Rastreamento da doença renal crônica: validação do questionário “Scored" nomograma para estimativa da taxa de filtração glomerular e avaliação dos marcadores funcional e de lesão do parênquima renal

Abstract

Triggering factors of Chronic Kidney Disease (CKD), such as hypertension and diabetes mostly, present an increase in the prevalence as the population ages. We are unaware of the prevalence of CKD in the pre-dialysis of the Brazilian population and Bang and Cols proposed a method to track the DRC called SCORED system (Screening For Occult Renal Disease). The aim of the study was to validate the Scored table in Brazil. This is a cross-sectional study which sampled 600 employees of the Universidade Federal de Juiz de Fora (UFJF), preferably. Socio-demographic data were collected, physical examinations, urine and blood were performed and those interviewed answered the Scored Table. To determine the presence of CKD were considered the Glomerular Filtration Rates (GFR) 60mL/min/1,73m2 and also the presence of proteinuria / microalbuminuria as a marker of kidney damage identified at a interval of at least 90 days, as proposed by the working group Kidney Disease Outcomes Quality Initiative (K / DOQI), supported by the american National Kidney Foundation (NKF). For the validation of the original questionnaire, the sensitivity, specificity, and accuracy were calculated, as well as the positive predictive values (PPV) and negative predictive values (NPV). The Scored questionnaire showed a sensitivity of 80%, specificity of 65%, PPV 14%, NPV 97% and an accuracy of 66%. CKD was diagnosed according to the criteria of estimate glomerular filtration rate < 60mL/min/1,73m2 (8,8%), by the relation of amended albumin creatinine (5%) and by the presence of glomerular hematuria (16.3%) at the first examination, being confirmed in the second examination by estimate glomerular filtration rate of 60mL/min/1,73m2 (3,5%), by the relation of amended albumin creatinine (3%) and by the presence of glomerular hematuria. The steps taken in the cross-cultural adaptation process allowed the development of the Brazilian version of the Scored questionnaire, easy to understand, with good acceptance and very low cost, this may constitute an important screening tool for people with chance of having CKD. As for the laboratory evaluation of CKD, repeating the exams to estimate the GF, the search for proteinuria / microalbuminuria and glomerular hematuria proved fundamental to the diagnostic conclusion, especially this latter, which showed significant percentage of confirmation.