The Prevalence of Chronic Kidney Disease in Hypertensive Patients in Primary Care in Hong Kong: A Cross-Sectional Study

Abstract

BackgroundTo identify the prevalence of Chronic Kidney Disease (CKD) in Chinese hypertensive population managed in a local public primary care clinic and to explore its associated risk factors. MethodsMedical records of Chinese adult hypertensive patients (> 18 years of age) who had been followed up in a public general outpatient clinic (GOPC) from 1 Jan 2018 to 30 Jun 2018 were retrieved and reviewed, and a sample group was randomly selected. Demographic, clinical parameters including age, gender, smoking status, body weight, height, systolic and diastolic blood pressure, biochemical data, and comorbidities were collected from the Computer Management System (CMS). Estimated glomerular filtration rate (eGFR) was calculated by using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. CKD was defined as eGFR < 60 ml/min/1.73m2 and staged according to Kidney Disease Improving Global Outcomes (KDIGO) 2012 criteria. Student's t-test was used to analyze continuous variables and the Chi-squared test was used for categorical data. Multivariate Logistic regression was used to examine the association between CKD and variable associated factors. All statistical tests were two-sided, and a P-value of <0.05 was considered significant.ResultsAmong the 993 Chinese hypertensive patients included in the final analysis, 152 were found to have CKD, with overall prevalence being 15.3%. In addition, the prevalence of CKD increased with the ageing of the population. In multivariate analysis, associated factors for CKD included age (OR 4.3 for every 10 years increase), history of congestive heart failure (OR 7.2), diabetes mellitus (OR 1.8), gout (OR 3.2), number of anti-hypertensive medications (OR 1.6) and high-density lipoprotein cholesterol level (OR 0.38). Conclusions15.3% of Chinese adult hypertensive patients have CKD. Associated factors for CKD include older age, concomitant cardiovascular disease, diabetes mellitus, gout, and lipid disorder. Family physicians should make a concerted effort in early recognition of these risk factors for CKD among HT patients.

Determination of Cystatin C Level in a Sample of Patients with Chronic Kidney Disease

“…SCys C, an alternative marker with few limitations, was examined and compared to SCr. One of the most infective CKD can occur in any age group, and these results agree with [24] who found that mean ages group of (40-49) years was largest these results agreed with [25] Moreover, other studies that agreed with this study were done by [26], who reported a mean age of (50 -≥ 60) years The gender disparity in CKD patients may be explained by the fact that females in these studies may have had greater than males [27]. The higher rate of CKD infection among females may be due to CKD risk factors such as hypertension, diabetes, proteinuria, renal anatomy, and change hormones, which have been observed to have differing impacts on men and women [28].…”