Targeted screening of adult first-degree relatives for chronic kidney disease and its risk factors.

BACKGROUND: First-degree relatives (FDRs) of chronic kidney disease (CKD) patients have a high prevalence of CKD and its risk factors. We evaluated adult FDRs of end-stage renal disease (ESRD) patients for the prevalence of CKD and its risk factors.

METHODS: Adult FDRs of ESRD patients were screened. Patients <18 years of age with CKD due to polycystic kidney disease, diabetic nephropathy and urological disease were excluded. Age, sex, hypertension, weight, blood pressure, urine analysis, fasting blood glucose, serum creatinine and cholesterol were done.

RESULTS: 606 FDRs of 145 index patients were screened; mean age was 39.8 years and 53.3% were male, 26 obese and 122 overweight. 29.7% had hypertension and 3.6% diabetes mellitus. Screening identified new cases of hypertension (21.5%), diabetes mellitus (2.0%), impaired fasting glucose (22.4%) and hypercholesterolemia (18.8%). 5.9% had proteinuria (≥1+). 61.2% of FDRs had eGFR in stage 1, 34.7% in stage 2, 3.6% in stage 3, and 0.5% in stage 4-5. 8.6% had CKD (88.5% were unaware). On multivariate analysis, older age, female sex, proteinuria and uncontrolled blood pressure had a significant association with eGFR <60 ml/min/1.73 m(2).

CONCLUSION: In India, CKD and its risk factors show a familial clustering, and screening of FDRs of ESRD patients will be a viable option for a CKD preventive program.