ABSTRACT
BACKGROUND: High altitude renal syndrome has been described in populations with excessive erythrocytosis. We evaluated whether high altitude (HA) dwellers might be at increased risk for kidney disease. METHODS: We performed a cross-sectional study to investigate differences in prevalence of kidney function and metabolic syndrome in healthy subjects living at HA vs. sea level (SL) without any known history of hypertension, diabetes or chronic kidney disease. RESULTS: We examined 293 subjects, aged 40 to 60 years: 125 SL (154 m) and 168 HA (3640 m) dwellers. HA dwellers had higher serum creatinine, lower estimated glomerular function rate (eGFR) (69.5 ± 15.2 vs. 102.1 ± 17.8 ml/min/1.73 m2, p < 0.0001), more proteinuria and higher hemoglobin concentrations compared to SL subjects. HA subjects had a lower prevalence of metabolic syndrome. Hemoglobin concentrations correlated inversely with eGFR in female (p = 0.001) and male (p = 0.03) HA dwellers. Using logistic regression analysis to compare subjects with eGFR < 90 vs. > 90 ml/min/1.73 m2, a lower eGFR was associated with female gender (odds ratio adjusted: 5.65 [95% confidence interval: 2.43-13.13]; p = 0.001), high altitude (14.78 [6.46-33.79]; p = 0.001), hemoglobin (1.68 [1.16-2.43]; p = 0.001) and uric acid (1.93 [1.36-2.72]; p = 0.001). CONCLUSIONS: Dwellers at high altitude who are considered healthy have worse kidney function, a higher prevalence of proteinuria and a lower prevalence of metabolic syndrome compared to people living at SL.
Subject(s)
Altitude , Kidney Diseases/epidemiology , Metabolic Syndrome/epidemiology , Adult , Creatinine/blood , Cross-Sectional Studies , Female , Glomerular Filtration Rate , Hemoglobins/metabolism , Humans , Kidney Diseases/physiopathology , Male , Middle Aged , Prevalence , Proteinuria/epidemiology , Sex Factors , Uric Acid/bloodABSTRACT
Uruguay and Bolivia are two countries that show heterogenicity of the Latin American region, including the national income, the expenditure on health and the services for renal care. In Bolivia, there is manpower shortage for renal care with only 5 nephrologists per million people (pmp) and the prevalence of patients on dialysis is only 200 pmp. This is much lower than the mean prevalence rate of renal replacement therapy for Latin America as a whole. Uruguay on the other hand has more dedicated renal resources with 50 nephrologists pmp, and renal replacement therapy is provided to ~ 1,000 dialysis patients pmp. In November 2012, a collaborative project financed by the Uruguayan International Cooperation Agency was signed by both the Uruguay and Bolivia Ministries of Health, and the goal was to develop a comprehensive program for the prevention and management of all stages of chronic kidney disease (CKD) in Bolivia. The specific objectives were to: a) promote renal healthcare in the primary healthcare setting, b) identify kidney disease in populations at risk, and c) optimize patient care at all stages of CKD, including dialysis and transplantation supported with a national ESRD registry in Bolivia. As a first step, delegates from the Bolivian Health Ministry, visited Uruguay in April 2014, primarily to strengthen the development of tools required for developing and maintaining a national registry. In addition, during this visit, a meeting with the president of the Latin American Society of Nephrology and Hypertension (SLANH) culminated in designing a training program for peritoneal dialysis. This highly cooperative relationship is advancing the prevention and care of CKD in Bolivia and may serve as a model for international approaches to advance system level CKD care in countries with limited healthcare resources.
Subject(s)
Kidney Failure, Chronic/epidemiology , Kidney Failure, Chronic/therapy , Registries , Renal Replacement Therapy/statistics & numerical data , Bolivia/epidemiology , Humans , Morbidity/trends , Prevalence , Uruguay/epidemiologyABSTRACT
El presente informe tiene la finalidad de presentar las características generales de las personas con alguna alteración al exámen de orina y al mismo tiempo, se pretende uniformar conceptos básicos ya aceptados, para mejorar la interpretación de los resultados presentados
Subject(s)
Humans , Education , Kidney Diseases , BoliviaABSTRACT
Esta primera campaña, realizada los días 3 al 14 de octubre de 1992, pretendió dar inicio a una serie de actividades en el campo de la salud, orientadas a modificar la historia natural de las enfermedades renales mediante medidas de intervención oportunas
Subject(s)
Humans , Kidney Diseases , Primary Prevention/education , BoliviaABSTRACT
La infección de las vías urinarias (IVU) es una de las enfermedades infecciosas más frecuentes en la práctica médica. Son inumerables los trabajos de investigación realizados al respecto, pero la definición, patogenesis, tratamiento y evolución aún son motivo de controversias
