Prevalence of chronic kidney disease in France - The constances cohort

Abstract

Background: Prevention and early detection of chronic kidney disease (CKD) are major public health goals to prevent and slow its progression to kidney failure. In this respect, our main objective was to estimate the prevalence of CKD (stages 1 to 5 without replacement therapy) in French adults and to study its determinants. Methods: Constances is a population-based cohort designed as a national research infrastructure. Eligible population included participants (18–69 years) who had both isotope dilution mass spectrometry (IDMS) traceable creatinine-based estimated glomerular filration rate (eGFR) and urinary albumin-creatinine ratio measurements. Multivariable analysis was performed to assess the association between covariables of interest and CKD. Results: Of the 11,429 subjects included in our sample, (48% women; mean (± standard deviation) age: 52 ± 13 years), 715 have CKD (ACR ≥ 3 mg/mmol creatinine and/or eGFR < 60 mL/min per 1.73 m2. Among these 715 subjects, only 136 had a decreased eGFR without increased albuminuria; 563 had increased albuminuria only, and 16 had both. Thus, the prevalence of all stage CKD was 6.26 [95% confidence interval, 5.81–6.70] %, including 4.93 [4.53–5.32] % for CKD stage 1–2 (ACR ≥ 3 mg/mmol creatinine and eGFR ≥ 60 mL/min per 1.73 m2), and 1.33 [1.12–1.54] % for CKD stage 3–5 (eGFR < 60 mL/min per 1.73 m2. In the multivariable analysis, independent risk factors for CKD included age, lower education or socio-economic level, hypertension, diabetes, obesity, and history of cardiovascular disease or cancer. Conclusions: Our large population-based cohort estimated that 6.3% of individuals had CKD. The majority of subjects with CKD had increased albuminuria without decreased eGFR. Albuminuria should be assessed more frequently in order to detect CKD earlier and to implement preventive treatments, especially in selected populations at risk of CKD. Clinical trial number: Not applicable.