Prevalencia de enfermedad renal crónica oculta en pacientes diabéticos e hipertensos en entorno rural
DOI:
https://doi.org/10.35381/s.v.v10i20.5159Palabras clave:
Enfermedad renal crónica oculta, diabetes tipo 2, hipertensión, albuminuria, cribado primario, (Fuente: DeCS).Resumen
Objetivo: Evaluar la prevalencia de enfermedad renal crónica oculta (ERCo) en pacientes con diabetes mellitus tipo 2 (DM2) e hipertensión arterial (HTA) en un área rural de la Provincia de Chimborazo, Ecuador. Método: Se incluyeron 197 pacientes en un estudio transversal (enero-junio 2026). Se cuantificó la eTFG (CKD-EPI) y el cociente albuminuria/creatinina (ACR) en orina; se adoptó un muestreo estratificado y los análisis fueron descriptivos y bivariados. Resultados: 23,35 % presentó ACR ≥30 mg/g o eTFG <60 mL/min/1,73 m²; la ERCo fue más frecuente en DM2+HTA, y se asoció a tabaquismo, perímetro abdominal aumentado y peor control tensional. Conclusión: El cribado combinado identifica casos de ERCo; la intervención sobre tabaquismo, peso y tensión arterial es consistente con los factores hallados.
Descargas
Citas
Caprara G. Mediterranean-Type Dietary Pattern and Physical Activity the Winning Combination to Counteract the Rising Burden of Non-Communicable Diseases (NCDs). Nutrients. 2021;13(2):429. https://doi.org/10.3390/nu13020429
Yamamoto R, Li Q, Otsuki N, Shinzawa M, Yamaguchi M, Wakasugi M, Nagasawa Y, Isaka Y. A Dose-Dependent Association between Alcohol Consumption and Incidence of Proteinuria and Low Glomerular Filtration Rate a Systematic Review and Meta-Analysis of Cohort Studies. Nutrients. 2023;5(7):1592. https://doi.org/10.3390/nu15071592.
Ruiz-Garcia A, Arranz-Martínez E, Iturmendi-Martínez N, Fernández-Vicente T, Rivera-Teijido M, García-Álvarez JC. Prevalence rates of chronic kidney disease and its association with cardiometabolic factors and cardiovascular diseases. SIMETAP-CKD study. Clin Investig Arterioscler. 2023;35(2):64-74. https://doi.org/10.1016/j.arteri.2022.07.002
Li Z, He R, Wang Y, Qu Z, Liu J, Yu R, Yang S. Global trends of chronic kidney disease from 1990 to 2021: a systematic analysis for the global burden of disease study 2021. BMC Nephrol. 2025;26(1):385. https://doi.org/10.1186/s12882-025-04309-7
GBD 2021 Diabetes Collaborators. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2023;402(10397):203-234. https://doi.org/10.1016/S0140-6736(23)01301-6
de Boer IH, Khunti K, Sadusky T, Tuttle KR, Neumiller JJ, Rhee CM, Rosas SE, Rossing P, Bakris G. Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO). Diabetes Care. 2022;45(12):3075-3090. https://doi.org/10.2337/dci22-0027
Ebert N, Bevc S, Bökenkamp A, Gaillard F, Hornum M, Jager KJ, Mariat C, Eriksen BO, Palsson R, Rule AD, van Londen M, White C, Schaeffner E. Assessment of kidney function: clinical indications for measured GFR. Clin Kidney J. 2021;14(8):1861-1870. https://doi.org/10.1093/ckj/sfab042
Cebrián Cuenca A, Cornejo Martin J, Álvarez Guisasola F, Orozco Beltrán D, Quesada JA, Artola Menéndez S, Mata Cases M, Ruiz-Quintero MA, Pérez Pérez A. Undiagnosed chronic kidney disease in people with type 2 diabetes in Spain: Prevalence, treatment patterns and associated factors in a multicentre cross-sectional study. Prim Care Diabetes. 2026;20(3):298-305. https://doi.org/10.1016/j.pcd.2026.02.007
Sánchez-Calavera MA, Navarro RG, Otal EA, González IB, Pardo DE, Celma LH, Lamarre M, Esteban PL, Lozano Del Hoyo ML, Mahulea L, Gallego IM, Romero-Vigara JC, Allué SS, Hueso ST, Gil FA; (ERCAR-DM Study Investigators). Prevalence and characteristics of chronic kidney disease in people with type 2 diabetes mellitus in the Autonomous Community of Aragon. Prim Care Diabetes. 2024;18(5):555-560. https://doi.org/10.1016/j.pcd.2024.06.006
Shin JI, Chang AR, Grams ME, Coresh J, Ballew SH, Surapaneni A, Matsushita K, Bilo HJG, Carrero JJ, Chodick G, Daratha KB, Jassal SK, Nadkarni GN, Nelson RG, Nowak C, Stempniewicz N, Sumida K, Traynor JP, Woodward M, Sang Y, Gansevoort RT; CKD Prognosis Consortium. Albuminuria Testing in Hypertension and Diabetes: An Individual-Participant Data Meta-Analysis in a Global Consortium. Hypertension. 2021;78(4):1042-1052. https://doi.org/10.1161/HYPERTENSIONAHA.121.17323
Marques M, López-Sánchez P, Tornero F, Gargantilla P, Maroto A, Ortiz A, Portolés J. The hidden diabetic kidney disease in a university hospital-based population: a real-world data analysis. Clin Kidney J. 2022;15(10):1865-1871. https://doi.org/10.1093/ckj/sfac100
Romagnani P, Agarwal R, Chan JCN, Levin A, Kalyesubula R, Karam S, Nangaku M, Rodríguez-Iturbe B, Anders HJ. Chronic kidney disease. Nat Rev Dis Primers. 2025;11(1):8. https://doi.org/10.1038/s41572-024-00589-9
