What is the clinical evidence from this study?

Study design: Systematic Review. Population: Chronic kidney disease. Intervention: MDRD equation vs. Cockcroft-Gault (CG) equation. Primary outcome: Prevalence of chronic kidney disease.

April 11, 2008Open Access

Prevalence of chronic kidney disease in population-based studies: Systematic review

Key Result

The median prevalence of chronic kidney disease was 7.2% in persons aged 30 years or older, with estimates strongly depending on whether the MDRD or Cockcroft-Gault equation was used.

Study Design

Type

Systematic Review

PICO

Population

Chronic kidney disease

Intervention / Comparator

MDRD equation vs Cockcroft-Gault (CG) equation

Primary Outcome

Prevalence of chronic kidney disease

Limitations

Differences in the prevalence of comorbidities and other risk factors across studies were not accounted for.
Prevalence of CKD might be underestimated because other indications of kidney damage such as proteinuria were not considered by most included studies.
Response rates were only available in some of the included studies.
Different assays of creatinine measurement make it difficult to compare the prevalence of CKD across studies directly.

Abstract

BACKGROUND: Chronic kidney disease (CKD) is becoming a major public health problem worldwide. This article reviews the published evidence of prevalence of CKD in population-based study samples that used the standardized definition from the Kidney Disease Outcomes Quality Initiative of the National Kidney Foundation (K/DOQI) practice guideline, and particularly focus on performance of serum-creatinine based equations for GFR estimation. We provide a summary of available data about the burden of CKD in various populations. METHODS: We performed a systematic review of available published data in MEDLINE. A combination of various keywords relevant to CKD was used in this research. Related data of included studies were extracted in a systematic way. RESULTS: A total of 26 studies were included in this review. The studies were conducted in different populations, and the number of study participants ranged from 237 to 65181. The median prevalence of CKD was 7.2% in persons aged 30 years or older. In persons aged 64 years or older prevalence of CKD varied from 23.4% to 35.8%. Importantly, the prevalence of CKD strongly depended on which estimating equations were used. The Modification of Diet in Renal Disease Study (MDRD) equation was likely to be preferred in recent epidemiological studies compared to the adjusted Cockcroft-Gault (CG) equation. CONCLUSION: Worldwide, CKD is becoming a common disease in the general population. Accurately detecting CKD in special groups remains inadequate, particularly among elderly persons, females or other ethnic groups such as Asians.

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