Detection and prevention of chronic kidney disease in Indonesia: initial community screening.
OBJECTIVE
This survey evaluated the prevalence of chronic kidney disease (CKD if estimated glomerular filtration rate (eGFR) <60 mL/min per 1.73 m(2)) and its risk factors amongst subjects from urban and semi-urban areas.


METHODS
History of hypertension, diabetes mellitus, kidney disease, cardio- and cerebrovascular diseases of subjects and their families was recorded. Blood pressure was determined as the mean of three readings in the sitting position and hypertension classified according to the Joint National Committee VII. Urinalysis was assessed using Combi 10R dipstick test. Random blood glucose and serum creatinine were measured in subjects with either hypertension, proteinuria, glycosuria and/or a history of diabetes. eGFR was calculated according Cockcroft-Gault (CG) adjusted by body surface area (BSA), Modification of Diet in Renal Disease (MDRD) and Chinese MDRD equations.


RESULTS
Of 9412 subjects recruited, 64.1% were female. Persistent proteinuria was found in almost 3%. Systolic and diastolic hypertension was found in 10%, isolated systolic hypertension in 4.8% and isolated diastolic hypertension in 4.6%. CKD was found in 12.5% (CG), 8.6% (MDRD) or 7.5% (Chinese MDRD) of subjects with either hypertension, proteinuria and/or diabetes. Proteinuria, systolic blood pressure and a history of diabetes mellitus were independent predictors of impaired eGFR. Obesity and smoking history were found in 32.5% and 19.8%, respectively.


CONCLUSIONS
The present study showed a high prevalence of CKD in representative urban and semi-urban areas and argues for screening and treatment of all Indonesians, particularly those at an increased risk of CKD.
Prodjosudjadi
Wiguno
W
Faculty of Medicine, University of Indonesia, Jakarta, Indonesia. pernefri@cbn.net.id
Suhardjono
Suwitra
Ketut
K
Pranawa
Widiana
I Gde Raka
IG
Loekman
Jodi Sidharta
JS
Nainggolan
Ginova
G
Prasanto
Heru
H
Wijayanti
Yanri
Y
Dharmeizar
Sja'bani
Mochammad
M
Nasution
M Yusuf
MY
Basuki
Widodo
W
Aditiawardana
Harris
David C H
DC
Pugsley
David J
DJ
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002908:Chronic Disease; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007214:Indonesia / Q000453:epidemiology; D007674:Kidney Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011507:Proteinuria / Q000453:epidemiology