الفهرس 
Chronic kidney diseaseOnly 14 pages are availabe for public view
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Abstract
CKD is defined as kidney damage or glomerular filtration rate (GFR) less than 60 ml / min/1.73 m2for 3 months or more, irrespective of cause. CKD represents a significant public health problem, with nearly 20 million people in the United States having kidney damage or reduced kidney function, most patients with kidney disease are asymptomatic, underling the need for routine screening of all patients who are at risk for developing kidney disease.
The two main causes of chronic kidney disease are diabetes and high blood pressure, which are responsible for up to two-thirds of the cases. Other conditions that affect the kidneys are: Glomerulonephritis, Inherited diseases, such as polycystic kidney disease, Lupus and other diseases that affect the body’s immune system, obstructions caused by problems like kidney stones, tumors or an enlarged prostate gland in men and repeated urinary infections.
The goal of a medical screening program is to recognize a disease in its preclinical phase so that intervention can occur at earlier stages, hopefully leading to better outcomes. Screening programs may also promote public awareness and education, encourage physician adherence to clinical practice guidelines, and serve as medical outreach to underserved populations.
The measurement of albuminuria provides a sensitive marker of CKD from very early to more advanced stages of the disease process. A 24-h urine collection for the diagnosis of albuminuria remains the gold standard; however, because of the inconvenience and errors associated with a timed urine sample, a spot urine sample using either albumin-
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Summary and conclusion
specific dipstick or albumin-to-creatinine ratio is now an accepted screening method.
The other option to screen for CKD is to measure GFR independent of the albuminuria status. In addition, because reduced GFR is part of the definition of CKD, validity of screening by this method could not be assessed; however, equations that estimate GFR and creatinine clearance from serum creatinine have been tested in several studies and are now recommended. The most commonly used equations in adults are the Cockroft-Gault.
The aim of this study was to screen of chronic kidney disease among apparently healthy individuals in Kafr- Elsheikh university, Egypt.
All individuals were subjected to:
• Full history taking including: personal history (age, sex), past history, family history, drug history.
• Physical examination including: blood pressure, body weight, height, body mass index.
• Lab investigations:
1. Serum creatinine.
2. Estimated GFR using Cockroft- Gault Formula (CCr={((l 40–age) x weight)/(72xSCr)}x 0.85 (if female)).
3. Urinary protein by dipstike.
4. HbA1c.
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Summary and conclusion
The results of our present study could be summarized as follow: About 13.8% of apparently healthy subjects had CKD (62.2% had stage I, 33.8% had stage II, 4% had stage III). CKD was higher among males than females. Obesity was a risk factor for CKD and the percentage of obese among CKD patients was 48%, Class I obesity was 47.3%, Class II obesity 0.7%. Overweight 29.1% and normal weight 22.9%. The mean of BMI among CKD patients was 28.3± 4.2. Higher frequency of hypertension were significantly associated with CKD patients 33.8% when compared to non CKD subjects 5.1%. Diabetics was diagnosed among 5.6% of all studied subjects. Higher frequency of diabetics were significantly associated with CKD when compared to non CKD subjects. The percentage of CKD had diabetics was (26%) while CKD had pre diabetics was (25%) of CKD patients. CKD patients had significantly higher creatinine concentration than non CKD patients. CKD patients had significantly lower eGFR than non CKD patients. Higher urinary protein grades were significantly associated with CKD.