Background: High blood pressure is a major cardiovascular risk factor in the development of stroke, heart failure, coronary heart disease and renal insufficiency (RF). In Togo, hypertension was cited as the leading cause of chronic kidney diseases (CKD) in a study carried out in the nephrology department. Objectives: The overall objective was to determine predictive factors RF in hypertensive patients. Material and Methods: We carried out an analytical and comparative study. Included in the study were all medical records of hypertensive patients who had been consulted or hospitalized in the cardiology department from January 2015 to December 2020 and who had undergone a renal workup. RF was defined for all patients by a GFR < 60 ml/min/1.73m2 calculated according to the MDRD formula. Risk factors associated with renal failure in hypertension were assessed using univariate and multivariate logistic regression. The dependent variable was GFR status, coded 1 if GFR < 60 and 0 if not. Results: 364 hypertensive patients were enrolled, with an estimated incidence of renal failure of 41.8%. The mean age was 57.90 years in the general population, and 59.21 years for patients with renal failure. Females predominated, with a sex ratio of 0.78. Renal failure predominated in subjects aged 70 and over in 28% (n = 42). Hypertension was associated with the diagnosis of dilated cardiomyopathy (DCM) in 87 cases (24%) and hypertrophic cardiomyopathy (HCM) in 6 cases (1.6%). There was a statistically significant difference between the proportion of renal failure patients and non-renal failure patients as a function of age, duration of hypertension, follow-up of hypertension, grade of hypertension on admission, the presence of lower limb edema, hemoglobin level and plasma urea value. Factors associated with the onset of renal failure in hypertension were: advanced age (over 65) (OR = 2.28 95% CI [1.28 - 4.03]); unmonitored AH (OR = 2.82 95% CI [1.66 - 4.77]); grade III AH (OR = 2.05 95% CI [1.17 - 3.57]) and hyper-uremia (OR = 13.34 95% CI [7.37 - 24.14]). Conclusion: IR during hypertension is very common in Togo. The predictive factors found corroborate the data in the literature.
References
[1]
WHO (1999) International Society of Hypertension. Guidelines for the Management of Hypertension. Journal of Hypertension, 17, 151-183.
[2]
WHO, Harvard School of Public Health and World Bank. The Global Burden of Disease.
[3]
Yayehd, K., Damorou, F., Akakpo, R., Tchérou, T., N’Da, N.W., Pessinaba, S., et al. (2013) Prévalence de l’hypertension artérielle et description de ses facteurs de risque à Lomé (Togo): Résultats d’un dépistage réalisé dans la population générale en mai 2011. Annales de Cardiologie et d’Angéiologie, 62, 43-50. https://doi.org/10.1016/j.ancard.2012.09.006
[4]
Damorou, F., Togbossi, E., Pessinaba, S., et al. (2008) Epidemiology and Circumstances of Discovery of Arterial Hypertension in Hospitals in Kpalimé (Secondary City of Togo). Mali Medical, 23, 17-20.
[5]
Damorou, F., Yayehd, K., Tchérou, T., et al. (2009) Epidemiology of Hypertension at Kara University Hospital. African Journal of Biomedical Research, 14, 95-102.
[6]
Bielecka-Dabrowa, A., Aronow, W.S., Rysz, J. and Banach, M. (2011) The Rise and Fall of Hypertension: Lessons Learned from Eastern Europe. Current Cardiovascular Risk Reports, 5, 174-179. https://doi.org/10.1007/s12170-010-0152-2
[7]
Banach, M., Mikhailidis, D.P., Kjeldsen, S.E., et al. (2009) Time for New Indications for Statins? Medical Science Monitor, 15, 1-5.
[8]
Agodoa, L.Y. and Eggers, P.W. (1995) Renal Replacement Therapy in the United States: Data from the United States Renal Data System. American Journal of Kidney Diseases, 25, 119-133. https://doi.org/10.1016/0272-6386(95)90638-x
[9]
Agence de la biomédecine (2007) Réseau épidémiologique et information en néphrologie: REIN 2007 Report. Néphrologie & Thérapeutique, 5, S1-S144.
[10]
Kaba, M.L., Baldé, M.D., Bah, A.O., et al. (2005) Evaluation de l’atteinte rénale au cours de l’hypertension artérielle de l’adulte à Conakry. Mali Medical, 3, 2-4.
[11]
Kan, C., Sita, N., Lagou, A., et al. (2014) Epidemiology of Uncontrolled Hypertension during Chronic Kidney Disease in Patients Admitted to a Black African Nephrology Unit: A Retrospective Study of 479 Patients. Elsevier Masson.
