Salgado-Filho Natalino, Lages Joyce Santos, Brito Dyego José, Salgado João Victor, Silva Gyl Eanes, Santos Alcione Miranda, Monteiro-Júnior Francisco Chagas, Santos Elisangela Milhomen, Silva Antônio Augusto, Araújo Denizar Vianna, Sesso Ricardo Castro
Kidney Disease Prevention Centre and Department of Medicine I, Federal University of Maranhão, São Luís, MA, Brasil.
Department of Public Health, Federal University of Maranhão, São Luís, MA, Brazil.
BMC Nephrol. 2018 Feb 26;19(1):43. doi: 10.1186/s12882-018-0839-z.
Chronic kidney disease (CKD) is considered a serious public health problem, both in Brazil and worldwide, with an increasing number of cases observed inrecent years. Especially, CKD has been reported to be highly prevalent in those of African descent. However, Brazil lacks data from early-stage CKD population studies, and the prevalence of CKD is unknown for both the overall and African descent populations. Hence, the present study aimsto estimate the prevalence of early-stage CKD and its associated risk factors in African-Brazilians from isolated African-descent communities. Herein, the detailed methodology design of the study is described.
This population-based, prospective, longitudinal, cohort study (PREVRENAL) is performed in three stages: first, clinical, nutritional, and anthropometric evaluations; measurements of serum and urinary markers; and examinations of comorbiditieswere performed. Second, repeated examinations of individuals with CKD, systemic arterial hypertension, and/or diabetes mellitus; image screening; and cardiac risk assessment were performed. Third, long-term monitoring of all selected individuals will be conducted (ongoing). Using probability sampling, 1539 individuals from 32 communities were selected. CKD was defined asaglomerular filtration rate (GFR) ≤60 mL/min/1.73m and albuminuria > 30 mg/day.
This study proposes to identify and monitor individuals with and without reduced GFR and high albuminuria in isolated populations of African descendants in Brazil. As there are currently no specific recommendations for detecting CKD in African descendants, four equations for estimating the GFR based on serum creatinine and cystatin C were used and will be retrospectively compared. The present report describes the characteristics of the target population, selection of individuals, and detection of a population at risk, along with the imaging, clinical, and laboratory methodologies used. The first and second stages have been concluded and the results will be published in the near future. The subsequent (third) stage is the long-term, continuous monitoring of individuals diagnosed with renal abnormalities or with CKD risk factors. The entire study population will be re-evaluated five years after the study initiation. The expectation is to obtain information about CKD evolution among this population, including the progression rate, complication development, and cardiovascular events.
慢性肾脏病（CKD）在巴西乃至全球都是一个严重的公共卫生问题，近年来病例数不断增加。特别是，据报道CKD在非洲裔人群中高度流行。然而，巴西缺乏早期CKD人群研究的数据，CKD在总体人群和非洲裔人群中的患病率尚不清楚。因此，本研究旨在估计来自孤立非洲裔社区的非洲裔巴西人早期CKD的患病率及其相关危险因素。本文描述了该研究的详细方法设计。
这项基于人群的前瞻性纵向队列研究（PREVRENAL）分三个阶段进行：第一，进行临床、营养和人体测量评估；测量血清和尿液标志物；检查合并症。第二，对患有CKD、系统性动脉高血压和/或糖尿病的个体进行重复检查；进行影像筛查和心脏风险评估。第三，将对所有选定个体进行长期监测（正在进行）。采用概率抽样，从32个社区中选取了1539名个体。CKD定义为肾小球滤过率（GFR）≤60 mL/min/1.73m²且蛋白尿>30 mg/天。
本研究提议在巴西非洲裔孤立人群中识别和监测GFR降低和蛋白尿高的个体与未受影响个体。由于目前尚无针对非洲裔人群检测CKD的具体建议，因此使用了四个基于血清肌酐和胱抑素C估计GFR的方程，并将进行回顾性比较。本报告描述了目标人群的特征、个体选择和高危人群检测，以及所使用的影像、临床和实验室方法。第一和第二阶段已经结束，结果将在不久后发表。后续（第三）阶段是对诊断为肾脏异常或有CKD危险因素的个体进行长期连续监测。整个研究人群将在研究开始五年后重新评估。期望获得该人群中CKD演变的信息，包括进展速度、并发症发展和心血管事件。