Suárez Rodríguez GL, Intriago Baldeón DP, Barroyeta García JR. Prevalencia de hipertensión arterial y diabetes en pacientes mayores de 20 años atendidos en la Unidad Metropolitana de Salud Norte del Distrito Metropolitano de Quito‑Ecuador, durante el período abril 2018 - abril 2023. (tesis de maestría). Quito: Universidad Internacional SEK; 2025. Disponible en: https://repositorio.uisek.edu.ec/jspui/handle/123456789/5538
Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney Int. 2022;102(5S):S1-S127. https://doi.org/10.1016/j.kint.2022.06.008
Gai Z, Wang T, Visentin M, Kullak-Ublick GA, Fu X, Wang Z. Lipid Accumulation and Chronic Kidney Disease. Nutrients. 2019;11(4):722 https://doi.org/10.3390/nu11040722
Domislović M, Domislović V, Stevanović R, Fuček M, Dika Ž, Karanović S, Kos J, Jelaković A, Premužić V, Leko N, Josipović J, Brzić I, Željković Vrkić T, Capak K, Jelaković B. Chronic Kidney Disease in Rural Population. Acta Clin Croat. 2022;61(2):228-237. https://doi.org/10.20471/acc.2022.61.02.09
De Cosmo SA, Russo G, Nicolucci A, Rossi C, Graziano G, Fioretto P, Tuccinardi D, Viazzi F, Sartore G, Muscarà A, Cuttone A, Piscitelli P, Candido R, Di Cianni G, Pontremoli R. Evolving kidney disease phenotypes in type 2 diabetes declining albuminuria and increasing isolated low eGFR. Clin Kidney J. 2026;19(4)sfag069. https://doi.org/10.1093/ckj/sfag069
Tangri N, Moriyama T, Schneider MP, Virgitti JB, De Nicola L, Arnold M, Barone S, Peach E, Wittbrodt E, Chen H, Järbrink K, Kushner P. Prevalence of undiagnosed stage 3 chronic kidney disease in France, Germany, Italy, Japan and the USA: results from the multinational observational REVEAL-CKD study. BMJ Open. 2023;13(5):e067386. https://doi.org/10.1136/bmjopen-2022-067386
Ruilope LM, Ortiz A, Ruiz-Hurtado G. Hypertension and the kidney an update, European Heart Journal. 2024;45(17):1497-1499. https://doi.org/10.1093/eurheartj/ehad896
Fularski P, Czarnik W, Frankenstein H, Gąsior M, Młynarska E, Rysz J, Franczyk B. Unveiling Selected Influences on Chronic Kidney Disease Development and Progression. Cells. 2024;13(9):751. https://doi.org/10.3390/cells13090751
Park CH, Kim HW, Park JT, Chang TI, Yoo TH, Park SK, Kim Y, Jung JY, Jeong JC, Oh KH, Kang SW, Han SH; KNOW-CKD (KoreaN Cohort Study for Outcomes in Patients with Chronic Kidney Disease) Investigators. The 2021 KDIGO blood pressure target and the progression of chronic kidney disease: Findings from KNOW-CKD. J Intern Med. 2023;294(5):653-664. https://doi.org/10.1111/joim.13701
Theodorakopoulou M, Ortiz A, Fernandez-Fernandez B, Kanbay M, Minutolo R, Sarafidis PA. Guidelines for the management of hypertension in CKD patients where do we stand in 2024. Clin Kidney J. 2024;17(Suppl 2):36-50. https://doi.org/10.1093/ckj/sfae278
Wang L, He Y, Han C, Zhu P, Zhou Y, Tang R, He W. Global burden of chronic kidney disease and risk factors, 1990-2021 an update from the global burden of disease study 2021. Front Public Health. 2025;131542329. https://doi.org/10.3389/fpubh.2025.1542329
Gündoğdu Y, Anaforoğlu İ. Effects of Smoking on Diabetic Nephropathy. Front Clin Diabetes Healthc. 2022;3:826383. https://doi.org/10.3389/fcdhc.2022.826383
Apperloo E, Neuen B, Fletcher R et al. Efficacy and safety of SGLT2 inhibitors with and without glucagon-like peptide 1 receptor agonists a SMART-C collaborative meta-analysis of randomised controlled trials. The Lancet Diabetes & Endocrinology, 2024;12:545-557. https://doi.org/10.1016/S2213-8587(24)00155-4
Qin Z, Chang K, Yang Q, Yu Q, Liao R, Su B. The association between weight-adjusted-waist index and increased urinary albumin excretion in adults. A population-based study. Front Nutr. 2022;9:941926. https://doi.org/10.3389/fnut.2022.941926
Zhang J, Thio CHL, Gansevoort RT, Snieder H. Familial Aggregation of CKD and Heritability of Kidney Biomarkers in the General Population: The Lifelines Cohort Study. Am J Kidney Dis. 2020;77(6):869-878. https://doi.org/10.1053/j.ajkd.2020.11.012
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2026 Emily Paulette Chuquimarca-Gaona, Jhonatan Ariel Rosario-Ramírez, Elena Tatiana Verdezoto-Bueno , Bryan Paul Cañizares-Clavijo

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
CC BY-NC-SA : Esta licencia permite a los reutilizadores distribuir, remezclar, adaptar y construir sobre el material en cualquier medio o formato solo con fines no comerciales, y solo siempre y cuando se dé la atribución al creador. Si remezcla, adapta o construye sobre el material, debe licenciar el material modificado bajo términos idénticos.
OAI-PMH: https://fundacionkoinonia.com.ve/ojs/index.php/saludyvida/oai.



