TY - JOUR
T1 - Prevalence of chronic kidney disease and risk factors for its progression
T2 - A cross-sectional comparison of Indians living in Indian versus U.S. cities
AU - Anand, Shuchi
AU - Kondal, Dimple
AU - Montez-Rath, Maria
AU - Zheng, Yuanchao
AU - Shivashankar, Roopa
AU - Singh, Kalpana
AU - Gupta, Priti
AU - Gupta, Ruby
AU - Ajay, Vamadevan S.
AU - Mohan, Viswanathan
AU - Pradeepa, Rajendra
AU - Tandon, Nikhil
AU - Ali, Mohammed K.
AU - Narayan, K. M.Venkat
AU - Chertow, Glenn M.
AU - Kandula, Namratha
AU - Prabhakaran, Dorairaj
AU - Kanaya, Alka M.
N1 - Publisher Copyright:
© 2017 Anand et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2017/3
Y1 - 2017/3
N2 - Background While data from the latter part of the twentieth century consistently showed that immigrants to high-income countries faced higher cardio-metabolic risk than their counterparts in lowand middle-income countries, urbanization and associated lifestyle changes may be changing these patterns, even for conditions considered to be advanced manifestations of cardiometabolic disease (e.g., chronic kidney disease [CKD]). Methods and findings Using cross-sectional data from the Center for cArdiometabolic Risk Reduction in South Asia (CARRS, n = 5294) and Mediators of Atherosclerosis in South Asians Living in America (MASALA, n = 748) studies, we investigated whether prevalence of CKD is similar among Indians living in Indian and U.S. cities. We compared crude, age-, waist-to-height ratio-, and diabetes-adjusted CKD prevalence difference. Among participants identified to have CKD, we compared management of risk factors for its progression. Overall age-adjusted prevalence of CKD was similar in MASALA (14.0% [95% CI 11.8-16.3]) compared with CARRS (10.8% [95% CI 10.0-11.6]). Among men the prevalence difference was low (prevalence difference 1.8 [95% CI-1.6,5.3]) and remained low after adjustment for age, waist-to-height ratio, and diabetes status (-0.4 [-3.2,2.5]). Adjusted prevalence difference was higher among women (prevalence difference 8.9 [4.8,12.9]), but driven entirely by a higher prevalence of albuminuria among women in MASALA. Severity of CKD-i.e., degree of albuminuria and proportion of participants with reduced glomerular filtration fraction-was higher in CARRS for both men and women. Fewer participants with CKD in CARRS were effectively treated. 4% of CARRS versus 51% of MASALA participants with CKD had A1c < 7%; and 7% of CARRS versus 59% of MASALA participants blood pressure < 140/90 mmHg. Our analysis applies only to urban populations. Demographic-particularly educational attainment-differences among participants in the two studies are a potential source of bias. Conclusions Prevalence of CKD among Indians living in Indian and U.S. cities is similar. Persons with CKD living in Indian cities face higher likelihood of experiencing end-stage renal disease since they have more severe kidney disease and little evidence of risk factor management.
AB - Background While data from the latter part of the twentieth century consistently showed that immigrants to high-income countries faced higher cardio-metabolic risk than their counterparts in lowand middle-income countries, urbanization and associated lifestyle changes may be changing these patterns, even for conditions considered to be advanced manifestations of cardiometabolic disease (e.g., chronic kidney disease [CKD]). Methods and findings Using cross-sectional data from the Center for cArdiometabolic Risk Reduction in South Asia (CARRS, n = 5294) and Mediators of Atherosclerosis in South Asians Living in America (MASALA, n = 748) studies, we investigated whether prevalence of CKD is similar among Indians living in Indian and U.S. cities. We compared crude, age-, waist-to-height ratio-, and diabetes-adjusted CKD prevalence difference. Among participants identified to have CKD, we compared management of risk factors for its progression. Overall age-adjusted prevalence of CKD was similar in MASALA (14.0% [95% CI 11.8-16.3]) compared with CARRS (10.8% [95% CI 10.0-11.6]). Among men the prevalence difference was low (prevalence difference 1.8 [95% CI-1.6,5.3]) and remained low after adjustment for age, waist-to-height ratio, and diabetes status (-0.4 [-3.2,2.5]). Adjusted prevalence difference was higher among women (prevalence difference 8.9 [4.8,12.9]), but driven entirely by a higher prevalence of albuminuria among women in MASALA. Severity of CKD-i.e., degree of albuminuria and proportion of participants with reduced glomerular filtration fraction-was higher in CARRS for both men and women. Fewer participants with CKD in CARRS were effectively treated. 4% of CARRS versus 51% of MASALA participants with CKD had A1c < 7%; and 7% of CARRS versus 59% of MASALA participants blood pressure < 140/90 mmHg. Our analysis applies only to urban populations. Demographic-particularly educational attainment-differences among participants in the two studies are a potential source of bias. Conclusions Prevalence of CKD among Indians living in Indian and U.S. cities is similar. Persons with CKD living in Indian cities face higher likelihood of experiencing end-stage renal disease since they have more severe kidney disease and little evidence of risk factor management.
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U2 - 10.1371/journal.pone.0173554
DO - 10.1371/journal.pone.0173554
M3 - Article
C2 - 28296920
AN - SCOPUS:85015304978
SN - 1932-6203
VL - 12
JO - PloS one
JF - PloS one
IS - 3
M1 - e0173554
ER -
