Abstract
Background: Hypertensives are screened for proteinuria largely to detect kidney involvement. In most reports from urban areas, the burden is considerable. We decided to see the scenario in a rural setting with the opportunity presented by our cardiovascular disease (CVD) survey of a rural area in North Central Nigeria.
Methodology: In 2008 we surveyed a rural population in Mangu Local Government area of Plateau State for CVD risk factors using the protocol of the National survey of 1991; slightly modified. One in three subjects was sequentially randomized to have blood and urine examination. Blood tests included glucose, creatinine, uric acid, total and high density lipoprotein cholesterol. Blood pressures were also taken.
Results: Blood and urine tests were done on 282 subjects. Eight of them(2.84%) had proteinuria . Ninety-nine of the 282 (35.11%) were hypertensive. Seven out of the 99 hypertensives (7.07%) had proteinuria. Between those hypertensives (positive or negative for proteinuria), the following indices: glucose, HDL cholesterol, SBP and DBP differed significantly (p=0.000, p=0.015, p=0.000, p=0.000 respectively).
Conclusion: Compared with rates in urban centres of Nigeria, our population recorded low proteinuria rates both for the whole population and the hypertensive segment. It therefore appears that proteinuria in hypertension is not only a reflection of severity and burden of hypertension, but has some relation with residence. Rural areas have lower constellation of CVD risk factor (due to different life style) and lower incidence of hypertension. Consequently, their proteinuria rates are low.
Keywords: Proteinuria, low, hypertension, rural, CVD risk factors
Résumé
Contexte: Les hypertendus sont examinés pour la protéinurie en grande partie afin de détecter une atteinte rénale. Dans la plupart des rapports issus des zones urbaines, la charge est considérable. Nous avons décidé de voir le scénario dans un cadre rural grâce à nos enquêtes menées sur les maladies cardiovasculaires (MCV) en milieux ruraux au centre du nord du Nigeria.
Méthodologie: En 2008, nous avons effectué un sondage auprès de la population rurale dans la préfecture de Mangu dans l’Etat de Plateau pour le risque des facteurs de la MCV en utilisant la procédure du sondage national mené en 1991 mais légèrement modifiée. Un patient sur trois a été successivement choisi afin d’avoir du sang et un examen d’urine. Des tests sanguins incluant le glucose, la créatinine, l’acide urique, le cholestérol des lipoprotéines ont été faits et à haute densité. La tension artérielle a été également prise.
Résultats:Les tests de sang et d’urine ont été effectués sur 282 patients. Huit d’entre eux, soit (2,84%) avaient une protéinurie. Quatrevingt-neuf des 282 (35,11%) étaient hypertendus. Sept des 99 patients hypertendus (7,07%) avaient une protéinurie. Entre ces hypertendus (positif ou négatif de la protéinurie), on note les indices suivants: le glucose, le cholestérol HDL, SBP et DBP diffèrent largement l’un de l’autre (p = 0,000, p = 0,015, p = 0,000, p = 0,000, respectivement).
Conclusion: En comparaison avec les taux dans les centres urbains du Nigeria, notre population a enregistré de faibles taux de protéinurie à la fois pour l’ensemble de la population et pour le segment hypertensif. Il apparaît donc que la protéinurie dans l’hypertension n’est pas seulement un reflet de la gravité et de la charge de l’hypertension, mais a une certaine relation avec la résidence. Les zones rurales ont moins de constellation de risque de facteurs du MCV (en raison du style de vie différent) et une plus faible incidence de l’hypertension. Par conséquent, leurs taux de protéinurie sont faibles.
Correspondence: Prof. B.N. Okeaihalam, Department of Medicine, University of Jos, Plateau State, Nigeria. E-mail: basokeam@yahoo.com
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