Replication Data for: Population Estimates of GFR and Risk Factors for CKD in Guatemala

Ann C. Miller, Eva Tuiz, Leah Shaw, David Flood, Pablo Garcia, Eloin Dhaenens, Dana R. Thomson, Joaquin Barnoya, Carlos Mendoza Montano, Peter Rohloff, Population Estimates of GFR and Risk Factors for CKD in Guatemala, Kidney International Reports, Volume 6, Issue 3, 2021, Pages 796-805, ISSN 2468-0249, https://doi.org/10.1016/j.ekir.2020.12.015. (https://www.sciencedirect.com/science/article/pii/S2468024920318477) Abstract: Introduction Chronic kidney disease (CKD) is an emerging public health priority in Central America. However, data on the prevalence of CKD in Guatemala, Central America’s most populous country, are limited, especially for rural communities. Methods We conducted a population-representative survey of 2 rural agricultural municipalities in Guatemala. We collected anthropometric data, blood pressure, serum and urine creatinine, glycosylated hemoglobin, and urine albumin. Sociodemographic, health, and exposure data were self-reported. Results We enrolled 807 individuals (63% of all eligible, 35% male, mean age 39.5 years). An estimated 4.0% (95% confidence interval [CI] 2.4–6.6) had CKD, defined as an estimated glomerular filtration rate (eGFR) less than 60 ml/min per 1.73 m2. Most individuals with an eGFR below 60 ml/min per 1.73 m2 had diabetes or hypertension. In multivariable analysis, the important factors associated with risk for an eGFR less than 60 ml/min per 1.73 m2 included a history of diabetes or hypertension (adjusted odds ratio [aOR] 11.21; 95% CI 3.28–38.24), underweight (body mass index [BMI] <18.5) (aOR 21.09; 95% CI 2.05–217.0), and an interaction between sugar cane agriculture and poverty (aOR 1.10; 95% CI 1.01–1.19). Conclusions In this population-based survey, most observed CKD was associated with diabetes and hypertension. These results emphasize the urgent public health need to address the emerging epidemic of diabetes, hypertension, and CKD in rural Guatemala. In addition, the association between CKD and sugar cane in individuals living in poverty provides some circumstantial evidence for existence of CKD of unknown etiology in the study communities, which requires further investigation. Keywords: Central America; CKD; CKD of unknown etiology; global health