Risk factors associated with disease progression and mortality in chronic kidney disease of uncertain etiology: a cohort study in Medawachchiya, Sri Lanka

Abstract

Background: The alarming rise in the prevalence of chronic kidney disease of uncertain etiology (CKDu) among the low socioeconomic farming community in the North Central Province of Sri Lanka has been recognized as an emerging public health issue in the country.

Methods: This study sought to determine the possible factors associated with the progression and mortality of CKDu. The study utilized a single-center cohort registered in 2003 and followed up until 2009 in a regional clinic in the endemic region, and used a Cox proportional hazards model.

Results: We repeatedly found an association between disease progression and hypertension. Men were at higher risk of CKDu than women. A significant proportion of the patients in this cohort were underweight, which emphasized the need for future studies on the nutritional status of these patients.

Conclusions: Compared with findings in western countries and other regions of Asia, we identified hypertension as a major risk factor for progression of CKDu in this cohort.

Fig. 1

Kaplan–Meier curves showing the probability of chronic kidney disease of uncertain etiology (CKDu) disease progression over the monitoring period with and without self-reported hypertension for CKDu stage 1 (glomerular filtration rate [GFR] >90 ml/min/1.73 m²) patients (please refer to the “Results” section in the text for Log-rank test and Wilcoxon test results)