Cardiovascular determinants of renal dysfunction among children and adolescents in South West Nigeria

Abstract

Background: New evidences reveal significant association of cardiovascular risk factors to development of chronic kidney disease among children and adolescents but there is paucity of data from Africa.
 Objectives: We examined the association of cardiovascular risk factors to renal dysfunction among Nigerian pediatric subjects.
 Materials and method: This was a prospective, cross-sectional study of pediatrics aged 2 to 17 years. Blood pressure, body mass index, serum lipids and creatinine were determined. Their glomerular filtration rate was calculated using the revised Schwartz equation. Data was analyzed with SPSS 20. Test of association was by Chi square at P <0.05.
 Results: We studied 114 children and adolescents. There were 55 (48.2%) males and 59 (51.8%) females with mean age of 8.99±4.26 years. There were 68 (53.5%) children and 53 adolescents (46.5%). Four (3.5%) subjects had proteinuria ≥1+. Renal dysfunction (eGFR <60ml/ min/1.73m2) was found among 9 (7.9%) participants. Renal dysfunction was higher among children than adolescents (13.1% v 1.9%) (p = 0.027). The presence and clustering of risk factors were higher among subjects with renal dysfunction (p value 0.466, 95% CI 0.19-28.3). Low HDL-c (44.4%), prehypertension(22.2%) and overweight (22.2%) were the most prevalent risk factors among those with renal dysfunction. Only age demonstrated relationship to renal dysfunction in terms of mean difference (p value 0.007, 95% CI, 1.125-6.818).
 Conclusions: The prevalence and clustering of cardiovascular risk factors is higher among children with renal dysfunction. Age showed association to renal dysfunction. Dyslipidemia and high body mass have propensity to influence the development of pediatric CKD.
 Keywords: Cardiovascular risk factors, renal dysfunction, association, pediatrics, Nigeria, Africa.