CHRONIC KIDNEY DISEASE IN NEPAL: FINDINGS FROM A COMMUNITY-BASED SURVEY

Introduction:

Chronic kidney disease (CKD) is a major public health problem in Nepal and a rapidly growing non-communicable disease globally. In this study we aim to assess the community prevalence of CKD in the COBIN cohort.  

Methods:

Data was collected from COBIN cohort participants in 2024. COBIN is a longitudinal population-based cohort for studying non-communicable diseases in Nepal by recruiting 2,815 participants in 2015.  A structured questionnaire adopted from the DEGREE protocol was administered. Blood samples were collected to measure serum creatinine, lipid panel, and hemoglobin A1c. Urine protein was assessed with a dipstick. The estimated glomerular filtration rate (eGFR) was calculated using the 2021 CKD-EPI equation. CKD was classified as stage 1-5 based on eGFR of ≥90, 60-89, 30-59, 15-29, < 15 mL/min/1.73m2 respectively. Statistical analysis was performed using Stata.  

Results:

A total of 2,158 participants (mean age: 55 years (SD ± 10); 67% female; 77% of 2015 cohort baseline participants) were surveyed. The median eGFR was 97.75 mL/min/1.73m2 (IQR 26.44). Participants with diabetes and hypertension had a lower eGFR, the difference in mean eGFR 2.45 mL/min/1.73m2 and 3.03 mL/min/1.73m2, respectively.  The prevalence of CKD stages 3-5 was found to be 5.4%, (n=116), similar among men and women and varied according to ethnicity (7.3% among Dalit vs 4.8% among Bramin/Chhetri). CKD stages 3-5 was more common in adults 65 and older (8.4%) compared to people aged 45-64 (5.2%) or 18-44 (2.6%). CKD stages 3-5 prevalence was higher among those who work outdoors than those who work indoors. The prevalence of CKD stages 3-5 was higher in people with diabetes (6.4%) compared to people without (5.0%) and higher in those with hypertension (6.1%) compared to those without hypertension (4.5%). There was no difference in the prevalence of CKD stages 3-5 of those obese (BMI > 30) versus not obese. 17.2% (n=20) of people with CKD stages 3-5 were less than 50 years old.  Further, 25.0% (n=5) of those under 50 years old did not have diabetes or hypertension and were not overweight (BMI<25). 

Conclusions:

The prevalence reported from this study is lower than other estimates for low- and middle-income countries. However, the high rate of CKD stages 3-5 among adults less than 50 years old demands further research to better understand their risk factors.  

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.