Journal Article

Urban–rural health disparity among patients with chronic kidney disease: a cross-sectional community-based study from 2012 to 2019

Wu, Yun-Chun, Akhmetzhanov, Andrei R, Wu, Mei-Yi, Lin, Yuh-Feng, Lin, Chia-Chin, Wu, Yi-Lien

2024

Overview

ObjectivesThe incidence of chronic kidney disease (CKD) is increasing owing to the ageing population, resulting in an increased demand for dialysis and kidney transplantation, which can be costly. Current research lacks clarity regarding the relationship between residence setting and CKD prevalence or its related risk factors. This study explored the urban–rural disparities in CKD prevalence and risk factors in Taiwan. Our findings will aid the understanding of the distribution of CKD and the design of more effective prevention programmes.DesignThis cross-sectional community-based study used the Renal Value Evaluation Awareness and Lift programme, which involves early screening and health education for CKD diagnosis and treatment. CKD prevalence and risk factors including alcohol consumption, smoking and betel nut chewing were compared between urban and rural areas.SettingUrbanisation levels were determined based on population density, education, age, agricultural population and medical resources.ParticipantsA total of 7786 participants from 26 urban and 15 rural townships were included.ResultsThe prevalence of CKD was significantly higher in rural (29.2%) than urban (10.8%) areas, representing a 2.7-fold difference (p<0.0001). Risk factors including diabetes (rural vs urban: 21.7% and 11.0%), hypertension (59.0% vs 39.9%), hyperuricaemia (36.7% vs 18.6%), alcohol consumption (29.0% vs 19.5%), smoking (15.9% vs 12.0%), betel nut chewing (12.6% vs 2.8%) and obesity (33.6% vs 19.4%) were significantly higher (p<0.0001) in rural areas.ConclusionsThe prevalence of CKD is three times higher in rural versus urban areas. Despite >99% National Health Insurance coverage, disparities in CKD prevalence persist between residential areas. Targeted interventions and further studies are crucial for addressing these disparities and enhancing CKD management across different settings.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Adult / Aged / Alcohol use / Awareness / Blood pressure / Chronic renal failure / Creatinine / Cross-Sectional Studies / Diabetes / Female / Glucose / Health care access / Health education / Health Status Disparities / Hemodialysis / Humans / Hypertension / Hypotheses / Kidney diseases / Male / Mass Screening / Middle Aged / National health insurance / Nephrology / Obesity / Original Research / Population / Prevalence / Proteins / Public Health / Questionnaires / Renal Insufficiency, Chronic - epidemiology / Risk Factors / Rural areas / Rural Health - statistics & numerical data / Rural Population - statistics & numerical data / Sample size / Self report / Smoking / Taiwan - epidemiology / Urban areas / Urban Population - statistics & numerical data / Uric acid / Urine / Womens health