Detección de factores de riesgo e indicadores tempranos de enfermedad renal crónica en población adulta en una campaña de salud renal / Detection of risk factors and early indicators of chronic kidney disease in an adult population during a kidney health campaign
Rev. nefrol. diál. traspl
; 33(4): 196-214, dic. 2013. tab, graf
Article
in Es
| LILACS
| ID: lil-716968
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AR444.1
RESUMEN
Introducción:
La Enfermedad Renal Crónica (ERC) en el adulto es una afección frecuente y constituye un importante problema de Salud Pública a nivel mundial. Se la ha relacionado con un riesgo elevado de insuficiencia renal crónica terminal, enfermedad cardiovascular y muerte. Dada la creciente incidencia de ERC y la disponibilidad de medidas terapéuticas efectivas, es de vital importancia realizar la detección precoz de factores de riesgo (FR), con el fin de retrasar o prevenir su progresión. Con el objetivo de detectar precozmente indicadores de ERC y FR asociados, realizamos una campaña de salud renal en una población adulta.Metodos:
Participaron 608 personas >18 años, evaluándose PA, IMC, glucemia, creatinina y en orina matinal se calculó el cociente albuminuria/creatininuria. La ERC se estadificó según albuminuria y/o filtrado glomerular estimado (IFG) por MDRD4, CKD-EPI y C.G.Resultados:
La media de edad,fue 54.8±15.4 años, con predominio de mujeres (72%). El 61.5% presentaban uno o más FR edad >55 años 52.8 %, HTA 39.3%, obesidad 36.8%, alteraciones del metabolismo hidrocarbonado (AMHC) 21.2%, diabetes 14.1% (DBT), tabaquismo 12.3% y albuminuria 11%. Detectamos ERC en el 14%, 40% varones, con albuminuria 78.8% e IFG<60 ml/m 37.6%. El 95.2% asociaba FR. Las siguientes variables estuvieron asociadas a ERC (p<0.05) sexo masculino, edad > 55, HTA, DBT, obesidad, tabaquismo y nivel de educación. En el análisis multivariado mantuvieron significación edad >55, obesidad, HTA, DBT y nivel de educación. El 21.8% de los hipertensos, el 37.3% con AMHC y el 100% con albuminuria lo desconocían.Conclusión:
En esta población ser varón, tener >55 años, HTA, obesidad y/o DBT incrementa el riesgo de desarrollar ERC. Identificamos un alto porcentaje (61.5%) de individuos con FR y ERC. La detección precoz de FR y su tratamiento reducirían significativamente la incidencia y progresión de la ERC. Encontramos una frecuencia de ERC y albuminuria similar a otros reportes, lo cual contribuye al conocimiento de esta enfermedad y su prevalencia en ArgentinaABSTRACT
Introduction:
Chronic kidney disease (CKD) in adults is a common condition and a major public health issue worldwide. There has been related to a high risk of End Stage Renal Disease (ESRD), cardiovascular disease and death. Given the increasing incidence of CKD and the availability of effective therapeutic measures, is of vital importance perform early detection of risk factors (RF), in order to delay or prevent progression to ESRD. The optimal cost-effective strategy seems to be an investigation aimed at patients with one or more risk factors for CKD. In order to detect early indicators of CKD and associated risk factors, we conducted a study in an adult population.Methods:
In a cross-sectional study was evaluated BP, BMI, blood glucose, serum creatinine and albumin/creatinine ratio in urine sample in 608 people> 18 years. Participants were classified for stages of CKD according to the presence of albuminuria and / or estimated glomerular filtration rate (MDRD4, CKD-EPI and CG). For statistical analysis (Stata 11.0) we used Fishers exact test, Ttest and Cox regression to explore the association between variables. Effect measure RR and 95% CI, was considered significant when P <0.05.Results:
Mean age 54.8 ± 15.4 years, 72% were females. 61.5% had one or more CKD RF.Presence of CKD RF age> 55 years 52.8%, hypertension 39.3% obesity 36.8%, carbohydrate metabolism disorders (CHMD)21.2%, diabetes 14.1% (DBT), smoking 12.31%, albuminuria 11%. CKD was found in 14% of participants, 40% were male, albuminuria in 78.8% and GFR <60 ml/m in 37.6%. The 95.2% of participants with CKD had RF. The following variables were associated with ERC (p <0.05) male gender, age> 55, hypertension, diabetes, obesity, smoking and educational level. In multivariate analysis remained significant age> 55, obesity, hypertension, diabetes and educational level. The 21.8% of hypertensive patients, 37.3% of those with CHMD and 100% with albuminuria did not know that condition.Conclusion:
In this population to be a male, to have> 55 years, hypertension, obesity and diabetes it increases the risk of developing CKD. We identified a high percentage (61.5%) of individuals with RF and ERC. The implementation of campaigns for early detection of RF and treatment would reduce the incidence and progression of CKD. We found a frequency of CKD and albuminuria similar to others international reports contributing to the understanding of this disease and its prevalence in Argentina.Key words
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Database:
LILACS
Main subject:
Kidney Failure, Chronic
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Health_technology_assessment
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Language:
Es
Journal:
Rev. nefrol. diál. traspl
Journal subject:
CIRURGIA GERAL
/
NEFROLOGIA
Year:
2013
Type:
Article
Affiliation country:
Argentina