Vieillissement rénal : facteurs de risque et néphroprotection

Prevalence and risk factors associated with chronic kidney disease in Moroccan rural communes: Fez-Meknes region

BACKGROUND AND AIMS

Chronic kidney disease is a worldwide public health issue. It can be a serious problem, especially in developing countries including Morocco. However, few studies have explored the factors influencing chronic kidney disease in this country. Hence, using the definitions proposed by Kidney Disease Improving Global Outcomes in 2012, we have conducted this study to establish the prevalence and risk factors of chronic kidney disease particularly in rural communities in the Fez-Meknes region.

METHODS

Weight, height, blood pressure, proteinuria, hematuria, plasma creatinine, estimated glomerular filtration rate (using the Modification of Diet in Renal Disease formula), and fasting glycemia were measured. Abnormal results were controlled within two weeks; estimated Glomerular filtration rate was retested at 3 months. Furthermore, to determine the factors associated with chronic kidney disease, multivariate logistic regression was used.

RESULTS

A total of 431 patients participated in the study; the prevalence of confirmed proteinuria, hematuria, and reduced estimated Glomerular filtration rate was 5.3%, 1.8%, and 3%, respectively. Overall, chronic kidney disease was found to be present in 6.5% of the population. Chronic kidney disease 1 and 2 accounted for 32.1% and 21.4% of the overall chronic kidney disease population, respectively, while chronic kidney disease 3 accounted for 46.4% (3A: 38.2%; 3B: 7.14%). Chronic kidney disease 4 and 5 were not present in the total chronic kidney disease population. Chronic kidney disease was strongly linked with advanced age (OR 2.65; 95%CI: 1.05-6.65), hypertension (OR 2.41; 95%CI: 1.03-5.63), agricultural occupation (OR 1.02; 95%CI: 1.00-1.04) and contact with Agrochemicals (OR 1.40; 95%CI: 0.81-2.71).

CONCLUSIONS

It is important to note that screening for kidney damage and being aware of the risks linked to it, is key for the early detection and management of chronic kidney disease; they are also crucial to provide in a database for the development of a national prevention policy.

Lower p66Shc promoter methylation in subjects with chronic renal failure

Objective

To determine the correlation between DNA methylation of p66Shc promoter and some markers of inflammatory and oxidative stress in chronic renal failure (CRF) patients compared with healthy subjects.

Methods

An observational cross-sectional study was conducted in the nephrology department at Sidi Bouzid Regional Hospital (Tunisia). In total, 39 patients with CRF and 37 healthy subjects were included. Several biochemical parameters were measured. Furthermore, markers of the oxidative and inflammatory status (MDA, TAS, SOD, and CRP) were evaluated. The p66Shc methylation status was determined using the methylation-specific PCR.

Results

Our results showed that levels of blood glucose, urea, creatinine, uric acid, ChT, TG, albuminuria, CRP and MDA were significantly elevated in CRF patients compared to controls. Furthermore, p66Shc promoter region was highly demethylated in CRF patients compared to healthy controls (84% vs 4%). Our data showed a positive correlation between p66Shc hypomethylation and levels of MDA (r = 0.93; p<0, 05) and CRP (r = 0.89; P <0, 05), as well as a significant negative correlation between p66Shc hypomethylation, TAS (r = -0.76; P <0, 05) and SOD (r = -0.77; p<0, 05) levels. Similarly, there was a positive correlation between p66Shc hypomethylation and the disease stages. Importantly, multiple regression analysis showed that p66shc DNA hypomethylation remains strongly correlated with MDA, CRP and stages of CRF.

Conclusion

This study indicates that the DNA hypomethylation of p66shc promoter was correlated with oxidative and inflammatory stress and the disease stages in CRF patients.

Undiagnosed chronic kidney disease and its associated risk factors in an agricultural Moroccan adult's population

INTRODUCTION

Chronic kidney disease is among the major non-communicable diseases with increasing prevalence. This study aimed to estimate the prevalence of chronic kidney disease and its associated risk factors among Moroccan population sample from Sidi Bennour province.

METHODS

An observational, descriptive and analytical study was conducted in an agricultural community of Morocco. A sample of 182 subjects aged 18 or older, randomly selected from the province health care centers. The information on the participants was collected using a structured questionnaire, blood samples were collected and the serum creatinine was determined. Subsequent glomerular filtration rate (eGFR) was estimated by the modification of diet in renal disease formula and the chronic kidney disease was defined by an eGFR<60 mL/min/1.73 m².

RESULTS

The participants mean age was 53.58±12.06 years, with a sex ratio of 0.30 and the prevalence of chronic kidney disease was 4.4%. The risk factors associated with chronic kidney disease were age, hypertension, and nephrotoxic treatment, that are significantly correlated with renal impairment (P=0.006 for age, P=0.008 for hypertension and P=0.001 for nephrotoxic medication used respectively).

CONCLUSIONS

The study data show that chronic kidney disease should be of important consideration in any strategy to address non-communicable diseases and associated risk factors.