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In Chile, the 2016 Chilean National Health Survey estimated the prevalence of chronic kidney disease (CKD), determined by an estimated Glomerular Filtration Rate (eGFR) below 60 mL/min/1.73m2, in 5.7% of the general population aged 40 years and older [1]. Although this prevalence has not increased significantly during the past ten years, it is expected to increase due to the aging of the Chilean population and the high prevalence of risk factors, such as diabetes mellitus, hypertension, and obesity [2,3]. Additionally, there is little data related to the prevalence of CKD in Chile based on the increase in the urinary albumin-creatinine rate (uACR). Our objective was to determine the prevalence of CKD (based on eGFR and uACR) and their cardiovascular risk factors in a Chilean cohort of an adult working population.
Prospective cohort of adult Chilean workers. Patients were evaluated in their workplaces based on the usual preventive medicine examination in the Chilean primary care system. Most patients at the time of screening were unaware of their health condition. This evaluation included clinical evaluation, measurement of serum creatinine for determination of eGFR based on CKD- EPI 2022 formula, and uACR in the morning urine. Also, we calculated risk factors based on KDIGO cardiovascular risk evaluation and the Kidney Failure Risk Equation (KFRE). The Institutional Ethics Committee approved this study. All patients delivered signed consent for participation.
CKD screening was performed on 2,014 people. Male: 54.5% (1,117). Age: 51 ± 7.0 years. 50% had high blood pressure within the hypertension range (AHA guidelines). 13% had a fasting glycemia above 126 mg/dL (within the range of diabetes based on the ADA guidelines). 43.4% were obese. The eGFR of the cohort was 93.2 ± 16.8 mL/min, with a prevalence of stage 3-4 CKD of 2.24%. uACR > 30 mg/g was found in 31.8% of the workers. When comparing the subgroup detected as high fasting glycemia versus normal fasting glycemia, there were statistically significant differences in age, prevalence of risk factors for CKD, and presence of uACR > 30 mg/g. We compared uACR in non-obese and obese patients according to body mass index and waist circumference, where uACR was higher in obese people (p<0.0001). Although KFRE was low risk overall in this cohort, the group with high fasting glycemia had worse KFRE than those with normal fasting glycemia (p<0.0001).
In Chilean workers aged 40 to 65 years old, unaware of their health condition, there is a high prevalence of CKD risk factors and significant uACR. The prevalence of CKD with eGFR < 60 ml/min was 2.24%, lower than that of this age group in the National Health Survey 2019. This study emphasizes the importance of early screening and the prevalence of CKD risk factors in this specific group.