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Is CKD Screening Program Necessary in Developing Countries?
Alaleh Gheissari1, Maryam Riahinejad, Mehryar Mehrkash
1Isfahan University of Medical Sciences, Isfahan Nephrology Research Center, Isfahan Acquired Immune Deficiency Research Center, Pediatric Nephrology Department, Isfahan, Iran. alaleh.gheissari@gmail.com.
Iranian Journal of Kidney Diseases
|February 5, 2023
Summary
This study screened Iranian first-grade pupils for chronic kidney disease (CKD) risk factors. Elevated blood pressure and microalbuminuria were common, suggesting a need for screening, but kidney ultrasound was not recommended.
Area of Science:
- Pediatrics
- Nephrology
- Public Health
Background:
- Congenital anomalies of the kidney and urinary tract (CAKUT) and chronic kidney disease (CKD) may be more prevalent in regions with high consanguinity rates.
- Evaluating CKD prevalence in children is crucial for early intervention and management.
Purpose of the Study:
- To assess the prevalence of chronic kidney disease (CKD) indicators in first-grade pupils using biochemical and kidney ultrasound measurements.
- To investigate the correlation between various health factors and CKD indicators in children.
Main Methods:
- A cross-sectional study involving 653 children aged 6-7 years.
- Evaluated urine analysis, serum creatinine, urine microalbumin to creatinine ratio, and kidney ultrasound.
- Measured blood pressure and anthropometric parameters (weight and waist Z-scores).
Main Results:
- Hypertension was observed in 6.5% (systolic stage 1) and 1.3% (diastolic stage 1).
- Microalbuminuria was present in 2.5% of students and showed no correlation with hypertension or other tested factors.
- Kidney abnormalities (hydronephrosis/hydroureter) were found in 1.5% of participants, and reduced GFR (<90 mL/min/1.73 m2) in 1.8%.
Conclusions:
- A CKD screening program focusing on microalbuminuria and blood pressure is recommended for Iranian children due to high prevalence.
- Kidney ultrasound is not advised as a primary screening tool for CKD in this population, despite high consanguinity rates.
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