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. 2017 Jun 8;2(6):1032-1041.
doi: 10.1016/j.ekir.2017.05.016. eCollection 2017 Nov.

Chronic Kidney Disease in Panama: Results From the PREFREC Study and National Mortality Trends

Ilais Moreno Velásquez  1 , Franz Castro  1 , Beatriz Gómez  1 , César Cuero  2   3 , Jorge Motta  1
Affiliations

Chronic Kidney Disease in Panama: Results From the PREFREC Study and National Mortality Trends

Ilais Moreno Velásquez et al. Kidney Int Rep. .

Abstract

Introduction: The magnitude of chronic kidney disease (CKD) in Panama has yet to be described. We investigated the association between sociodemographic and cardiovascular exposures with CKD in 2 Panamanian provinces. Further, we analyzed national trends of CKD mortality from 2001 to 2014.

Methods: Data were derived from Prevalencia de Factores de Riesgo de Enfermedad Cardiovascular (PREFREC [Survey on Risk Factors Associated With Cardiovascular Disease]), a cross-sectional study designed to analyze the prevalence of risk factors associated with cardiovascular disease. Biomarkers of kidney function were measured in 3590 participants. CKD was defined as an estimated glomerular filtration rate (eGFR) of <60 ml/min/1.73 m2 and/or albuminuria ≥30 mg/g creatinine. Odds ratios (ORs) with 95% confidence intervals (CIs) for CKD were calculated using logistic regression. We calculated age-standardized CKD mortality rates in the country using the National Mortality Register. Annual percentage change and 95% CIs were estimated to evaluate the trends over time.

Results: The prevalence of CKD was 12% (reduced eGFR: 3.3%; albuminuria; 9.9%). CKD was associated with hypertension (OR: 1.8; 95% CI: 1.2-2.7), age 60 years or older (OR: 1.9; 95% CI: 1.2-2.9), and previous myocardial infarction (OR: 2.4; 95% CI: 1.0-5.7), whereas monthly family income was inversely associated with CKD (OR: 0.4; 95% CI: 0.1-0.9) (adjusted). A sustained increase in the trend of CKD mortality was observed from 2001 to 2006, followed by a decreasing trend in subsequent years. Coclé province had the highest adjusted mortality rate.

Discussion: CKD poses a significant health problem for Panama. Health inequalities and an increase of cardiometabolic risk factors warrant robust epidemiological surveillance, improved diagnosis, and treatment. Further national studies aimed to address geographical disparities are necessary.

Keywords: Panama; chronic kidney disease; mortality.

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Figures

Figure 1
Figure 1
(a) Chronic kidney disease (ICD-10 codes N18−N19) age-adjusted mortality rates and trends by sex in Panama, from 2001 to 2014. Statistically significant trends are shown as solid lines. Nonstatistically significant trends are presented as dashed lines. (b) Trends expressed as annual percentage change (APC) and 95% confidence intervals (CI). Mortality rates were standardized for 5-years age-groups using the direct method. *P < 0.05.
Figure 2
Figure 2
(a) Chronic kidney disease (ICD-10 codes N18−N19) age-adjusted mortality rates and trends by sex in the Coclé province in comparison to the rest of the country, from 2001 to 2014. Statistically significant trends are shown as solid lines. Nonstatistically significant trends are presented as dashed lines. (b) Trends expressed as annual percentage change (APC) and 95% confidence intervals (CI). Mortality rates were standardized for 5-years age-groups using the direct method. *P < 0.05.
Figure S1
Figure S1
(A) Chronic kidney disease age-adjusted mortality rates and trends by sex in Panama, from 2001 to 2014. (B) Trends expressed as annual percentage change (APC) and 95% confidence intervals (CI).
Figure S2
Figure S2
(A) Chronic kidney disease age-adjusted mortality rates and trends by sex in Coclé province in comparison to the rest of the country, from 2001 to 2014. (B) Trends expressed as annual percentage change (APC) and 95% confidence intervals (CI).
See this image and copyright information in PMC

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