prevalence-of-chronic-kidney-disease-and-associated-factors-among-the-chinese-population-in-taian-china/

Chronic kidney disease (CKD) has become a major global public health problem with a substantial economic burden. Globally, in 2017, there were 697.5 million cases (the prevalence was estimated as 9.1%) of CKD, and China had the highest number of CKD patients (132.3 million cases and 9.5% prevalence) [1]. Meanwhile, CKD ranked 17th in the list of causes of total deaths worldwide in 1990 and rose to 12th in 2017 [1]. CKD is widely regarded as a disease multiplier because it increases the risk of other common related complications, including acute kidney injury [2], mineral and bone diseases [3], anemia [4], and death from all causes and cardiovascular diseases [5]. In both developing and developed countries, less than 10% of patients with CKD are aware of their disease because most patients have an insidious onset and have no symptoms in the early stage [1]. Patients with stages 3–5 CKD account for nearly half of CKD cases worldwide [1], and most of them gradually develop end-stage renal disease (ESRD) and require dialysis or renal transplantation due to the irreversible nature of CKD stages 3–5 [6].

The rapid increase in risk factors such as aging, diabetes, hypertension, and obesity will lead to an even heavier burden of a higher prevalence of CKD in the coming decades [7, 8]. The prevalence of CKD stages 3–5 in the elderly 60 years and older was 4.9% in China [9], while the rate of CKD stages 1–5 among the same age group is 18.2% in the UK [10]. However, the link between some laboratory test variables and CKD is controversial, such as albumin (Alb) [11, 12] and uric acid (UA) [13,14,15]. Furthermore, impaired physical performance and disability are common in older adults with CKD [16, 17], so the current elderly population for prevention and treatment of CKD should also emphasize people with disabilities. The onset and general patterns of elderly disabled patients with chronic diseases are usually different from those of their healthy peers [18]. To date, epidemiological studies of CKD in the elderly general population are relatively abundant, and less attention has been given to the elderly disabled population [16]. Relevant data on the number of elderly people with disabilities are limited, but over 1 billion people have disabilities worldwide (approximately 15.6%), of whom approximately 110–190 million suffer from severe functional impairments [19]. In addition, the number of people with disabilities in China has reached 85 million, accounting for 6.21% of the total population [20]. Our previous study showed that patients with elderly physical disabilities have a higher risk of hypertension, diabetes, and other chronic diseases, which are more likely to cause kidney function impairment[21].

Therefore, we conducted a cross-sectional study to identify the prevalence of and potential risk factors for CKD stages 3–5 in the elderly (over 60 years) physically disabled population in Shanghai, China.