Prevalence of chronic kidney disease and risk factors for its progression

A cross-sectional comparison of Indians living in Indian versus U.S. cities

Shuchi Anand, Dimple Kondal, Maria Montez-Rath, Yuanchao Zheng, Roopa Shivashankar, Kalpana Singh, Priti Gupta, Ruby Gupta, Vamadevan S. Ajay, Viswanathan Mohan, Rajendra Pradeepa, Nikhil Tandon, Mohammed K. Ali, K. M.Venkat Narayan, Glenn M. Chertow, Namratha R Kandula, Dorairaj Prabhakaran, Alka M. Kanaya

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Article numbere0173554
JournalPloS one
Volume12
Issue number3
DOIs
StatePublished - Mar 1 2017

Fingerprint

kidney diseases
Chronic Renal Insufficiency
risk factors
Albuminuria
Medical problems
diabetes
income
Urbanization
Urban Population
Risk Management
Kidney Diseases
Risk Reduction Behavior
Disease Management
urban population
South Asia
disease prevalence
risk reduction
Chronic Kidney Failure
Life Style
Blood pressure

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Anand, Shuchi ; Kondal, Dimple ; Montez-Rath, Maria ; Zheng, Yuanchao ; Shivashankar, Roopa ; Singh, Kalpana ; Gupta, Priti ; Gupta, Ruby ; Ajay, Vamadevan S. ; Mohan, Viswanathan ; Pradeepa, Rajendra ; Tandon, Nikhil ; Ali, Mohammed K. ; Narayan, K. M.Venkat ; Chertow, Glenn M. ; Kandula, Namratha R ; Prabhakaran, Dorairaj ; Kanaya, Alka M. / Prevalence of chronic kidney disease and risk factors for its progression : A cross-sectional comparison of Indians living in Indian versus U.S. cities. In: PloS one. 2017 ; Vol. 12, No. 3.
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title = "Prevalence of chronic kidney disease and risk factors for its progression: A cross-sectional comparison of Indians living in Indian versus U.S. cities",
abstract = "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.",
author = "Shuchi Anand and Dimple Kondal and Maria Montez-Rath and Yuanchao Zheng and Roopa Shivashankar and Kalpana Singh and Priti Gupta and Ruby Gupta and Ajay, {Vamadevan S.} and Viswanathan Mohan and Rajendra Pradeepa and Nikhil Tandon and Ali, {Mohammed K.} and Narayan, {K. M.Venkat} and Chertow, {Glenn M.} and Kandula, {Namratha R} and Dorairaj Prabhakaran and Kanaya, {Alka M.}",
year = "2017",
month = "3",
day = "1",
doi = "10.1371/journal.pone.0173554",
language = "English (US)",
volume = "12",
journal = "PLoS One",
issn = "1932-6203",
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Anand, S, Kondal, D, Montez-Rath, M, Zheng, Y, Shivashankar, R, Singh, K, Gupta, P, Gupta, R, Ajay, VS, Mohan, V, Pradeepa, R, Tandon, N, Ali, MK, Narayan, KMV, Chertow, GM, Kandula, NR, Prabhakaran, D & Kanaya, AM 2017, 'Prevalence of chronic kidney disease and risk factors for its progression: A cross-sectional comparison of Indians living in Indian versus U.S. cities', PloS one, vol. 12, no. 3, e0173554. https://doi.org/10.1371/journal.pone.0173554

Prevalence of chronic kidney disease and risk factors for its progression : A cross-sectional comparison of Indians living in Indian versus U.S. cities. / Anand, Shuchi; Kondal, Dimple; Montez-Rath, Maria; Zheng, Yuanchao; Shivashankar, Roopa; Singh, Kalpana; Gupta, Priti; Gupta, Ruby; Ajay, Vamadevan S.; Mohan, Viswanathan; Pradeepa, Rajendra; Tandon, Nikhil; Ali, Mohammed K.; Narayan, K. M.Venkat; Chertow, Glenn M.; Kandula, Namratha R; Prabhakaran, Dorairaj; Kanaya, Alka M.

In: PloS one, Vol. 12, No. 3, e0173554, 01.03.2017.

Research output: Contribution to journalArticle

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 R

AU - Prabhakaran, Dorairaj

AU - Kanaya, Alka M.

PY - 2017/3/1

Y1 - 2017/3/1

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

VL - 12

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 3

M1 - e0173554

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