Prevalence and Severity of Chronic Kidney Disease in Haiti.
Academic Article
Overview
abstract
BACKGROUND: Chronic kidney disease (CKD) is a major cause of morbidity and mortality in lower-income countries. However, population-based studies characterizing the epidemiology of CKD in these settings are lacking. The study objective was to describe the epidemiology of CKD in a population-based cohort in urban Haiti, including estimates of the prevalence by CKD stage, the magnitude of associated factors with CKD, and the proportion on guideline-recommended treatment. METHODS: We assessed the prevalence of CKD and associated risk factors in the population-based Haiti Cardiovascular Disease Cohort. We analyzed cross-sectional data from 2,424 adults who completed a clinical exam, risk factor surveys, and laboratory measurements for serum creatinine, urinary albumin, and urinary creatinine. We compared our results to U.S. estimates from the National Health and Nutrition Examination Survey. CKD was defined as either a reduced eGFR <60 mL/min/1.73m2 or urinary albumin to creatinine ratio (UACR) ≥30 mg/g according to Kidney Disease: Improving Global Outcomes guidelines. Multivariable logistic regression identified associated factors with CKD. RESULTS: Mean age was 42 years, 57% of participants were female, and 69% lived in extreme poverty on ≤1 U.S. dollar per day. The age-standardized prevalence of CKD was 14% (95% confidence interval: 12-15). The age-standardized prevalence of reduced eGFR and elevated UACR were 3% (95% CI: 2-4) and 11% (95% CI: 10-13), respectively. Diabetes (adjusted odds ratio [aOR]: 4.1; 95% CI: 2.7-6.2) and hypertension (aOR: 2.9; 95% CI: 2.0-4.2) were significantly associated with CKD. Only 12% of participants with CKD and albuminuria were on guideline-recommended agents like ACE inhibitors and ARBs. CONCLUSIONS: In a large population-based cohort of Haitian adults, CKD was highly associated with both diabetes and hypertension. The proportion of participants with CKD on treatment was low, underscoring the need for strengthening clinical management and renal care health infrastructure in Haiti.
