High prevalence of kidney disease in two rural communities in Kosovo and Metohia

Figures & data

TABLE 1.  Results of laboratory analyses for 423 adult inhabitants from Velika Hoča and Orahovac

Parameter	Reference values	Mean ± SD	Pts with pathological finding
			No.	%
Hematocrit	M: 40–54%	43.4 ± 4.6	25	5.9
	F: 37–47%	39.7 ± 3.5	40	9.5
Glucose	3.9–6.1 mmol/L	5.5 ± 2.4	89	21
Albumin	34–55 g/L	45.7 ± 4.4	1	0.2
Total cholesterol	<5.2 mmol/L	6.4 ± 1.7	315	74.5
Triglycerides	<1.7 mmol/L	2.0 ± 0.9	214	50.6
Urea	2.5–7.5 mmol/L	5.2 ± 2.3	34	8.0
Creatinine	M: 74–124 μmol/L	81 ± 61	7	1.7
	F: 53–106 μmol/L	64 ± 52	4	0.9
eGFR (MDRD)	>60 mL/min/1.73 m^2	103 ± 33	22	5.2
Proteinuria ± hemoglobinuria	1+ to 3+		81	19.1
Hemoglobinuria	1+ to 2+		19	4.5

TABLE 2.  Frequency of kidney abnormalities found by ultrasound in 423 adults from the communities of Velika Hoča and Orahovac

	Kidney
	Right	Left
Length < 10.0 cm	38 (9.0%)^a	24 (5.7%)
Cysts	21 (5.0%)	27 (6.4%)
Polycystic kidney	4 (0.9%)	4 (0.9%)
Hydronephrosis	3 (0.7%)	5 (1.2%)
Chronic pyelonephritis	2 (0.5%)	6 (1.4%)
Kidney stone	9 (2.1%)	3 (0.7%)
Ren duplex	2 (0.5%)

Note: ^aNumber of patients (%).

TABLE 3.  Number of patients with kidney and urinary tract disease found in examined populations by the use of questionnaire, physical, laboratory, and ultrasound examination, and available medical documentation

Diagnosis	Known before survey	Detected at survey
Polycystic kidney disease	2	2
Diabetic nephropathy	2	4
Pyelonephritis	6	2
Tuberculosis	2	0
Nephrolithiasis	9	3
Chronic renal failure^a	10	2
ESRD (hemodialysis)^a	4	0
Nephrectomy^b	2	0
Urinary tract infection	4	5
Urinary bladder tumor	3	0
Prostate hyperplasia	8	6

Notes: ESRD, end-stage renal disease.

^aChronic renal failure or ESRD of unknown etiology.

^bNephrectomy because of kidney stone according to anamnesis, medical documentation not available.

TABLE 4.  Demographic data and laboratory results obtained in 22 patients with kidney disease detected in the present survey which require further clinical examination to establish diagnosis of kidney disease

	Sex (M/F)	Age (years)	eGFR<60 mL/min/1.73 m^2	u-Protein (g/g Cr)	Alpha1MG (mg/mmol Cr)	NAG (U/L)	AP (U/mmol Cr)	Kidney length (cm)
Mean ± SD		48 ± 27	83 ± 32	0.113 ± 0.144	1.8 ± 1.9	1.7 ± 1.5	1.3 ± 1.2	10.3 ± 0.3
No. of patients^a	9/8		8	12	11	5	7	3

Notes: eGFR calculated by MDRD; alpha1MG-urine, alpha1-microglobulin, NAG, N-acetyl-β-d-glucosaminidase; AP, urine alkaline phosphatase.

^aNumber of patients with pathological finding.

FIGURE 1. Presence of diagnostic criteria for Balkan endemic nephropathy (BEN) in 22 patients with detected kidney disease and unclear diagnosis. Criteria: (1) familial history positive for BEN, (2) mild proteinuria, (3) alpha1-microglobulinuria, (4) eGFR<60 mL/min/1.73 m², (5) anemia, (6) low specific gravity of the urine, and (7) reduced kidney length.