Паёми Сино (Mar 2019)
SCREENING OF CHRONIC KIDNEY DISEASE IN TAJIKISTAN RESIDENTS
Abstract
Objective: Assessment of the prevalence causes and risk factors for the development of chronic kidney disease (CKD) in the Republic of Tajikistan Methods: Screening of CKD and risk factors for its development among 374 persons in the course of scheduled prophylactic examinations in the urban health centers of Dushanbe city in 2017. The age of residents ranged from 18 to 82 years, averaging 55.2±12.3 years. Of these, 201 (53.7%) were females, 173 (46.3%) were males. The average weight of the examined was 85.9±11.2 kg, height – 168.3±6.92 cm, and body mass index (BMI) – 30.4±3.75. CKD was established on the basis of albuminuria, a reduction in glomerular filtration rate (GFR) and the identification of risk factors. Results: Albuminuria was detected in 63 (16.8%) residents (29 men; 34 women), more often among the age group 45-74 years (46 cases), as well as among patients with the first (n=34) and the second (n=11) degrees of obesity. Increased creatinine level in venous blood was detected in 37 patients with albuminuria (average concentration 165.5±52.5 μmol/l), mainly among people aged 45-74 years (n=23). A decrease in GFR was detected in 18 (9.9% of the total number of the examined) men and 19 (9.9% of the total number of the examined) women. A population-based screening of CKD based on the results of albuminuria, endogenous creatinine, and GFR, and other risk factors allowed us to identify various stages of CKD out of 63 cases of the positive result of albuminuria in 37 cases, which was 9.9%. The first stage of CKD was in 8 (21.6%) patients, the second stage in 15 (40.5%) patients, the third stage in 12 (32.4%) cases, and the fourth stage in 2 (5.4%) cases. Depending on age, CKD prevailed among people aged 45-74 years (62.1%). In young people (18-44 years), it occurred in 9 (24.3%) cases, and in elderly patients (75-90 years) – in 5 (13.5%) cases. Depending on the gender of the surveyed, various stages of CKD occurred in 18 (48.6%) men and 19 (51.4%) women, the diagnosis of CKD among the general population in men was 10.9%, in women – 8.9%. Conclusion: The incidence of CKD among the general population was 9.9%. Diagnosis of CKD is based on the determination of GFR and the detection of albuminuria. For the early diagnosis of CKD and adequate treatment, an algorithm has been proposed that is acceptable both economically and in terms of use in daily clinical practice.
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