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 m2 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 m2. It is a priority to find the causes of albuminuria and CKD in this Mexican region.

Sustainable Development Goals relevant to kidney health: an update on progress

“…Kidney disease is more prevalent in adults from these communities than in those from other Jalisco municipalities -CKD, 20.1% versus 10.4%; proteinuria, 36.1% versus 11.0%. Similar findings were reported for children 194,195 . Unsafe drinking water, poor sanitation and contamination of the lake and water wells are likely risk factors.…”

Safe Water Community Project in Jalisco, Mexico

“…In children, although the prevalence of CKD was similar to other Jalisco municipalities, the prevalence of proteinuria was 10 times higher [16]. Similarly, a recent cross-sectional study in children residing in these communities reported a prevalence of albuminuria and CKD of 45% and 33%, respectively; these rates of albuminuria are 3-5 times higher than reported in the state of Jalisco and the international literature [17]. Information from Jalisco's vital statistics shows a high prevalence of intestinal infection, associated with a high mortality rate among children under 5 years of age [10].…”

Urinary Pesticide Levels in Children and Adolescents Residing in Two Agricultural Communities in Mexico

“…Since 2016, the Department of Public Health of the University of Guadalajara has carried out studies in the zone, specifically in the community of Agua Caliente, Poncitlán Municipality, State of Jalisco. In this community, health problems have been detected such as malnutrition and albuminuria, specifically in children and adolescents under the age of 17 years [7].…”