Burkhalter Felix, Sannon Herriot, Mayr Michael, Dickenmann Michael, Ernst Silvia
Clinic for Transplant Immunology and Nephrology, University Hospital Basel, Switzerland.
Clinic for Internal Medicine, Hôpital Albert Schweitzer Deschappelles, Haiti.
Swiss Med Wkly. 2014 Dec 23;144:w14067. doi: 10.4414/smw.2014.14067. eCollection 2014.
In the Caribbean region chronic kidney disease (CKD) is an increasing challenge. High rates of non-communicable and infectious diseases and the rise in people suffering from diabetes and hypertension explain the observed and further expected increase of CKD. However, data about the magnitude of the problem are rare and in some countries such as Haiti completely lacking. The aim of our study was to generate data about the prevalence and risk factors for CKD in a rural region in Haiti.
In this prospective cross-sectional study, adult patients visiting the medical outpatient clinic of the Hôpital Albert Schweitzer (HAS) in Deschapelles Haiti were included. CKD was assessed by estimated glomerular filtration rate (eGFR) and measurement of proteinuria by dipstick test. Risk factors for CKD were assessed by clinical examinations and questionnaires.
Overall 608 patients were screened for CKD, of whom 27% had CKD. CKD stages 1 to 2 were found in 15.3% and stages 3 to 5 in 11.7%. The prevalence of hypertension and diabetes mellitus was 49.2% and 36.3%, respectively. Risk factors independently associated with CKD were hypertension (p = 0.0002) and HIV infection (p = 0.019) and age >60 years (p = 0.0052), whereas diabetes mellitus was not independently associated (p = 0.72).
Our data show a high prevalence of CKD and traditional risk factors, and their association with CKD in Haiti. These findings have now to be confirmed in other regions in longitudinal analyses as a basic step to build up screening and prevention programmes for CKD.
在加勒比地区，慢性肾脏病（CKD）是一个日益严峻的挑战。非传染性疾病和传染性疾病的高发病率以及糖尿病和高血压患者人数的增加，解释了CKD已观察到的增长以及未来预期的增长。然而，关于该问题严重程度的数据很少，在一些国家，如海地，数据完全缺失。我们研究的目的是获取海地一个农村地区CKD的患病率和危险因素的数据。
在这项前瞻性横断面研究中，纳入了前往海地德沙佩勒市阿尔贝特·施韦泽医院（HAS）门诊就诊的成年患者。通过估算肾小球滤过率（eGFR）评估CKD，并通过试纸条检测测量蛋白尿。通过临床检查和问卷调查评估CKD的危险因素。
总共对608名患者进行了CKD筛查，其中27%患有CKD。发现15.3%的患者处于CKD 1至2期，11.7%的患者处于3至5期。高血压和糖尿病的患病率分别为49.2%和36.3%。与CKD独立相关的危险因素是高血压（p = 0.0002）、HIV感染（p = 0.019）和年龄>60岁（p = 0.0052），而糖尿病并非独立相关（p = 0.72）。
我们的数据显示海地CKD和传统危险因素的患病率很高，以及它们与CKD的关联。这些发现现在需要在其他地区通过纵向分析加以证实，作为建立CKD筛查和预防计划的基本步骤。
