Microalbuminuria in patients with chronic kidney disease at Parirenyatwa Hospital in Zimbabwe

Nyasha Chin'Ombe,Ophius Msengezi,Hilda Matarira

doi:10.11604/pamj.2013.14.39.1747

Abstract

Microalbuminuria (MAU) has been linked to chronic kidney disease (CKD) and other metabolic conditions such as hypertension and diabetes. In Zimbabwe, CKD is a common occurrence and many new cases of the disease are recorded yearly. The objective of the study was to evaluate MAU in patients with CKD at Parirenyatwa Hospital in Zimbabwe. Patients with CKD were recruited from Parirenyatwa Hospital in Zimbabwe. Microalbumin levels in urine were evaluated using a microalbumin ELISA kit. Plasma urea, creatinine and electrolytes (sodium and potassium) in the patients were determined using a CX5 analyser. The haemoglobin measurement was carried out using a Coulter S plus counter (USA). Proteins and nitrites in the urine were evaluated by the Bayer reagent strips. Patients with CKD had various clinical conditions such as hypertension and diabetes, The levels of microalbumin excreted in the urine of the patients and control subjects were 157 ± 71 mg/l and 6.6 ± 5.0 mg/l respectively (p < 0.001). Out of all the CKD patients, 44 (63%) had microalbumin as high as 210 mg/l. The levels of serum creatinine in the patients were significantly above those of the control subjects. The mean levels of serum sodium and potassium sodium in the patients were also significantly above the mean levels in control group (p < 0.001). Urine nitrites were negative in 87% of the patients and proteinuria was positive in 67% of the renal patients. MAU was highly elevated in CKD patients in Zimbabwe and could be a good clinical marker for renal dysfunction in low-resource settings.

Highlights

Microalbuminuria (MAU), which is the presence of high levels of microalbumin in urine, has been linked to kidney damage or chronic kidney disease (CKD) [1,2]
There were other conditions such as small kidney, tuberculosis infection, urinary tract obstruction, history of schistosomiasis infection, systemic lupus erythematosus (SLE) with hypertension, malaria infection, malignancy with hypertension and traditional African herbal poisoning which were found in the patients
Other minor interesting clinical conditions found in the renal patients included HIV infection with hypertension, small kidney, tuberculosis infection, urinary tract obstruction, history of schistosomiasis infection, malaria infection, malignancy with hypertension and traditional African herbal poisoning

Summary

Introduction

Microalbuminuria (MAU), which is the presence of high levels of microalbumin in urine, has been linked to kidney damage or chronic kidney disease (CKD) [1,2]. According to the Zimbabwe Kidney Foundation, the number of patients with CKD continues to go up every year. We evaluated the presence of MAU in 70 patients with CKD attending Parirenyatwa Referral Hospital Renal Unit in Harare, Zimbabwe.

Results

Conclusion