Abstract: PO2297
Factors Related to Significant Albuminuria or Low Glomerular Filtration Rate in Adolescents from a Population with a High Prevalence of CKD of Unknown Origin
Session Information
- Pediatric Nephrology: Benign Urology, AKI, Neonatal Nephrology, and Case Reports
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1700 Pediatric Nephrology
Authors
- Arreola Guerra, Jose Manuel, Centenario Hospital Miguel Hidalgo, Aguascalientes, Mexico
- Gutierrez, Cesar Mauricio, Centenario Hospital Miguel Hidalgo, Aguascalientes, Mexico
- Ovalle, Itzel, Centenario Hospital Miguel Hidalgo, Aguascalientes, Mexico
- Macias, Mariana Jocelyn, Centenario Hospital Miguel Hidalgo, Aguascalientes, Mexico
- Garcia Diaz, Andrea Lucia, Centenario Hospital Miguel Hidalgo, Aguascalientes, Mexico
Background
Chronic kidney disease (CKD) of unknown origin has been recognized as the leading cause of kidney disease in young adults in some underdeveloped countries. In Aguascalientes Mexico we report a high prevalence of treated CKD (1997 pmp), with more than half (54%) of unknown cause. The peak of prevalence is between 20 - 30 years (45%), being in that group 73% CKD of unknown origin. For this reason, a CKD screening study was designed in high school students in the state. The aim of this report is to describe the findings of a pilot study obtained in the first three schools.
Methods
Cross-sectional study of high school students. Determination of albumin/creatinine ratio was performed in isolated urine sample and standardized serum creatinine to calculate GFR with Schwartz formula, an abnormal albumin/creatinine ratio>30 mg/gr and GFR≤75 ml/min were defined as CKD. Students and parents were questioned about potentially risk factors. For the multivariate analysis, only students with complete questioning were included.
Results
During March 2020, three high schools in the municipality of Calvillo (Aguascalientes) were visited, accepting entry to the study 187 students out of 260 (72%). The average age was 13.3 years (IQR 12-14) with a predominance of males (n = 109, 58.2%). 33 students with pb CKD were detected (17.6%), 32 of which were due to the presence abnormal albumin/creatinine ratio. Only two patients had low GFR, one with 43 ml/min and the other with 75 ml / min. Four patients presented macro albuminuria, the rest microalbuminuria. In the multivariate analysis, next varibles remainad significant: economic income less than 4,000 Mx$, (OR 4.4, 95% CI, 1.3 - 14.7), frequent NSAID intake (OR 3.8 95% CI 1.16 - 13, p= 0.02), ≥ sweetened beverages per day (OR 4.3, 95% CI1.2 - 14.5, p = 0.01), use of clay dishes by parents and grandparents (OR 4.3 95% CI 1.4 - 12.9, p = <0.01), and BMI <17 kg / m2 (OR 5.8, 95% CI, 1.8 - 18.7, <0.01).
Conclusion
The frequency of abnormal albuminuria or low GFR in adolescents in Aguascalientes is high; follow-up is necessary to confirm these findings. The associated factors significantly guide possible toxics that may be associated with the high prevalence of CKD of unknown cause in our state.