乌干达西南部一家大型公立门诊诊所中高血压非糖尿病患者的微量白蛋白尿和视网膜病变

Microalbuminuria and Retinopathy among Hypertensive Nondiabetic Patients at a Large Public Outpatient Clinic in Southwestern Uganda.

作者信息

Kangwagye Peter, Rwebembera Joselyn, Wilson Tony, Bajunirwe Francis

机构信息

Department of Internal Medicine, Mbarara University of Science and Technology, P.O. BOX 1410, Mbarara, Uganda.

Uganda Heart Institute, P.O. BOX 7051, Kampala, Uganda.

出版信息

Int J Nephrol. 2018 Jun 6;2018:4802396. doi: 10.1155/2018/4802396. eCollection 2018.

DOI:10.1155/2018/4802396

PMID:29977618

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6011089/

Abstract

BACKGROUND

Routine testing of microalbuminuria and retinopathy is not done among patients with high blood pressure in resource-limited settings. We determined the prevalence of microalbuminuria and retinopathy and their risk factors among hypertensive patients at a large hospital in western Uganda.

METHODS

We consecutively recruited nondiabetic patients with hypertension at the outpatients' clinic over a period of 3 months. Spot urine samples were tested for urine albumin. Direct fundoscopy was done to assess retinal vasculature and optic disc for signs of hypertensive retinopathy. Logistic regression was done with retinopathy and microalbuminuria as primary outcomes.

RESULTS

We enrolled 334 patients and, of these, 208 (62.3%) were females, with median age of 55 years (range: 25-90). The prevalence of microalbuminuria was 59.3% (95% CI: 50.1-72.2) and that of retinopathy was 66.8% (95% CI: 58.6-76.5). The independent correlates of retinopathy and microalbuminuria were systolic blood pressure (SBP) > 140 mmHg (OR = 2.76, 95% CI: 1.29-5.93) and treatment with beta-blockers (OR = 2.16, 95% CI: 1.05-4.44). Use of ACEIs was unrelated to the study outcomes.

CONCLUSION

The prevalence of retinopathy and microalbuminuria is high. Clinicians should aim for better control of blood pressure and routinely perform fundoscopy and urine albumin, especially for patients with poorly controlled blood pressure.

摘要

背景

在资源有限的环境中，高血压患者未进行微量白蛋白尿和视网膜病变的常规检测。我们确定了乌干达西部一家大型医院高血压患者中微量白蛋白尿和视网膜病变的患病率及其危险因素。

方法

我们在3个月的时间里，在门诊连续招募非糖尿病高血压患者。采集随机尿样检测尿白蛋白。进行直接检眼镜检查以评估视网膜血管系统和视盘，以寻找高血压视网膜病变的体征。以视网膜病变和微量白蛋白尿作为主要结局进行逻辑回归分析。

结果

我们纳入了334例患者，其中208例（62.3%）为女性，中位年龄为55岁（范围：25 - 90岁）。微量白蛋白尿的患病率为59.3%（95%置信区间：50.1 - 72.2），视网膜病变的患病率为66.8%（95%置信区间：58.6 - 76.5）。视网膜病变和微量白蛋白尿的独立相关因素为收缩压（SBP）>140 mmHg（比值比[OR]=2.76，95%置信区间：1.29 - 5.93）以及使用β受体阻滞剂（OR = 2.16，95%置信区间：1.05 - 4.44）。使用血管紧张素转换酶抑制剂（ACEIs）与研究结局无关。