Prevalence of renal impairment in urban adults: A community-based study from Kerala, India

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Background and objectives Community-based studies on detecting renal impairment are minimal from India, though early detection could prevent progression to end-stage renal disease (ESRD). This study aims to estimate the prevalence of renal impairment among adults aged 30 y or above, and to find out the socio-demographic, lifestyle, and comorbid factors responsible for low estimated glomerular filtration rate (eGFR). Methods Renal impairment is a reduction in kidney function, often defined by a low eGFR, an increase in serum creatinine, or proteinuria. A cross-sectional, population-based study was done by the cluster-sampling method from March 2024 to February 2025, among 1031 participants in Kerala. The eGFR and albuminuria were estimated using facilities at a multidisciplinary research unit. Associations of sociodemographic, lifestyle, and comorbid factors with renal impairment were studied. Results Among the 1031 participants, 24.9 - 44.4% had low eGFR. The older age group had a higher prevalence of renal impairment (mean age 62.2 y). Mean serum creatinine was 1.03±0.24 mg/dL (1-5 mg/dL). Main comorbidities were diabetes (40.5%) and hypertension (41.5%). Regression analysis showed that advanced age [62.2 y vs . 53.9 y, Odds ratio (OR) 1.92 (1.28-2.9)], being unmarried/widower/divorcee [2.7% vs . 1.7%, OR 4.18 (1.29-13.51)], ever detected as a hypertensive [55.4% vs. 34.1%, OR 2.97 (1.42-6.17)], and the presence of abdominal obesity [84.2% vs. 55.2% in males, OR 8.18 (2.76-24.21)] were significantly associated with the development of renal impairment. Interpretation and conclusions The prevalence of renal impairment ranged between 24.9 to 44.4%. Advanced age, being unmarried/widower/widow/divorcee, ever detected as a hypertensive, and the presence of abdominal obesity contributed to the development of renal impairment.