Prevalence of early stages of chronic kidney disease in apparently healthy central government employees in India

Background. Chronic kidney disease (CKD) is associated with significant morbidity and mortality. US data show that 11-15.6% of population has CKD, but there is no data from India on early stages of CKD. The aim of this study was to estimate the prevalence of early stages of CKD using the Kidney Disease Quality Outcomes Initiative (KDOQI) guidelines in an Indian population. Methods. A cross-sectional study of Indian central government employees over 18 years of age was carried out. Data on anthropometric profile and investigations including routine urine exam, semi-quantitative microalbuminuria (MAU), serum creatinine, lipid profile and fasting blood glucose (FPG) were collected. Estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Diseases (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. Results. A total of 3398 subjects, with 2244 (66.04%) males and 1154 (33.96%) females, were studied. Of the subjects, 9.96% (n = 284) were found to have MAU >30 mg/L, and 11.47% (n = 327) had a deranged albumin:creatinine ratio (ACR) of 30-300 mg/g. Mean GFR was 98 mL/min/1.73 m(2) (+/- 25.25) by the MDRD equation, and 100 mL/min/1.73 m2 (+/- 19.48) by CKD-EPI. Using the MDRD equation for GFR, 189 (6.62%) had stage I CKD, 154(5.40%) had stage II CKD and 86 (3.02%) had stage III CKD. By using the CKD-EPI equation, the corresponding percentages were 192 (6.73%), 122 (4.28%) and 60 (2.11%), respectively. Age >40 years, FPG >126 mg/dL and hypertension were found to be independent risk factors for CKD. Conclusions. Of the apparently healthy adult Indian central government employees, 15.04% and 13.12% were found to have early stages of CKD using the MDRD and CKD-EPI criteria for GFR, respectively.