title: Preventing renal and cardiovascular risk by renal function assessment: insights from a cross-sectional study in low-income countries and the USA.
abstract: OBJECTIVE
  To assess the prevalence of microalbuminuria and kidney dysfunction in low-income countries and in the USA.
  
  
  METHODS
  Cross-sectional study of screening programmes in five countries.
  
  
  METHODS
  Screening programmes in Nepal, Bolivia, the USA (National Health and Nutrition Examination Survey (NHANES) 2005-2008) Bangladesh and Georgia.
  
  
  METHODS
  General population in Nepal (n=20 811), Bolivia (n=3436) and in the USA (n=4299) and high-risk subjects in Bangladesh (n=1518) and Georgia (n=1549).
  
  
  METHODS
  Estimated glomerular filtration rate (eGFR)<60ml/min/1.73 m(2) and microalbuminuria (defined as urinary albumin creatinine ratio values of 30-300 mg/g) were the main outcome measures. The cardiovascular (CV) risk was also evaluated on the basis of demographic, clinical and blood data.
  
  
  RESULTS
  The prevalence of eGFR<60ml/min/1.73 m(2) was 19%, 3.2% and 7% in Nepal, Bolivia and the USA, respectively. In Nepal, 7% of subjects were microalbuminuric compared to 8.6% in the USA. The prevalence of participants with predicted 10-year CV disease (CVD) risk ≥10% was 16.9%, 9.4% and 17% in Nepal, Bolivia and in the USA, respectively. In Bangladesh and Georgia, subjects with eGFR<60 ml/min/1.73 m(2) were 8.6% and 4.9%, whereas those with microalbuminuria were 45.4% and 56.5%, respectively. Predicted 10-year CVD risk ≥10% was 25.4% and 25% in Bangladesh and Georgia, respectively.
  
  
  CONCLUSIONS
  Renal abnormalities are common among low-income countries and in the USA. Prevention programmes, particularly focused on those with renal abnormalities, should be established worldwide to prevent CVD and progression to end-stage renal disease.
authors.affiliation: Clinical Research Center for Rare Diseases "Aldo e Cele Daccò", Villa Camozzi, Ranica, and Centro Anna Maria Astori, Science and Technology Park Kilometro Rosso, Mario Negri Institute for Pharmacological Research, Bergamo, Italy.
authors.forename: Paolo
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authors.lastname: Perico