title: High prevalence of early chronic kidney disease in high risk outpatients.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is a significant public health problem. The aim of this study was to determine the presence of early stages of renal disease in hypertensive and diabetic outpatients without previously diagnosed renal damages.
  
  
  METHODS
  In this cross-sectional study we studied a random sample of outpatients with essential hypertension and/or diabetes mellitus type 2 in the general practice ambulance of city Sarajevo. Renal function was evaluated by using MDRD (Modification of Diet in Renal Disease) equation and with measurement of renal biomarkers. K/DOQI classification was used to define the stages of CKD.
  
  
  RESULTS
  The study included 200 patients, of whom 75 (37.5%) were females, mean age of 54.81 ± 6.1 years, and 125 (62.5%) male, mean age 52.46 ± 8.2 years. More than half of respondents (54.0%) were hypertensive during the follow up period. Early CKD was detected in 52% respondents. Higher prevalence of early CKD was verified in the group of patients who had hypertension associated with diabetes mellitus type 2 (59.6% vs. 47.2% in hypertension group vs. 54,0% in diabetic group, p<0.05). Significant negative correlation was found between estimated glomerular filtration rate and presence of albuminuria (p<0.001), duration of hypertension (p=0.003), duration of type 2 diabetes mellitus (p=0.021), stages of hypertension (p=0.012), female gender (p<0.001) and older age of subjects (p=0.040).
  
  
  CONCLUSIONS
  Our results confirmed high prevalence of CKD and the importance of early detection of CKD in high risk groups of patients in order to prevent the progression of the same. Prevention of chronic kidney disease in our country is still not carried out satisfactorily. Required is a much greater collaboration between primary care health givers and nephrologists.
authors.affiliation: Institute for Occupational Medicine of Canton Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors.forename: Ramajana
authors.initials: R
authors.lastname: Temimovic
authors.affiliation: Clinic for Nephrology, University Clinical Centre Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors.forename: Senija
authors.initials: S
authors.lastname: Rasic
authors.affiliation: Clinic for Nephrology, University Clinical Centre Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors.forename: Alma
authors.initials: A
authors.lastname: Muslimovic
keywords: diabetes mellitus type 2; early chronic kidney disease; hypertension