Prevalence of Chronic Kidney Disease among Diagnosed and Undiagnosed Hypertensive Individuals in the General Population of the Northern Region of Senegal.

INTRODUCTION

Chronic kidney disease (CKD) is closely linked to high blood pressure (HBP), which is its leading cause in developing countries. Hypertension affects 1.2 billion people worldwide. However, a significant portion of individuals with HBP are undiagnosed, and their kidney function is even less known. The objective of this study was to determine the prevalence and associated factors of CKD among three sub-groups of blood pressure status (normotensive, diagnosed hypertension, and undiagnosed hypertension) individuals.

PATIENTS AND METHODS

We conducted a cross-sectional study in the general population of three northern regions in Senegal using a two-level cluster sampling method. The sample was constituted with a precision of 5% and a power of 80%, with an additional 10% attrition margin. Individuals aged 18-80 years were included in the study after consent. Pregnant women, hospitalized persons within the past 3 months, patients with general or urinary symptoms within the past 7 days and individuals undergoing renal replacement therapy were excluded. Investigators collected clinical and biological data at participants' homes using a modified version of the WHO's STEPwise questionnaire. Samples were collected for biochemical analysis (serum creatinine, lipid profile, and blood sugar). Estimated glomerular filtration rate was calculated using the CKD-EPI 2021 formula.

RESULTS

A total of 2,441 participants were included in the study with a mean age of 45.4 ± 16.0 years and a sex ratio M/F of 0.4. The overall prevalence of HBP and CKD were, respectively, 52.0% and 17.8%. Three out of every five hypertensive patients were undiagnosed. CKD was more frequent among known hypertensive patients (30.5%) compared to individuals with undiagnosed hypertension (19.1%) and normotensive individuals (10.9%). Multivariate analysis showed that CKD was associated with older age and female sex.

CONCLUSION

Undiagnosed hypertension is common among populations in northern Senegal. A high prevalence of CKD was found among both diagnosed and undiagnosed individuals with hypertension. Extending strategies for early detection and management in the general population could help prevent or reduce morbidity and mortality associated with CKD.