蛋白尿
微量白蛋白尿
医学
肾脏疾病
优势比
人口
置信区间
肾
百分位
内科学
四分位数
泌尿科
肾功能
环境卫生
统计
数学
作者
Mónica Linneth Alcalde-Ortiz,Fernando Jaramillo-Arriaga,Daniel Ibarra-Orenday,Salomón Israel González-Domínguez,Héctor David Calzada-Gallegos,Alma Alejandra Pinales-Jiménez,Itzel Alondra Carrillo-Aguilera,Dimitri Alejandro Flota-Marin,Mariana Guadalupe Collazo-Zamores,Paola Daniela Aguirre-Moreno,Sidharta Denise Gutiérrez-Hernández,Valeria Del Toro-Delgado,Rodolfo Delgadillo‐Castañeda,María del Rosario Sánchez-Ortiz,Irene Sanchez-González,Carmen Lucrecia Ramos-Medellin,Alfredo Chew‐Wong,Dulce Maria Macías-Diaz,José Manuel Arreola-Guerra
标识
DOI:10.1016/j.kint.2023.11.034
摘要
In Mexico, chronic kidney disease of unknown origin is highly prevalent. Screening studies in adolescents have shown persistent microalbuminuria (pACR), adaptive podocytopathy and decreased kidney volume (KV). Here, we sought to develop normality tables of kidney dimensions by ultrasound in the Mexican state of Aguascalientes pediatric population (0 to 18y) and evaluate the relationship between the KV and pACR among the region's adolescents in a cross-sectional study. Kidney length (KL) and KV were determined by ultrasound. Our findings were compared with those in international literature of different populations where tables and graphs of normal kidney dimensions by ultrasound were reported. We compared organ dimensions in individuals above the age of 11 without albuminuria with those in patients with pACR recruited through screening studies in adolescents in Aguascalientes. This included 1068 individuals to construct percentile tables and graphs of the KL. Kidney dimensions were significantly lower when compared with all international comparisons. From a total 14,805 screen individuals, we compared 218 adolescents with pACR and 377 individuals without significant albuminuria. The Total KV adjusted to body surface (TKVBS) was significantly associated with pACR (odds ratio 1.03, 95% confidence interval 1.02–1.03). The upper quartile of TKVBS was highly associated with pACR (7.57, 4.13–13.87), hypertension (2.53, 1.66–3.86), and hyperfiltration (26 vs 11.5%). Thus, TKVBS is directly associated with pACR while greater KV, arterial hypertension, and hyperfiltration in patients with pACR suggest that the increase in volume is secondary to kidney hypertrophy. Additionally, the adaptative podocytopathy with low fibrosis seen on kidney biopsy which was performed in a subset of patients, and the smaller kidney dimensions in our population point to prenatal oligonephronia as the primary cause of the detected kidney disease.
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