Abstract

RIOS BRUNO, Pablo et al. Importance of preventive medical examination for early diagnosis of renal disease in Uruguay.: The National Renal Health Program. Arch. Med Int [online]. 2015, vol.37, n. 3, pp.114-121. ISSN 0250-3816.

Introduction: The National Renal Health Program showed that chronic kidney disease (CKD) can be stabilized in the outcome. Objective: To assess screening Chronic Kidney Disease presumptive (pCKD) in an outpatient population of a Preventive Clinic with dipstick proteinuria (TPu) and/or eGFR <60 ml/min. Method: It is an observational, descriptive and cross sectional study.  Between 1/1/2008 and 12/31/2012 was performed medical check to 83.912 individual  (average age=34.4 years) from a Preventive Clinic with a proteinuria by TPu. In a selective population with predominant hypertension and diabetes (n 11.161 individuals, age 44.7 years odl) was performed determination of creatina and eGFR was estimated by CKD-EPI formula.  pCKD prevalence was assessed by Pu + and/or eGFR<60 ml/min/1.73m2  alone or combined. We analyzed the risk factors (RF) for pCKD with SPSS 15.0 statistical software and logistic regression was used for multivariate analysis. Results: The prevalence of Pu + in total population was 6% (5.5% in the reference group, 6.7% in hypertension-without-diabetes, 9.2% in diabetes-without-hypertension and 13.6% in both RF group); the risk of Pu+ was increased in the previous groups (p < 0.05). Pu + false positives were unknown. The prevalence of eGFR< 60 ml/min was 1.8%, and age and hypertension were independent risk factors. When Pu + and/or eGFR<60 ml/min are considered together, the prevalence of pCKD reaches 9.2%. RF increases the frequency of pCKD (p < 0.05). With isolated Pu +,  pCKD is detected between 85-90% according to whether or not they have RF; by age groups the isolated Pu + detects 100% of individuals with pCKD <20 years, is > 90% in those with <50 years and drop to 30% at 70 years or more, where is relevant the eGFR: 21.9% in RF group. Conclusions: The Preventive Clinic population is a useful place for screening early pCKD. This study identified renal markers of pCKD for different population segments: isolated Pu + detects pCKD in more than 90% of people < 50 years and the eGFR makes it in aged people.

Keywords : screening; CKD; Proteinuria; GFR; Diabetes; Hypertension.