Predictors of Kidney Damage in Newly-Diagnosed Hypertensive Nigerians

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TO Olanrewaju
A Aderibigbe
A Chijioke
SA Dada
MO Rafiu

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Abstract

Systemic hypertension is an important cause of chronic kidney disease. Identifying predictors of hypertensive kidney damage provides clinicians with opportunity for appropriate therapeutic interventions. This will forestall kidney damage and prevent development of chronic kidney disease. The study aims at determining predictors of kidney damage using microscopic haematuria as surrogate marker in newly diagnosed hypertensive patients. A cross sectional study of 138 newly diagnosed hypertensive Nigerian, matched with age and sex controls was conducted. The surrogate marker of kidney damage was microscopic haematuria defined as 3/hpf, determined by examination of urine sediment under a bright field microscope after application of Sternheimer’s stain. Potential predictors of kidney damage evaluated were: age, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), pulse pressure (PP), and body mass index (BMI). Mean age of the patients was 43.2±9.6years and 76 (55%) were males. SBP correlates positively with kidney damage (r=0.209, p=0.048). Stepwise regression models identified SBP as the best sole predictor of kidney damage (r=0.557, r2=0.310, adjusted r2=0.272, df=1, P=0.011), followed by age (r=0.72, r2=0.505, adjusted r2=0.447, df=2, P=0.019). Other variables were rejected by the model (probability level of entrance was 0.05 and removal, 0 0.1). The study suggests that systolic blood pressure may predict kidney damage in newly diagnosed hypertensive patients, and it seems to be amplified with increasing age. A longitudinal study
with larger population is recommended to confirm this relationship.

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