PREVALENCE AND ASSOCIATED FACTORS IN THE DECLINE OF RENAL FUNCTION AMONG OUTPATIENTS ATTENDING A COMMUNITY HOSPITAL, CENTRAL THAILAND

  • Chatchaya Chamnanmont Queen Savang Vadhana Memorial Hospital, Chonburi, Thailand
  • Napat Chaiyakham Fort Kawila Hospital, Chiang Mai, Thailand
  • Sittirat Kaensingh Fort Chakrabongse Hospital, Prachin Buri, Thailand
  • Wisit Kaewput Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Ram Rangsin Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Boonsub Sakboonyarat Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
Keywords: Decline of renal function, Community hospital, NSAIDs, Pulse pressure, Prevalence, Thailand

Abstract

Introduction: Chronic kidney disease (CKD) is recognized as global public health issue especially affecting developing countries including Thailand. The epidemiologic data in the decline of renal function and the risk factors among Thai patients especially in community hospital settings were limited.

Methods: A cross-sectional study was conducted to identify the prevalence and associated risk factors in the decline of renal function among outpatients in Thaluang Community Hospital, Lop Buri Province, central Thailand, between November 1, 2018 and October 31, 2019. The decline in renal function was defined by glomerular filtration rate (GFR) <60 mL/min/1.73m2. Multivariate logistic regression analysis was performed to obtain the adjusted odds ratios (AOR) and 95% confidence interval (CI) of the factors related to the decline of renal function.

Results: A total of 874 outpatients participated in the study. The overall prevalence in the decline of renal function (eGFR <60 mL/min/1.73m2) was 20.3% (95% CI; 17.5%-22.9%). Among male participants, the prevalence in the decline of renal function was 21.1% (95%CI; 16.7%-25.5%) while it totaled 19.7% (95%CI; 16.3%-23.1%) among females. The independent associated factors in the decline of renal function included greater age (AOR 1.07; 95% CI=1.05-1.09), history of NSAIDs used (AOR 2.97; 95% CI=1.85-4.79) and elevated pulse pressure (PP) >75th percentile (AOR 1.64; 95% CI=1.07-2.53)

Conclusion: We reported the prevalence in the decline of renal function among outpatients in a Thai community hospital which was comparable with the national level. Advanced age, history of NSAIDs used and PP were related to reduced kidney function. Therefore, effective health interventions should be conducted especially, appropriate NSAIDs used among outpatients.

Downloads

Download data is not yet available.

References

Abraham G, Varughese S, Thandavan T, Iyengar A, Fernando E, Naqvi SA, et al. Chronic kidney disease hotspots in developing countries in South Asia. Clin Kidney J 2016; 9: 135–41.

Awuah KT, Finkelstein SH, Finkelstein FO. Quality of life of chronic kidney disease patients in developing countries. Kidney Int Suppl 2013; 3: 227–9.

Ingsathit A, Thakkinstian A, Chaiprasert A, Sangthawan P, Gojaseni P, Kiattisunthorn K, et al. Prevalence and risk factors of chronic kidney disease in the Thai adult population: Thai SEEK study. Nephrol Dial Transplant 2010; 25: 1567–75.

Eriksen BO, Ingebretsen OC. The progression of chronic kidney disease: A 10-year populationbased study of the effects of gender and age. Kidney Int 2006; 69: 375–82.

Rifkin DE, Shlipak MG, Katz R, Fried LF, Siscovick D, Chonchol M, et al. Rapid kidney function decline and mortality risk in older adults. Arch Inter Med 2008; 168: 2212–8.

Kazancioğlu R. Risk factors for chronic kidney disease: an update. Kidney Int Suppl 2013; 3: 368–71.

Duan J, Wang C, Liu D, Qiao Y, Pan S, Jiang D, et al. Prevalence and risk factors of chronic kidney disease and diabetic kidney disease in Chinese rural residents: a cross-sectional survey. Sci Rep 2019; 9: 10408.

Tótoli C, Carvalho AB, Ammirati AL, Draibe SA, Canziani MEF. Associated factors related to chronic kidney disease progression in elderly patients. PloS One 2019; 14: e0219956

ICD-10 World Health Organization: international statistical classification of diseases and related health problems: 10th reprint in 2015. http://www.who.int/classifications

Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro 3rd AF, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med 2009; 150: 604–12.

Levey AS, de Jong PE, Coresh J, Nahas ME l., Astor BC, Matsushita K, et al. The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int 2011; 80: 17–28.

