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. 2022 Mar 21;12(3):e057509.
doi: 10.1136/bmjopen-2021-057509.

Prevalence and risk factors associated with chronic kidney disease in Nepal: evidence from a nationally representative population-based cross-sectional study

Anil Poudyal #  1 , Khem Bahadur Karki #  2   3 , Namuna Shrestha  4 , Krishna Kumar Aryal  4 , Namra Kumar Mahato  5 , Bihungum Bista  5 , Laxmi Ghimire  6 , Dirghayu Kc  4 , Pradip Gyanwali  5 , Anjani Kumar Jha  5 , Vanessa Garcia-Larsen  7 , Ulrich Kuch  2 , David A Groneberg  2 , Sanjib Kumar Sharma  8 , Meghnath Dhimal  1   2
Affiliations

Prevalence and risk factors associated with chronic kidney disease in Nepal: evidence from a nationally representative population-based cross-sectional study

Anil Poudyal et al. BMJ Open. .

Abstract

Objective: This study aimed to determine population-based prevalence of chronic kidney disease (CKD) and its associated factors in Nepal.

Study design: The study was a nationwide population-based cross-sectional study.

Setting and participants: Cross-sectional survey conducted in a nationally representative sample of 12 109 Nepalese adult from 2016 to 2018 on selected chronic non-communicable diseases was examined. Multistage cluster sampling with a mix of probability proportionate to size and systematic random sampling was used for the selection of individuals aged 20 years and above.

Primary and secondary outcome measures: Primary outcome in this study was population-based prevalence of CKD in Nepal. A participant was considered to have CKD if the urine albumin-to-creatinine ratio was greater than or equal to 30 mg/g and/or estimated glomerular filtration rate is less than 60 mL/min/1.73 m2 at baseline and in follow-up using modification of diet in renal disease study equations. The secondary outcome measure was factors associated with CKD in Nepal. The covariate adjusted association of risk factors and CKD was calculated using multivariable binary logistic regression.

Results: The overall prevalence of CKD in Nepal was 6.0% (95% CI 5.5 to 6.6). Factors independently associated with CKD included older age (adjusted OR (AOR) 2.6, 95% CI 1.9 to 3.6), Dalit caste (AOR 1.6, 95% CI 1.1 to 2.3), hypertension (AOR 2.4, 95% CI 2.0 to 3.0), diabetes mellitus (AOR 3.2, 95% CI 2.5 to 4.1), raised total cholesterol (AOR 1.3, 95% CI 1.0 to 1.6) and increased waist-to-hip ratio (AOR 1.6, 95% CI 1.2 to 2.3).

Conclusion: This nationally representative study shows that the prevalence of CKD in the adult population of Nepal is substantial, and it is independently associated with several cardiometabolic traits. These findings warrant longitudinal studies to identify the causes of CKD in Nepal and effective strategies to prevent it.

Keywords: chronic renal failure; dialysis; glomerulonephritis; renal transplantation.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Map of Nepal showing the study clusters (400 clusters)
Figure 2
Figure 2
Histogram of estimated glomerular filtration rate (eGFR) distribution among 12 097 participants in baseline by sex
Figure 3
Figure 3
Histogram of estimated glomerular filtration rate (eGFR) distribution among 1194 participants in follow-up by sex
See this image and copyright information in PMC

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