Education and screening for chronic kidney disease in Indian youth: pilot program results
Authors Rao PS, Wright Nunes JA, Gillespie BW, Perlman RL, Ravichandran R
Received 22 November 2016
Accepted for publication 2 March 2017
Published 24 April 2017 Volume 2017:10 Pages 85—90
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Akshita Wason
Peer reviewer comments 2
Editor who approved publication: Professor Pravin Singhal
Panduranga S Rao,1 Julie A Wright Nunes,1 Brenda W Gillespie,2 Rachel L Perlman,1 Rajan Ravichandran3
1Division of Nephrology, Department of Internal Medicine, University of Michigan Health System, 2Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA; 3Department of Nephrology, Madras Institute of Nephrology, Madras Institute of Orthopedics and Trauma Hospitals, Chennai, India
Background: There is a paucity of information on kidney education and screening programs in Indian youth.
Methods: Participants (n=2,158) from Chennai colleges were educated about the kidneys and chronic kidney disease (CKD) and screened in a pilot program from April to May 2013. This entailed: 1) a presentation and educational video and 2) an on-site assessment of weight, blood pressure, and demographic information. Urinalysis (UA) kits were distributed and returned in ≤48 hours. We examined participant characteristics and their association with dipstick proteinuria using logistic regression.
Results: The mean (standard deviation [SD]) age was 18.9 (1.6) years, and 1,451 (68%) were men. Mean (SD) body mass index (BMI) was 21.9 (4.3) kg/m2; 745 (36%) had a BMI consistent with being overweight or obese. Mean (SD) systolic blood pressure (SBP) was 118.7 (13.1) mm Hg, and 94 (5%) of the participants had SBP ≥140. Mean (SD) diastolic blood pressure (DBP) was 70.9 (11.4) mm Hg, with 119 participants (6%) having ≥90 mm Hg. A total of 136 participants had glycosuria (UA≥1+) and 120 (6%) had proteinuria (UA≥1+). In unadjusted analyses, sex (odds ratio [OR]=1.64 [confidence interval, CI 1.06–2.55]; p=0.026 men vs. women) and age (OR=1.13 per year [CI 1.01–1.26]; p=0.032) were significantly associated with proteinuria. In the analysis adjusted for age, sex, SBP, DBP, glycosuria, and BMI, age remained independently associated with higher odds for proteinuria (OR=1.14 per year [1.02–1.29]; p=0.026). Males showed a trend of higher risk compared with women (OR=1.57 [CI 1.00–2.50]; p=0.051).
Conclusion: This education and screening pilot program in a population of college students offers unique opportunities for identification, education, and early intervention for CKD.
Keywords: screening, youth, CKD, proteinuria, glycosuria, education, hypertension, BMI, Indian youth
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