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Jalisco stands out among the Mexican states for its significant incidence and prevalence of end-stage chronic kidney disease (ESKD). Poncitlán, in particular, is one of the regions most severely affected. However, the prevalence of chronic kidney disease (CKD) and its associated risk factors in this area remain to be fully elucidated. The aim was to describe the frequency of CKD, and its associated risk factors, limited to pediatric patients with relatives that suffer from ESKD in the region of Poncitlán, Chapala, Jalisco.
We perform a cross-sectional study, in low-income, ESKD high risk families attending a community center in Poncitlán, Jalisco. Children and adolescents between 4 - 17 years old were invited to participate after their parents signed the informed consent. A medical history was taken, and exposure to environmental and nutritional factors were evaluated. The serum creatinine concentration was determined to estimate the glomerular filtration rate (GFR) using the Schwartz formula, as well as the albuminuria/creatininuria ratio in an isolated urine sample.
A total of 437 pediatric patients were evaluated, mean age was 10 ± 2.9 years, 245 (56%) were women and 192 (44%) men; 7% did not live with their mother and 30% with their father, 5% did not attend the school and 39% had a direct relative with ESKD; regarding personal antecedents, 14% had low-birth weight, 3%, 66% and 16% of their mothers were exposed to radiation, wood or tobacco smoke and solvents respectively, during the pregnancy, 38% had nicturia, 26% had at some point a dog or rat bite or a sting from a poisonous animal and 90% use to eat fish from the lake. Only 309 people took the urine test (70.7%) and 307 the blood test (70.25%). Considering the subjects with renal function evaluation (290 subjects): 15 (4.9%) had albuminuria, the mean GFR was 107 ml/min/1.73m2 (97-119), and 3 (1%) had a GFR <60 ml/min/1.73m2. With the combined data of GFR and albuminuria, 15 (4.9%) had CKD (See Table). Children with CKD had significantly higher systolic blood pressure and higher frequency of radiation exposure of their mother during pregnancy. No significant differences were found in personal antecedents or nutritional variables. In the logistic regression analysis, only systolic blood pressure significantly predicted the presence of CKD.
Almost 5% of pediatric subjects had CKD. Systolic blood pressure was the only significant variable associated with the presence of CKD in the multivariate analysis.