Chronic kidney disease in patients at high risk of cardiovascular disease in the United Arab Emirates: A population-based study

Chronic kidney disease has become an increasingly significant clinical and public health issue, accounting for 1.1 million deaths worldwide. Information on the epidemiology of chronic kidney disease and associated risk factors is limited in the United Arab Emirates. Therefore, this study aimed to evaluate the incidence and causes of chronic kidney disease stages 3–5 in adult United Arab Emirates nationals with or at high risk of cardiovascular disease. This retrospective study included 491 adults with or at high risk of cardiovascular disease (diabetes mellitus or associated clinical disease) who attended outpatient clinics at a tertiary care hospital in Al-Ain, United Arab Emirates. Estimated glomerular filtration rate was assessed every 3 months from baseline to June 30, 2017. Chronic kidney disease stages 3–5 were defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m2 for ≥ 3 months. Multivariable Cox's proportional hazards analysis was used to determine the independent risk factors associated with developing chronic kidney disease stages 3–5. The cumulative incidence of chronic kidney disease stages 3–5 over a 9-year period was 11.4% (95% confidence interval 8.6, 14.0). The incidence rate of these disease stages was 164.8 (95% confidence interval 121.6, 207.9) per 10,000 person-years. The independent risk factors for developing chronic kidney disease stages 3–5 were older age, history of coronary heart disease, history of diabetes mellitus, and history of smoking. These data may be useful to develop effective strategies to prevent chronic kidney disease development in high-risk United Arab Emirates nationals.

[1]  F. Dekker,et al.  Performance of the Cockcroft-Gault, MDRD, and new CKD-EPI formulas in relation to GFR, age, and body size. , 2010, Clinical journal of the American Society of Nephrology : CJASN.

[2]  O. Harrison,et al.  A profile and approach to chronic disease in Abu Dhabi , 2012, Globalization and Health.

[3]  C. Lenfant,et al.  National High Blood Pressure Education Program. , 1986, Journal of the American Optometric Association.

[4]  L. Valente,et al.  Smoking as risk factor for chronic kidney disease: systematic review. , 2014, Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia.

[5]  S. Hallan,et al.  Smoking: a risk factor for progression of chronic kidney disease and for cardiovascular morbidity and mortality in renal patients--absence of evidence or evidence of absence? , 2008, Clinical journal of the American Society of Nephrology : CJASN.

[6]  H. Parving Diabetic nephropathy: prevention and treatment. , 2001, Kidney international.

[7]  F. Azizi,et al.  Incidence of Chronic Kidney Disease and Its Risk Factors, Results of Over 10 Year Follow Up in an Iranian Cohort , 2012, PloS one.

[8]  N. Nagelkerke,et al.  Prevalence of diabetes mellitus and its complications in a population-based sample in Al Ain, United Arab Emirates. , 2007, Diabetes research and clinical practice.

[9]  Ajay K. Singh,et al.  Chronic Kidney Disease in the Arab World: A Call for Action , 2012, Nephron Clinical Practice.

[10]  F. Hobbs,et al.  Global Prevalence of Chronic Kidney Disease – A Systematic Review and Meta-Analysis , 2016, PloS one.

[11]  R. Jiménez-García,et al.  Five-Year Incidence of Chronic Kidney Disease (Stage 3-5) and Associated Risk Factors in a Spanish Cohort: The MADIABETES Study , 2015, PloS one.

[12]  G. Eknoyan,et al.  Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[13]  E. Bae,et al.  Determinants and burden of chronic kidney disease in a high-risk population in Korea: results from a cross-sectional study , 2016, The Korean journal of internal medicine.

[14]  Shaohua Wang,et al.  Diabetes mellitus as a risk factor for incident chronic kidney disease and end-stage renal disease in women compared with men: a systematic review and meta-analysis , 2016, Endocrine.

[15]  K. Chien,et al.  Risk Factors for Development and Progression of Chronic Kidney Disease , 2016, Medicine.

[16]  Maarten W. Taal,et al.  The burden of comorbidity in people with chronic kidney disease stage 3: a cohort study , 2015, BMC Nephrology.

[17]  S. Seliger,et al.  Cigarette Smoking and Incident Chronic Kidney Disease: A Systematic Review , 2007, American Journal of Nephrology.

[18]  J. Mckenney,et al.  Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). , 2001, JAMA.

[19]  J. Coresh,et al.  Plasma lipids and risk of developing renal dysfunction: the atherosclerosis risk in communities study. , 2000, Kidney international.

[20]  O. Bakoush,et al.  Provision of care for chronic kidney disease by non-nephrologists in a developing nation: a national survey , 2016, BMJ Open.

[21]  Craig S. Wong,et al.  Risk factors for progression of chronic kidney disease , 2010, Current opinion in pediatrics.

