title: Chronic kidney disease management program in Shahreza, Iran.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is a public health problem that needs an integrated program to be detected, monitored, and controlled. This study reports the results of a CKD program designed and implemented in Shahreza, Iran.
  
  
  METHODS
  After initial evaluation of CKD in Shahreza, a CKD management program was developed in the Ministry of Health and the pilot project was started in February 2011 in Shahreza rural areas. The patients at risk, including those with diabetes mellitus and hypertension, were tested with serum creatinine and urine albumin-creatinine ratio. The CKD management program included training, screening, monitoring, and controlling of weight, hypertension, diabetes mellitus, lipids, and vitamin D.
  
  
  RESULTS
  This pilot program was organized in the rural population aged over 30 years who were suffering from hypertension, diabetes mellitus, or both, and resulted in the discovery of cases in various stages of CKD. The prevalence of CKD in this high-risk group was 21.5%. Persistent albuminuria and a glomerular filtration rate less than 60 mL/min/1.73 m(2) were 13% and 11%, respectively. The rate of CKD stages 1, 2, 3a, 3b, 4, and 5 were 2.75%, 6.82%, 10.08%, 0.92%, 0.31%, and 0.17% respectively. After 1 year of the program implemented, incidence rate of CKD was 24% and improvement rate was 21%. In diabetic patients, the mean of hemoglobin A1c decreased from 8.5 ± 1.9% to 7.5% ± 1.8%.
  
  
  CONCLUSIONS
  Integration of CKD programs in primary health care is possible and results in improvement in management of CKD patients.
authors.affiliation: Tehran University of Medical Science. hamid_barahimi@yahoo.com.
authors.forename: Hamid
authors.initials: H
authors.lastname: Barahimi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Aghighi
authors.forename: Katayon
authors.initials: K
authors.lastname: Aghayani
authors.forename: Abbas
authors.initials: A
authors.lastname: Rahimi Foroushani
mesh_terms: D000328:Adult; D006801:Humans; D006973:Hypertension / Q000150:complications; D007492:Iran; D010865:Pilot Projects; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000628:therapy*; D012424:Rural Population; D012709:Serum Albumin / Q000032:analysis; D014512:Ureohydrolases / Q000097:blood / Q000652:urine
chemical_list: D012709:Serum Albumin; D014512:Ureohydrolases; C019944:creatinase