Community-based screening to determine the prevalence, health and nutritional status of patients with CKD in rural and peri-urban Bangladesh

Mohammad Habibur Rahman Sarker; Michiko Moriyama; Harun Ur Rashid; Mohammod Jobayer Chisti; Md Moshiur Rahman; Sumon Kumar Das; Aftab Uddin; Samir Kumar Saha; Shams El Arifeen; Tahmeed Ahmed; Asg Faruque

doi:10.1177/20406223211035281

Community-based screening to determine the prevalence, health and nutritional status of patients with CKD in rural and peri-urban Bangladesh

Ther Adv Chronic Dis. 2021 Jul 31:12:20406223211035281. doi: 10.1177/20406223211035281. eCollection 2021.

Affiliations

¹ Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
² Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
³ Kidney Foundation Hospital and Research Institute, Dhaka, Bangladesh.
⁴ International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh.
⁵ Menzies - School of Health Research, Charles Darwin University, Darwin, Australia.
⁶ Dhaka Shishu Hospital, Dhaka, Bangladesh.

Abstract

Background: Studies have labelled chronic kidney disease (CKD) among the adult population in urban Bangladesh. To address knowledge gaps on CKD, we aimed to generate data on prevalence, health and nutrition of CKD individuals living in rural and peri-urban Bangladesh.

Methods: Participants were recruited from the Mirzapur Demographic Surveillance System by age-stratified random sampling. We screened participants by measuring serum creatinine and urine albumin to creatinine ratio, and collected socio-demographic, lifestyles and health information (phase I). After 3 months (phase II), we repeated the urine and blood tests as per the Kidney Disease Outcomes Quality Initiative guidelines. The glomerular filtration rate was calculated using the CKD Epidemiology Collaboration equation.

Results: Among 928 participants, 872 completed the study. In phase I, probable CKD cases were 281 (32.2%); in phase II, confirmed cases were 192 (22.0%) (stage 1, 4.0%; stage 2, 11.8%; stage 3, 5.5%; stage 4, 0.6%; stage 5, 0.1%). In multivariable analysis, associated factors for prevalent CKD included aged ⩾60 years [adjusted odds ratio (aOR) 5.02; 95% confidence interval (CI) 1.85-13.65], hypertension (aOR 3.08; 95% CI 2.07-4.59), diabetes (aOR 2.52; 95% CI 1.60-3.96), presence of red blood cell in urine (aOR 3.20; 95% CI 1.71-5.98) and anemia (aOR 2.50; 95% CI 1.63-3.84).

Conclusions: This is the first ever research on CKD prevalence in rural and peri-urban Bangladesh and recorded about 22%, which is higher than urban settings. Monitoring systems are needed to evaluate the overall burden and to mitigate risk factors with an emphasis on the rural and peri-urban population.

Keywords: Bangladesh; chronic kidney disease; health and nutritional status; prevalence; rural and peri-urban.