Predictive Factors of Renal Failure in Hypertensive Patients at Chu-So Lome

Abstract

Background: High blood pressure is a major cardiovascular risk factor in the development of stroke, heart failure, coronary heart disease and renal insufficiency (RF). In Togo, hypertension was cited as the leading cause of chronic kidney diseases (CKD) in a study carried out in the nephrology department. Objectives: The overall objective was to determine predictive factors RF in hypertensive patients. Material and Methods : We carried out an analytical and comparative study. Included in the study were all medical records of hypertensive patients who had been consulted or hospitalized in the cardiology department from January 2015 to December 2020 and who had undergone a renal workup. RF was defined for all patients by a GFR < 60 ml/min/1.73m 2 calculated according to the MDRD formula. Risk factors associated with renal failure in hypertension were assessed using univariate and multivariate logistic regression. The dependent variable was GFR status, coded 1 if GFR < 60 and 0 if not. Results: 364 hypertensive patients were enrolled, with an estimated incidence of renal failure of 41.8%. The mean age was 57.90 years in the general population, and 59.21 years for patients with renal failure. Females predominated, with a sex ratio of 0.78. Renal failure predominated in subjects aged 70 and over in 28% (n = 42). Hypertension was associated with the diagnosis of dilated cardiomyopathy (DCM) in 87 cases (24%) and hypertrophic cardiomyopathy (HCM) in 6 cases (1.6%). There was a statistically significant difference between the proportion of renal failure patients and non-renal failure patients as a function of age, duration of hypertension, follow-up of hypertension, grade of hypertension on admission, the presence of lower limb edema, hemoglobin level and plasma urea value. Factors associated with the onset of renal failure in hypertension were: advanced age (over 65) (OR = 2.28 95% CI [1.28 - 4.03]); unmonitored AH (OR = 2.82 95% CI [1.66 - 4.77]); grade III AH (OR = 2.05 95% CI [1.17 - 3.57]) and hyper-uremia (OR = 13.34 95% CI [7.37 - 24.14]). Conclusion: IR during hypertension is very common in Togo. The predictive factors found corroborate the data in the literature.