Burden of Chronic Kidney Disease in Hypertensive Patients in Medical Outpatient Clinic of a Rural Tertiary Hospital

Abstract

Background: There is an alarming rise of chronic kidney disease (CKD) prevalence globally, which is associated with significant morbidity and mortality necessitating special attention as a major public health problem. Data on the burden of CKD on the African continent are sparse for rural population. Hypertension related kidney disease accounts for a large percentage of the population requiring renal replacement therapy worldwide. Therefore, we determined the burden of CKD in patients with hypertension attending a tertiary hospital located in a rural community. Methods: This cross-sectional study included patients of a medical outpatient clinic in Federal Teaching Hospital Ido Ekiti, Ekiti State, Nigeria. Study patients were consecutively recruited from Cardiac clinic and baseline data were obtained from the patients' files which include the blood pressure, plasma creatinine, age, gender, ethnicity, and other necessary data. Glomerular filtration rate (GFR) was calculated using estimated GFR by Modification of diet in renal disease (MDRD) equation. The estimated minimum sample size was 179 with probability of type 1 error, assumption of α = 0.05 and power of 95%. A total of 204 patients with the minimum number of investigation results were included. Results: A total of 204 hypertensive patients were studied. The patients were aged between 29 and 90 years with a mean age of 62.9 ± 12.9 years. The study population was made up of 93 males and 111 females. Overall, about 50% of the patients at presentation have CKD (GFR below 60 ml/ min/1.73 m 2), p < 0.05. Majority of the patients belonged to the low socioeconomic class presenting with stage 2 hypertension. Conclusion: The burden of CKD in this report among hypertensive patients suggest a significant public-health problem on the basis of the tremendous burden of CKD among the poor, its distribution among the patients, and the existence of effective treatments that are not affordable and available to a large proportion of these groups of people.