Kriengsak Vareesangthip, Leena Ongajyooth, Panrasri Khonputsa*, Wichai Aekplakorn** Renal Division, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, *Setting Priorities using Information on Cost-Effectiveness (SPICE) Project, Ministry of Public Health,**Community Medicine Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand


Introduction:
The prevalence of patients with end stage renal disease (ESRD) who need dialysis and/or transplantation has more than double in Thailand during the past two decades. In addition to being at risk of ESRD, people with chronic kidney disease (CKD) have an increased risk of cardiovascular death. Besides, chronic kidney disease is associated with an increased risk of a multitude of adverse health outcomes, including end stage kidney disease (ESRD) as well as a substantial reduction in life expectancy. ESRD has a profound effect on morbidity, mortality and quality of life and imposes a substantial burden on health care expenditure. Therapeutic strategies to reduce the risk of ESRD and other complications in CKD are now available. So early recognition and the institution of proven therapeutic strategies are important and beneficial.

Objective:
To determine the prevalence of the causes of chronic kidney disease in Thai adults from National Health Examination Survey in 2004.

Material and method:
Data from a nationally representative sample of 3,117 individuals aged 15 years and older was collected using questionnaires, physical examination and blood samples. GFR was estimated using the Chinese modified Modification of Diet in Renal Disease Study equation. Chronic kidney Disease (CKD) stages were classified based on kidney Disease Outcome Quality Initiative (K/DOQI).

Results:
The prevalence of CKD in Thai adults weighted to the 2004 Thai population by stage was 4.47% for stage 3, 0.11% and 0.11% for stage 4 and 5 respectively. Compared to non-CKD, individuals with CKD were older, having higher level of cholesterol, and blood pressure. The prevalence of cardiovascular risk factors were more common in those with CKD ( stage 3-5) than those without, including hypertension (48.8% vs 15.4%), diabetes (18.6% vs 4.9%) and overweight (BMI>-25 kg/m2, 24.0% vs 22.9% respectively). The prevalence of hypertension was significantly high in the group with CKD comparing with the non-CKD group (51% vs 15%, p < 0.001).

Conclusions:
The identification of high prevalence of hypertension in CKD patients should be evaluated and monitored for appropriate treatment in order to prevent the progression of chronic kidney disease.