[12]
Sabi, K.A., Gnionsahe, D.A. and Amedegnato, D. (2011) Chronic Kidney Failure in Togo: Clinical, Laboratory and Etiological Aspects. Medecine santé tropicale, 71, 74-76.
[13]
Lemrabott, A., Faye, M., Khadra, H., Cissé, M.M., Fall, K., Mbengue, M., et al. (2018) Néphroangiosclérose bénigne au CHU A. Le Dantec de Dakar: Aspects épidémiologique, clinique, paraclinique, thérapeutique et évolutif. Néphrologie & Thérapeutique, 14, 335-402. https://doi.org/10.1016/j.nephro.2018.07.302
[14]
Lengani, A., Samadoulougou, A. and Cissé, M. (2000) Characteristics of Renal Involvement in Adult Hypertensive Morbidity in Burkina Faso. Archives des maladies du cœur et des vaisseaux, 93, 1053-1057.
[15]
Lengani, A., Laville, M., Serme, D., et al. (1994) Renal Failure during Hypertension in Black Africa. La presseMédicale, 23, 788-792.
[16]
Tsevi, M.Y., Salifou, S., Sabi, A.K., Noto-Kadou-Kaza, B., Amekoudi, E.Y. and Dassa, S.K. (2016) Hémodialyse chronique et dépression au Centre Hospitalier Universitaire Sylvanus Olympio de Lomé (Togo). Pan African Medical Journal, 25, 2-3.
[17]
Sabi, A.K., Noto-Kadou-Kaza, B., Amekoudi, E.Y., et al. (2017) Cout direct de la prise en charge de l’insuffisance rénale chronique non dialyse au Togo. Revue Scientifique du Tchad—Series B, 2017, 5-9.
[18]
Maric, C. and Sullivan, S. (2008) Estrogens and the Diabetic Kidney. Gender Medicine, 5, S103-S113. https://doi.org/10.1016/j.genm.2008.03.010
[19]
Klag, M.J. (1997) End-Stage Renal Disease in African-American and White Men. Journal of the American Medical Association, 277, Article 1293. https://doi.org/10.1001/jama.1997.03540400043029
[20]
Rule, A.D. (2010) The Association between Age and Nephrosclerosis on Renal Biopsy among Healthy Adults. Annals of Internal Medicine, 152, 561-567. https://doi.org/10.7326/0003-4819-152-9-201005040-00006
[21]
Hsu, C., McCulloch, C.E., Darbinian, J., Go, A.S. and Iribarren, C. (2005) Elevated Blood Pressure and Risk of End-Stage Renal Disease in Subjects without Baseline Kidney Disease. Archives of Internal Medicine, 165, 923-928. https://doi.org/10.1001/archinte.165.8.923
[22]
Haroun, M.K., Jaar, B.G., Hoffman, S.C., Comstock, G.W., Klag, M.J. and Coresh, J. (2003) Risk Factors for Chronic Kidney Disease. Journal of the American Society of Nephrology, 14, 2934-2941. https://doi.org/10.1097/01.asn.0000095249.99803.85
[23]
Waikar, S.S. and Bonventre, J.V. (2007) Biomarkers for the Diagnosis of Acute Kidney Injury. Current Opinion in Nephrology and Hypertension, 16, 557-564. https://doi.org/10.1097/mnh.0b013e3282f08745
[24]
Beaufils, M. (2005) Néphroangiosclérose. EMC—Néphrologie, 2, 103-124. https://doi.org/10.1016/j.emcnep.2005.07.001
[25]
Aps, J.K.M. and Martens, L.C. (2005) Review: The Physiology of Saliva and Transfer of Drugs into Saliva. Forensic Science International, 150, 119-131. https://doi.org/10.1016/j.forsciint.2004.10.026
[26]
Soares Nunes, L.A., Mussavira, S. and Sukumaran Bindhu, O. (2015) Clinical and Diagnostic Utility of Saliva as a Non-Invasive Diagnostic Fluid: A Systematic Review. Biochemia Medica, 25, 177-192. https://doi.org/10.11613/bm.2015.018
[27]
Brochard, L., Abroug, F., Brenner, M., Broccard, A.F., Danner, R.L., Ferrer, M., et al. (2010) An Official ATS/ERS/ESICM/SCCM/SRLF Statement: Prevention and Management of Acute Renal Failure in the ICU Patient. American Journal of Respiratory and Critical Care Medicine, 181, 1128-1155. https://doi.org/10.1164/rccm.200711-1664st