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Ortega-Romero M, Méndez-Hernández P, Cruz-Angulo MDC, Hernández-Sánchez AM, Álvarez-Elías AC, Muñoz-Arizpe R, Sales-Heredia F, Aguilar-Madrid G, Juárez-Perez CA, Soto V, Valadés T, Olvera-Rivas N, Obrador-Vera GT, Barbier OC, Medeiros M. Chronic Kidney Disease in Children Aged 6-15 Years and Associated Risk Factors in Apizaco, Tlaxcala, Mexico, a Pilot Study. Nephron Clin Pract 2019; 143:264-273. [PMID: 31487709 DOI: 10.1159/000502481] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 08/05/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Tlaxcala, a small state in central Mexico, has the highest prevalence of chronic kidney disease (CKD) deaths in population aged 5-14 in Mexico, most of them with unknown etiology. OBJECTIVE To determine the prevalence of CKD in apparently healthy pediatric population in Apizaco, Tlaxcala. METHODS A cross-sectional pilot study was carried out in children deemed as healthy; subjects with previous diagnosis of CKD were excluded. Informed consent was obtained in all cases. A physical examination was performed, a questionnaire was applied. Blood and urine samples were obtained for serum creatinine, urinalysis, and microalbumin/creatinine ratio. A second and third evaluation was performed after 6 and 18 months in those found with urinary anomalies/CKD to confirm the diagnosis. RESULTS One hundred and nine subjects completed physical examination, which are the biological samples. Median age was 12 years. CKD stage 2 was confirmed in 5 subjects in the sixth month confirmation visit (4.6%). One patient accepted renal biopsy and Alport Syndrome was found. In a robust multivariate analysis, the risk factors related to reduction in the glomerular filtration rate were males -5.15 mL/min/1.73 m2 (p = 0.002), older participants as by -1.58 mL/min/1.73 m2 per year (p < 0.0001), and among participants living close to a river -3.76 mL/min/1.73 m2 (p = 0.033). DISCUSSION/CONCLUSION The prevalence of CKD in the population studied in Apizaco Tlaxcala was confirmed in 4.6 cases per 100 inhabitants between 6 and 15 years. Males, older age, and living close to a river were the risk predictive factors. More studies are needed to determine the causes of the high CKD prevalence in this population.
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Affiliation(s)
- Manolo Ortega-Romero
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico, Mexico
| | - Pablo Méndez-Hernández
- Departamento de Calidad y Educación en Salud, Secretaría de Salud de Tlaxcala, Tlaxcala, Mexico.,Facultad de Ciencias de la Salud, Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico
| | | | - Ana María Hernández-Sánchez
- Unidad de Investigación en Nefrología y Metabolismo Mineral Óseo, Hospital Infantil de México Federico Gómez, Mexico, Mexico
| | - Ana Catalina Álvarez-Elías
- Unidad de Investigación en Nefrología y Metabolismo Mineral Óseo, Hospital Infantil de México Federico Gómez, Mexico, Mexico
| | - Ricardo Muñoz-Arizpe
- Unidad de Investigación en Nefrología y Metabolismo Mineral Óseo, Hospital Infantil de México Federico Gómez, Mexico, Mexico
| | | | - Guadalupe Aguilar-Madrid
- Claustro Universitario de Chihuahua, Dirección de Investigación y de Posgrado, Chihuahua, Mexico.,Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional Autonoma de México, Mexico, Mexico
| | - Cuauhtémoc Arturo Juárez-Perez
- Unidad de Investigación de Salud en el Trabajo, Centro Médico Nacional SXXI Instituto Mexicano del Seguro Social, Mexico, Mexico
| | - Virgilia Soto
- Departamento de Patología, Instituto Nacional de Cardiología, Mexico, Mexico
| | - Teresa Valadés
- Departamento de Radiología, Hospital Infantil de México Federico Gómez, Mexico, Mexico
| | | | | | - Olivier C Barbier
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico, Mexico
| | - Mara Medeiros
- Unidad de Investigación en Nefrología y Metabolismo Mineral Óseo, Hospital Infantil de México Federico Gómez, Mexico, Mexico, .,Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autonoma de México, Mexico, Mexico,
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