Renal insufficiency among urban populations in Bangladesh: A decade of laboratory-based observations

Sumon Kumar Das, Syeda Momena Afsana, Shahriar Bin Elahi, Mohammod Jobayer Chisti, Jui Das, Abdullah Al Mamun, Harold David McIntyre, Tahmeed Ahmed, Abu Syed Golam Faruque, Mohammed Abdus Salam

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    Abstract

    Objective: The objective of this study was to describe the age and sex-specific prevalence of renal insufficiency, and observe its trends over a decade at an urban Bangladesh setup. 

    Method: This was a cross-sectional study, in which we observed the Estimated Glomerular Filtration Rate (eGFR) of 218,888 adults, aged 19 years, who had submitted their blood specimen to the Clinical Biochemistry Laboratory of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) during the years 2006–2015. We applied CKD-EPI definition in estimating eGFR using their age-and sex-specific serum creatinine concentrations. Based on the eGFR, we classified the population into five stages of renal insufficiency (stage-1 to stage-5), at age intervals of five-years. Data were analysed using the Linear Regression and Multinomial Logistic Regression models. 

    Results: Females constituted 43% (n = 94,931) of the study population; and 34% (n = 42,576) of the males and 31% (n = 29,830) of the females had their serum creatinine concentrations above the upper limit of the laboratory reference cut-off. The overall prevalence of stage-2 to stage-5 renal insufficiency were 24% (n = 52,126), 17% (n = 38,539), 8% (n = 16,504) and 6% (n = 12,665) respectively; the prevalence were 23% (n = 1,890), 19% (n = 1,579), 9% (n = 769) and 9% (n = 770) respectively in 2006, and 24% (n = 10,062), 17% (n = 6,903), 6% (n = 2,537) and 5% (n = 1,924) respectively in 2015. The prevalence was higher among the females. At least 2% of the adults, younger than <44 years, had stage-4 and stage-5 in 2015. The age-adjusted eGFR was significantly lower among the postmenopausal females (aged 46 y) compared to the same age group males (64.08±10.83 vs. 66.83±10.41 mL/min/1.73 m 2 ; p<0.001). Compared to 2006, the number of individuals with renal insufficiency (stage 2 and above) had increased at least two times, irrespective of age, in 2015. A single year of increase in the age was significantly associated with 1.32 unit reductions in the eGFR; and the reductions were higher for females who also had higher odds of renal insufficiency stages-2 and beyond. 

    Conclusion: This study observed high prevalence of stage-2 to stage-5 renal insufficiency in Bangladeshi populations, irrespective of age, and especially among the females.

    Original languageEnglish
    Article numbere0214568
    Pages (from-to)1-13
    Number of pages13
    JournalPLoS One
    Volume14
    Issue number4
    DOIs
    Publication statusPublished - 4 Apr 2019

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    Das, S. K., Afsana, S. M., Elahi, S. B., Chisti, M. J., Das, J., Mamun, A. A., McIntyre, H. D., Ahmed, T., Faruque, A. S. G., & Salam, M. A. (2019). Renal insufficiency among urban populations in Bangladesh: A decade of laboratory-based observations. PLoS One, 14(4), 1-13. [e0214568]. https://doi.org/10.1371/journal.pone.0214568