Detección y clasificación de la enfermedad renal crónica en Atención Primaria y la importancia de la albuminuria / Detection and classification of chronic kidney disease in Primary Care and importance of albuminuria

Introducción. La enfermedad renal crónica (ERC) es un problema de salud pública. La Atención Primaria (AP) es clave en su detección y estratificación, mediante el filtrado glomerular estimado (FGe) y el grado de albuminuria, para un correcto manejo. Nuestro objetivo ha sido valorar la prevalencia de pacientes atendidos en AP con ERC y su estratificación. Material y métodos. Hemos analizado la prevalencia de ERC en pacientes mayores de 18 años y su estratificación según las guías Kidney Disease-Improving Global Outcomes, a través de los controles bioquímicos solicitados desde AP durante 5 años. Cuando un mismo paciente disponía de varios controles bioquímicos se seleccionó el control con mejor FGe. Resultados. Entre 2010 y 2014 se solicitaron desde AP de nuestra área de salud 304.523 analíticas pertenecientes a 97.470 pacientes, con una edad media de 53,4±19,4 años; el 57,2% eran mujeres. La prevalencia de FGe<60mL/min/1,73m2 fue del 7,6%. Del total de analíticas, solo el 16,6% disponían de alguna cuantificación de albuminuria o proteinuria, correspondientes al 15,2% de los pacientes. La albuminuria fue cuantificada en el 15,4% de los controles con FGe ≥ 60 mL/min/1,73m2. En aquellos con FGe entre 30-59mL/min/1,73m2 (estadios G3a-3b) la determinación de albuminuria o proteinuria fue del 27,1%, y en los que tenían un FGe<30mL/min/1,73m2 (estadios G4-5) fue del 23,4%. En los diabéticos ascendía al 37,7% y era del 23,5% en los pacientes con glucemia basal alterada. Conclusiones. La determinación de albuminuria sigue siendo poco solicitada. Solo uno de cada 6 pacientes atendidos en AP puede ser correctamente estratificado, aunque es algo superior en pacientes con FGe disminuido y diabéticos

Introduction. Chronic kidney disease (CKD) is a public health problem, and Primary Care (PC) plays a key role in its detection and classification based on estimated glomerular filtration rate (eGFR), as well as the level of albuminuria for its proper management. The aim of this study was to analyse the prevalence and classification of CKD in patients attended in PC. Material and methods. An analysis was made of CKD prevalence and classification according to the Kidney Disease-Improving Global Outcomes guidelines in PC patients. All biochemical analyses requested from PC on patients 18 years and older over a 5-year period were collected. When several analyses were available on a patient, the biochemistry result with the best eGFR was selected. Results. Between 2010 and 2014, PC requested 304,523 biochemical analyses on 97,470 adult patients, with a mean age of 53.4±19.4 years, of which 57.2% were women. CKD prevalence was 7.6%. Urine protein results were present in only 16.6% of analyses, and only 15.2% patients had a urine protein result. Urine albumin was measured 15.4% of biochemical controls with eGFR≥60mL/min/1.73m2, in 27.1% of patients with eGFR between 30-59mL/min/1.73m2 (G3a-3b stages), and in 23.4% of patients with eGFR<30mL/min/1.73m2 (G4-5 stages). Urine albumin was tested in 37.7% of diabetics and in 23.5% of impaired fasting glucose. Conclusions. Requests for the measurement of urine proteins/albumin in PC patients are low, leading to only one in 6 PC patients being classified correctly. The measurement of urine proteins/albumin is higher in CKD and diabetic patients

[Detection and classification of chronic kidney disease in Primary Care and importance of albuminuria]. / Detección y clasificación de la enfermedad renal crónica en Atención Primaria y la importancia de la albuminuria.

INTRODUCTION: Chronic kidney disease (CKD) is a public health problem, and Primary Care (PC) plays a key role in its detection and classification based on estimated glomerular filtration rate (eGFR), as well as the level of albuminuria for its proper management. The aim of this study was to analyse the prevalence and classification of CKD in patients attended in PC. MATERIAL AND METHODS: An analysis was made of CKD prevalence and classification according to the Kidney Disease-Improving Global Outcomes guidelines in PC patients. All biochemical analyses requested from PC on patients 18 years and older over a 5-year period were collected. When several analyses were available on a patient, the biochemistry result with the best eGFR was selected. RESULTS: Between 2010 and 2014, PC requested 304,523 biochemical analyses on 97,470 adult patients, with a mean age of 53.4±19.4 years, of which 57.2% were women. CKD prevalence was 7.6%. Urine protein results were present in only 16.6% of analyses, and only 15.2% patients had a urine protein result. Urine albumin was measured 15.4% of biochemical controls with eGFR≥60mL/min/1.73m2, in 27.1% of patients with eGFR between 30-59mL/min/1.73m2 (G3a-3b stages), and in 23.4% of patients with eGFR<30mL/min/1.73m2 (G4-5 stages). Urine albumin was tested in 37.7% of diabetics and in 23.5% of impaired fasting glucose. CONCLUSIONS: Requests for the measurement of urine proteins/albumin in PC patients are low, leading to only one in 6 PC patients being classified correctly. The measurement of urine proteins/albumin is higher in CKD and diabetic patients.

