IFGH 2012: Screening Program in Children for Prevention of Chronic Renal Disease and Hypertension in the Peruvian Andes

January 29, 2012

Authors:HurtadoA.1,2 ,PandoJ.4,PadillaE.2,3,FigueroaJ.2,3

Author Affiliations: 1 Head of the Department of Nephrology, Arzobispo Loayza Hospital, Lima-Peru 2 Cayetano Heredia Peruvian University, Lima-Peru
3 Family Medicine Resident
4 Clinical Lecturer, Department of Paediatrics and Child Health, University College Cork (UCC), Ireland

Option 1– Scientific / Empirical Research Findings Presented as – Poster


  • To identify children and adolescents at risk for Renal Disease based on an early detection of proteinuria.
  • To slow the progression of chronic kidney disease (CKD) by early intervention after diagnosis. 


In September 2010, the Screening was started in the rural town of Llamellin (Peruvian Andes at 3200 meters above sea level) among school children.


1) Weights and heights 

2) Proteinuria: A clean-catch, midstream morning urine specimen was collected from the children 

The urine was screened for:

a) proteinuria and hematuria using standard urinary dipstick

b) microalbuminuria using micraltest 

3)Arterial Blood Pressure 


Between September and November 2010, 754 children from 5 schools in Llamellin were evaluated. In the first screening 0,5% had proteinuria, 4,9% had hematuria, 11, 3% had microalbuminuria. In the second screening none had hematuria or proteinuria, but 1,45% had microalbuminuria. Positive microalbuminuria in both screening was found in 11 children. 
In 2011, 149 children were screened. 13 children (8.7%) had positive microalbuminuria in 3 screenings.
All children with persistent microalbuminuria had normal creatinine and renal ultrasounds
In total, 14 children were started treatment with Enalapril. 9 children received treatment for at least 6 months. From these, 3/9 had negative microalbuminuria at the end of 6 months, in 3/9 microalbuminuria had diminished and in the 3 remaining, microalbuminuria persisted the same. 

Discussion/conclusions/ implications:
Populations living at high altitude such as in Llamellin (Peru), are exposed to many of the factors responsible for the development of CKD: low birth weight, malnutrition, and chronic hypoxia which recently has been recognized as responsible for renal injury.
Our results show a higher frequency of urinary abnormalities compared to those reported previously in children. Short term follow up of these children, show good response to treatment. 
Community-based mass screening, targeting populations at high risk for CKD, should prove to be cost-effective in the long term. 


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