title: Identifying undetected cases of chronic kidney disease in Mexico. Targeting high-risk populations.
abstract: OBJECTIVE
  Chronic kidney disease (CKD) is a major public health problem in Mexico. Current guidelines recommend routine CKD testing in patients at increased risk for CKD. We undertook this study to examine the diagnostic yield of targeted screening (case-finding) for CKD in high-risk populations in rural and urban communities in Jalisco, Mexico.
  
  
  METHODS
  In a cross-sectional study, we did laboratory tests searching for CKD and its risk factors and compared the characteristics of participants with those reported by the National Health and Nutrition Survey 2006 (NHNS). Individuals who were aware that they had CKD and those <18 years of age were excluded.
  
  
  RESULTS
  There were 9,169 participants assessed: 28.7% were men and mean age was 55.6 ± 13.7 years. They were predominantly female (71.3 vs. 55.6%, p = 0.0001) and older (55.59 ± 0.1 vs. 42.5 ± 0.3 years, p = 0.0001) than the NHNS population. Self-reported diabetes (41.9 vs. 7.3%, p = 0001) and fasting blood sugar >126 mg/dl (56.1 vs. 14.4%, p = 0.0001) were more prevalent among the participants; self-reported hypertension (41.9 vs. 7.3%, p = 0.0001), systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure ≥ 90 mm Hg (52.5 vs. 43.2%, p = 0.0001), and obesity (42.8. vs. 29.3%, p = 0.0001) were also more frequent among participants. There were 19.7% with proteinuria; CKD was more prevalent among the high risk participants in our study (31.3 vs. 8.0%, p = 0.0001) than in the general population.
  
  
  CONCLUSIONS
  CKD was detected frequently in high-risk Mexican populations. Trials of case-finding and intervention are feasible and warranted in Mexico.
authors.affiliation: Division of Nephrology, Civil Hospital of Guadalajara, University of Guadalajara Health Sciences Center, Guadalajara, Jalisco, Mexico. Electronic address: ggarcia1952@gmail.com.
authors.forename: Guillermo
authors.initials: G
authors.lastname: García-García
authors.forename: Alfonso J
authors.initials: AJ
authors.lastname: Gutiérrez-Padilla
authors.forename: Jonathan
authors.initials: J
authors.lastname: Chávez-Iñiguez
authors.forename: Héctor R
authors.initials: HR
authors.lastname: Pérez-Gómez
authors.forename: Martha
authors.initials: M
authors.lastname: Mendoza-García
authors.forename: Ma Del Mar
authors.initials: Mdel M
authors.lastname: González-De la Peña
authors.forename: Marcello
authors.initials: M
authors.lastname: Tonelli
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors
keywords: Chronic kidney disease; Diabetes; Hypertension; Proteinuria