Hypertensive Nephropathy: Prevalence, Patient’s Profiles and Evolution in a University Hospital at Dakar

Abstract

Background: Hypertensive nephrosclerosis is chronic impact of high blood pressure on the kidney. The objective of this study was to determine prevalence, clinical presentation, and evolution of hypertensive nephrosclerosis in patients admitting in our service. Patients and Methods: We performed a retrospective, descriptive and analytical study in nephrology department of Aristide Le Dantec University Hospital in Dakar during a period of 05 years. Patients with long-term hypertension, hypertensive retinopathy, left ventricular hypertrophy, and progressive kidney failure were included. Results: 461 patients were included. Hospital prevalence was 7.7%. Mean age was 56.95±13.23 years and sex ratio was 1.07. Uncontrolled high blood pressure has been found in 400 patients. Mean systolic blood pressure was 168.34 ± 27.57 mmHg. Mean diastolic blood pressure was 97.28±19.59 mmHg. On the urine dipstick, 44 patients had proteinuria (<2cross). Mean GFR, was 22.02±17.78 ml/min. Antihypertensive treatment was administered as bitherapy in 232 patients (50.3%). On admission, 47 patients (10.2%) had already started dialysis. At 12 months, 406 patients were regularly followed. Blood pressure was normal in 138 patients and serum creatinine decreased in 74 patients. Advanced age (p=0.0001) and female gender (p =0.0001) were correlated with a low level of GFR. The high 24 hours proteinuria level was unfavorable factor on GFR (p = 0.004). Conclusion: This study shows a high prevalence of hypertensive nephropathy in our study population. His evolution to end stage of kidney disease is inevitable, hence the importance of prevention and early management of hypertension in black subjects