Division of Nephrology, Hospital Civil de Guadalajara Fray Antonio Alcalde, University of Guadalajara Health Sciences Center, Guadalajara, Jalisco - Mexico.
J Nephrol. 2010 Mar-Apr;23(2):224-30.
In 2006, the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF) introduced World Kidney Day, to educate the public about the importance of chronic kidney disease (CKD) and its early detection. This prospective study examined the diagnostic yield of screening for CKD in poor neighborhoods in Guadalajara, Mexico, on World Kidney Day.
On World Kidney Day in 2006 and 2007, 2 screening stations were set up in Guadalajara, with a 2-week promotion period beforehand in the local media. Individuals who were aware that they had CKD and those <18 years of age were excluded. Data were prospectively collected by the staff of the screening programs using a standard form; all participants provided blood and urine specimens for serum creatinine assays and dipstick urinalysis.
We studied 634 participants, of whom approximately 24% had proteinuria, 35% had hematuria and 6.4% had an estimated glomerular filtration rate (eGFR) <60 ml/min per 1.73 m2. Overall, the number needed to screen (NNS) to detect 1 new case of eGFR <60 ml/min per 1.73 m2 was 16 (95% confidence interval [95% CI], 12-22), varying from as low as 5 (95% CI, 4-8) in participants >60 years of age, to as high as 84 (95% CI, 35 to >200) in people aged 18 to 40 years.
Proteinuria and eGFR <60 ml/min per 1.73 m2 were frequently detected among participants in community-based screening carried out on World Kidney Day in the state of Jalisco, Mexico, especially in people over 40 years old. Our data indicate that screening on World Kidney Day may be useful for identifying Jalisco residents with CKD, and suggest that trials of targeted screening and intervention are feasible and warranted.
2006 年，国际肾脏病学会（ISN）和国际肾脏基金会联合会（IFKF）推出了世界肾脏日，旨在教育公众了解慢性肾脏病（CKD）的重要性及其早期发现。本前瞻性研究调查了在墨西哥瓜达拉哈拉的贫困社区，在世界肾脏日进行 CKD 筛查的诊断效果。
在 2006 年和 2007 年的世界肾脏日，在瓜达拉哈拉设立了 2 个筛查站，在当地媒体上进行了为期 2 周的宣传。排除已知患有 CKD 且年龄<18 岁的个体。筛查项目工作人员使用标准表格进行前瞻性数据收集；所有参与者均提供血液和尿液标本，用于血清肌酐检测和尿沉渣分析。
我们研究了 634 名参与者，其中约 24%有蛋白尿，35%有血尿，6.4%估计肾小球滤过率（eGFR）<60 ml/min/1.73 m2。总体而言，发现 1 例新的 eGFR<60 ml/min/1.73 m2 所需的筛查人数（NNS）为 16（95%置信区间[95%CI]，12-22），在年龄>60 岁的参与者中低至 5（95%CI，4-8），在 18-40 岁的人群中高至 84（95%CI，35->200）。
在墨西哥哈利斯科州的社区基础筛查中，在世界肾脏日进行的参与者中经常发现蛋白尿和 eGFR<60 ml/min/1.73 m2，尤其是 40 岁以上的人群。我们的数据表明，在世界肾脏日进行筛查可能有助于识别患有 CKD 的哈利斯科州居民，并表明针对特定人群的筛查和干预试验是可行和必要的。
