Decreased glomerular filtration rate and markers of kidney damage persisting for more than three months in a sample of biochemistry students of the Universidad Nacional del Litoral (Santa Fe, Argentine). 2014-2015
Abstract
Introduction: Early stages of chronic kidney disease (CKD) are asymptomatic and patients may ignore their condition or discover it in a routine medical consultation or because of the consultation about other disease. CKD high global prevalence is accepted. Reliable data is needed to provide evidence and knowledge about the disease in the region. Methods: Descriptive study. 81 students. Period May 2014 to December 2015. Glomerular Filtration Rate, GFR, was estimated by CKD-EPI and creatinine clearance. Kidney damage was determined in 1st morning urine: test strip and urinary sediment and proteinuria. Students with GFR <60 mL/min/1.73m2, proteinuria, hematuria and / or cylindruria were reassessed at 3 months to establish chronicity. Results: In the first visit 27.2% of the students presented proteinuria >150 mg/24 h; 8.6% hematuria and 1.2% cylindruria, isolated or combined with GFR<60 ml/min/1.73m2 and 1.2% had GFR <60 ml/min/1.73m2. At 3 months reevaluation persistent findings were seen in 11.2% of the subjects studied. Conclusions: The high proportion of apparently healthy young people with persistent impaired renal function or markers of renal damage in a follow-up greater than 3 months provides an evidence of the magnitude of the CKD problem.
References
National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39(2 Suppl 1):S1-266.
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl. 2013;3(1):1-150.
Levey AS, De Jong PE, Coresh J, El Nahas M, Astor BC, Matsushita K, et al. The definition, classification, and prognosis of chronic kidney
disease: a KDIGO Controversies Conference report. Kidney Int. 2011;80(1):17-28.
Chronic Kidney Disease Prognosis Consortium, Matsushita K, Van der Velde M, Astor BC, Woodward M, Levey AS, et al. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010;375(9731):2073-81.
Gansevoort RT, Matsushita K, Van der Velde M, Astor BC, Woodward M, Levey AS, et al. Lower estimated GFR and higher albuminuria are associated with adverse kidney outcomes. A collaborative meta-analysis of general and high-risk population cohorts. Kidney Int. 2011;80(1):93-104.
Astor BC, Matsushita K, Gansevoort RT, Van der Velde M, Woodward M, Levey AS, et al. Lower estimated glomerular filtration rate and higher
albuminuria are associated with mortality and end-stage renal disease. A collaborative meta-analysis of kidney disease population cohorts. Kidney Int. 2011;79(12):1331-40.
Argentina. Instituto Nacional Central Único Coordinador de Ablación e Implante, Ministerio de Salud. Programa de Abordaje Integral Enfermedad Renal Crónica (PAIERC) [citado feb 28 2016]. Disponible en: http://www.incucai.gov.ar/index.php/institucional/lineamientos-estrategicos/20-lineas-deaccion/64-abordaje-integral-enfermedad-renal-cronica.html
Brück K, Jager KJ, Dounousi E, Kainz A, Nitsch D, Ärnlöv J, et al. Methodology used in studies reporting chronic kidney disease prevalence: a systematic literature review. Nephrol Dial Transplant. 2015;30 Suppl 4:iv6-16.
Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604-12.
Martínez-Castelao A, Górriz JL, Segurade la Morena J, Cebollada J, Escalada J, Esmatjes E, et al. Consensus document for the detection and
management of chronic kidney disease. Nefrologia. 2014;34(2):243-62.
Alles A, Fraga A, García R, Gómez A, Greloni G, Inserra F, et al. Detección precoz de enfermedad renal crónica. Acta Bioquím Clín Latinoam. 2010;44(3):377-84.
Hallan SI, Dahl K, Oien CM, Grootendorst DC, Aasberg A, Holmen J, et al. Screening strategies for chronic kidney disease in the general
population: follow-up of cross sectional health survey. BMJ. 2006;333(7577):1047.
Otero A, De Francisco A, Gayoso P, García F. Prevalence of chronic renal disease in Spain: results of the EPIRCE study. Nefrologia. 2010;30(1):78-86.
Molina Flores R, Mojica Sandi M, Brissón C, Corrales Corrales M, Duran Pérez J, Loayza G. Tasa de filtrado glomerular estimada por ecuaciones, según sexo, en estudiantes de bioquímica de Sucre, Bolivia [poster]. I Congreso Virtual de Bioquímica Clínica; 2015 nov 16-30 [citado ene 23 2016]. Disponible en: http://www.virtualab.org.ar/POSTERS/Poster27.pdf
Afecciones crónicas [Internet]. En: Tercera encuesta nacional de factores de riesgo para enfermedades no transmisibles. Buenos Aires: Ministerio de Salud de la Nación, Instituto Nacional de Estadísticas y Censos; 2015. p. 119-24. [citado nov 29 2015]. Disponible en:
http://www.msal.gob.ar/ent/images/stories/vigilancia/pdf/2015-11_enfr_cap14_afecciones-cronicas.pdf
Cusumano AM, Inserra F. Enfermedad renal crónica: Necesidad de implementar programas para su detección precoz y prevención de su progresión. Rev Nefrol Dial Traspl. 2007;27(3):113-8.
Marini A, Bacqué M, De los Santos R, Dorado E, Wikinski R, Robaina J, et al. Relevamiento de factores de riesgo e indicadores de daño renal y cardiovascular en estudiantes de medicina. Rev Nefrol Dial Traspl. 2009;29(4):153-61.
Bianchi ME, Farías EF, Bolaño J, Massari PU. Epidemiology of renal and cardiovascular risk factors in Toba Aborigines. Ren Fail. 2006;28(8):665-70.
Atkins RC, Briganti EM, Zimmet PZ, Chadban SJ. Association between albuminuria and proteinuria in the general population: the AusDiab Study. Nephrol Dial Transplant. 2003;18(10):2170-4.
Molina Flores R, Mojica Sandi M, Brissón C, Corrales Corrales M, Duran Pérez J, Loayza G. Prevalencia de marcadores de daño renal en estudiantes de bioquímica de la Universidad San Francisco Xavier de Chuquisaca en 2013 [poster]. VII Expo Congreso Bioquímico; 2014 Jun 5-8; Rosario.
Chadban SJ, Briganti EM, Kerr PG, Dunstan DW, Welborn TA, Zimmet PZ, et al. Prevalence of kidney damage in Australian adults: The AusDiab kidney study. J Am Soc Nephrol. 2003;14(7 Suppl 2):S131-8.
