Burden and identification of associated risk factors of Chronic Kidney Disease in hypertensive urban population: A community based study of Karachi Pakistan
Kidney failure is a worldwide public health problem, with increasing incidence and prevalence, high costs and poor outcome. Detection and treatment of chronic kidney disease (CKD), prior to kidney failure, is therefore of paramount importance. Albuminuria is one of the earlier markers of kidney damage and screening for albuminuria is recommended in high risk patients.
Objective: To determine the prevalence and associated risk factors of CKD, defined as urine albumin concentration of 20mg/L and urine sex-specific albumin-to-creatinine ratio of 20 and 30mg/gm for males and females respectively persisting for more than 3 months in hypertensive population.
METHODS: 72% of 1340 newly diagnosed hypertensive subjects from ongoing community based cohort study (c) who had been screened once for the presence of albuminuria (n=240), were retested for the presence of persistent albuminuria in this study. Albumin concentration (mg/l) and albumin-to-craetinine ratio (mg/gm) were determined in a spot morning urine sample by Nephlometry.
RESULTS:
Prevalence of CKD was 9.3% [7.8%-10.8%]. Mean age was 52 (±11.4) years and 58% were males. Factors independently associated were male gender (OR 2.0 (1.24-2.97)), young age with positive family history of KD disease (OR 15.51 (7.35-32.97)), high cholesterol levels (P=<0.001), and progressively higher levels of systolic BP (p<0.001).
CONCLUSIONS:
Hypertensive kidney damage is already present in a significant number among newly diagnosed hypertensive population suggesting late detection of high blood pressure. Public awareness through education is necessary in developing countries to detect hypertension before target organ damage has occurred.