Nephrology Dialysis Transplantation, Vol 13, Issue 12 3034-3036, Copyright © 1998 by Oxford University Press
R Plata, C Silva, J Yahuita, L Perez, A Schieppati and G Remuzzi
Background. The prevalence and incidence of renal
diseases in developing countries are not known. This lack of knowledge is
an obstacle to the adoption of preventive measures which may be of great
value in a social and economic environment where treatment options for
end-stage renal failure are simply not available to the vast majority of
the population. Urinalysis, a simple and inexpensive test, remains a
cornerstone in the evaluation of the kidney and may also be easily employed
in mass screening for renal abnormalities in a developing country.
Methods. An educational campaign on renal diseases was
conducted in three selected areas of Bolivia. Urine samples were collected
and sent to one of 21 participating clinical centers. Fresh urine specimens
were screened using a dipstick for chemical analysis and by microscopic
urinalysis after centrifugation. In those patients in whom urinary
abnormalities were found, further investigations were carried out in order
to define the diagnosis; these patients were enrolled in a 3-year follow-up
program. Results. Apparently healthy subjects
(n=14 082) were referred to the First Clinical and
Epidemiological Program of Renal Diseases from rural and metropolitan areas
in Bolivia. Urinary abnormalities were detected in 4261 subjects at first
screening. The most common form of urinary abnormality was hematuria, which
was found in 2010 (47% of positively screened subjects). Other renal
abnormalities were leukocyturia (41%) and proteinuria (11%). Confirmatory
tests and further clinical studies were then carried out in 1019 people. On
a second screening 35% of the subjects had no urinary abnormalities; in the
remaining people the following diagnosis were made: asymptomatic urinary
tract infection (48.4%), isolated benign hematuria (43.9%), chronic renal
failure (1.6%), renal tuberculosis (1.6%). Other diagnosis were: renal
stones 1.3%, diabetic nephropathy 1% and polycystic kidney diseases 1.9%.
Conclusions. This study helped define for the first
time the frequency of asymptomatic renal diseases in Bolivia. It shows that
it is possible to screen a large population of patients at relatively low
cost, providing the framework for further action that may help in the
prevention and timely diagnosis of renal diseases. Keywords:
Bolivia; developing countries; epidemiology; renal diseases
ORIGINAL ARTICLES
Renal epidemiology. The first clinical and epidemiological programme on renal disease in Bolivia: a model for prevention and early diagnosis of renal diseases in the developing countries
Marionegri per L'America Latina, Renal Diseases Project, Laboratorio de Biologia, San Calixto, Pichincha No 374, Casilla 4892, La Paz, Bolivia; Department of Nephrology and Dialisis Hospital Juan XXIII, La Paz, Bolivia; Nephrology Unit, Ospedali Riuniti and Negri Bergamo Laboratories, Bergamo, Italy; Corresponding author
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