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Project
Faculty of Engineering
Biomedical Engineering Department
Prevalence and risk factors of chronic kidney disease:
a population study in the Tibetan population
By: * Mohammad Mahdi Sekhavat Pisheh – 932011113017
(sekhavat.m76@gmail.com)
S. Mohammad Zargar – 932011113013
Mohammad Hosein AliNaghi – 932011113022
Biostatistics
Spring 2016
Supervisor: Dr. Marateb
4
First page of article
5
ISI
6
IF, SJR, Quartile
7
#Citations
Research Question
8
Is the prevalence of Chronic Kidney Disease (CKD) in the
Tibetan population who have mentioned risk factors below,
More than the prevalence of CKD in the population who don’t
have them?
Risk factors: Hypertension, albuminuria, hyperuricemia, high
hematocrit.
PICOT criteria
Population: 1289 person of the Tibetan adult(>=18 years)
population in Lhasa city and Dangxiong county of Lhasa city.
Intervention: ---
Comparison Group: Adults(>=18 years) who have not intended
risk factor (every time we survey).
Outcome: Risk of CKD
Time: --- (cross-sectional study)
9
FINER criteria
Feasible
10
FINER criteria
Interesting
Novel
11
FINER criteria
Ethical
Relevant
12
Research Hypothesis
 𝑃1 : The prevalence of CKD in adults(>=18 years) who have intended
risk factor (every time we survey).
 𝑃2 : The prevalence of CKD in adults(>=18 years) who have NOT
intended risk factor (every time we survey).
13
Two-Sided Hypothesis:
NULL Hypothesis 𝐻0: 𝑃1 = 𝑃2
Alternative Hypothesis 𝐻1: 𝑃1 ≠ 𝑃2
Research Objective
We conducted a population-based survey in Tibet to identify
the prevalence and associated risk factors of CKD in subjects
living at altitudes of >3500 m.
14
Variables in the Research
15
No Variable Type Measurement Scale Categories
1 Age (years) Independent Interval -
2 Weight (kg) Independent Interval -
3 Serum creatinine (μmol/L) Independent Interval -
4 Blood cholesterol (mmol/L) Independent Interval -
5 Serum triglyceride (mmol/L) Independent Interval -
6 Blood uric acid (μmol/L) Independent Interval -
7 Fast blood glucose (mmol/L) Independent Interval -
8 Systolic blood pressure (mmHg) Independent Interval -
9 Diastolic blood pressure (mmHg) Independent Interval -
10 Hemoglobin (g/L) Independent Interval -
11 Hematocrit Independent Interval -
Variables in the Research
16
No Variable Type Measurement Scale Categories
12 BMI Independent Interval -
13 ≥High school education Independent Nominal Above/Under
14 Health insurance coverage Independent Nominal Yes/No
15 Smoking Independent Nominal Yes/No
16 History of CKD Independent Nominal Yes/No
17 Family history of diabetes Background Nominal Yes/No
18 Family history of hypertension Background Nominal Yes/No
19 Family history of CKD Background Nominal Yes/No
20 Repeatedly respiratory tract infection Background Nominal Yes/No
21 Nephrotoxic medications Independent Nominal Yes/No
22 Obesity Independent Nominal Yes/No
Variables in the Research
17
No Variable Type Measurement Scale Categories
23 Central obesity Independent Nominal Yes/No
24 Metabolic syndrome Independent Nominal Yes/No
25 Hypertension Independent Nominal Yes/No
26 Diabetes Independent Nominal Yes/No
27 Hyperlipidemia Independent Nominal Yes/No
28 Hyperuricemia Independent Nominal Yes/No
29 Cardiovascular disease Independent Nominal Yes/No
30 eGFR <60 mL/min/1.73 m2 Independent Nominal Yes(<60)/No(>60)
31 ACR >30 mg/g Independent Nominal Yes(>30)/No(<30)
32 Hematuria Independent Nominal Yes/No
33 CKD Status Dependent Nominal Yes/No
18
19
Result
20
The overall prevalence of CKD (stages 1–5) was 19.1% (95% CI: 17.9–
22.3%) after adjustment for age and gender (Table 2). The prevalence of CKD in
CKD stage from 1 to 5 was 12.8%, 4.6%, 1.1%, 0.3% and 0.3%, respectively.
The prevalence of CKD was higher in the subjects with hyperuricaemia (32.3%
versus 12.5%, P = 0.0001), hypertension (29.2% versus 11.9%, P = 0.0001),
hyperlipidaemia (23.1% versus 10.1%, P < 0.001) and metabolic syndrome
(21.8% versus 12.1%, P < 0.001) compared with subjects without these
indicators, respectively. No difference of CKD prevalence was found between
male and female subjects (18.9% versus 19.9%, P = 0.45), but the prevalence of
CKD increased with increasing age in both groups (P < 0.001 across age
groups).
Implementation
of Article
21
Dataset
22
Normality of variables
23
One-Sample Kolmogorov-Smirnov Test
What tests?
