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Multicenter Study
. 2019 Oct;21(10):1542-1550.
doi: 10.1111/jch.13672. Epub 2019 Aug 29.

Prevalence and predictors of chronic kidney disease among Ghanaian patients with hypertension and diabetes mellitus: A multicenter cross-sectional study

Elliot K Tannor  1 , Fred Stephen Sarfo  1   2 , Linda M Mobula  3   4 , Osei Sarfo-Kantanka  1 , Rexford Adu-Gyamfi  5 , Jacob Plange-Rhule  6
Affiliations
Multicenter Study

Prevalence and predictors of chronic kidney disease among Ghanaian patients with hypertension and diabetes mellitus: A multicenter cross-sectional study

Elliot K Tannor et al. J Clin Hypertens (Greenwich). 2019 Oct.

Abstract

The burden of chronic kidney disease (CKD) is rapidly rising in developing countries due to astronomical increases in key risk factors including hypertension and diabetes. We sought to assess the burden and predictors of CKD among Ghanaians with hypertension and/or diabetes mellitus in a multicenter hospital-based study. We conducted a cross-sectional study in the Ghana Access and Affordability Program (GAAP) involving adults with hypertension only (HPT), hypertension with diabetes mellitus (HPT + DM), and diabetes mellitus only (DM) in 5 health facilities in Ghana. A structured questionnaire was administered to collect data on demographic variables, medical history, and clinical examination. Serum creatinine and proteinuria were measured, and estimated glomerular filtration rate derived using the CKD-EPI formula. A multivariable logistic regression model was used to identify factors associated with CKD. A total of 2781 (84.4%) of 3294 participants had serum creatinine and proteinuria data available for analysis. The prevalence of CKD was 242 (28.5%) among participants with both DM and HPT, 417 (26.3%) among participants with HPT, and 56 (16.1%) among those with DM alone. Predictors of CKD were increasing age aOR 1.26 (1.17-1.36), low educational level aOR 1.7 (1.23-2.35), duration of HPT OR, 1.02 (1.01-1.04), and use of herbal medications aOR 1.39 (1.10-1.75). Female gender was protective of CKD aOR 0.75 (0.62-0.92). Among patients with DM, increasing age and systolic blood pressure were associated with CKD. There is high prevalence of CKD among DM and hypertension patients in Ghana. Optimizing blood pressure control and limiting the use of herbal preparations may mitigate CKD occurrence in high cardiovascular risk populations in developing countries.

Keywords: ACE inhibitors; Ghana; chronic kidney disease; diabetes; diabetes mellitus; epidemiology; hypertension.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Use of antiproteinuric antihypertensive medications on frequency of proteinuria among renally impaired Ghanaian patients with hypertension and or diabetes. ACE‐I, angiotensin‐converting enzyme inhibitors; ARB, angiotensin II receptor blockers
See this image and copyright information in PMC

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