Sumaili Ernest K, Nseka Nazaire M, Lepira François B, Krzesinski Jean Marie, Makulo Jean Robert R, Bukabau Justine B, Nkoy Josée B, Mokoli Vieux M, Longokolo Murielle M, Owandjalola Julie A, Kayembe Patrick K
Nephrology Unit, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
Nephron Clin Pract. 2008;110(4):c220-8. doi: 10.1159/000167869. Epub 2008 Oct 31.
Although screening programs for chronic kidney disease (CKD) may be of great value, these programs are not yet implemented in the Democratic Republic of Congo. This study focused on proteinuria and examined its prevalence in terms of the number needed to screen for the different risk factors of CKD. Such knowledge would guide the utility of population screening to prevent end-stage renal disease.
A cross-sectional survey was conducted in Kinshasa on the Second World Kidney Day. A sample of 3,018 subjects was interviewed and the following measurements were performed: blood pressure, body mass index, glycemia and urine protein. Logistic regression analysis was used to identify determinants of proteinuria.
The prevalence of proteinuria was 17.1% (95% CI 15.8-18.6). Other CKD risk factors identified were: hypertension, diabetes mellitus, obesity and metabolic syndrome. To identify 1 case of proteinuria, one would need to screen 4 persons with diabetes, 5 persons with hypertension, 4 subjects having metabolic syndrome, 5 persons aged >or=72 years and 9 persons without any of the conditions mentioned above. Age, overweight and diabetes were the strongest factors associated with proteinuria.
This study indicates that proteinuria and traditional risk factors for CKD are very prevalent in Kinshasa. Realistic policies to stem these conditions should be a public health priority.
尽管慢性肾脏病（CKD）筛查项目可能具有重大价值，但刚果民主共和国尚未实施这些项目。本研究聚焦蛋白尿，并根据筛查CKD不同风险因素所需人数来考察其患病率。此类知识将指导人群筛查预防终末期肾病的效用。
在金沙萨世界肾脏日开展了一项横断面调查。对3018名受试者进行了访谈，并进行了以下测量：血压、体重指数、血糖和尿蛋白。采用逻辑回归分析确定蛋白尿的决定因素。
蛋白尿患病率为17.1%（95%可信区间15.8 - 18.6）。确定的其他CKD风险因素有：高血压、糖尿病、肥胖和代谢综合征。要筛查出1例蛋白尿患者，需要筛查4名糖尿病患者、5名高血压患者、4名患有代谢综合征的受试者、5名年龄≥72岁的人以及9名无上述任何情况的人。年龄、超重和糖尿病是与蛋白尿关联最强的因素。
本研究表明，蛋白尿和CKD传统风险因素在金沙萨非常普遍。遏制这些情况的切实可行政策应成为公共卫生的优先事项。
