High prevalence of chronic kidney disease in La Reunion island and its association with the metabolic syndrome in the non-diabetic population: La Reunion Diabetes (REDIA) Study

Aim. - To estimate the prevalence of chronic kidney disease (CKD) in La Reunion island and to investigate the link with the metabolic syndrome in the non-diabetic population. Methods. - The Reunion Diabetes (REDIA) Study included a random sample of 3600 adults aged 30-69 years. Clinical proteinuria (> 200 mg/g creatinine), albuminuria (>= 30 mg/g) and estimated glomerular filtration rate (eGFR) were studied in 920 subjects, 411 of whom had diabetes and 509 who did not. Their relations with the metabolic syndrome (as defined by the US National Cholesterol Education Program Adult Treatment Panel III guidelines) were analyzed among those without diabetes. Results. - Age-, gender- and diabetes-standardized prevalence of CKD stage 1 or 2 (proteinuria or albuminuria with eGFR >= 60 mL/min/1.73 m(2)) was 13.8% and, for CKD stage 3 or more (eGFR < 60 ml/min/1.73 m(2)), 10.7%. The adjusted odds ratios (OR) for proteinuria increased with the number of metabolic syndrome traits: 1.5 (95% confidence interval, 0.4-5.2) in non-diabetic participants with one trait compared with those with no trait, 2.0 (CI 0.6-6.6) for two traits and 4.1 (CI 1.3-12.8) for three or more; corresponding ORs for cGFR < 60 ml/min/1.73 m(2) were 1.9 (CI 0.8-4.5), 0.9 (CI 0.4-2.4) and 2.2 (CI 0.9-5.1), respectively. Clustering of either high blood pressure and triglyceride levels, or high triglycerides and plasma glucose, or all three, conferred the strongest associations with both clinical proteinuria and low eGFR. Conclusions. - CKD prevalence is high in La Reunion island population, and the metabolic syndrome may help to target early diagnosis of CKD in non-diabetic individuals. (C) 2007 Elsevier Masson SAS. All rights reserved.