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Screening for chronic kidney disease in North Vietnam
Jun Ito MD 1), Dinh Thi Kim Dung MD, PhD 2), Masato Fujisawa MD, PhD 3), Masato Kawabata MD, PhD 1), Toshiro Shirakawa MD, PhD 1)3)
1) International Center for Medical Research and Treatment, Kobe University School of Medicine, Japan
2) Department of Nephrourology, Bach Mai Hospital, Vietnam
3) Division of Urology, Department of Organs Therapeutics, Kobe University Graduate School of Medicine, Japan

Back ground
The prevalence of chronic kidney disease (CKD) in Vietnam is expected to increase along with those of hypertension and diabetes. Many of these cases are not treated at medical facilities, and thus progress to end stage renal disease (ESRD). Renal replacement therapy is so expensive that most ESRD patients die without treatment. Thus countermeasures against pre-dialysis period of CKD are urgently warranted. Nevertheless the situation of the disease has not been reported in the country.

Methods
Screening for CKD was conducted in 8,509 inhabitants aged >40 years in the Hoai Duc District, Hatay Province, Vietnam. In each case a general medical check and dip stick urine test were performed. Subjects with urine abnormalities or suspected of decreased kidney function were further examined, which included serum creatinine levels and kidney morphology using ultrasonography.

Results
Among the 8,509 participants, the present method identified 330 subjects (3.9%) with moderately or severely decreased kidney function indicated by <60 ml/min of estimated creatinine clearance. Twenty-two hundred ninety subjects (27.0%) showed a blood pressure of _140 mmHg. Seventy-two subjects (0.8%) showed _6.5% of hemoglobin A1c.

Discussion
This is the first report on the situation of CKD in Vietnam. We found a significant number of cases of CKD and related diseases. Based on our findings, we strongly recommend the establishment of CKD management system using inexpensive method in the country where medical resources are limited.