The Risk Factors of Chronic Kidney Disease among Nursing Home Residents

Background: The prevalence of end-stage renal disease in Taiwan is the highest in the world; haemodialysis accounts for about 7% of the expenditure of the National Health Insurance. Nursing home residents with chronic kidney disease (CKD) have not been identified yet in Taiwan, along with associated risk factors. The objective of this study is to investigate the risk factors of CKD in long-term care facilities in Taiwan and those significantly associated with the presence of CKD. Methods: The nursing home residents who received health examination between January and June 2012, age >= 55 years, were enrolled in this study. They were categorized into two subgroups according to estimated glomerular filtration rate (eGFR): < 60 and >= 60 mL/min. Risk factors were evaluated per recommendations from the National Kidney Foundation: body mass index (BMI), waist circumference, blood pressure, fasting glucose and lipid profile. Metabolic syndrome among the residents was also identified. Results: Fifty-three nursing home residents were enrolled in the final study; 16 (30%) had eGFR below 60 mL/min, and nine (56%) of them had BMI higher than 25 kg/m(2). The residents with advanced CKD had significantly higher BMI, triglyceride and lower high-density lipoprotein (HDL). Twelve (75%) had metabolic syndrome. Central obesity was observed in 10 (63%) with advanced CKD. Conclusion: Most of the nursing home elderly with advanced CKD have poor control of associated risk factors, including obesity, hypertension, dyslipidaemia and hyperglycaemia. For them, metabolic syndrome may be a major contributant to the aetiology. Monitoring their BMI and waist circumference is a simple but effective way to suspect the presence of CKD.