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Regional variation in chronic kidney disease and associated factors in hypertensive individuals in rural South Asia: findings from control of blood pressure and risk attenuation-Bangladesh, Pakistan and Sri Lanka.

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dc.contributor.author Feng, L. en_US
dc.contributor.author de Silva, H.A. en_US
dc.contributor.author Jehan, I. en
dc.contributor.author Naheed, A. en_US
dc.contributor.author Kasturiratne, A. en
dc.contributor.author Himani, G. en
dc.contributor.author Hasnat, M.A. en
dc.contributor.author Jafar, T.H. en_US
dc.contributor.author COBRA-BPS Study Group en_US
dc.date.accessioned 2018-08-08T09:29:24Z en
dc.date.available 2018-08-08T09:29:24Z en
dc.date.issued 2019 en_US
dc.identifier.citation Nephrology, Dialysis, Transplantation. 2018[Epub ahead of print] en_US
dc.identifier.issn 0931-0509 (Print) en_US
dc.identifier.issn 1460-2385 (Electronic) en_US
dc.identifier.issn 0931-0509 (Linking) en_US
dc.identifier.uri http://repository.kln.ac.lk/handle/123456789/18962 en_US
dc.description Indexed In MEDLINE en_US
dc.description.abstract BACKGROUND: We aimed to determine the prevalence of chronic kidney disease (CKD) and its cross-country variation among hypertensive individuals in rural Bangladesh, Pakistan and Sri Lanka. We also explored the factors associated with CKD in these populations. METHOD: We studied baseline data from the Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan and Sri Lanka (COBRA-BPS) trial, an ongoing cluster randomized controlled trial on 2643 hypertensive adults ≥40 years of age from 30 randomly selected rural clusters, 10 in each of the three countries. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or a urine albumin:creatinine ratio (UACR)  ≥30 mg/g. Determinants for CKD were assessed using logistic regression analysis. RESULTS: The overall prevalence of CKD was 38.1% (95% confidence interval 36.2-40.1%): 21.5% with eGFR <60 mL/min/1.73 m2 and 24.4% with UACR ≥30 mg/g. CKD prevalence varied across the three countries (58.3% in Sri Lanka, 36.4% Bangladesh and 16.9% Pakistan; P <0.001). The factors independently associated with higher odds of CKD were older age, being unmarried, higher 24-h urinary sodium excretion, presence of diabetes, elevated systolic blood pressure, diuretic use and living in Bangladesh or Sri Lanka (versus Pakistan). CONCLUSIONS: The prevalence of CKD is alarmingly high in community-dwelling hypertensive adults, with significant cross-country variation in South Asia. Our findings underscore the urgency for further research into the etiology of CKD and address associated factors in targeted public health strategies with hypertension care outreach services in rural South Asia. en_US
dc.language.iso en_US en_US
dc.publisher Oxford University Press en_US
dc.subject chronic kidney disease en_US
dc.title Regional variation in chronic kidney disease and associated factors in hypertensive individuals in rural South Asia: findings from control of blood pressure and risk attenuation-Bangladesh, Pakistan and Sri Lanka. en_US
dc.type Article en_US


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