Use of Estimated Glomerular Filtration Rate and Urine Albumin-Creatinine Ratio Based on KDIGO 2012 Guideline in a Thai Community Hospital: Prevalence of Chronic Kidney Disease and its Risk Factors

BACKGROUND: Kidney disease is hard to detect at its early stage; therefore, the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 guideline was developed for improving care and outcomes of patients with kidney disease. This study aimed to determine clinical outcomes from applying this guideline in a community hospital service. MATERIAL/METHODS: The patients’ data were extracted from their medical records and analyzed for outcomes of using the estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (UACR) for detecting kidney disease. RESULTS: The eGFR was utilized in 36 172 patients aged ≥18 years, and 76.86% of them had normal kidney function. The prevalence of chronic kidney disease (CKD) was 8.20%; most patients (68%) with CKD were in stages 3a and 3b. The most common causes of CKD were diabetes and hypertension. The UACR was mainly used in patients with diabetes. The percentage of patients with UACR ≥3 mg/mmol creatinine alone was significantly higher than that of patients with eGFR <60 mL/min/1.73 m(2) alone in diabetes. Patients with controlled diabetes had a significantly higher percentage of normal kidney function and lower percentage of high UACR alone than patients with uncontrolled diabetes. CONCLUSIONS: The prevalence and etiology of CKD in this region were similar to that of other regions. The KDIGO 2012 guideline helped identify CKD at the early stage. Most patients with diabetes in this region developed diabetic nephropathy in a classical pattern; thus, using eGFR concurrently with UACR could increase chances of detecting diabetic nephropathy at the early stage.