Prevalence and metabolic risk factors of chronic kidney disease among a Mexican adult population: a cross-sectional study in primary healthcare medical units
Authors: Alvarez Paredes Alfonso R. , Gómez García Anel , Alvarez Paredes Martha Angélica , Velázquez Nely , Ojeda Bolaños Diana Cindy , Padilla Sandoval Miriam Sarai , Gallardo Juan M. , Muñoz Cortés Gerardo , Reyes Granados Seydhel Cristina , Rodríguez Morán Mario Felipe , Tripp Joaquin , Lopez Pineda Arturo , Alvarez Aguilar Cleto 
Published: July 2024

Introduction
The intricate relationship between obesity and chronic kidney disease (CKD) progression underscores a significant public health challenge. Obesity is strongly linked to the onset of several health conditions, including arterial hypertension (AHTN), metabolic syndrome, diabetes, dyslipidemia, and hyperuricemia. Understanding the connection between CKD and obesity is crucial for addressing their complex interplay in public health strategies.

Objective
This research aimed to determine the prevalence of CKD in a population with high obesity rates and evaluate the associated metabolic risk factors.

Material and Methods
In this cross-sectional study conducted from January 2017 to December 2019 we included 3,901 participants of both sexes aged ≥20 years who were selected from primary healthcare medical units of the Mexican Social Security Institute (IMSS) in Michoacan, Mexico. We measured the participants’ weight, height, systolic and diastolic blood pressure, glucose, creatinine, total cholesterol, triglycerides, HDL-c, LDL-c, and uric acid. We estimated the glomerular filtration rate using the Collaborative Chronic Kidney Disease Epidemiology (CKD-EPI) equation.

Results
Among the population studied, 50.6% were women and 49.4% were men, with a mean age of 49 years (range: 23–90). The prevalence of CKD was 21.9%. Factors significantly associated with an increased risk of CKD included age ≥60 years (OR = 11.70, 95% CI [9.83–15.93]), overweight (OR = 4.19, 95% CI [2.88–6.11]), obesity (OR = 13.31, 95% CI [11.12–15.93]), abdominal obesity (OR = 9.25, 95% CI [7.13–11.99]), AHTN (OR = 20.63, 95% CI [17.02–25.02]), impaired fasting glucose (IFG) (OR = 2.73, 95% CI [2.31–3.23]), type 2 diabetes (T2D) (OR = 14.30, 95% CI [11.14–18.37]), total cholesterol (TC) ≥200 mg/dL (OR = 6.04, 95% CI [5.11–7.14]), triglycerides (TG) ≥150 mg/dL (OR = 5.63, 95% CI 4.76-6.66), HDL-c <40 mg/dL (OR = 4.458, 95% CI [3.74–5.31]), LDL-c ≥130 mg/dL (OR = 6.06, 95% CI [5.12–7.18]), and serum uric acid levels ≥6 mg/dL in women and ≥7 mg/dL in men (OR = 8.18, 95% CI [6.92–9.68]), (p < 0.0001). These factors independently contribute to the development of CKD.

Conclusions
This study underscores the intricate relationship between obesity and CKD, revealing a high prevalence of CKD. Obesity, including overweight, abdominal obesity, AHTN, IFG, T2D, dyslipidemia, and hyperuricemia emerged as significant metabolic risk factors for CKD. Early identification of these risk factors is crucial for effective intervention strategies. Public health policies should integrate both pharmacological and non-pharmacological approaches to address obesity-related conditions and prevent kidney damage directly.