Chronic kidney disease (CKD) is a global health concern and a major long-term complication of diabetes, yet its burden remains understudied in regions with limited epidemiological data. This study aimed to evaluate the prevalence of CKD and its associated risk factors in the Iranian adult population, stratified by diabetes status.

Population-based cross-sectional study.

Nationally representative survey across Iran (STEPS 2021).

17 607 adults aged ≥25 years with complete kidney function and albuminuria data, selected through systematic sampling with weighting to ensure national representativeness.

CKD was defined as an estimated glomerular filtration rate (eGFR)

The national prevalence of CKD was 11.9% (95% CI 11.2% to 12.6%), with 9.1% (8.5% to 9.9%) among individuals without diabetes and 28.6% (26.2% to 31.1%) among those with diabetes. According to KDIGO classification, 88.1% (87.4% to 88.8%) were at low risk, 9.0% (8.4% to 9.6%) at moderate risk, 2.0% (1.6% to 2.4%) at high risk and 0.9% (0.7% to 1.1%) at very high risk. Albuminuria was more prevalent than low eGFR in both groups with (22.5% (20.4% to 24.8%) vs 10.3% (8.7% to 12.1%)) and without (5.7% (5.2% to 6.3%) vs 4.3% (3.8% to 4.8%)) diabetes. Diabetes was more strongly linked to albuminuria than low eGFR and was progressively associated with higher risk categories (adjusted ORs (aORs) 2.41 (2.03–2.86) for moderate, 2.63 (1.74–3.97) for high, 3.93 (2.56–6.07) for very high vs low-risk). CKD prevalence was highest in northwest Iran, increased significantly with age, with a stronger association observed for low eGFR than albuminuria, and was associated with hypertension (aOR 2.41 (2.07–2.82)), dyslipidaemia (1.60 (1.31–1.94)), obesity (1.94 (1.59–2.36)), ischaemic heart disease (1.53 (1.25–1.87)) and physical inactivity (1.40 (1.20–1.62)). Higher socioeconomic status and education were associated with lower odds of CKD.

CKD is a major burden, especially in individuals with diabetes, with regional and socioeconomic disparities. Addressing risk factors, integrating CKD into non-communicable disease surveillance and prioritising it in global health agendas, including the Sustainable Development Goals, are essential.

Enhancing empowerment and self-care practices during pregnancy reduces complications for women during this critical period. Health literacy stands as a crucial component in empowering pregnant women. Without a sufficient grasp of healthcare information, making informed decisions and choices for desired health outcomes becomes challenging. This study will assess the effectiveness of virtual group counselling based on health literacy in enhancing empowerment and self-care among pregnant women.

This randomised controlled trial will be conducted in parallel groups on 84 pregnant women. Eligible participants will be randomly assigned to either the control or intervention group using a permuted-block-randomised allocation method with four blocks. The intervention group will engage in five structured online sessions, lasting 30–40 min with 5–8 participants. The study’s primary endpoints are the empowerment and self-care of pregnant women, which will be assessed using questionnaires administered before and 1 month after the intervention. The study is planned to start on 20 April 2024 and end on 22 September 2024. The primary outcome analysis will use analysis of covariance (ANCOVA or multivariate ANCOVA), with preintervention scores entered as covariates and the intervention group as a fixed factor.

The Ethics Committee of Babol University of Medical Sciences (IR.MUBABOL.HRI.REC.1402.202) approved this protocol. The study findings will be disseminated through peer-reviewed journal publication and scientific conferences.

This trial is prospectively registered on 4 April 2024 at the Iranian Registry of Clinical Trials (IRCT20221109056451N1).