[22]  T. Sairenchi,et al.  Risk factors for chronic kidney disease in a community-based population: a 10-year follow-up study. , 2007, Kidney international.

[23]  D. Grobbee,et al.  Accelerated decline and prognostic impact of renal function after myocardial infarction and the benefits of ACE inhibition: the CATS randomized trial. , 2003, European heart journal.

[24]  G. Remuzzi,et al.  Prevention and treatment of diabetic renal disease in type 2 diabetes: the BENEDICT study. , 2006, Journal of the American Society of Nephrology : JASN.

[25]  M. Woodward,et al.  Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate. , 2012, JAMA.

[26]  A. Levin Identification of patients and risk factors in chronic kidney disease--evaluating risk factors and therapeutic strategies. , 2001, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[27]  N. Unwin,et al.  Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Detection, Evaluation, and Treatment of High Blood Cholesterol Education Program (NCEP) Expert Panel on Executive Summary of the Third Report of the National , 2009 .

[28]  C. Schmid,et al.  A new equation to estimate glomerular filtration rate. , 2009, Annals of internal medicine.

[29]  O. Harrison,et al.  Weqaya: a population-wide cardiovascular screening program in Abu Dhabi, United Arab Emirates. , 2012, American journal of public health.

[30]  Bashir Aden,et al.  Cigarette, Water-pipe, and Medwakh Smoking Prevalence Among Applicants to Abu Dhabi's Pre-marital Screening Program, 2011 , 2013, International journal of preventive medicine.

[31]  R. Malekzadeh,et al.  Prevalence and determinants of chronic kidney disease in northeast of Iran: Results of the Golestan cohort study , 2017, PloS one.

[32]  M. F. Yusoff,et al.  A population-based study measuring the prevalence of chronic kidney disease among adults in West Malaysia. , 2013, Kidney international.

[33]  Rachel A. Nugent,et al.  The Burden of Chronic Kidney Disease on Developing Nations: A 21st Century Challenge in Global Health , 2011, Nephron Clinical Practice.

[34]  P. Heagerty,et al.  Clinical Manifestations of Kidney Disease Among US Adults With Diabetes, 1988-2014. , 2016, JAMA.

[35]  P. Whelton,et al.  Risk of end-stage renal disease in diabetes mellitus: a prospective cohort study of men screened for MRFIT. Multiple Risk Factor Intervention Trial. , 1997, JAMA.

[36]  J. Franch-Nadal,et al.  Prevalence of chronic kidney disease in patients with type 2 diabetes in Spain: PERCEDIME2 study , 2013, BMC Nephrology.

[37]  S. Laehn,et al.  Comparisons of GFR estimation using the CKD Epidemiology Collaboration (CKD-EPI) equation and other creatinine-based equations in Asian population: a systematic review , 2016, International Urology and Nephrology.

[38]  P. O S I T I O N S T A T E M E N T,et al.  Diagnosis and Classification of Diabetes Mellitus , 2011, Diabetes Care.

[39]  P. Clark,et al.  Identification of modifiable chronic kidney disease risk factors by gender in an African-American metabolic syndrome cohort. , 2010, Nephrology nursing journal : journal of the American Nephrology Nurses' Association.

[40]  M. Zeier,et al.  Kidney and hypertension. , 2002, Kidney international. Supplement.

[41]  R. Kazancioglu Risk factors for chronic kidney disease: an update , 2013, Kidney international supplements.

[42]  C. Weill The Burden of Chronic Kidney Disease on Developing Nations: A 21st Century Challenge in Global Health , 2016 .

[43]  G. Remuzzi,et al.  Progression, remission, regression of chronic renal diseases , 2001, The Lancet.

[44]  Effect of intensive therapy on the development and progression of diabetic nephropathy in the Diabetes Control and Complications Trial. The Diabetes Control and Complications (DCCT) Research Group. , 1995, Kidney international.

[45]  A. Majeed,et al.  Prevalences of overweight, obesity, hyperglycaemia, hypertension and dyslipidaemia in the Gulf: systematic review , 2011, JRSM short reports.

[46]  P. Whelton,et al.  Risk of End-stage Renal Disease in Diabetes Mellitus: A Prospective Cohort Study of Men Screened for MRFIT , 1997 .

[47]  Daniel Levy,et al.  Predictors of new-onset kidney disease in a community-based population. , 2004, JAMA.

[48]  Daniel W. Jones,et al.  The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. , 2003, JAMA.

[49]  D. Marcelli,et al.  Epidemiology and referral patterns of patients with chronic kidney disease in the Emirate of Abu Dhabi. , 2015, Saudi Journal of Kidney Diseases and Transplantation.

[50]  R. Nelson,et al.  Estimation of chronic kidney disease incidence from prevalence and mortality data in American Indians with type 2 diabetes , 2017, PloS one.

[51]  M. Hall National Heart, Lung, and Blood Institute , 2020, The Grants Register 2022.