GEOGRAPHIC DISTRIBUTION AND HOSPITAL-BASED INCIDENCE AND PREVALENCE OF CHRONIC KIDNEY DISEASE IN PATIENTS ADMITTED AT A TERTIARY GOVERNMENT HOSPITAL

Chronic kidney disease (CKD) remains a major global health threat, disproportionately affecting low- and middle-income countries where health infrastructure and access to renal replacement therapy are limited. The Philippines ranks among Southeast Asia’s highest in CKD prevalence, yet region-specific data from Mindanao are lacking. Establishing local epidemiologic baselines is vital to guide prevention, resource allocation, and policy formulation. This study aimed to determine the hospital-based incidence, prevalence, and geographic distribution of CKD among adult patients admitted at a 600-bed tertiary referral hospital in Cagayan de Oro City from May 2024 to May 2025. 

A retrospective, cross-sectional descriptive study was conducted at a tertiary referral center in Cagayan de Oro City, Northern Mindanao from May 1, 2024 to May 31, 2025. Adult inpatients of ≥18 years old with permanent resident addresses in Mindanao and with a documented diagnosis of CKD (ICD 10 N18.1-N18.9) on discharge were included. Data on demographics, comorbidities, and geographic origin were collected from medical records. To protect patient identity, all extracted data was de-identified such as patient names, birthdates, contact numbers and hospital numbers. Other personal informations such as sex, religion, civil status, occupation, social service classification were removed and replaced with unique coded identifiers (Table 1). The re-identification was stored on a separate, encrypted, password-protected file accessible only to the principal investigator. Incidence and prevalence rates were computed relative to the total hospital admissions. Geographic mapping of patient addresses was visualized using R statistical programming through its heat-map analysis.

Among 32,378 total admissions, 1,207 (3.73%) had CKD, of which 551 (1.70%) were newly diagnosed (Table 3). The mean age was 53.97 ± 13.99 years, with near-equal sex distribution (female 50.8%, male 49.2%). Most patients were unemployed (81.5%), married (59.5%), and classified under social service category C (patients whose per capita household income is above the poverty threshold but still with limited capacity to pay) (Table 2). Middle-aged adults (40-59 years) represent the largest proportion of CKD admissions, accounting for 45.9% of cases (Figure 1). The leading causes of CKD were hypertension (35.7%) and diabetes mellitus (34.8%), followed by chronic glomerulonephritis (16.2%) (Figure 2-3). The majority presented with CKD Stage 5 (82.4%), and 98.4% were on dialysis—predominantly hemodialysis (95.8%) (Figure 4). Region X (Northern Mindanao) accounted for 97.7% of admissions, with clustering around Cagayan de Oro City and adjacent municipalities (Figure 5-8).

The incidence and prevalence of CKD among hospital admissions in Northern Mindanao indicate a significant and geographically concentrated disease burden. Hypertension and diabetes remain the dominant etiologies, with late-stage presentation and high dependence on hemodialysis. These findings underscore the urgent need for early CKD screening, preventive nephrology programs, and equitable resource distribution—particularly in high-density and underserved areas of Mindanao.