Screening for decreased renal function in taxi drivers in Tehran, Iran.

BACKGROUND AND OBJECTIVES

The rapid increase in end stage renal disease (ESRD) prevalence, plus the enormous cost of treatment, necessitates an urgent approach to implement strategies to prevent development and progression of ESRD, especially in the developing world. Screening that leads to early identification and treatment has been recommended, as it may slow or prevent progression to a more expensive and disabling stage of the disease and thus may save lives as well as finite resources.

METHODS

In 2007, the Healthy City Office of Tehran municipality conducted a large-scale population-based cross-sectional survey titled "Kidney Disease Screening of Taxi Drivers in Tehran." Taxi drivers or applicants of purchasing taxi participated in mentioned screening program in the last three months of 2007. Demographic data, blood pressure, and history of hypertension or smoking-and then in specific laboratories creatinine, lipid profile, complete blood count, fasting blood sugar, and urinalysis-have been checked. Results. The survey covered 31,999 people across Tehran (in a population of 12 million) during the study period. The mean and SD of age of participants was 43.77 +/- 11.32 (range from 18 to 86) years, and 98.4% (31,489) were male. Using the MDRD equation, overall prevalence of eGFR <60 mL/min/1.73 m(2) was 6.5%. However, the prevalence was 6.4% (1982/30949) in males in relation to 13.7% (69/503) in females. Mean and SD of BMI in males and females were 25.90 +/- 3.91 and 26.48 +/- 4.50 g, respectively. The overall prevalence of proteinuria (>or=1+ proteinuria) was 0.6% in males vs. 1.8% in females in normal GFR group. Age, LDL cholesterol, hypertension, blood glucose, and BMI showed to be strong risk factors for low GFR. Education level did not show a significant correlation with low GFR.

DISCUSSION AND CONCLUSIONS

The findings of the study insist on the fact that CKD prevalence is significantly higher in old age, females, hypertensives, and uncontrolled diabetic patients. Our ability to decrease the incidence of ESRD is predicated on recognizing those patients with CKD and implementing all preventive strategies.