Screening chronic kidney disease in long-standing diabetic patients at a primary care unit UMF 222
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Keywords

Diabetes Mellitus type 2
screening
chronic kidney disease
CKD-EPI equation

How to Cite

1.
Espinosa Fuentes GA, Julián Hernández YJ, López Lievanos M Ángel, Berumen Lechuga MG. Screening chronic kidney disease in long-standing diabetic patients at a primary care unit UMF 222. Rev. Colomb. Nefrol. [Internet]. 2022 Feb. 21 [cited 2022 May 18];9(1):e543. Available from: https://revistanefrologia.org/index.php/rcn/article/view/543

Abstract

Background: Diabetic nephropathy is the main cause of chronic kidney disease (CKD), however, thereare no data available about the prevalence of chronic kidney disease in the early stages in Mexico. Akey role in first level attention consists in performing timely screenings for diseases such as CKD. Inmost cases CKD is underdiagnosed in early stages, because it is asymptomatic.

Purpose: To determine the frequency of CKD in long-standing diabetes type 2.

Methods:This was a cross-sectional descriptive study. We included 263 patients with diabetes type 2 with at least 5 years of evolution, not undergoing renal function replacement therapy. The variables of this study were: sociodemographic characteristics and estimation of the glomerular filtration rate through the CKD-EPI equation. Categorical variables were summarized as frequencies and percentages. For continuous variables, mean and standard deviation were reported. The significance of differences between groups was assessed by Student’s t-test or square chi or Fisher’s exact test, and p-value ?0.05 was considered statistically significant.

Results: the KDIGO classification has 5 stages. The results regarding the degree of glomerular filtra-tion: stage 1 with 39.5 % (95 % CI, 34.2-45.6) , stage 2 with 38.8 % ( 95 % CI, 32.77-44.5),stage 3a with 8 %( 95 % CI, 4.9-11.4), stage 3b with 5.7 % (95 % CI, 3.4-8.7), grade 4 with 6.8 % (95 % CI, 3.8-9.9) and stage5 with 1.1 % (95 % CI 0.0-2.7). The average age was 69.26±11.01 in the group with CKD. Male gender predominated in the group CKD with 34 (59.6 %) and 23 (40.3 %), for female. Regarding comorbidities, hypertension arterial and treatment when analyzed for either absence or presence of CKD were statistically significant. The same findings can be obtained in laboratory results.

Conclusion :The prevalence of suspected CKD in our population is 21 %, at least 1 in 5 diabetic patients with >5 years of evolution suffer a decrease in GFR; however, we cannot consider it to be CKD untilthe presence of kidney damage is assessed and confirmed at 3 months.

https://doi.org/10.22265/acnef.9.1.543
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References

Lopera-Medina MM. La enfermedad renal crónica en Colombia: necesidades en saludy respuesta del Sistema General de Seguridad Social en Salud. Rev Gerenc Polít Salud.2016;15(30):212-33. https://doi.org/10.11144/Javeriana.rgyps15-30.ercc

Méndez-Durán A, Ignorosa-Luna MH, Pérez-Aguilar G, Rivera-Rodríguez FJ, González-Izquierdo JJ, Dávila-Torres J. Estado actual de las terapias sustitutivas de la función renal enel Instituto Mexicano del Seguro Social. Rev Med Inst Mex Seguro Soc.2016; 54(5):588-93.

Méndez-Durán A, Pérez-Aguilar G, Ayala-Ayala F, Ruiz-Rosas RA, González-Izquierdo JJ,Dávila-Torres J. Panorama epidemiológico de la insuciencia renal crónica en el segundonivel de atención del Instituto Mexicano del Seguro Social. Dial Traspl. 2014;35(4):148-56.https://doi.org/10.1016/j.dialis.2014.08.001

Rojas-Martínez R, Basto-Abreu A, Aguilar-Salinas C, Zárate-Rojas E, Villalpando S,Barrientos-Gutiérrez T. Prevalencia de diabetes por diagnóstico médico previo en México.Salud Pública Méx. 2018;60(3):224-32. https://doi.org/10.21149/8566

Laclé-Murray A, Valero JL. Prevalencia de nefropatía diabética y sus factores de ries-go en un área urbano marginal de la meseta Central de Costa Rica. Acta Méd. Costarric.2009;51(1):26-33. https://doi.org/10.51481/amc.v51i1.29

Chavés-Gómez NL, Cabello-López A, Gopar-Nieto R, Aguilar-Madrid G, Marin-López KS,Aceves-Valdez M,et al. Enfermedad renal crónica en México y su relación con los metalespesados. Rev Med Inst Mex Seguro Soc. 2017;55(6):725-34.

Espinosa-Cuevas M. Enfermedad renal. Gac Med Mex. 2016;152(1):90-6.

