[Prevalence of chronic kidney disease in subjects consulting in urban primary care clinics].
BACKGROUND
Chronic kidney disease (CKD) is a major worldwide public health problem and is associated with increased risk of cardiovascular disease and death.


OBJECTIVE
To assess CKD prevalence in urban Primary Care Services (PCS) of Concepcion, Chile.


METHODS
The clinical records of 27.894 adults aged 55 ± 18 years (66% females), consulting in outpatient clinics and in whom serum creatinine was measured, with or without assessment of urine albumin levels, were reviewed. The glomerular filtration rate (eGFR) was estimated using the Modification of Diet in Renal Disease (MDRD)-4 equation. CKD was defined as an eGFR < 60 ml/min/1.73 m2 and classified according to the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NFK-KDOQI) guidelines.


RESULTS
Mean eGFR was 77.1 ± 16.3 ml/min/1.73 m2. Twelve percent of subjects had CKD (women, 14.5% and men 7,4%, p < 0,05). The prevalence of stages 3, 4 and 5 of CKD were 11.6, 0.3 and 0.2 % respectively. eGFR was negatively correlated with age ( r = -0,54, p < 0,05). Among patients with an eGFR < 60 ml/min/1.73 m2, 96.3% had eGFR 30-59, 2.3% 15-29 and 1.4 % < of 15. Seventy nine percent were women. 75.1% were aged 65 years or more, 26.8% had a serum creatinine equal or less than 1.0 mg/dL and 40.5% had microalbuminuria. Only 1% of outpatients ascribed to Cardiovascular or Diabetes Programs had the diagnosis of CKD registered. Independent risk predictors of CKD were age > 60 years, female sex and microalbuminuria.


CONCLUSIONS
This study showed a high prevalence of CKD in ambulatory patients, mainly among women and older people. The low level of diagnosis of CKD in cardiovascular and diabetes programs is of concern.
Facultad de Medicina, Universidad Católica de Santísima Concepción, Chile. czunigasm2002@yahoo.com
Carlos
C
Zúñiga S M
Hans
H
Müller O
Maritza
M
Flores O
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002677:Chile / Q000453:epidemiology; D002908:Chronic Disease; D003404:Creatinine / Q000652:urine; D004812:Epidemiologic Methods; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D017678:Sex Distribution; D019037:Urban Health Services / Q000706:statistics & numerical data*; D055815:Young Adult
D003404:Creatinine