Estimated glomerular filtration rate for research into chronic kidney disease from Primary Health Care.

A single-center observational study.

Abstract

Introduction: Primary health care (PHC) is fundamental in preventing and managing chronic kidney disease (CKD). By early detection of kidney disorders and providing comprehensive care to patients, PHC contributes to improving the quality of life of people with kidney disease and reducing the burden that this disease represents for health systems. This study aimed to determine the prevalence of chronic kidney disease in a primary care referral center in Holguín, Cuba.

Methods: This analytical observational study was conducted at the “Máximo Gómez Báez” University Polyclinic, Cuba, from February to November 2021. Patients diagnosed with noncommunicable chronic disease without known CKD were included, subsequently Group 1 (G1): patients with CKD. Group 2 (G2): patients without CKD. The estimated glomerular filtration rate, comorbidities, nutritional status, and laboratory variables were recorded.

Results: In Group 1 (CKD), 188 cases, and the control group, 348 cases. The prevalence of chronic kidney disease was 35% (95% CI 31-39%). The age in G1 was 61.6 ± 10.3 years in G2: 59.3 ± 11.6 (P =0.001). Women were the most affected by CKD (P =0.001). Of the total, 76% were hypertensive, with similar distributions between both groups (79% vs 74%). Type 2 diabetes was a risk factor for developing CKD (OR = 5.9; 95% CI: 3.9-8.9). 35%, 37% and 31% had an eGFR ≤ 60 mL/min/1.73 m2, by the CKD-EPI, MDRD-4 and Cockcroft-Gault formulas, respectively. The distributions of CKD stages were 76.1% for 3a, 16.5% for 3b, 6.9% for 4, and 0.5% for 5, by CKD-EPI.

Conclusion: The eGFR by Cockcroft-Gault introduces erroneous results due to the patient's weight. CKD-EPI and MDRD-4 proved to be the most appropriate for diagnosing and staging CKD in the study population.