Screening for Decreased Renal Function in Taxi Drivers in Tehran, Iran

Abstract

Background and objectives. The rapid increase in end stage renal disease (ESRD) prevalence, plus the enormous cost of treatment, necessitates an urgent approach to implement strategies to prevent development and progression of ESRD, especially in the developing world. Screening that leads to early identification and treatment has been recommended, as it may slow or prevent progression to a more expensive and disabling stage of the disease and thus may save lives as well as finite resources. Methods. In 2007, the Healthy City Office of Tehran municipality conducted a large-scale population-based crosssectional survey titled "Kidney Disease Screening of Taxi Drivers in Tehran." Taxi drivers or applicants of purchasing taxi participated in mentioned screening program in the last three months of 2007. Demographic data, blood pressure, and history of hypertension or smoking-and then in specific laboratories creatinine, lipid profile, complete blood count, fasting blood sugar, and urinalysis-have been checked. Results. The survey covered 31,999 people across Tehran (in a population of 12 million) during the study period. The mean and SD of age of participants was 43.77 ± 11.32 (range from18 to 86) years, and 98.4% (31,489) were male. Using the MDRD equation, overall prevalence of eGFR <60 mL/min/1.73 m 2 was 6.5%. However, the prevalence was 6.4% (1982/30949) in males in relation to 13.7% (69/503) in females. Mean and SD of BMI in males and females were 25.90 ± 3.91 and 26.48 ± 4.50 g, respectively. The overall prevalence of proteinuria (≥1+ proteinuria) was 0.6% in males vs. 1.8% in females in normal GFR group. Age, LDL cholesterol, hypertension, blood glucose, and BMI showed to be strong risk factors for low GFR. Education level did not show a significant correlation with low GFR. Discussion and conclusions. The findings of the study insist on the fact that CKD prevalence is significantly higher in old age, females, hypertensives, and uncontrolled diabetic patients. Our ability to decrease the incidence of ESRD is predicated on recognizing those patients with CKD and implementing all preventive strategies.

Renal Function and Risk Factors of Moderate to Severe Chronic Kidney Disease in Golestan Province, Northeast of Iran

“…The reported prevalence rates for diabetes and hypertension in other areas of Iran varies considerably. Among studies on CKD in Iran, the reported prevalence in three studies was 9.2%, 13.7%, and 29.0% for diabetes and 9.9%, 25.8%, and 17.4% for hypertension [10], [26], [27]. However, in a recent national surveillance on approximately 30,000 Iranians aged 15–64 years, prevalence of diabetes and hypertension was reported as 17.4% and 3.5%, respectively [31].…”

“…A part of the studies, even within a country, have reported very different rates [24]. For example, prevalence of CKD–S3-5 was reported as 18.7% in Japanese general population [25] and as 18.9%, 7.8%, and 6.5% in 3 other studies from Iran [10], [26], [27]. This can be related to true differences in prevalence of the disease in different populations, variation in the methodology that was used, and differences in demographic characteristics of study participants, including age structure.…”

Efficacy of HBV Vaccination in Various Stages of Chronic Kidney Disease: Is Earlier Better?

“…In a separate study involving more than 30,000 subjects, it was shown that more significant underestimation occurred when using the corrected Cockcroft-Gault equation compared to the MDRD formula in subjects older than 55 years, although a strong correlation was observed between the 2 methods (r = 0.91, P = 0.001) [8]. In our study, although the CKD stage weakly contributed to a higher HBsAb titer, it did not significantly correlate with the seroconversion rate.…”

The combined use of edaravone, diuretics, and nonsteroidal anti-inflammatory drugs caused acute kidney injury in an elderly patient with chronic kidney disease

“…Clinical studies have reported that long-term hypertension, diabetes, hyperuricemia, renal arteriosclerosis, ischemic heart disease, and smoking can cause CKD [18][19][20][21][22][23]. In the present patient, multiple chronic diseases and a long-term smoking habit led to the occurrence of CKD.…”