Hirst JA, Hill N, O’ Ordóñez CA, Lasserson D, McManus RJ,Ogburn E. et al. Prevalence of chronic kidney disease in the community using data from OxRen: A UK populationbased cohort study. Br J Gen Pract 2020; 70: e285-93.

Chukwuonye II, Ohagwu KA, Adelowo OO, Chuku A, Obi EC, Onwuchekwa U, et al. Prevalence and Predictors of Chronic Kidney Disease in a Semiurban Community in Lagos. Inter J Nephrol 2019; 2019: 1625837

Jayasekara JMKB, Dissanayake DM, Sivakanesan R, Ranasinghe A, Karunarathna RH, Priyantha Kumara GWG. Epidemiology of chronic kidney disease, with special emphasis on chronic kidney disease of uncertain etiology, in the North Central Region of Sri Lanka. J Epi 2015; 25: 275-80.

Delanaye P, Jager KJ, Bökenkamp A, Christensson A, Dubourg L, Eriksen BO, et al. CKD: A call for an age-adapted definition. J Am Soc Nephrol 2019; 30: 1785-1850.

Pan Y, Zhang L, Wang F, Li X, Wang H. Status of non-steroidal anti-inflammatory drugs use and its association with chronic kidney disease: A cross-sectional survey in China. Nephrol 2014; 19: 655-60.

Gooch K, Culleton BF, Manns BJ, Zhang J, Alfonso H, Tonelli M, et al. NSAID Use and Progression of Chronic Kidney Disease. Am J Med 2007; 120: 280.e1-7.

Lucas GNC, Leitão ACC, Alencar RL, Xavier RMF, Daher EDF, Silva Junior GB da. Pathophysiological aspects of nephropathy caused by non-steroidal anti-inflammatory drugs. J Bras Nefrol 2019: 41: 124–30.

Levey AS, Coresh J. Chronic kidney disease. Lancet 2012; 379: 165–80.

Atta MG, Whelton A. Acute renal papillary necrosis induced by ibuprofen. Am J Ther 1997; 4 : 55–60.

Luanghirun P, Tanaboriboon P, Mahissarakul P, Lertvivatpong N. Prevalence and associated factors of regular nonsteroidal anti-inflammatory drugs used in a rural community, Thailand. Glob J Health Sci 2017; 9: 58.

Raina R, Polaconda S, Nair N, Chakraborty R, Sethi S, Krishnappa V, et al. Association of pulse pressure, pulse pressure index, and ambulatory arterial stiffness index with kidney function in a cross-sectional pediatric chronic kidney disease cohort from the CKiD study. J Clin Hypertens 2020; 22: 1059–69.

Townsend RR, Chirinos JA, Parsa A, Weir MA, Sozio SM, Lash JP, et al. Central pulse pressure in chronic kidney disease: A chronic renal insufficiency cohort ancillary study. Hypertension 2010; 56: 518–24.

Euswas N, Phonnopparat N, Morasert K, Thakhampaeng P, Kaewsanit A, Mungthin M, et al. National trends in the prevalence of diabetic retinopathy among Thai patients with type 2 diabetes and its associated factors from 2014 to 2018. PLoS One 2021; 16: e0245801.

Steppan J, Barodka V, Berkowitz DE, Nyhan D. Vascular Stiffness and Increased Pulse Pressure in the Aging Cardiovascular System. Cardio Res Prac 2011; 2011: 263585.

Avolio AP, Kuznetsova T, Heyndrickx GR, Kerkhof PLM, Li JK-J. Arterial Flow, Pulse Pressure and Pulse Wave Velocity in Men and Women at Various Ages. In: Kerkhof PLM, Miller VM, editors. Sex-Specific Analysis of Cardiovascular Function Cham: Springer International Publishing; 2018. pp. 153–68.

Xiao W, Wen Y, Ye P, Wang F, Cao R, Bai Y, et al. Noninvasive central pulse pressure is an independent determinant of renal function. J Clin Hypertens 2020; 22: 234–42.

Published
2021-11-09
How to Cite
1.
Chamnanmont C, Chaiyakham N, Kaensingh S, Kaewput W, Rangsin R, Sakboonyarat B. PREVALENCE AND ASSOCIATED FACTORS IN THE DECLINE OF RENAL FUNCTION AMONG OUTPATIENTS ATTENDING A COMMUNITY HOSPITAL, CENTRAL THAILAND. J Southeast Asian Med Res [Internet]. 2021Nov.9 [cited 2022Jan.25];5(2):58-6. Available from: https://www.jseamed.org/index.php/jseamed/article/view/90
Section
Original Articles