CKD Prevalence and Associated Factors in Jamaica

Abstract

Introduction: Jamaica has a high attributable burden of chronic kidney disease (CKD) but no population-based prevalence estimates. We aimed to estimate the prevalence of CKD and explore associated factors.

Methods: A secondary analysis of data from Jamaican residents aged ≥ 15 years from the nationally representative Jamaica Health and Lifestyle Survey-III was performed. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min per 1.73 m², using the CKD Epidemiology Collaboration 2021 or Schwartz-Lyon equations, and/or urine albumin-to-creatinine ratio (UACR) ≥ 30 mg/g. Associated factors included age, sex, socioeconomic status (SES), education level, body mass index (BMI), hypertension, diabetes mellitus, and sickle cell trait (SCT). Weighted prevalence estimates were determined, accounting for survey design. Multivariable logistic regression was used to evaluate CKD associations.

Results: Analyses included 583 individuals, 366 females, mean ± SD age was 49.0 ± 18.2 years. CKD prevalence was 14.8% (95% confidence interval [CI]: 11.5%-18.9%). Seven percent (7.2% (95% CI: 5.1%-10.1%) had CKD stage 3 or higher and 8.8% (95% CI: 6.3%-12.0%) had albuminuria. Individuals with CKD were older (mean age: 57 vs. 46.3 years, P < 0.001), had higher mean systolic blood pressure (140.3 mm Hg vs. 128.3 mm Hg, P < 0.001), and fasting glucose (6.7 vs. 5.8 mM/l, P < 0.001). In a multivariable regression model, hypertension (odds ratio [OR]: 2.14, 95% CI: 1.22-3.75), diabetes mellitus (OR: 2.39, 95% CI: 1.36-4.19), hemoglobin AC genotype (OR: 2.14, 95% CI: 0.64-7.13) were associated with higher odds of CKD, whereas higher education level with lower odds of CKD (OR: 0.47, 95% CI: 0.25-0.89) and (OR: 0.41, 95% CI: 0.18-0.96) for secondary and tertiary education, respectively.

Conclusion: CKD prevalence was estimated at 15%. This may translate to increased burden on the Jamaican health system.

Keywords: Caribbean; Jamaica; chronic kidney disease; health-disparities; hypertension.

Graphical abstract

Figure 1

Prevalence of CKD stages by Kidney Disease Improving Global Outcomes risk categories. Bold is percentages based on weighted estimates, with 95% confidence intervals in brackets. CKD, Chronic kidney disease; GFR, glomerular filtration rate; A1, urine albumin creatinine ratio (UACR) <30mg/g; A2, UACR 30-300mg/g; A3, UACR >300mg/g; G1, GFR ≧90mL/min/1.73m²; G2, 60-89 mL/min/1.72m²; G3a, GFR 45-59mL/min/1.73m²; G3b, GFR 30-44mL/min/1.73m2; G4, 15-29mL/min/1.73m²; G5, <15 mL/min/1.73m².

Figure 2

Frequency of chronic kidney disease by 10-year age categories.