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Abstract：
Background and objective Chronic kidney disease (CKD) poses a significant global public health challenge, especially among the Asian population who experience higher prevalence and more rapid disease progression. This study aimed to compare the epidemiology and risk factors associated with CKD between rural and urban residents in Peshawar, Pakistan. Materials and methods A cross-sectional study involving adult patients with CKD was conducted at a public tertiary care hospital in Peshawar between July 2023 and January 2024. To collect data, a tool was developed based on existing literature. CKD was defined as follows: a low estimated glomerular filtration rate (eGFR) below 60 mL/min per 1.73 m2, albuminuria (urine albumin-creatinine ratio >3 mg/mmol), or a combination of both low eGFR and albuminuria. The prevalence of moderate to severe CKD, adjusted for place of residence, was calculated. Statistical analysis was performed using SPSS Statistics V. 26 (IBM Corp., Armonk, NY). Results Among the study sample, 114 (41.45%) patients hailed from rural areas while 161 (58.55%) resided in urban areas. Urban patients had a higher prevalence of albuminuria levels below 30 mg/g than rural patients (83.2% vs. 76.3%, p=0.00). Additionally, the mean eGFR was slightly higher among rural residents. Rural patients had a higher prevalence of hypertension, and there was a noticeable disparity in the occurrence of kidney stones, with rural residents experiencing a greater incidence. Patients living in urban areas showed a higher level of understanding of risk factors and reported taking preventive measures for CKD. Factors associated with moderate to severe CKD included living in urban areas and having a medical history of diabetes and hypertension (p=0.00). No significant association was observed between behavioral factors and the severity of CKD. Conclusions Urban residents exhibited higher rates of CKD and albuminuria and had a greater awareness of CKD risk factors. In contrast, rural areas had a slightly higher mean eGFR and greater prevalence of hypertension and kidney stones. Diabetes and hypertension were key predictors of moderate to severe CKD.
摘要：
背景与目的慢性肾脏病(CKD)对全球公共卫生构成重大挑战。特别是在亚洲人群中，他们的患病率更高，疾病进展更快。本研究旨在比较白沙瓦农村居民和城市居民与CKD相关的流行病学和危险因素。巴基斯坦。材料和方法2023年7月至2024年1月在白沙瓦一家公立三级医院进行了一项涉及CKD成年患者的横断面研究。为了收集数据，在现有文献的基础上开发了一个工具。CKD定义如下：低估计肾小球滤过率（eGFR）低于60mL/min/1.73m2，白蛋白尿（尿白蛋白-肌酐比值>3mg/mmol），或低eGFR和白蛋白尿的组合。中度至重度CKD的患病率，调整居住地，已计算。使用SPSSStatisticsV.26(IBMCorp.,Armonk,NY).结果在研究样本中，114名（41.45％）患者来自农村地区，而161名（58.55％）居住在城市地区。城市患者的白蛋白尿水平低于30mg/g的患病率高于农村患者（83.2％vs.76.3%,p=0.00)。此外,农村居民的平均eGFR略高。农村患者高血压患病率较高,肾结石的发生率有明显的差异，农村居民的发病率更高。生活在城市地区的患者对危险因素有较高的了解，并报告采取了CKD的预防措施。与中度至重度CKD相关的因素包括居住在城市地区，有糖尿病和高血压病史（p=0.00）。行为因素与CKD严重程度无显著相关性。结论城市居民CKD和蛋白尿的患病率较高，对CKD危险因素的认识更高。相比之下,农村地区的平均eGFR略高,高血压和肾结石患病率较高.糖尿病和高血压是中重度CKD的关键预测因子。