Evolución del perfil lipídico en la población general del Área de Salud de Cáceres / Trend of lipid profile in general population from Caceres Health Area

Introducción y objetivos: La dislipidemia es un factor de riesgo cardiovascular modificable. Nuestro objetivo ha sido analizar el perfil lipídico en población general, la prevalencia de dislipidemia y su evolución en 5 años. Métodos: Desde enero de 2010 hasta diciembre del 2014, hemos recogido los controles bioquímicos solicitados desde Atención Primaria a sujetos mayores de 18 años. Los valores de referencia de los parámetros lipídicos fueron los establecidos por la Sociedad Europea de Cardiología y de Hipertensión Arterial. Cuando un mismo paciente disponía de varias analíticas, la prevalencia se calculó en 2 escenarios incluyendo el mejor y peor resultado para cualquier parámetro. Resultados: Se incluyeron 304.523 analíticas de 97.470 pacientes (edad media 53,4 ± 19,4 años, 57,2% mujeres). Los niveles de colesterol total, LDL-c, HDL-c y triglicéridos fueron 193,2 ± 38,7 mg/dl, 114,9 ± 33,6 mg/dl, 56,9 ± 15,4 mg/dl y 113,2 ± 78,1 mg/dl, respectivamente. La prevalencia de hipercolesterolemia, LDL-c elevado, HDL-c bajo e hipertrigliceridemia en el primer y el segundo escenarios fueron 33,9% vs. 63,4%, 31,7% vs. 59,1%, 11,2% vs. 23,9% y 9,9% vs. 27,5%, respectivamente. Entre 2010 y 2014, los niveles medios de colesterol total y LDL-c se redujeron un 12,2% y un 14%. Conclusiones: La prevalencia de dislipidemia es elevada, aunque existe una reducción en los niveles medios de colesterol total y LDL-c

Introduction and objectives: Dyslipidaemias are a modifiable cardiovascular risk factor. The aim of our study was to analyse lipid profile in general population, prevalence, and trend in five years. Methods: From January 2010 to December 2014, all biochemical controls from Primary Care in 18 years-old adults were analysed. We used as reference for lipid levels those stablished for the European Society Cardiology and Hypertension. When several controls from same patient were found, the best and worst levels were used for prevalence. Results: 304.523 controls were included from 97.470 patients (mean age 53.4 ± 19.4 years, 57.2% were women). Mean levels of total cholesterol, LDL-c, HDL-c and triglycerides were 193.2 ± 38.7 mg/dL, 114.9 ± 33.6 mg/dL, 56.9 ± 15.4 mg/dL and 113.2 ± 78.1 mg/dL, respectively. Prevalence of hypercholesterolemia, high LDL-c, low HDL-c and hypertriglyceridemia, in the best and worst levels, were 33.9% vs. 63.4%, 31.7% vs. 59.1%, 11.2% vs 23.9% and 9.9% vs. 27.5%. Between 2010 and 2014, mean levels of total cholesterol and LDL-c decreased in 12.2% and 14%. Conclusions: Prevalence of dyslipidaemia is high, although a decreased in mean levels of total cholesterol and LDL-c has been achieved

[Trend of lipid profile in general population from Caceres Health Area]. / Evolución del perfil lipídico en la población general del Área de Salud de Cáceres.

INTRODUCTION AND OBJECTIVES: Dyslipidaemias are a modifiable cardiovascular risk factor. The aim of our study was to analyse lipid profile in general population, prevalence, and trend in five years. METHODS: From January 2010 to December 2014, all biochemical controls from Primary Care in 18 years-old adults were analysed. We used as reference for lipid levels those stablished for the European Society Cardiology and Hypertension. When several controls from same patient were found, the best and worst levels were used for prevalence. RESULTS: 304.523 controls were included from 97.470 patients (mean age 53.4±19.4 years, 57.2% were women). Mean levels of total cholesterol, LDL-c, HDL-c and triglycerides were 193.2±38.7mg/dL, 114.9±33.6mg/dL, 56.9±15.4mg/dL and 113.2±78.1mg/dL, respectively. Prevalence of hypercholesterolemia, high LDL-c, low HDL-c and hypertriglyceridemia, in the best and worst levels, were 33.9% vs. 63.4%, 31.7% vs. 59.1%, 11.2% vs 23.9% and 9.9% vs. 27.5%. Between 2010 and 2014, mean levels of total cholesterol and LDL-c decreased in 12.2% and 14%. CONCLUSIONS: Prevalence of dyslipidaemia is high, although a decreased in mean levels of total cholesterol and LDL-c has been achieved.