Prevalence of chronic kidney disease in adults in England: comparison of nationally representative cross-sectional surveys from 2003 to 2016
Prevalence of chronic kidney disease in adults in England: comparison of nationally representative cross-sectional surveys from 2003 to 2016
Objectives To identify recent trends in chronic kidney disease (CKD) prevalence in England and explore their association with changes in sociodemographic, behavioural and clinical factors. Design Pooled cross-sectional analysis. Setting Health Survey for England 2003, 2009/2010 combined and 2016. Participants 17 663 individuals (aged 16+) living in private households. Primary and secondary outcome measures Prevalence of estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m 2 and albuminuria (measured by albumin-creatinine ratio) during 2009/2010 and 2016 and trends in eGFR between 2003 and 2016. eGFR was estimated using serum creatinine Chronic Kidney Disease Epidemiology Collaboration and Modification of Diet in Renal Disease equations. Results GFR <60 mL/min/1.73 m 2 prevalence was 7.7% (95% CI 7.1% to 8.4%), 7.0% (6.4% to 7.7%) and 7.3%(6.5% to 8.2%) in 2003, 2009/2010 and 2016, respectively. Albuminuria prevalence was 8.7% (8.1% to 9.5%) in 2009/2010 and 9.8% (8.7% to 10.9%) in 2016. Prevalence of CKD G1-5 (eGFR <60 mL/min/1.73 m 2 or albuminuria) was 12.6% (11.8% to 13.4%) in 2009/2010 and 13.9% (12.8% to 15.2%) in 2016. Prevalence of diabetes and obesity increased during 2003-2016 while prevalence of hypertension and smoking fell. The age-adjusted and gender-adjusted OR of eGFR <60 mL/min/1.73 m 2 for 2016 versus 2009/2010 was 0.99 (0.82 to 1.18) and fully adjusted OR was 1.13 (0.93 to 1.37). There was no significant period effect on the prevalence of albuminuria or CKD G1-5 from 2009/2010 to 2016 in age and gender or fully adjusted models. Conclusion The fall in eGFR <60 mL/min/1.73 m 2 seen from 2003 to 2009/2010 did not continue to 2016. However, absolute CKD burden is likely to rise with population growth and ageing, particularly if diabetes prevalence continues to increase. This highlights the need for greater CKD prevention efforts and continued surveillance.
chronic renal failure, epidemiology, public health
Hounkpatin, Hilda
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Harris, Scott
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Fraser, Simon
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Day, Julie
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Mindell, Jennifer S.
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Taal, Maarten W.
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O'Donoghue, Donal
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Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
13 August 2020
Hounkpatin, Hilda
5612e5b4-6286-48c8-b81f-e96d1148681d
Harris, Scott
19ea097b-df15-4f0f-be19-8ac42c190028
Fraser, Simon
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Day, Julie
4fc7e066-aed2-444e-905c-ba309b3bc347
Mindell, Jennifer S.
e3983969-4181-4699-9bf5-ee876f7c54c2
Taal, Maarten W.
10eeea62-a2fc-43b6-b5af-359e75c501ea
O'Donoghue, Donal
fdc1b5eb-a472-408c-b841-5f8fddcc773f
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Hounkpatin, Hilda, Harris, Scott, Fraser, Simon, Day, Julie, Mindell, Jennifer S., Taal, Maarten W., O'Donoghue, Donal and Roderick, Paul
(2020)
Prevalence of chronic kidney disease in adults in England: comparison of nationally representative cross-sectional surveys from 2003 to 2016.
BMJ Open, 10 (8), [e038423].
(doi:10.1136/bmjopen-2020-038423).
Abstract
Objectives To identify recent trends in chronic kidney disease (CKD) prevalence in England and explore their association with changes in sociodemographic, behavioural and clinical factors. Design Pooled cross-sectional analysis. Setting Health Survey for England 2003, 2009/2010 combined and 2016. Participants 17 663 individuals (aged 16+) living in private households. Primary and secondary outcome measures Prevalence of estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m 2 and albuminuria (measured by albumin-creatinine ratio) during 2009/2010 and 2016 and trends in eGFR between 2003 and 2016. eGFR was estimated using serum creatinine Chronic Kidney Disease Epidemiology Collaboration and Modification of Diet in Renal Disease equations. Results GFR <60 mL/min/1.73 m 2 prevalence was 7.7% (95% CI 7.1% to 8.4%), 7.0% (6.4% to 7.7%) and 7.3%(6.5% to 8.2%) in 2003, 2009/2010 and 2016, respectively. Albuminuria prevalence was 8.7% (8.1% to 9.5%) in 2009/2010 and 9.8% (8.7% to 10.9%) in 2016. Prevalence of CKD G1-5 (eGFR <60 mL/min/1.73 m 2 or albuminuria) was 12.6% (11.8% to 13.4%) in 2009/2010 and 13.9% (12.8% to 15.2%) in 2016. Prevalence of diabetes and obesity increased during 2003-2016 while prevalence of hypertension and smoking fell. The age-adjusted and gender-adjusted OR of eGFR <60 mL/min/1.73 m 2 for 2016 versus 2009/2010 was 0.99 (0.82 to 1.18) and fully adjusted OR was 1.13 (0.93 to 1.37). There was no significant period effect on the prevalence of albuminuria or CKD G1-5 from 2009/2010 to 2016 in age and gender or fully adjusted models. Conclusion The fall in eGFR <60 mL/min/1.73 m 2 seen from 2003 to 2009/2010 did not continue to 2016. However, absolute CKD burden is likely to rise with population growth and ageing, particularly if diabetes prevalence continues to increase. This highlights the need for greater CKD prevention efforts and continued surveillance.
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HSE study Main text and tables figures CLEAN copy April 2020
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More information
Accepted/In Press date: 29 May 2020
e-pub ahead of print date: 13 August 2020
Published date: 13 August 2020
Additional Information:
Funding Information:
Funding HSE 2003 was funded by the Department of Health; HSE 2009, 2010 and 2016 were funded by the Health and Social Care Information Centre (now NHS Digital). This CKD work was funded by Kidney Research UK (KRUK), grant number: KRUK RP37/2015. This funding supported kidney function testing, data management and analyses.
Publisher Copyright:
© 2020 Author(s) (or their employer(s)). Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Keywords:
chronic renal failure, epidemiology, public health
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Local EPrints ID: 441300
URI: http://eprints.soton.ac.uk/id/eprint/441300
ISSN: 2044-6055
PURE UUID: 9fdf7cb0-0da4-4a7b-ae20-06be5308fdac
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Date deposited: 09 Jun 2020 16:30
Last modified: 17 Mar 2024 03:39
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Contributors
Author:
Julie Day
Author:
Jennifer S. Mindell
Author:
Maarten W. Taal
Author:
Donal O'Donoghue
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