Background The prevalence of chronic kidney disease is high in developing countries. However, no national survey of chronic kidney disease has been done incorporating both estimated glomerular filtration rate (eGFR) and albuminuria in a developing country with the economic diversity of China. We aimed to measure the prevalence of chronic kidney disease in China with such a survey.
Methods We did a cross-sectional survey of a nationally representative sample of Chinese adults. Chronic kidney disease was defined as eGFR less than 60 mL/min per 1.73 m(2) or the presence of albuminuria. Participants completed a lifestyle and medical history questionnaire and had their blood pressure measured, and blood and urine samples taken. Serum creatinine was measured and used to estimate glomerular filtration rate. Urinary albumin and creatinine were tested to assess albuminuria. The crude and adjusted prevalence of indicators of kidney damage were calculated and factors associated with the presence of chronic kidney disease analysed by logistic regression.
Findings 50 550 people were invited to participate, of whom 47 204 agreed. The adjusted prevalence of eGFR less than 60 mL/min per 1.73 m(2) was 1.7% (95% CI 1.5-1.9) and of albuminuria was 9.4% (8.9-10.0). The overall prevalence of chronic kidney disease was 10.8% (10.2-11.3); therefore the number of patients with chronic kidney disease in China is estimated to be about 119.5 million (112.9-125.0 million). In rural areas, economic development was independently associated with the presence of albuminuria. The prevalence of chronic kidney disease was high in north (16.9% [15.1-18.7]) and southwest (18.3% [16.4-20.4]) regions compared with other regions. Other factors independently associated with kidney damage were age, sex, hypertension, diabetes, history of cardiovascular disease, hyperuricaemia, area of residence, and economic status.
Interpretation Chronic kidney disease has become an important public health problem in China. Special attention should be paid to residents in economically improving rural areas and specific geographical regions in China.
[1]Peking Univ, Hosp 1, Div Nephrol, Inst Nephrol, Beijing 100871, Peoples R China.
[2]Sichuan Acad Med Sci, Div Nephrol, Chengdu, Peoples R China.
[3]Sichuan Prov Peoples Hosp, Chengdu, Peoples R China.
[4]Chifeng Second Hosp, Div Nephrol, Chifeng, Peoples R China.
[5]Southwest Univ, Zhongda Hosp, Inst Nephrol, Nanjing, Jiangsu, Peoples R China.
[6]Southwest Univ, Zhongda Hosp, Div Nephrol, Nanjing, Jiangsu, Peoples R China.
[7]Xinjiang Med Univ, Hosp 1, Div Nephrol, Uramuqi, Peoples R China.
[8]Ningxia Univ Med, Affiliated Hosp, Div Nephrol, Yinchuan, Peoples R China.
[9]Zhejiang Univ, Affiliated Hosp 1, Div Nephrol, Hangzhou 310003, Zhejiang, Peoples R China.
[10]Guangxi Univ Med, Affiliated Hosp 1, Div Nephrol, Nanning, Peoples R China.
[11]Sun Yat Sen Univ, Affiliated Hosp 1, Div Nephrol, Guangzhou 510275, Guangdong, Peoples R China.
[12]Shanghai Jiao Tong Univ, Ruijin Hosp, Div Nephrol, Shanghai 200030, Peoples R China.
[13]Hubei Univ Med, Taihe Hosp, Div Nephrol, Shiyan, Peoples R China.
[14]Shandong Univ, Qilu Hosp, Div Nephrol, Jinan 250100, Peoples R China.
[15]Cent S Univ, Xiangya Hosp 2, Div Nephrol, Changsha, Peoples R China.
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