The mean age at menarche for the school girls is 15.26 years. There was no difference in menarcheal age between the rural and urban school girls. Further longitudinal studies to compare rural school girls and urban school girls in private schools are required.

Background and Aims Kidneys are target organs in hypertension. Hypertensive damage results in glomerular as well as tubular dysfunction. Albuminuria is a known marker of glomerular damage. Whereas, urinary uromodulin is increasingly considered as potential biomarker of early tubular dysfunction. The aim of this study was to identify the pattern of early renal involvement based on glomerular and tubular function assessment by measuring urinary albumin and uromodulin in hypertensive patients Method In this cross-sectional study 122 hypertensive subjects with age>30 years, duration of hypertension <5years, without accelerated or malignant BP, absence of dipstick proteinuria and eGFR>60ml/min. Subjects with possibility of secondary hypertension were excluded. There were also 33 normotensive volunteers included as healthy referents. Morning spot urine for albumin-creatinine ratio (ACR mg/g), urine uromodulin-creatinine ratio (urUMODµg/g), urinary sodium-creatinine ratio (mEq/g) and potassium-creatinine ratio (mEq/g) were measured in single urine sample. Urine uromodulin was measured by ELISA method. Results The hypertensive and healthy subjects were matched for age 48±11 vs. 47±11, years (P=NS). The systolic BP was 145±15 vs. 112±12 mmHg and diastolic BP 86±9 vs. 70±8 mmHg; (p<0.001) and the mean ACR was 29±65 vs. 5.6±2.7 mg/g, (p<0.001) respectively. Around 20% hypertensives had albuminuria. Urinary potassium excretion was lower in hypertensives (51±31 vs. 69±31, mEq/g; p<0.02). The median urUMOD in hypertensive subjects was 3.38 (1.73-9.06) and in normotensives 3.85(2.28-5.69) µg/g (P=NS).Multivariate analysis showed significant inverse association between diastolic blood pressure and urinary uromodulin excretion. An urURMOD cut-off of 2.9 (25th percentile in normotensives) showed eGFR, urinary sodium & potassium excretions were significantly lower at low uromodulin cut-off and this was seen in38%subjects. Conclusion The glomerular involvement was found in 20% hypertensives as evidenced by albuminuria. In general urinary uromodulin level was not different between hypertensive and normotensive subjects. Association of low uromodulin cut-off with lower eGFR, Na+ and K+ excretion indicates simultaneous tubule glomerular involvement in 38%.

Background and Aims The common etiologies of CKD are diabetes, hypertension and glomerulonephritis. Prevalence of CKD of unknown (CKDu) etiology is being increasingly considered as an emerging etiology, especially in the developing countries, with environmental predisposition to hot humid climate, dehydration and toxic metal contaminations. The aim was to identify the frequency of CKDu as an etiology in a rural population with environmental exposure. Method In this observational study subjects were selected from a geographically defined rural population in Bangladesh. Baseline information was recorded by the translated WHO STEP wise approach surveillance- Instrument v.3.1 (Core and Expanded). Blood Pressure was measured by digital blood pressure monitor. Serum creatinine was measured by enzymatic method using assays traceable to isotope dilution mass spectrometry (IDMS). A fasting blood sample and spot urine was collected. BP ≥140/90mmHg; FBS > 5.6 mmol/l and HbA1c ≥6.5%; and eGFR< 60ml/min (CKD-EPI equation) or urine ACR > 30mg/g was taken as diagnostic cut-offs for hypertension, diabetes and nephropathy respectively. From diagnosed CKD patients CKDu group was further identified by stepwise approach of WHO criteria as suspected and probable stages. Results The mean age was 41.3 ± 12.7 years with male/female ratio 37/63 in preliminary 303 study subjects. They were 12.5% diabetic, 21% hypertensive and 75% had some form of dyslipidemia. Among all 51 subjects (16.8%) were diagnosed as CKD based on single measurement of eGFR and ACR. Of these 30 study subjects (58%) met the criteria of suspected CKDu. After repeat measures of eGFR and ACR at 3 months, prevalence of CKD came down to 10.2% persisting in 31 subjects (G1:5.3%, G2:2.3% and G3: 2.6%). Of these 7 study subjects (23%) met the criteria of probable CKDu. The main etiologies of CKD among these subjects were diabetic nephropathy (48%) followed by CKDu. The frequency of CKDu in total study population as a whole was 2.3%.The pattern of environmental exposures like types of farming, use of pesticide-fertilizer, NSAIDs intakes, water sources, amount of drinking water per day, duration of work under direct sun, pattern of fish-meat intakes, etc. were not different between subjects with CKDu versus the others. Conclusion The prevalence of chronic kidney disease in a rural area of Bangladesh is one in ten (10.2%). Among these nearly one-fourth (23%) of the subjects belonged to probable CKDu category. This alarmingly high frequency of CKDu needs further extensive evaluation to identify the predisposing factors responsible.

aren't differences between the comorbidity examined. The days of stay in-hospital of patients of group A was of days 7.00 (IQR 5.00-10.25) and it was statistically inferior with respect to the stay in-hospital of patients' group B that was of 9.00 days (IQR 7.00-13.0) (p<0.0001). In the group A the GFR correlate to days of stay in-hospital (-,248; p¼,000). This don't occur in the group B (-,06; p¼,469). (TAB1) Bringing back to normal for GFR between 11 and 30 (GFR Group A 16.74ml/min IQR 14. p¼,701) into the two group there are the different during the hospitalization days (group A 7.00 IQR 5.50-10.00; group B 9.50 IQR 7.00-12.75; p<0.007). (TAB.2) In a subanalysis that analyzes in hypertensive patients and in non-hypertensive patients the role of serum potassium, our study shows a different in the days of hospitalization between the group B and the group A. (TAB 3; TAB 4). The risk of a re-hospitalization is of 1,131 in 9 month; 1,223 in 12 month; 1,237 in 18 month. Conclusions: The frequency of hyperkalemia in the patients that stay in-hospital don't seem associated to utilization of RAAS-blocker. Our study shows that the value of K, outmoded the cut-off of5,1 mmol/L, bring about a augmentation of the duration of the period of hospitalization and the risk of a re-hospitalization, also in low Hyperkalemia. Others analysis are needed to understand if it is awkward to more serious clinical conditions or to a not suitable therapeutic approach of hyperkalemia even if light.