define elevated BP would substantially increase the financial public health challenge of further improving attainment levels at each step of the care cascade. Innovative and collaborative strategies are needed to improve hypertension management, especially among males.

Project description:BackgroundHealth-related quality of life (HRQoL) is defined as the patient's perception of their health status. HRQoL can be modified by illnesses, treatments or social and health policies. Chronic musculoskeletal pain is a modifying factor of HRQoL that leads to lower quality of life, elevated suffering and disability. Knowing HRQoL in subjects reporting chronic musculoskeletal symptoms (cMSS), like pain, discomfort or swollenness lasting more than 3 months, will provide information to health teams and organizations engaged in the Chilean health system. This study aim was to determine the relationship between HRQoL and musculoskeletal symptoms measured in three different Chilean groups: [1] without symptoms; [2] with acute symptoms; and [3] with cMSS.MethodsA secondary analysis of the 2009-10 Chilean National Health Survey (NHS) was executed to determine the relationship between HRQoL (measured with SF-12) in three MSS groups. The Chilean NHS considered a national, probabilistic, stratified and multistage sample of 5293 participants aged 15 and older; it was representative at the national, urban-rural and regional levels. A multivariate logistic regression model studied the relationship between cMSS and HRQoL, adjusted for age, sex, educational level and residence area as control variables (p < 0.05).ResultsOut of 5293 participants in the NHS 2009-10, 5276 subjects were included for analysis. The median age was 46 years (IQR 31-60), 59.4% women, a median of 10 years formal education (IQR 7-12) and an urban residence in 85.2% of the population of the NHS 2009-10. The observed population prevalence of people with cMSS was 42.6% (95% CI 40.4-44.9). Presence of cMSS is a risk factor for low HRQoL, exhibited both in the physical (OR 3.1 95% CI 2.7-3.5) and mental (OR 1.9 95% CI 1.6-2,) HRQoL dimensions, independent of control variables.ConclusionsPhysical and mental HRQoL are affected in people with cMSS, low educational level and advanced age. This is especially seen in women. This information will facilitate assessment and treatment of cMSS as a prevalent and multidimensional health problem.

Project description:Background Overweight and obesity impose a significant health burden in Australia, predominantly the middle-aged and older adults. Studies of the association between obesity and chronic diseases are primarily based on cross-sectional data, which is insufficient to deduce a temporal relationship. Using nationally representative panel data, this study aims to investigate whether obesity is a significant risk factor for type 2 diabetes, heart diseases, asthma, arthritis, and depression in Australian middle-aged and older adults. Methods Longitudinal data comprising three waves (waves 9, 13 and 17) of the Household, Income and Labour Dynamics in Australia (HILDA) survey were used in this study. This study fitted longitudinal random-effect logistic regression models to estimate the between-person differences in the association between obesity and chronic diseases. Results The findings indicated that obesity was associated with a higher prevalence of chronic diseases among Australian middle-aged and older adults. Obese adults (Body Mass Index [BMI] ≥ 30) were at 12.76, 2.05, 1.97, 2.25, and 1.96, times of higher risks of having type 2 diabetes (OR: 12.76, CI 95%: 8.88–18.36), heart disease (OR: 2.05, CI 95%: 1.54–2.74), asthma (OR: 1.97, CI 95%: 1.49–2.62), arthritis (OR: 2.25, 95% CI: 1.90–2.68) and depression (OR: 1.96, CI 95%: 1.56–2.48), respectively, compared with healthy weight counterparts. However, the study did not find any evidence of a statistically significant association between obesity and cancer. Besides, gender stratified regression results showed that obesity is associated with a higher likelihood of asthma (OR: 2.64, 95% CI: 1.84–3.80) among female adults, but not in the case of male adults. Conclusion Excessive weight is strongly associated with a higher incidence of chronic disease in Australian middle-aged and older adults. This finding has clear public health implications. Health promotion programs and strategies would be helpful to meet the challenge of excessive weight gain and thus contribute to the prevention of chronic diseases.

Dataset Information

Chronic kidney disease in adults aged 18 years and older in Chile: findings from the cross-sectional Chilean National Health Surveys 2009-2010 and 2016-2017.

Publications

Chronic kidney disease in adults aged 18 years and older in Chile: findings from the cross-sectional Chilean National Health Surveys 2009-2010 and 2016-2017.

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