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Screening for kidney disease in children on World Kidney Day in Jalisco, Mexico

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Abstract

World Kidney Day (WKD) is intended to raise awareness and increase detection of chronic kidney disease (CKD), but most emphasis is placed on adults rather than children. We examined yield of screening for CKD and hypertension among poor children in Mexico. On WKD (2006, 2007), children (age < 18 years) without known CKD were invited to participate at two screening stations. We measured body mass index (BMI), blood pressure, and serum creatinine, and performed dipstick urinalysis. The Schwartz equation was used to estimate glomerular filtration rate (GFR; reduced GFR defined as < 60 ml/min per 1.73 m2). Proteinuria and hematuria were defined by a reading of ≥ 1+ protein or blood on dipstick. Hypertension was defined by gender, age, and height-specific norms. In total, 240 children were screened (mean age 8.9 ± 4.1 years; 44.2% male). Proteinuria and hematuria were detected in 38 (16.1%) and 41 (17.5%), respectively; 15% had BMI > 95th percentile for age. Reduced GFR was detected in four (1.7%) individuals. Systolic hypertension was more prevalent in younger children (age 0–8 years, 19.6%; age 9–13 years, 7.1%; age 14–17 years, 5.3%) suggesting a possible white-coat effect. Hematuria, proteinuria, hypertension and obesity were frequently detected among children in a community based screening program in Mexico. This form of screening might be useful in identifying children with CKD and hypertension in developing nations.

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Acknowledgments

Drs. Tonelli and Hemmelgarn are supported by Population Health Investigator Awards from the Alberta Heritage Foundation for Medical Research (AHFMR) and by New Investigator Awards from the Canadian Institutes of Health Research. Dr. Koshy is supported by a Clinical Fellowship award from AHFMR. This study was funded by a grant from the Foundation of the Hospitales Civiles de Guadalajara. The sponsor did not participate in analyses or influence the decision to submit this article for publication. The authors have no relevant competing financial interests to disclose.

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Authors and Affiliations

  1. Alberta Children’s Hospital, Calgary, AB, Canada

    Susan M. Koshy

  2. Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, Jalisco, Mexico

    Guillermo Garcia-Garcia, Jacob Sandoval Pamplona & Karina Renoirte-Lopez

  3. Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara, Jalisco, Mexico

    Gustavo Perez-Cortes & Ma. Luisa Salazar Gutierrez

  4. University of Calgary, Calgary, AB, Canada

    Brenda Hemmelgarn

  5. University of Alberta, 7-129 Clinical Sciences Building, Edmonton, AB, T6G 2G3, Canada

    Anita Lloyd & Marcello Tonelli

Authors
  1. Susan M. Koshy
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  2. Guillermo Garcia-Garcia
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  3. Jacob Sandoval Pamplona
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  4. Karina Renoirte-Lopez
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  5. Gustavo Perez-Cortes
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  6. Ma. Luisa Salazar Gutierrez
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  9. Marcello Tonelli
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Correspondence to Marcello Tonelli.

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Koshy, S.M., Garcia-Garcia, G., Pamplona, J.S. et al. Screening for kidney disease in children on World Kidney Day in Jalisco, Mexico. Pediatr Nephrol 24, 1219–1225 (2009). https://doi.org/10.1007/s00467-009-1136-7

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  • DOI: https://doi.org/10.1007/s00467-009-1136-7

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