塞拉利昂农村高血压患者中慢性肾脏病的高患病率：一项横断面研究

High Prevalence of Chronic Kidney Disease Among People Living with Hypertension in Rural Sierra Leone: A Cross-Sectional Study.

作者信息

Kachimanga Chiyembekezo, Williams Anu Jegede, Bangura Musa, Lado Marta, Kanawa Sahr, Lavallie Daniel, Mhango Michael, Wurie Haja Isatta, Rodriguez Marta Patiño

机构信息

Partners in Health Sierra Leone, Koidu City, Sierra Leone.

Partners in Health Malawi, Neno, Malawi.

出版信息

Int J Nephrol Renovasc Dis. 2021 Dec 21;14:459-474. doi: 10.2147/IJNRD.S342099. eCollection 2021.

DOI:10.2147/IJNRD.S342099

PMID:34992425

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8710521/

Abstract

INTRODUCTION

Currently, there are no data on prevalence and associated risk factors of chronic kidney disease (CKD) among patients with hypertension in rural Sierra Leone.

PURPOSE

To estimate the prevalence and associated risk factors of CKD in rural Sierra Leone.

PATIENTS AND METHODS

A cross-sectional study of hypertension patients aged between 18 and 75 years attending a non-communicable disease clinic at Koidu Government Hospital, Kono District, Sierra Leone was conducted between February and December 2020. Using systematic random sampling, a structured questionnaire, which comprised of questions on social demographic characteristics and past and current clinical history, was administered followed by measurement of creatinine and urinary protein and glucose. Estimated glomerular filtration rate (eGFR) was estimated using CKD-epidemiology formula without race as a factor. Baseline eGFR between 60-89 min/mL/1.73m and <60 min/mL/1.73m defined reduced eGFR and renal impairment, respectively. Estimated GFR less than 60 min/mL/1.73m measured two times at least 3 months apart was used to define CKD.

RESULTS

Ninety-six percent (n = 304) patients out of 317 patients were included in the study. Among all included patients, only 3.9% (n = 12) had eGFR of 90 min/mL/1.73m and above. The prevalence of renal impairment and CKD was 52% (158/304, CI 46.2-57.7) and 29.9% (91/304, CI 24.8-34.5), respectively. In adjusted logistic regression analysis, currently taking herbal medications as treatment of hypertension (OR 4.11 (CI 1.14-14.80), p = 0.03) and being overweight and/or obese (OR 2.16 (CI 1.24-3.78), p < 0.001) was associated with CKD. Additionally, receiving some education was associated with a 48% (OR 0.52 (CI 0.29-0.91), p = 0.02) reduced likelihood of CKD.

CONCLUSION

The prevalence of renal impairment and CKD is high among hypertensive patients in rural Sierra Leone. CKD was associated with current history of taking herbal medications and being overweight and/or obese. Additionally, CKD was associated with reduced likelihood in patients who received some education.

摘要

引言

目前，关于塞拉利昂农村高血压患者慢性肾脏病（CKD）的患病率及相关危险因素尚无数据。

目的

评估塞拉利昂农村CKD的患病率及相关危险因素。

患者与方法

2020年2月至12月，对在塞拉利昂科诺区科伊杜政府医院非传染性疾病诊所就诊的18至75岁高血压患者进行了一项横断面研究。采用系统随机抽样方法，发放一份结构化问卷，内容包括社会人口统计学特征以及过去和当前的临床病史，随后测量肌酐、尿蛋白和血糖。使用不考虑种族因素的CKD流行病学公式估算肾小球滤过率（eGFR）。eGFR在60 - 89ml/min/1.73m²和<60ml/min/1.73m²分别定义为eGFR降低和肾功能损害。至少间隔3个月测量两次eGFR小于60ml/min/1.73m²用于定义CKD。

结果

317例患者中有96%（n = 304）纳入研究。在所有纳入患者中，仅3.9%（n = 12）的eGFR为90ml/min/1.73m²及以上。肾功能损害和CKD的患病率分别为52%（158/304，CI 46.2 - 57.7）和29.9%（91/304，CI 2,4.8 - 34.5）。在调整后的逻辑回归分析中，目前服用草药治疗高血压（OR 4.11（CI 1.14 - 14.80），p = 0.03）以及超重和/或肥胖（OR 2.16（CI 1.24 - 3.78），p < 0.001）与CKD相关。此外，接受过一些教育与CKD发生可能性降低48%（OR 0.52（CI 0.29 - 0.91），p = 0.02）相关。