Prevalencia por áreas sanitarias de enfermedad renal crónica en la población diabética de Extremadura durante los años 2012, 2013 y 2014. Un estudio observacional / Prevalence by health areas of chronic kidney disease in diabetic population of Extremadura during the years 2012, 2013 and 2014. An observational study

Antecedentes y objetivo: La diabetes mellitus es la principal causa de enfermedad renal crónica (ERC) en nuestro país. El objetivo fue estimar la prevalencia global y por áreas sanitarias de ERC en la población diabética de Extremadura. Pacientes y métodos: Estudio observacional, longitudinal, retrospectivo en la población diabética atendida en el Sistema Extremeño de Salud durante el periodo 2012-2014. Se incluyeron 90.709 pacientes ≥ 18 años. El cálculo del filtrado glomerular estimado (FGe) se realizó mediante la ecuación CKD-EPI (derivada de la ecuación desarrollada por la Chronic Kidney Disease Epidemiology Collaboration) y se calculó el cociente albúmina/creatinina en orina (CAC). Se consideró paciente con ERC a todo aquel que en su última analítica tenía un FGe<60 mL/min/1,73 m2 y/o un CAC ≥ 30 mg/g, confirmados en una determinación previa separada al menos por tres meses. Resultados: La prevalencia global de ERC fue del 15,6% (17,5% en mujeres y 13,7% en varones) y fue mayor en la provincia de Cáceres (17%) que en la de Badajoz (14,8%, p<0,001), encontrándose la menor prevalencia en el área sanitaria de Navalmoral de la Mata (13%) y la mayor en la de Plasencia (17,8%, p < 0,001). La prevalencia de ERC definida sin necesidad de confirmación de la sostenibilidad del daño renal o del FGe disminuido fue del 26,1% (29,3% en mujeres y 22,9% en varones), lo que supone una sobreestimación de la prevalencia del 67%. Conclusiones: La prevalencia de ERC en población diabética extremeña es menor a la referida habitualmente y difiere significativamente entre sus áreas sanitarias. (AU)

Background and objective: Diabetes mellitus is the leading cause of chronic kidney disease (CKD) in our country. The objective was to estimate the global prevalence and by health areas of CKD in the diabetic population of Extremadura. Patients and methods: Observational, longitudinal retrospective study in the diabetic population attended in the Extremadura Health System in 2012–2014. A total of 90,709 patients ≥ 18 years old were studied. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). The presence of CKD was defined as follows: an eGFR<60 mL/min/1.73 m2 in a time period of greater than three months or the presence of renal damage, as evaluated by an urine albumin-creatinine ratio (UACR) ≥ 30 mg/g, with or without reduced eGFR, also in a time period of greater than three months. Results: The overall prevalence of CKD was 15.6% (17.5% in women and 13.7% in men) and it was higher in the province of Cáceres (17%) than in Badajoz (14.8%, p<0.001), with the lowest prevalence in the Navalmoral de la Mata health area (13%) and the highest in Plasencia (17.8%, p<0.001). The prevalence of CKD defined without the need for confirmation of the sustainability of kidney damage or decreased eGFR was 26.1% (29.3% in women and 22.9% in men), which represents an overestimation of the prevalence of 67%. Conclusions: The prevalence of CKD in Extremadura's diabetic population is lower than usually referred to and differs significantly between its health areas. (AU)

Prevalence by health areas of chronic kidney disease in the diabetic population of Extremadura in 2012, 2013 and 2014. An observational study.

BACKGROUND AND OBJECTIVE: Diabetes mellitus is the leading cause of chronic kidney disease (CKD) in our country. The objective was to estimate the global prevalence and by health areas of CKD in the diabetic population of Extremadura. METHODS: Observational, longitudinal retrospective study in the diabetic population attended in the Extremadura Health System in 2012-2014. A total of 90,709 patients ≥18 years old were studied. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). The presence of CKD was was defined as follows: an eGFR <60ml/min/1.73m2 in a time period≥of three months or the presence of renal damage, as evaluated by an urine albumin-creatinine ratio (UACR) ≥30mg/g, with or without reduced eGFR, also in a time period ≥ of three months. RESULTS: The overall prevalence of CKD was 15.6% (17.5% in women and 13.7% in men) and it was higher in the province of Cáceres (17.0%) than in Badajoz (14.8%, p<0.001), with the lowest prevalence in the Navalmoral de la Mata health area (13.0%) and the highest in Plasencia (17.8%, p<0.001). The prevalence of CKD defined without the need for confirmation of the sustainability of kidney damage or decreased eGFR was 26.1% (29.3% in women and 22.9% in men), which represents an overestimation of the prevalence of 67%. CONCLUSIONS: The prevalence of CKD in Extremadura's diabetic population is lower than usually referred to and differs significantly between its health areas.