Screening for kidney disease on World Kidney Day in Jalisco, Mexico.
BACKGROUND
In 2006, the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF) introduced World Kidney Day, to educate the public about the importance of chronic kidney disease (CKD) and its early detection. This prospective study examined the diagnostic yield of screening for CKD in poor neighborhoods in Guadalajara, Mexico, on World Kidney Day.


METHODS
On World Kidney Day in 2006 and 2007, 2 screening stations were set up in Guadalajara, with a 2-week promotion period beforehand in the local media. Individuals who were aware that they had CKD and those <18 years of age were excluded. Data were prospectively collected by the staff of the screening programs using a standard form; all participants provided blood and urine specimens for serum creatinine assays and dipstick urinalysis.


RESULTS
We studied 634 participants, of whom approximately 24% had proteinuria, 35% had hematuria and 6.4% had an estimated glomerular filtration rate (eGFR) <60 ml/min per 1.73 m2. Overall, the number needed to screen (NNS) to detect 1 new case of eGFR <60 ml/min per 1.73 m2 was 16 (95% confidence interval [95% CI], 12-22), varying from as low as 5 (95% CI, 4-8) in participants >60 years of age, to as high as 84 (95% CI, 35 to >200) in people aged 18 to 40 years.


CONCLUSIONS
Proteinuria and eGFR <60 ml/min per 1.73 m2 were frequently detected among participants in community-based screening carried out on World Kidney Day in the state of Jalisco, Mexico, especially in people over 40 years old. Our data indicate that screening on World Kidney Day may be useful for identifying Jalisco residents with CKD, and suggest that trials of targeted screening and intervention are feasible and warranted.
Garcia-Garcia
Guillermo
G
Division of Nephrology, Hospital Civil de Guadalajara Fray Antonio Alcalde, University of Guadalajara Health Sciences Center, Guadalajara, Jalisco - Mexico. ggarcia1952@gmail.com
Marquez-Magaña
Isela
I
Renoirte-Lopez
Karina
K
Perez-Cortes
Gustavo
G
Salazar Gutierrez
M Luisa
ML
Klarenbach
Scott
S
Lloyd
Anita
A
Tonelli
Marcello
M
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003153:Community Health Services; D003404:Creatinine / Q000097:blood; D042241:Early Diagnosis; D005260:Female; D005919:Glomerular Filtration Rate; D006417:Hematuria / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007391:International Cooperation; D007674:Kidney Diseases / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008403:Mass Screening / Q000379:methods; D008800:Mexico; D008875:Middle Aged; D009313:National Health Programs; D011203:Poverty; D011237:Predictive Value of Tests; D015397:Program Evaluation; D011446:Prospective Studies; D011507:Proteinuria / Q000175:diagnosis / Q000209:etiology; D011933:Reagent Kits, Diagnostic; D011934:Reagent Strips; D012955:Societies, Medical; D055815:Young Adult
D015415:Biomarkers; D011933:Reagent Kits, Diagnostic; D011934:Reagent Strips; D003404:Creatinine