Pattern of kidney disease among hypertensive patients attending cardiac clinics in Dar es salaam
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Date
2023
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Hubert Kairuki Memorial University
Abstract
BACKGROUND
Hypertension is a widespread problem. It is estimated that 1.28 billion adults aged 30-
79 years globally have hypertension, and two-thirds of them are living in low- and
middle-income countries .In Africa setting hypertension emerged as a major problem
in recent years and in some countries is the second leading cause of chronic kidney
disease. This is due to closely interlinked pathophysiological states such that sustained
hypertension impairs kidney function. Progressive decline in kidney function conversely
lead to worsening hypertension. Therefore, early detection of markers of kidney
disease among hypertensive individuals and timely preventive intervention are the key
strategies to prevent development of kidney disease among hypertensive patients.
AIM/OBJECTIVES
To determine the Patterns of kidney disease among hypertensive patients attending
cardiac clinics in Dar es Salaam.
METHOD
This is a descriptive cross-sectional study conducted among adult hypertensive
patients attending hypertension clinic in Dar-es-Salaam, Tanzania .Structured
questionnaires were used for social-demographic data. Blood pressure and
anthropometric measurements (body weight and height) were taken by using
standardized method. Blood sample was collected to measure serum creatinine and
estimated eGFR, while urine was collected for biochemical analysis (dipstick method)
and albumin creatinine ratio measurement.
RESULTS
In this study, 400 study participants were enrolled with a response rate of 100%. Of
these, 287 (72%) were females, the mean, and standard deviation of the age was
59.9 and 15 respectively. Of the study participants majority had primary education
249(62%), 232(58%) were unemployed followed by self-employed 155(38.8%).240
(60%) had history of hypertension less than 10 years,346(86.5%) had no history of
alcohol consumption and 380(95%) had no history of cigarette smoking Furthermore
participants, 240(60%) and 211(52.8%) study participants had a blood pressure
of≥140 mmHg for systolic and 90 mmHg for diastolic blood pressure respectively.. BMI
of ≥25kg/m2 was found among 236(59%) study participants. Reduced eGFR
(<60Ml/Min/1.73M 2
) and microalbuminuria were observed among 119 (30%) and
179(61.5%) study participants respectively. The most pattern of kidney diseases
from this study were AKI (22.3%), Nephrotic syndrome (12.8%) and End stage renal
failure (2.8%) and 62.3% had no signs kidney disease.
CONCLUSION
Clinical pattern of kidney disease is dominated by AKI, Nephrotic Syndrome and End
Stage Renal Disease (ESRD). Higher systolic blood pressure, advanced age, long
duration of hypertension and unemployment were associated significantly with decline
in eGFR. Furthermore an increase in body mass index (BMI) was (BMI) associated
significantly with increase in albumin-creatinine ratio among adult hypertensive
patients.
Recommendation
It is recommended that various measures against hypertension should be taken early
to prevent the development of kidney disease that end up with end stage renal failure.
Such measures may include implementing early kidney disease screening among
hypertensive patients, comprehensive care at cardiac clinics as it will have beneficial
impact on hypertension control and management of kidney disease. Furthermore it
will minimizing the cost of treating patients by early detection of early markers of
hypertensive kidney disease and minimize the social-economic impact of disease
treatment.
Description
A Dissertation Submitted in (partial) Fulfillment of the Requirements for the Degree of aster of Medicine (Internal medicine) of Hubert Kairuki Memorial University.
Keywords
Dar es salaam, Hypertension, Kidney disease
Citation
Maiseri, A. I.,2023. Pattern of kidney disease among hypertensive patients attending cardiac clinics in Dar es salaam.