24
Chi-Square test >> Between CKD and Hypertension
Mann-Whitney test >> Between CKD and Age
Bi-Variate correlation test >> Between eGFR and Age
Chi square test
25
Between
CKD and Hypertension
Chi-Square test
26
Mann-Whitney test
27
Between
CKD and age
Bi-Variate correlation test
28
Between
eGFR and age
Bi-Variate correlation test
29
Scatter plot
Sample size (N)
calculation
30
Sample size calculation
31
Sample size calculation
32
Thanks for
your attention

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Project of Biostatistics

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  • 3. Faculty of Engineering Biomedical Engineering Department Prevalence and risk factors of chronic kidney disease: a population study in the Tibetan population By: * Mohammad Mahdi Sekhavat Pisheh – 932011113017 (sekhavat.m76@gmail.com) S. Mohammad Zargar – 932011113013 Mohammad Hosein AliNaghi – 932011113022 Biostatistics Spring 2016 Supervisor: Dr. Marateb
  • 4. 4 First page of article
  • 8. Research Question 8 Is the prevalence of Chronic Kidney Disease (CKD) in the Tibetan population who have mentioned risk factors below, More than the prevalence of CKD in the population who don’t have them? Risk factors: Hypertension, albuminuria, hyperuricemia, high hematocrit.
  • 9. PICOT criteria Population: 1289 person of the Tibetan adult(>=18 years) population in Lhasa city and Dangxiong county of Lhasa city. Intervention: --- Comparison Group: Adults(>=18 years) who have not intended risk factor (every time we survey). Outcome: Risk of CKD Time: --- (cross-sectional study) 9
  • 13. Research Hypothesis  𝑃1 : The prevalence of CKD in adults(>=18 years) who have intended risk factor (every time we survey).  𝑃2 : The prevalence of CKD in adults(>=18 years) who have NOT intended risk factor (every time we survey). 13 Two-Sided Hypothesis: NULL Hypothesis 𝐻0: 𝑃1 = 𝑃2 Alternative Hypothesis 𝐻1: 𝑃1 ≠ 𝑃2
  • 14. Research Objective We conducted a population-based survey in Tibet to identify the prevalence and associated risk factors of CKD in subjects living at altitudes of >3500 m. 14
  • 15. Variables in the Research 15 No Variable Type Measurement Scale Categories 1 Age (years) Independent Interval - 2 Weight (kg) Independent Interval - 3 Serum creatinine (μmol/L) Independent Interval - 4 Blood cholesterol (mmol/L) Independent Interval - 5 Serum triglyceride (mmol/L) Independent Interval - 6 Blood uric acid (μmol/L) Independent Interval - 7 Fast blood glucose (mmol/L) Independent Interval - 8 Systolic blood pressure (mmHg) Independent Interval - 9 Diastolic blood pressure (mmHg) Independent Interval - 10 Hemoglobin (g/L) Independent Interval - 11 Hematocrit Independent Interval -
  • 16. Variables in the Research 16 No Variable Type Measurement Scale Categories 12 BMI Independent Interval - 13 ≥High school education Independent Nominal Above/Under 14 Health insurance coverage Independent Nominal Yes/No 15 Smoking Independent Nominal Yes/No 16 History of CKD Independent Nominal Yes/No 17 Family history of diabetes Background Nominal Yes/No 18 Family history of hypertension Background Nominal Yes/No 19 Family history of CKD Background Nominal Yes/No 20 Repeatedly respiratory tract infection Background Nominal Yes/No 21 Nephrotoxic medications Independent Nominal Yes/No 22 Obesity Independent Nominal Yes/No
  • 17. Variables in the Research 17 No Variable Type Measurement Scale Categories 23 Central obesity Independent Nominal Yes/No 24 Metabolic syndrome Independent Nominal Yes/No 25 Hypertension Independent Nominal Yes/No 26 Diabetes Independent Nominal Yes/No 27 Hyperlipidemia Independent Nominal Yes/No 28 Hyperuricemia Independent Nominal Yes/No 29 Cardiovascular disease Independent Nominal Yes/No 30 eGFR <60 mL/min/1.73 m2 Independent Nominal Yes(<60)/No(>60) 31 ACR >30 mg/g Independent Nominal Yes(>30)/No(<30) 32 Hematuria Independent Nominal Yes/No 33 CKD Status Dependent Nominal Yes/No
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  • 20. Result 20 The overall prevalence of CKD (stages 1–5) was 19.1% (95% CI: 17.9– 22.3%) after adjustment for age and gender (Table 2). The prevalence of CKD in CKD stage from 1 to 5 was 12.8%, 4.6%, 1.1%, 0.3% and 0.3%, respectively. The prevalence of CKD was higher in the subjects with hyperuricaemia (32.3% versus 12.5%, P = 0.0001), hypertension (29.2% versus 11.9%, P = 0.0001), hyperlipidaemia (23.1% versus 10.1%, P < 0.001) and metabolic syndrome (21.8% versus 12.1%, P < 0.001) compared with subjects without these indicators, respectively. No difference of CKD prevalence was found between male and female subjects (18.9% versus 19.9%, P = 0.45), but the prevalence of CKD increased with increasing age in both groups (P < 0.001 across age groups).
  • 23. Normality of variables 23 One-Sample Kolmogorov-Smirnov Test
  • 24. What tests? 24 Chi-Square test >> Between CKD and Hypertension Mann-Whitney test >> Between CKD and Age Bi-Variate correlation test >> Between eGFR and Age
  • 25. Chi square test 25 Between CKD and Hypertension