Chala Getahun, Sisay Tariku, Teshome Yonas
Department of Medical Physiology, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Department of Biomedical Science, College of Health Sciences, Mizan Tepi University, Mizan, Ethiopia.
Int J Nephrol Renovasc Dis. 2019 Sep 18;12:205-211. doi: 10.2147/IJNRD.S223196. eCollection 2019.
Chronic kidney diseases (CKDs) are known in patients with cardiovascular diseases (CVDs) and cause extra morbidity and mortality. There were few related studies in Africa, and no such studies exist in Ethiopia.
To determine the magnitude of chronic kidney disease and associated risk factors among cardiovascular (CV) patients.
A cross-sectional study was conducted on randomly selected 163 CV patients attending Tikur-Anbessa Specialized Hospital (TASH), Ethiopia. Estimated glomerular filtration rate (GFR) was determined using the Simplified Modification of Diet in Renal Disease (MDRD) equation. Body weight, height, and blood pressure were recorded, and body mass index (BMI) was calculated. Serum urea and creatinine were analyzed using an automatic analyzer (MINDRAY, BE-2000), and blood urea nitrogen (BUN) was calculated.
In this study, CKD, defined as estimated GFR (eGFR) < 60 mL/min/1.73m was found in 39 (23.9%) participants using the MDRD equation. Normal serum creatinine (SCr) was observed in 114 (69.9%) participants and proteinuria was found in 41 (25.2%) participants. CKD was significantly associated with systolic blood pressure (COR: -0.240, 95% CI: -0.439 to -0.041, p = 0.018), SCr (COR: -0.679; 95% CI: -0.778 to -0.580; p = 0.001) and BUN (COR: -0.422; 95% CI: -0.550 to -0.295; p = 0.001). In multivariate analysis, only high SCr (AOR = 47.57; 95% CI: 13.72-164.89; p = 0.001) was independently associated with CKD.
These findings indicated that the CKD was significantly associated with SBP and increased BUN, while independently associated with increased SCr. Thus, early detection and recognition of CKD in-patient with CVD helps to avoid extra morbidity and mortality. We recommend using the MDRD formula in health facilities for diagnosing of CKD to reduce duplication of laboratory tests (SCr and BUN), as it is the easiest practice and saves patients and the public sector costs.
慢性肾脏病（CKD）在心血管疾病（CVD）患者中较为常见，并会导致额外的发病率和死亡率。非洲相关研究较少，埃塞俄比亚尚无此类研究。
确定心血管（CV）疾病患者中慢性肾脏病的严重程度及相关危险因素。
对埃塞俄比亚提库尔·安贝萨专科医院（TASH）随机选取的163例CV疾病患者进行了一项横断面研究。使用简化的肾脏病饮食改良（MDRD）公式测定估算肾小球滤过率（GFR）。记录体重、身高和血压，并计算体重指数（BMI）。使用自动分析仪（迈瑞，BE - 2000）分析血清尿素和肌酐，并计算血尿素氮（BUN）。
在本研究中，使用MDRD公式发现39例（23.9%）参与者的估算GFR（eGFR）<60 mL/min/1.73m²，即患有CKD。114例（69.9%）参与者血清肌酐（SCr）正常，41例（25.2%）参与者存在蛋白尿。CKD与收缩压（校正比值比：-0.240，95%置信区间：-0.439至-0.041，p = 0.018）、SCr（校正比值比：-0.679；95%置信区间：-0.778至-0.580；p = 0.001）和BUN（校正比值比：-0.422；95%置信区间：-0.550至-0.295；p = 0.001）显著相关。在多变量分析中，只有高SCr（调整后比值比 = 47.57；95%置信区间：13.72 - 164.89；p = 0.001）与CKD独立相关。
这些发现表明，CKD与收缩压和BUN升高显著相关，而与SCr升高独立相关。因此，对CVD住院患者早期检测和识别CKD有助于避免额外的发病率和死亡率。我们建议在医疗机构中使用MDRD公式诊断CKD，以减少实验室检查（SCr和BUN）的重复，因为这是最简单的做法，可节省患者和公共部门成本。
