Abstract
Introduction: Cardiovascular disease (CVD) is the major cause of morbidity and mortality in patients with chronic kidney disease (CKD). Objective: To evaluate the burden of CVD and audit the management of cardiovascular risk factors (CVRF) in patients with non-dialysis (ND) dependent CKD in Cameroon. Patients and Methods: A cross-sectional study in the Douala general hospital was conducted from January to March 2016, including CKD patients’ stages 3 - 5 ND. Socio-demographic data, comorbidities, medications and biological data were extracted from patient’s records. For each participant, lipid profile and urinary protein excretion were measured; a resting electrocardiogram was done. Hypertension, diabetes, dyslipidemia, obesity, smoking, alcohol consumption, anemia, hyperuricemia, proteinuria and high calcium-phosphorus product were considered as CVRF. CVD was defined as a history of stroke, peripheral artery disease, coronary heart disease (CHD), left ventricular hypertrophy (LVH), heart failure (HF) and arrhythmia. We used KDOQI 2003, KDIGO 2012 and JNC 8 guidelines for definition and evaluation of the management of lipid abnormalities, proteinuria and hypertension respectively. Results: A total of 83 patients (45 males) were included; mean age was 56 ± 15 years. Mean number of CVRFs per patient was 5.19 ± 1.64; hypertension (90.3%), obesity (79.5%), anemia (78.3%), dyslipidemia (69.8%) and hyperuricemia (69.8%) were the most frequent. Mean number of CVD per patient was 1.5 ± 0.63 with an overall prevalence of 69.8%; LVH (48.2%) and CHD (30.1%), were the most frequent and prevalence increased significantly with CKD stage. Treatment rate of hypertension was 100%, 53.4% for dyslipidemia and 75.3% for anemia. Target values were achieved in 50% of participants for LDL-cholesterol and phosphorus levels, 26.6% for blood pressure and 6% for hemoglobin levels. Conclusion: CVRF are highly prevalent in non-dialyzed CKD populations in this setting. This may contribute to the burden of CVD implying strict control of these factors.
Highlights
Cardiovascular disease (CVD) is the major cause of morbidity and mortality in patients with chronic kidney disease (CKD)
The mean number of non-traditional cardiovascular risk factors (CVRF) significantly increased with stage of CKD (p = 0.004)
In the present study including 83 patients with CKD stage 3 - 5 ND in Cameroon, we found that CVD more than 2/3 of participants presented at least one CVD with left ventricular hypertrophy (LVH), coronary heart disease (CHD) and heart failure (HF) being the most frequent
Summary
Cardiovascular disease (CVD) is the major cause of morbidity and mortality in patients with chronic kidney disease (CKD). Objective: To evaluate the burden of CVD and audit the management of cardiovascular risk factors (CVRF) in patients with non-dialysis (ND) dependent CKD in Cameroon. Hypertension, diabetes, dyslipidemia, obesity, smoking, alcohol consumption, anemia, hyperuricemia, proteinuria and high calcium-phosphorus product were considered as CVRF. We used KDOQI 2003, KDIGO 2012 and JNC 8 guidelines for definition and evaluation of the management of lipid abnormalities, proteinuria and hypertension respectively. Results: A total of 83 patients (45 males) were included; mean age was 56 ± 15 years. Mean number of CVRFs per patient was 5.19 ± 1.64; hypertension (90.3%), obesity (79.5%), anemia (78.3%), dyslipidemia (69.8%) and hyperuricemia (69.8%) were the most frequent.
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