Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico, Mexico.
Departamento de Calidad y Educación en Salud, Secretaría de Salud de Tlaxcala, Tlaxcala, Mexico.
Nephron. 2019;143(4):264-273. doi: 10.1159/000502481. Epub 2019 Sep 5.
Tlaxcala, a small state in central Mexico, has the highest prevalence of chronic kidney disease (CKD) deaths in population aged 5-14 in Mexico, most of them with unknown etiology.
To determine the prevalence of CKD in apparently healthy pediatric population in Apizaco, Tlaxcala.
A cross-sectional pilot study was carried out in children deemed as healthy; subjects with previous diagnosis of CKD were excluded. Informed consent was obtained in all cases. A physical examination was performed, a questionnaire was applied. Blood and urine samples were obtained for serum creatinine, urinalysis, and microalbumin/creatinine ratio. A second and third evaluation was performed after 6 and 18 months in those found with urinary anomalies/CKD to confirm the diagnosis.
One hundred and nine subjects completed physical examination, which are the biological samples. Median age was 12 years. CKD stage 2 was confirmed in 5 subjects in the sixth month confirmation visit (4.6%). One patient accepted renal biopsy and Alport Syndrome was found. In a robust multivariate analysis, the risk factors related to reduction in the glomerular filtration rate were males -5.15 mL/min/1.73 m2 (p = 0.002), older participants as by -1.58 mL/min/1.73 m2 per year (p < 0.0001), and among participants living close to a river -3.76 mL/min/1.73 m2 (p = 0.033).
DISCUSSION/CONCLUSION: The prevalence of CKD in the population studied in Apizaco Tlaxcala was confirmed in 4.6 cases per 100 inhabitants between 6 and 15 years. Males, older age, and living close to a river were the risk predictive factors. More studies are needed to determine the causes of the high CKD prevalence in this population.
墨西哥中部的特拉斯卡拉州，是墨西哥 5-14 岁人群中慢性肾脏病（CKD）死亡率最高的州，其中大多数病因不明。
确定特拉斯卡拉州阿皮萨科看似健康的儿科人群中 CKD 的患病率。
对被认为健康的儿童进行横断面试点研究；排除有 CKD 既往诊断的患者。在所有情况下均获得知情同意。进行体格检查，应用问卷。采集血清肌酐、尿液分析和微量白蛋白/肌酐比值的血、尿样本。对尿液异常/CKD 患者进行第二次和第三次评估，以确认诊断。
109 例完成了体格检查和生物样本采集。中位年龄为 12 岁。在第六个月的确认就诊中，有 5 例患者被确诊为 CKD 2 期（4.6%）。1 例患者接受了肾活检，发现 Alport 综合征。在稳健的多变量分析中，与肾小球滤过率降低相关的危险因素为男性-5.15 mL/min/1.73 m2（p = 0.002）、参与者年龄每增加 1 岁-1.58 mL/min/1.73 m2/年（p < 0.0001）、以及居住在河流附近的参与者-3.76 mL/min/1.73 m2（p = 0.033）。
讨论/结论：在特拉斯卡拉州阿皮萨科研究人群中，6-15 岁人群中每 100 名居民中有 4.6 例被确诊为 CKD。男性、年龄较大和居住在河流附近是预测风险的因素。需要进一步研究以确定该人群中 CKD 高患病率的原因。
