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Chronic Kidney Disease Stages 3-5 in Iranian Children: Need for a School-based Screening Strategy: The CASPIAN-III

Alaleh Gheissari1, Roya Kelishadi, Peyman Roomizadeh

  • 1Department of Pediatric Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran ; Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

International Journal of Preventive Medicine
|February 16, 2013
PubMed

Insights

Chronic kidney disease (CKD) is more prevalent in Iranian children than previously reported. This study highlights the need for early detection through school screening programs for pediatric kidney disease.

Area of Science:

  • Pediatric Nephrology
  • Epidemiology
  • Public Health

Background:

  • Limited epidemiological data exists for early and asymptomatic chronic kidney disease (CKD) in children, particularly in developing nations.
  • This study addresses the gap by investigating CKD stages 3-5 frequency in Isfahan, Iran, comparing general student data with referral center findings.

Purpose of the Study:

  • To determine the prevalence of CKD stages 3-5 among school students in Isfahan, Iran.
  • To compare the epidemiological data from general student screening with data from a pediatric nephrology referral center.

Main Methods:

  • A cross-sectional study involving 712 Isfahani school students (aged 7-18 years) was conducted.
  • Glomerular filtration rate (GFR) was calculated using two 2009 Schwartz equations; CKD was defined as GFR <60 ml/min/1.73 m².
  • Retrospective analysis of clinical records of children with stages 3-5 CKD referred to the main provincial center (November 2001-December 2011) was also performed.

Main Results:

  • The screening of students revealed a CKD frequency of 1.3% and 1.7% using the updated and new Schwartz equations, respectively.
  • The referral center data indicated an annual incidence of 14.5 per million age-related population (pmarp) and a prevalence of 118.8 pmarp.

Conclusions:

  • The actual prevalence of asymptomatic, undetected low GFR in Iranian children is likely higher than referral center reports suggest.
  • Implementing simple screening programs, such as annual urinalysis for high-risk school students, is recommended for early detection of pediatric kidney disease.
Abstract

Keywords:
ChildrenIranchronic kidney diseasecystatin Cepidemiology

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