Chronic Kidney Disease in Urban, Adult Sri Lankans: A Cohort Follow-Up Study

Background: Chronic kidney disease (CKD) affects approximately 850 million adults worldwide, with its prevalence rising due to increasing rates of diabetes and hypertension in aging populations. This study aims to assess the prevalence and associated factors of CKD in an urban adult cohort in Sri Lanka, where such data are limited. 

Methods: We conducted a stratified random sampling of participants from Ragama, Sri Lanka, initially in 2007 (ages 35–64) and reassessed them in 2014. Data collection involved structured interviews, anthropometric measurements, and biochemical tests. CKD was evaluated in 2014 using the estimated glomerular filtration rate (eGFR) calculated via the CKD-EPI formula, defining CKD as eGFR < 60 mL/min/1.72 m² according to KDIGO/KDOQI guidelines. A follow-up in 2017 assessed all-cause and cardiovascular mortality and morbidity. Results: Of 2985 individuals recruited in 2007, 2148 (71.6%) participated in the 2014 follow-up; 2032 (94.6%) had complete data to assess CKD status in 2014. Mean age of the participants was 52.3 (SD 7.7) years; 57% were women. Age-adjusted prevalence of CKD was 3.03 (1.98–4.11) per 100 population in 2014; most were Stage 3A (67.2%), followed by Stage 3B (23%) and Stage 4 (9.8%). Older age (p < 0.001), male gender (p < 0.05), diabetes (p < 0.001), and hypertension (p < 0.001) at baseline were associated with CKD in 2014. No association was observed between CKD and all-cause or cardiovascular mortality or morbidity by 2017 (p > 0.05). 

Conclusions: Diabetes and hypertension are significant contributors to CKD prevalence, with most patients at Stage 3, where early detection and management can slow disease progression. CKD remains underrecognized in Sri Lanka, highlighting the need for extensive population-based studies to better understand this growing health issue better.