The Association Between Chronic Kidney Disease, Hyperuricaemia and Proteinuria in Adult Patients Attending Outpatient Clinics in Banjul, the Gambia

Abstract

Background: Chronic kidney disease (CKD) is manifested by irreversible worsening renal function and is associated with proteinuria and hyperuricaemia.Objective: To determine the prevalence of CKD, hyperuricaemia and proteinuria and explore the relationship between CKD, hyperuricaemia and proteinuria among outpatients in Banjul, The Gambia.Design: Prospective cross-sectional studySetting: Outpatient clinics of Edward Francis Small Teaching Hospital and Medical Research Council Laboratories in Banjul.Methods: Two hundred and eight consecutive patients with hypertension on treatment and 108 nonhypertensive patients aged over 25years were enrolled. A questionnaire was filled and anthropometric measurements were taken. An oral glucose tolerance test was done. Serum uric acid and creatinine were determined from venous blood samples and proteinuria was determined by urine dipsticks. The estimated glomerular filtration rate (GFR) was calculated using the Cockcroft and Gault equation. CKD was defined and classified by The National Kidney Foundation’s Kidney Diseases Outcomes Quality Initiative guidelines.Results: The results of 300 participants were included in this analysis. The prevalence of hyperuricaemia was 36%, proteinuria 25% and CKD 41% (10.7% of participants had Stage 1, 6.7% Stage 2, 21.7% Stage 3, 1.3% Stage 4 and 0.3% Stage 5). The mean uric acid was 0.33 (0.13) mmol/L, mean creatinine 88.1 (54.1) μmol/L and mean GFR was 103.2 (80.2) ml/min/1.73 m2 .There was a strong and significant association between hyperuricaemia, proteinuria and CKD among these participants before and even after controlling for age, sex, hypertension and diabetes mellitus.Conclusion: The prevalence of CKD, hyperuricaemia and proteinuria in patients attending clinics in Banjul was high. There was a strong and significant association between CKD, hyperuricaemia and proteinuria.