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Vol. 156. Issue 4.
Pages 157-165 (February 2021)
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Vol. 156. Issue 4.
Pages 157-165 (February 2021)
Original article
DOI: 10.1016/j.medcle.2020.03.011
Prevalence of chronic kidney disease and associated factors in the Spanish population attended in primary care: Results of the IBERICAN study
Prevalencia de la enfermedad renal crónica y factores asociados en la población asistida en atención primaria de España: resultados del estudio IBERICAN
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José Luis Llisterria, Rafael Manuel Micó-Pérezb, Sonsoles Velilla-Zancadac, Gustavo Cristóbal Rodríguez-Rocad,
Corresponding author
grodriguezr@semergen.es

Corresponding author.
, Miguel Ángel Prieto-Díaze, Vicente Martín-Sánchezf, Alfonso Barquillag, José Polo-Garcíah, Antonio Segura-Fragosoi, Sergio Cinza-Sanjurjoj, on behalf of the IBERICAN study investigators and the Fundación de la Sociedad Española de Médicos de Atención Primaria (SEMERGEN)
a Fundación de la Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Madrid, Spain
b Consultorio local de Fontanars dels Alforins, Departamento de Salud de Xàtiva-Ontinyent, Valencia, Spain
c Centro de Salud Joaquín Elizalde, Logroño, Spain
d Centro de Salud de La Puebla de Montalbán, Toledo, Spain
e Centro de Salud Vallobín-La Florida, Oviedo, Spain
f Instituto de Biomedicina (IBIOMED), Universidad de León, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), León, Spain
g Centro de Salud de Trujillo, Cáceres, Spain
h Centro de Salud Casar de Cáceres, Cáceres, Spain
i Facultad de Ciencias de la Salud, Universidad de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
j Centro de Salud de Porto do Son, EOXI Santiago de Compostela, Santiago de Compostela, Spain
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Figures (2)
Tables (4)
Table 1. Prevalence of chronic kidney disease by age groups and gender.
Table 2. Stages of chronic kidney disease.
Table 3. Clinical characteristics of patients with and without chronic kidney disease.
Table 4. Variables associated with chronic kidney disease in the total population.
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Abstract
Objectives

To determine the prevalence of chronic kidney disease (CKD) and the factors associated with impaired renal function in the population attended in primary care (PC).

Patients and method

Cross-sectional and multicentre study carried out in the baseline patients of the IBERICAN study (Identificación de la poBlación Española de RIesgo CArdiovascular y reNal). CKD was considered with an estimated glomerular filtration (eGF) <60 ml / min/1.73 m2 or elevated albuminuria (≥ 30 mg/g). According to the eGF, the CKD was classified in six stages (1, 2, 3a, 3b, 4 and 5) and according to albuminuria in three stages (A1 or normal / slightly increased, A2 or moderately increased and A3 or severely increased). The clinical characteristics and the relationship of CKD with the main cardiovascular risk factors (CVRF) and other variables of interest were analysed using unconditional logistic regression.

Results

7895 patients were included (mean age 57.9 ± 14.8 years; 54.5% women). 14.4% (95% CI: 13.6−15.1) had CKD; 16.1% (95% CI: 14.9−17.3) in men and 12.9% (95% CI: 11.9−14.0) in women. A continuous increase of the prevalence was observed with age (24.8% in ≥ 65 years) and with CVFR aggregation. The variables that were most associated with the probability of suffering CKD were left ventricular hypertrophy (OR: 1.95; p < .001), diabetes (OR: 1.58; p < .001) and hypertension (OR: 1.56; p < .001).

Conclusions

Fourteen out of every 100 patients included in the IBERICAN study have CKD. The prevalence of CKD affects a quarter of patients ≥ 65 years and increases exponentially with the aggregation of FRCV.

Keywords:
Primary care
Chronic kidney disease
Associated factors
Prevalence
RESUMEN
Objetivos

Conocer la prevalencia de enfermedad renal crónica (ERC) y determinar los factores asociados al deterioro de la función renal en población asistida en atención primaria (AP).

Pacientes y método

Estudio transversal y multicéntrico realizado en los pacientes basales del estudio IBERICAN (Identificación de la poBlación Española de RIesgo CArdiovascular y reNal). Se consideró ERC a un filtrado glomerular estimado (FGe) < 60 ml/min/1,73 m2 o albuminuria elevada (≥ 30 mg/g). Según el FGe se clasificó la ERC en seis estadios (1, 2, 3a, 3b, 4 y 5) y según la albuminuria en tres (A1 o normal/ligeramente aumentada, A2 o moderadamente aumentada y A3 o gravemente aumentada). Se analizaron las características clínicas y la relación de la ERC con los principales factores de riesgo cardiovascular (FRCV) y otras variables de interés mediante regresión logística no condicional.

Resultados

Se incluyeron 7.895 pacientes (edad media 57,9 ± 14,8 años; 54,5% mujeres). El 14,4% (IC95%: 13,6-15,1) presentaba ERC; en hombres un 16,1% (IC95%:14,9-17,3) y en mujeres un 12,9% (IC95%: 11,9-14,0). Se observó un aumento continuo de la prevalencia con la edad (24,8% en ≥ 65 años) y con la agregación de FRCV. Las variables que más se asociaron a la probabilidad de padecer ERC fueron hipertrofia ventricular izquierda (OR: 1,95; p < 0,001), diabetes (OR: 1,58; p < 0,001) e hipertensión (OR: 1,56; p < 0,001).

Conclusiones

Catorce de cada 100 pacientes incluidos en el estudio IBERICAN presenta ERC. La prevalencia de ERC afecta a la cuarta parte de pacientes ≥ 65 años y aumenta exponencialmente con la agregación de FRCV.

Palabras clave:
Atención primaria
Enfermedad renal crónica
Factores asociados
Prevalencia

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