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2020年埃塞俄比亚西北部阿姆哈拉转诊医院成年高血压患者慢性肾脏病的患病率及相关因素

Prevalence and Associated Factors of Chronic Kidney Disease among Adult Hypertensive Patients at Northwest Amhara Referral Hospitals, Northwest Ethiopia, 2020.

作者信息

Hunegnaw Anteneh, Mekonnen Habtamu Sewunet, Techane Masresha Asmare, Agegnehu Chilot Desta

机构信息

University of Gondar, Comprehensive Specialised Hospital, Gondar, Ethiopia.

Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Int J Hypertens. 2021 Aug 26;2021:5515832. doi: 10.1155/2021/5515832. eCollection 2021.

Abstract

BACKGROUND

Chronic kidney disease (CKD) is a progressive loss of the kidney function which leads to a decreased kidneys' ability to process waste in the blood and it affects the other important functions of the kidney. The disease has different stages that can alter the health status of individuals. During the early stages, patients may present with a normal or slight decrease in glomerular filtration rate (GFR) and albuminuria. Later, it progresses and leads to end-stage renal disease (ESRD) or kidney failure. Hypertension is considered as the major contributing risk factor of CKD.

OBJECTIVE

This study was aimed to assess the prevalence and associated factors of chronic kidney disease among adult hypertensive patients in referral hospitals of the Northwest Ethiopia.

METHODS

An institution-based cross-sectional study was conducted among 581 adult hypertensive patients in a chronic follow-up clinic in referral hospitals, Northwest Ethiopia, from July to August 2020. Systematic random sampling was used to select the study participants. Data were collected using the interviewer-administered questionnaire and participants medical records. Both bivariable and multiple logistic regression analyses were performed. Model fitness was assessed using a Hosmer-Lemeshow test.

RESULT

The total prevalence of CKD among adult hypertensive patients was 17.6% (95% CI: 14.7-20.8). Diastolic blood pressure ≥90 mmHg (AOR = 8.65; 95% CI: 4.77-15.68), duration of hypertension ≥10 years (AOR = 8.81; 95% CI: 2.47-31.45), stage II HTN (AOR = 2.61; 95% CI: 1.04-6.50), comorbid disease (AOR = 7.0; 95% CI: 2.20-22.21), proteinuria (AOR = 4.59; 95% CI: 2.08-10.12), dyslipidemia (AOR = 3.40; 95% CI: 1.56-7.24), and serum creatinine ≥1 mg/dl (AOR = 8.88; 95% CI: 4.40-17.91) were associated with chronic kidney disease among adult hypertensive patients.

CONCLUSION

In this study, the prevalence of CKD among hypertensive patients found was 17.6%. Regarding associated factors, dyslipidemia, proteinuria, comorbid disease, serum creatinine greater than 0.9 mg/dl, duration of hypertension greater than 10 years, and diastolic blood pressure greater than 90 mmHg are factors associated with the occurrence of chronic kidney disease among hypertensive patients.

摘要

背景

慢性肾脏病(CKD)是一种肾功能进行性丧失的疾病,会导致肾脏处理血液中废物的能力下降,并影响肾脏的其他重要功能。该疾病有不同阶段,可改变个体的健康状况。在早期阶段,患者可能表现为肾小球滤过率(GFR)正常或略有下降以及蛋白尿。随后,病情进展并导致终末期肾病(ESRD)或肾衰竭。高血压被认为是慢性肾脏病的主要危险因素。

目的

本研究旨在评估埃塞俄比亚西北部转诊医院成年高血压患者中慢性肾脏病的患病率及相关因素。

方法

2020年7月至8月,在埃塞俄比亚西北部转诊医院的慢性随访门诊中,对581名成年高血压患者进行了一项基于机构的横断面研究。采用系统随机抽样方法选择研究参与者。通过访谈式问卷和参与者的病历收集数据。进行了双变量和多因素逻辑回归分析。使用Hosmer-Lemeshow检验评估模型拟合度。

结果

成年高血压患者中慢性肾脏病的总患病率为17.6%(95%置信区间:14.7 - 20.8)。舒张压≥90 mmHg(调整后比值比[AOR]=8.65;95%置信区间:4.77 - 15.68)、高血压病程≥10年(AOR = 8.81;95%置信区间:2.47 - 31.45)、II期高血压(AOR = 2.61;95%置信区间:1.04 - 6.50)、合并症(AOR = 7.0;95%置信区间:2.20 - 22.21)、蛋白尿(AOR = 4.59;95%置信区间:2.08 - 10.12)、血脂异常(AOR = 3.40;95%置信区间:1.56 - 7.24)以及血清肌酐≥1 mg/dl(AOR = 8.88;95%置信区间:4.40 - 17.91)与成年高血压患者的慢性肾脏病相关。

结论

在本研究中,发现高血压患者中慢性肾脏病的患病率为17.6%。关于相关因素,血脂异常、蛋白尿、合并症、血清肌酐大于0.9 mg/dl、高血压病程大于10年以及舒张压大于≥90 mmHg是高血压患者发生慢性肾脏病的相关因素。

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