The burden of chronic kidney disease of uncertain aetiology in Anuradhapura District

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Thilanga Ruwanpathirana

Ministry of Health, Sri Lanka

: J Nephrol Ren Dis

Abstract

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Introduction: Chronic Kidney Disease of unknown aetiology (CKDu) is known as a problem among paddy farmers of the North Central province. Ministry of Health published a three-tiered epidemiological case definition in 2016 as suspected, probable and confirmed CKDu. Suspected CKDu provides a uniform method to estimate the burden in epidemiological studies and is defined as the presence of essential criteria of eGFR<60 mL/min and/or albuminuria ≥30 mg/g. Among those satisfying essential criteria, those with urine protein: creatinine ratio >2 g/g creatinine or urine albumin: creatinine ratio >0.3 g/g creatinine; hypertensive on >2 drugs or untreated blood pressure >160/100 mmHg; history of diabetes or being on treatment or capillary random plasma glucose >200 mg/dL were excluded. Objectives: To assess the prevalence of suspected CKDu in the Anuradhapura District. Methods: A cross-sectional survey in five Gramaniladhari (GN) areas of Anuradhapura District included adults >18 years resident for the past 6 months other than pregnant and undergoing treatment for cancers. The study was based on the published standardized international protocol degree. A sample of 1000 per area was required to estimate the prevalence with 2.5% precision. Recruiting the study units was through a household survey and laboratory testing was in clinics organized in the locality. Medical history was through an interviewer-administered questionnaire. Laboratory testing was done at Anuradhapura Teaching Hospital. Results: The study included 4803 with a response rate of 88.7%. A majority were females (68.2%) and 46.3% were 31-50 years old. Most males (85.7%) were full time/part time farmers. The prevalence of suspected CKDu was 10.7% (95% CI 9.8-11.7) with a marked male preponderance (males 17.5% vs. females 6%). Conclusion: Prevalence of suspected CKDu is a considerable public health problem. Periodic estimation using the same case definition and protocol is recommended to observe the trends.

Biography

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E-mail: thilangar@yahoo.com