Prevalence of Albuminuria in Children Living in a Rural Agricultural and Fishing Subsistence Community in Lake Chapala, Mexico

Abstract

The occurrence of Chronic Kidney Disease (CKD) of unknown etiology in autochthonous child populations residing along the Lake Chapala lakeshore is endemic (Jalisco, México). The objective of this study was to determine the prevalence of albuminuria in the pediatric population and to measure the glomerular filtration rate in children with two positive albuminuria tests. Urinary albumin was measured in 394 children. Subjects with two or more positive albuminuria test donated blood samples for the determination of serum biomarkers. From a rural community with 565 children under the age of 17 years, 394 (69.7%) participated with first morning urine samples. A total of 180 children were positive (with two or more positive albuminuria tests). The prevalence of albuminuria among the children participating in the study was 45.7%. Of the 180 children with persistent albuminuria, 160 (88.9%) were tested for serum creatinine, urea, and cystatin C. The 68.1% of the children studied, were found in stages 3a and 3b of the Kidney Disease Improving Global Outcomes (KDIGO) classification (mean glomerular filtration rate (GFR) 51.9 and 38.4 mL/min/1.73 m ² respectively). The lowest frequencies were for classifications 1 and 4. None of the subjects was classified as grade 5. The prevalence of albuminuria in children from this rural community is 3–5 times higher than reported in international literature. Regarding GFR, more than 50% of children studied are under 60 mL/min/1.73 m ². It is a priority to find the causes of albuminuria and CKD in this Mexican region.