PREVALENCE OF CHRONIC KIDNEY DISEASE IN A RURAL AND SUBURBAN POPULATION OF JACUARO, MICHOACAN MEXICO

INTRODUCTION: Chronic kidney disease (CKD) is a worldwide public health challenge. It affects around 8-16 % of the adult global population and an unknown percentage of younger individuals. Those with CKD have an increased risk for cardiovascular disease, ESRD, and death. Jacuaro, Michoacan in Mexico is a community with a perception of very high prevalence of CKD among its inhabitants, apparently of unknown origin, and has been focus of attention by health authorities.

METHODS: A population based cross-sectional study was carried out, including both sexes and all ages. For this report we include only individuals 20y and older (n= 1984). A questionnaire for demography and risk factors was applied. Fasting serum and first void urine samples were obtained. Serum creatinine was measured with the Jaffe kinetic method. Proteinuria/microalbuminuria were measured with test strips. For estimation of renal function (eGFR), CKD-EPI formula and KDIGO 2009 classification was employed.

RESULTS: Female 66 %, mean age 41.9y. Prevalence of diabetes mellitus was 9%. In accordance with eGFR, 15.57 % were CKD2, 1.96% CKD3, 0.25% CKD4, and 0.30% CKD5 and CKD5 transplant 0.26%. macroalbuminuria (>300 mg/l) was present in 4.06% and microalbuminuria (30-299 mg/L) in 3.53% (two-sequential urine spot). A total of 15 individuals were either on CKD5 predialyisis, on dialysis or had received a kidney transplant, the prevalence of this group is significantly higher than that observed in other series.

CONCLUSIONS: Prevalence rates of CKD 2 to 4 in this adult Mexican rural and suburban population are lower than other reported on Mexican (Amato, 2005) and non-Mexican groups (NHANES 2003). Nevertheless, we found a very high prevalence of CKD 5 and transplanted individuals for whom we have not a clear explanation, hence further research and more detailed analyses are warranted.