title: Community-based screening for chronic kidney disease, hypertension and diabetes in Dharan.
abstract: BACKGROUND
  Nepal cannot afford renal replacement therapy for End Stage Renal Disease due to lack of resources. Early diagnosis of Chronic Kidney Disease and its risk factors may reduce the need of renal replacement therapy.
  
  
  METHODS
  A community-based screening on, 3218 people ≥20 years were assessed by door-to-door survey in Dharan, Nepal. Health status, lifestyle habit, physical examination and blood pressure were evaluated. Spot urine was examined for proteins and glucose by dipstick. Fasting blood glucose and serum creatinine were measured in a subset of 1000 people and the prevalence of Chronic Kidney Disease was evaluated.
  
  
  RESULTS
  Overweight, obesity, hypertension, diabetes and proteinuria were found in 20%, 5.0%, 38.6%, 7.5%, and 5.1% respectively. In the subset group, Chronic Kidney Disease was detected in 10.6%. Multivariate analysis indicated age (P <0.0001) and diabetes (P = 0.027) as statistically significant predictors for Chronic Kidney Disease. Total of 848 patients entered the management program of lifestyle modification and pharmacologic intervention. Glycemic and blood pressure control was achieved in 60% and 72%, respectively. Regression or stabilization of proteinuria was reported in 52% of patients.
  
  
  CONCLUSIONS
  Burden of Chronic Kidney Disease and cardiovascular risk factors are high in Dharan. Reasonable control of blood sugar, hypertension and proteinuria was achieved in this program. Findings indicate that activation a large prevention and intervention program to tackle Chronic Kidney Disease and Cardiovascular Disease in Nepal is needed.
authors.affiliation: Department of Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: Sanjib Kumar
authors.initials: SK
authors.lastname: Sharma
authors.forename: Subodh
authors.initials: S
authors.lastname: Dhakal
authors.forename: Lekhjung
authors.initials: L
authors.lastname: Thapa
authors.forename: Anup
authors.initials: A
authors.lastname: Ghimire
authors.forename: Rikesh
authors.initials: R
authors.lastname: Tamrakar
authors.forename: Satdal
authors.initials: S
authors.lastname: Chaudhary
authors.forename: Rajib
authors.initials: R
authors.lastname: Deo
authors.forename: Dhiraj
authors.initials: D
authors.lastname: Manandhar
authors.forename: Norberto
authors.initials: N
authors.lastname: Perico
authors.forename: Annalisa
authors.initials: A
authors.lastname: Perna
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Remuzzi
authors.forename: Madhav
authors.initials: M
authors.lastname: Lamsal
mesh_terms: D000328:Adult; D003153:Community Health Services; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D008875:Middle Aged; D009390:Nepal; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult