Diabetes mellitus, hypertension and albuminuria in rural Zambia: a hospital‐based survey

Abstract

Abstractobjective To assess albuminuria in rural Zambia among patients with diabetes mellitus only (DM group), hypertension only (HTN group) and patients with combined DM and HTN (DM/HTN group).methods A cross-sectional survey was conducted at St. Francis Hospital in the Eastern province of Zambia. Albumin-creatinine ratio in one urine sample was used to assess albuminuria. Other information obtained included age, sex, body mass index (BMI), waist circumference (WC), blood pressure (BP), glycosylated haemoglobin (HbA 1c ), random capillary glucose, time since diagnosis, medication and family history of DM or HTN.results A total of 193 participants were included (DM group: n = 33; HTN group: n = 92; DM/HTN group: n = 68). The participants in the DM group used insulin more frequently as diabetes medication than the DM/HTN group (P < 0.05). Furthermore, the DM group was younger and had lower BMI, WC and BP than the two other groups. In the DM group, HTN group and DM/HTN group, microalbuminuria was found in 12.1%, 19.6% and 29.4% (P = 0.11), and macroalbuminuria was found in 0.0%, 3.3% and 13.2% (P = 0.014), respectively. The urine albumin (P = 0.014) and albumin-creatinine ratio (P = 0.0006) differed between the three groups.conclusion This hospital-based survey in rural Zambia found a lower frequency of albuminuria among the participants than in previous studies of patients with DM or HTN in urban sub-Saharan Africa.

Body Mass Index (BMI) Is Associated with Microalbuminuria in Chinese Hypertensive Patients

“…The prevalence rates of microalbuminuria in hypertensive subjects have been reported to range from 6.6% to 46% [ 6 , 10 , 18 , 19 ]. A broad-based international survey indicates that this figure could be as high as 53%–71% in various countries [ 20 ].…”

Several Conventional Risk Markers Suggesting Presence of Albuminuria Are Weak Among Rural Africans With Hypertension

“…We conducted a cross‐sectional study from February to April 2011 in patients with hypertension at St. Francis Hospital in Katéte, a rural area in the Eastern province of Zambia. We assessed anthropometry, glycemic control, albuminuria, and other patient characteristics including information on medication among patients with DM and hypertension . All patients with known hypertension who came to the outpatient department of St. Francis Hospital for a clinical review of their hypertension treatment were invited to participate in this substudy.…”

“…We assessed anthropometry, glycemic control, albuminuria, and other patient characteristics including information on medication among patients with DM and hypertension. 8,9 All patients with known hypertension who came to the outpatient department of St. Francis Hospital for a clinical review of their hypertension treatment were invited to participate in this substudy. Exclusion criteria were positive urine dipstick for nitrites, leukocytes, blood, or fever (defined as an ear temperature ≥37.5°C).…”

“…7 Thus, risk markers indicating presence of albuminuria could diverge from urban settings. Comorbidity of DM has been shown to be strongly associated with albuminuria among patients with hypertension in rural SSA, 8 but, otherwise, information on risk markers indicating albuminuria is virtually nonexistent. The objective of this study is to investigate the risk markers suggesting presence of albuminuria among patients with hypertension in a rural population of SSA.…”

Insulin resistance is associated with urinary albumin‐creatinine ratio in normal weight individuals with hypertension and diabetes: The REACTION study

“…The prevalence of microalbuminuria in diabetic patients is 2-3 times higher than that in healthy people, and the prevalence rate is more than 10%. 5 The prevalence increases with increasing blood glucose levels; however, reduced insulin sensitivity may augment the risk of albuminuria. 6 Studies have shown that microalbuminuria can occur concurrently with diabetes and that microalbuminuria predicts the risk of type 2 diabetes mellitus (T2DM).…”