ORIGINAL ARTICLE Screening for kidney disease in children on World Kidney Day in Jalisco, Mexico Susan M. Koshy & Guillermo Garcia-Garcia & Jacob Sandoval Pamplona & Karina Renoirte-Lopez & Gustavo Perez-Cortes & Ma. Luisa Salazar Gutierrez & Brenda Hemmelgarn & Anita Lloyd & Marcello Tonelli Received: 11 September 2008 / Revised: 12 December 2008 / Accepted: 12 January 2009 / Published online: 7 March 2009 # IPNA 2009 Abstract World Kidney Day (WKD) is intended to raise awareness and increase detection of chronic kidney disease (CKD), but most emphasis is placed on adults rather than children. We examined yield of screening for CKD and hypertension among poor children in Mexico. On WKD (2006, 2007), children (age < 18 years) without known CKD were invited to participate at two screening stations. We measured body mass index (BMI), blood pressure, and serum creatinine, and performed dipstick urinalysis. The Schwartz equation was used to estimate glomerular filtra- tion rate (GFR; reduced GFR defined as < 60 ml/min per 1.73 m 2 ). Proteinuria and hematuria were defined by a reading of ≥ 1+ protein or blood on dipstick. Hypertension was defined by gender, age, and height-specific norms. In total, 240 children were screened (mean age 8.9±4.1 years; 44.2% male). Proteinuria and hematuria were detected in 38 (16.1%) and 41 (17.5%), respectively; 15% had BMI > 95th percentile for age. Reduced GFR was detected in four (1.7%) individuals. Systolic hypertension was more preva- lent in younger children (age 0–8 years, 19.6%; age 9– 13 years, 7.1%; age 14–17 years, 5.3%) suggesting a possible white-coat effect. Hematuria, proteinuria, hyperten- sion and obesity were frequently detected among children in a community based screening program in Mexico. This form of screening might be useful in identifying children with CKD and hypertension in developing nations. Keywords Chronic kidney disease . Screening . Children . Hypertension . Mexico Introduction World Kidney Day (WKD) is an initiative of the International Society of Nephrology and International Federation of Kidney Foundations that is intended to raise awareness and increase the detection of chronic kidney disease (CKD) in the general population [1]. The message of WKD is that kidney disease is ‘common’, ‘harmful’ and ‘treatable’. The initiative calls for CKD to be recognized as a global public health problem while promoting early detection and treatment of CKD, a focus particularly relevant as treatment for end-stage renal disease with dialysis and transplantation may not be affordable or accessible to many living in developing nations. CKD has been become a ‘silent epidemic’ in developing countries, mainly due to an increasing prevalence of diabetes and hypertension in the general population [2–4]. To date, most of the public campaigns for detection of CKD and its risk factors have placed emphasis on adults rather than children. Screening programs for CKD in healthy adults have been performed in several countries, including Pediatr Nephrol (2009) 24:1219–1225 DOI 10.1007/s00467-009-1136-7 S. M. Koshy Alberta Children’ s Hospital, Calgary, AB, Canada G. Garcia-Garcia : J. S. Pamplona : K. Renoirte-Lopez Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, Jalisco, Mexico G. Perez-Cortes : M. L. S. Gutierrez Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara, Jalisco, Mexico B. Hemmelgarn University of Calgary, Calgary, AB, Canada A. Lloyd : M. Tonelli (*) University of Alberta, 7-129 Clinical Sciences Building, Edmonton, AB T6G 2G3, Canada e-mail: mtonelli@ualberta.ca