laboratory characteristics across six regions.CKD etiologies were classified as diabetes, hypertension, glomerulonephritis, or other causes.Complications included anemia (Hb 4.5 mg/dL), hyperkalemia (>5.5 mmol/L), and secondary hyperparathyroidism (PTH >65 pg/mL).Regional differences were evaluated using 2 testing.Results: Among 3,344 participants (mean age 69 12 years; 45% female), CKD stages were distributed as G3a 20%, G3b 33%, G4 37%, and G5 10%.CKD etiologies: Diabetes and hypertension were predominant, but their distributions varied markedly by region (p < 0.001).Diabetes-related CKD was the most common etiology across several regions, particularly in the Northeast (43%), East (41%), West (41%), and South (39%).Hypertension-related CKD predominated in the North (41%).The highest proportions of CKD of unknown etiology (CKDu) were observed in the Central (34%) and West (25%) regions.Glomerulonephritis accounted for only a small proportion in all regions (1-5%).Overall, diabetes and hypertension remained the leading causes of chronic kidney disease nationwide.(Figure 1) Complications: Overall prevalence was 22% for anemia, 22% for metabolic acidosis, 6% for hyperphosphatemia, 1.4% for hyperkalemia, and 58% for secondary hyperparathyroidism.Regional variation was statistically significant for anemia, metabolic acidosis, hyperphosphatemia, and secondary hyperparathyroidism (all p < 0.001), and modest for hyperkalemia (p = 0.013).The most pronounced disparity was observed in metabolic acidosis across regions.(Figure 2)The etiology and complication patterns of CKD in Thailand reveal significant regional variations.The high incidence of unknown causes in Central and West areas, along with significant differences in metabolic complications, highlights the necessity for additional research and implementation of region-specific clinical and public health strategies to effectively reduce the nationwide burden of CKD.
Franceschini et al. (Wed,) studied this question.