Gulias A. Manual de terapéutica médica y procedimientos de urgencias. 7 a ed. México:McGraw Hill Education; 2016.

Chen TK, Knicely DH, Grams ME. Chronic kidney disease diagnosis and management: Areview. JAMA. 2019;322(13):1294-304. https://doi.org/10.1001/jama.2019.14745

Costa NR, Carvalho AR, Pinto CM, Andriolo A, Guerra I. Laboratory diagnosis of chro-nic kidney disease in adults: an overview of hospitals inserted in the Portuguese NationalHealth System. J Bras Patol Med Lab. 2017;53(6):388-96. https://doi.org/10.5935/1676-2444.20170062

González-Gil A, Estrada-Vaillant A, Izada-Carnesoltas LT, Hernández-Hernández R,Achiong-Alemañy M, Quiñones-Cabrera D. Marcadores de funcionamiento renal en pa-cientes diabéticos tipo 2. Policlínico “Milanés”. Municipio Matanzas. Rev Med Electrón.2017;39(1):718-28. doi: https://doi.org/10.37345/23045329.v1i20.34

Martínez-Castelao A, Górriz-Teruel JL, Bover-Sanjuán J, Segura-de la Morena J, CebolladaJ, Escalada J,et al. Documento de consenso para la detección y manejo de la enfermedadrenal crónica. Nefrología. 2014;34(2):243-62. https://doi.org/10.37345/23045329.v1i20.34

Arreola-Guerra JM, Rincón-Pedrero R, Cruz-Rivera C, Belmont-Pérez T, Correa-RotterR, Niño-Cruz J. Performance of MDRD-IDMS and CKD-EPI equations in Mexican indivi-duals with normal renal function. Nefrología. 2014;34(5):591-98. doi: https://doi.org/10.3265/Nefrologia.pre2014.Jun.12538

Frasser SD, Blakeman T. Chronic kidney disease: identification and management in pri-mary care. Pragmat Obs Res. 2016;7:21-32. https://doi.org/10.2147/POR.S97310

Kalra S, Balachandran K, Ramachandran A. The CKD-EPI Pakistan Equation: A small stepfor Pakistan, a great leap for South Asia. J Pak Med Assoc. 2018;68(9):1293-4.

Figueroa-Montes LE. Prevalencia de albuminuria en una red de establecimientos de saluddel primer y segundo nivel de atención durante el periodo 2013-2014, Lima - Perú. Acta MedPeru. 2018;35(4):197-203. https://doi.org/10.35663/amp.2018.354.537

Barreto S, León D, Rojas R, Álvarez MA, Mendieta D, Oviedo L,et al. Detección de en-fermedad renal crónica oculta en pacientes de las unidades de salud familiar de Loma Pyta-Asunción. Rev. Salud Pública Parag. 2016;6(1):37-43.

Flood D, García P, Douglas K, Hawkins J, Rohloff P. Screening for chronic kidney diseasein a comunity-based diabetes cohort in rural Guatemala: a cross-sectional study. BMJ Open.2018;e019778. https://doi.org/10.1136/bmjopen-2017-019778

Liébana A, Nieto J, Robles N.R. Hipertensión y proteinuria. Estrategias actua-les de tratamiento. Nefrologia Sup Ext 2011;2(5):57-66 DOI: https://doi.org/10.3265/NefrologiaSuplementoExtraordinario.pre2011.Jul.11074

renas MD, Martín-Gómez MD, Carrero JJ, Ruiz-Cantero MT. La nefrología desde unaperspectiva de género. Nefrología. 2018;38(5):463-5. doi: https://doi.org/10.1016/j.nefro.2018.04.001

Palomo-Piñon S, Rosas-Peralta M, Paniagua-Sierra J. Tratamiento de la hipertensión enla enfermedad renal crónica. Rev Med Inst Mex Seguro Soc. 2016;54(1):78-88

Anders HJ, Huber TB, Isermann B, Schiffer M. CKD in diabetes: diabetic kidney diseaseversus nondiabetic kidney disease. Nat Rev Nephrol. 2018;14(6):361-77. https://doi.org/10.1038/s41581-018-0001-y

McFarlane P, Cherney D, Gilbert R, Senior P. Chronic kidney disease in diabetes. Can JDiabetes. 2018;42(1):201-09. https://doi.org/10.1016/j.jcjd.2017.11.004

Obrador GT, García-García G, Villa AR, Rubilar X, Olvera N, Ferreira E,et al. Prevalen-ce of chronic kidney disease in the Kidney Early Evaluation Program (KEEP) México andcomparison with KEEP US. Kidney Int Suppl. 2010 mzo.;(116):S2-8. https://doi.org/10.1038/ki.2009.540

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