Public Health Department, University of Guadalajara, C.P. 44340 Guadalajara, Jalisco, Mexico.
Int J Environ Res Public Health. 2017 Dec 14;14(12):1577. doi: 10.3390/ijerph14121577.
The occurrence of Chronic Kidney Disease (CKD) of unknown etiology in autochthonous child populations residing along the Lake Chapala lakeshore is endemic (Jalisco, México). The objective of this study was to determine the prevalence of albuminuria in the pediatric population and to measure the glomerular filtration rate in children with two positive albuminuria tests. Urinary albumin was measured in 394 children. Subjects with two or more positive albuminuria test donated blood samples for the determination of serum biomarkers. From a rural community with 565 children under the age of 17 years, 394 (69.7%) participated with first morning urine samples. A total of 180 children were positive (with two or more positive albuminuria tests). The prevalence of albuminuria among the children participating in the study was 45.7%. Of the 180 children with persistent albuminuria, 160 (88.9%) were tested for serum creatinine, urea, and cystatin C. The 68.1% of the children studied, were found in stages 3a and 3b of the Kidney Disease Improving Global Outcomes (KDIGO) classification (mean glomerular filtration rate (GFR) 51.9 and 38.4 mL/min/1.73 m² respectively). The lowest frequencies were for classifications 1 and 4. None of the subjects was classified as grade 5. The prevalence of albuminuria in children from this rural community is 3-5 times higher than reported in international literature. Regarding GFR, more than 50% of children studied are under 60 mL/min/1.73 m². It is a priority to find the causes of albuminuria and CKD in this Mexican region.
在湖查帕拉湖岸居住的土着儿童人群中,不明病因的慢性肾脏病(CKD)的发生是地方性的(墨西哥哈利斯科州)。本研究的目的是确定儿科人群中蛋白尿的患病率,并测量两次蛋白尿检测呈阳性的儿童的肾小球滤过率。对 394 名儿童进行了尿白蛋白检测。两次或多次蛋白尿检测呈阳性的受试者捐献血液样本,以测定血清生物标志物。从一个有 565 名 17 岁以下儿童的农村社区中,有 394 名(69.7%)儿童参与了研究,他们提供了清晨第一次尿液样本。共有 180 名儿童呈阳性(有两次或两次以上蛋白尿检测阳性)。参与研究的儿童中蛋白尿的患病率为 45.7%。在持续存在蛋白尿的 180 名儿童中,有 160 名(88.9%)接受了血清肌酐、尿素和胱抑素 C 的检测。在所研究的 68.1%的儿童中,根据肾脏病改善全球结局(KDIGO)分类处于 3a 和 3b 期(平均肾小球滤过率(GFR)分别为 51.9 和 38.4 mL/min/1.73 m²)。分类为 1 期和 4 期的儿童频率最低。没有受试者被分类为 5 期。来自这个农村社区的儿童蛋白尿的患病率比国际文献报道的要高 3-5 倍。关于 GFR,超过 50%的研究儿童的肾小球滤过率低于 60 mL/min/1.73 m²。在这个墨西哥地区找到蛋白尿和 CKD 的病因是当务之急。