Silent kidney disease and hypertension in Cambodia--a pilot study in Mercy Medical Center Cambodia.

Abstract

The incidence and prevalence of end-stage renal disease (ESRD) has been increasing in most developed countries. In developing countries, however, there has been a lack of reliable data. To assess the frequency of unsuspected urine abnormality and hypertension in Cambodia. From April to December 2012, 1,013 new patient records of the Mercy Medical Center (MMC) in Cambodia were reviewed. 915 patients aged ≥ 18 years were included for analysis. Patients with history of hypertension (HT) were excluded for blood pressure (BP) analysis. Patients with history of diabetes mellitus (DM), hypertension (HT), chronic kidney disease (CKD), or with symptoms of renal disease were excluded for urinalysis study. 820 patients had no history of HT. Among this group, 73 (8.9%) had abnormal BP with 60 (7.3%) having BP ≥ 140/90 mmHg and 13 (1.6%) having isolated systolic HT (BP ≥ 140/ 5/high power field (HPF)), 156 (30.6%) having either significant proteinuria or hematuria; and 199 (39.0%) had urine white blood cell count (WBC) ≥ 1+. Overall, 275 patients (53.9%) had 1 or more urinary abnormalities on urinalysis. Abnormal urinalysis (53.9%) and abnormal BP measurement (8.9%) were common findings among asymptomatic patients referred to the MMC. Unlike findings in other countries, no association of family history of DM, HT, or CKD and the risk of kidney disease or abnormal BP was found. A comprehensive community screening program for HT and kidney disease is urgently needed to prevent ESRD in Cambodia.