International prevalence patterns of low eGFR in adults aged 18-60 without traditional risk factors from a population-based cross-sectional disadvantaged populations eGFR epidemiology (DEGREE) study

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• dc.contributor.author Rutter, Charlotte E.
• dc.contributor.author O'Callaghan-Gordo, Cristina
• dc.contributor.author DEGREE Study Group
• dc.date.accessioned 2025-04-09T06:46:10Z
• dc.date.available 2025-04-09T06:46:10Z
• dc.date.issued 2025
• dc.description.abstract The disadvantaged populations eGFR (estimated glomerular filtration rate) epidemiology (DEGREE) study was designed to gain insight into the burden of chronic kidney disease (CKD) of undetermined cause (CKDu) using standard protocols to estimate the general-population prevalence of low eGFR internationally. Therefore, we estimated the age-standardized prevalence of eGFR under 60 ml/min per 1.73m2 in adults aged 18-60, excluding participants with commonly known causes of CKD; an ACR (albumin/creatinine ratio) over 300 mg/g or equivalent, or self-reported or measured (HT) hypertension or (DM) diabetes mellitus, stratified by sex and location. We included population-representative surveys conducted around the world that were either designed to estimate CKDu burden or were re-analyses of large surveys. There were 60,964 participants from 43 areas across 14 countries, with data collected 2007- 2023. The highest prevalence was seen in rural men in Uddanam, India (14%) and Northwest Nicaragua (14%). Prevalence above 5% was generally only observed in rural men, with exceptions for rural women in Ecuador (6%) and parts of Uddanam (6%‒8%), and for urban men in Leon, Nicaragua (7%). Outside of Central America and South Asia, prevalence was below 2%. Our observations represent the first attempts to estimate the prevalence of eGFR under 60 without commonly known causes of CKD around the world, as an estimate of CKDu burden, and provide a starting point for global monitoring. It is not yet clear what drives the differences, but available evidence supports a high general-population burden of CKDu in multiple areas within Central America and South Asia, although the possibility that unidentified clusters of disease may exist elsewhere cannot be excluded.
• dc.description.sponsorship This work was funded by grants from the UK Colt Foundation (CF/02/18) and the UK Medical Research Council (MR/P02386X/1 and MR/V033743/1). In addition, individual centers received funding as follows: the study in Chile was supported by the Chilean Agency of Research and Development, FONDECYT grant 1221680, and FONDAP-MAUCO grant 1523A0008; the study in Ecuador was supported by Universidad Internacional del Ecuador grant EDM-INV-04-19; the study in Guatemala was supported by National Institutes of Health (NIH) grant NIH/FIC 5R21TW010831; the Indian study in Uddanam was supported by a Grand Challenge Award from the Indian Council of Medical Research and the State Government of Andhra Pradesh; the Sri Lankan study was supported by the National Science Foundation of Sri Lanka (RPHS/2016/CKDu 07), the Ministry of Health, Sri Lanka, Nutrition and Indigenous Medicine, and the World Health Organization Country Office Sri Lanka. The study in Italy was supported by the European Union’s Horizon 2020 research and innovation programme grant 824484; the Kenyan study was supported by the National Institute for Occupational Safety and Health, Illinois Education and Research Center Pilot Project Research Training Grant (T42/OH008672), Environmental and Occupational Health unrestricted global health research funds, Michael Bruton Workplace Safety Foundation Scholarship (2019), UIC Graduate College Award for Graduate Research (2019), Paul Brandt-Rauf Scholarship in Global Health (2018–2019), and Donna Farley Global Health Scholarship (2020–21); the UDAY study in India was supported by an unrestricted educational grant from Eli Lilly and Company under the Lilly NCD Partnership Program. The funding agency had no role in the design, conduct, or analysis of the study; the Indian study in Prakasam district was supported by the Indian Council of Medical Research, New Delhi; the earlier Nicaraguan study was supported by the Swedish International Agency for Development Cooperation (Sida), through the SAREC project of Bilateral Research Cooperation with UNAN-León and the Sida-Health supported SALTRA; the later Nicaraguan study was supported by a grant from the Dutch National Postcode Lottery, which provided funding to Solidaridad covering a proportion of the fieldwork costs and by the La Isla Network. The Thai NHES V study was supported by the Bureau of Policy and Strategy, Ministry of Public Health, Thailand, the Thai Health Promotion Foundation, Thailand, and the National Health Security Office, Thailand.
• dc.format.mimetype application/pdf
• dc.identifier.citation Rutter CE, Njoroge M, Cooper PJ, Prabhakaran D, Jha V, Kaur P, et al. International prevalence patterns of low eGFR in adults aged 18-60 without traditional risk factors from a population-based cross-sectional disadvantaged populations eGFR epidemiology (DEGREE) study. Kidney Int. 2025 Mar;107(3):541-57. DOI: 10.1016/j.kint.2024.11.028
• dc.identifier.doi http://dx.doi.org/10.1016/j.kint.2024.11.028
• dc.identifier.issn 0085-2538
• dc.identifier.uri http://hdl.handle.net/10230/70114
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Kidney Int. 2025 Mar;107(3):541-57
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/824484
• dc.rights © 2024, International Society of Nephrology. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Mesoamerican nephropathy (MeN)
• dc.subject.keyword Chronic interstitial nephritis of agricultural communities (CINAC)
• dc.subject.keyword Chronic kidney disease of non-traditional cause (CKDnt)
• dc.subject.keyword Chronic kidney disease of undetermined cause (CKDu)
• dc.subject.keyword Estimated glomerular filtration rate (eGFR)
• dc.subject.keyword Prevalence
• dc.title International prevalence patterns of low eGFR in adults aged 18-60 without traditional risk factors from a population-based cross-sectional disadvantaged populations eGFR epidemiology (DEGREE) study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion