EFFECT OF HYPERTENSION ON RENAL FUNCTIONS IN DIABETICS ATTENDING A REFERRAL HOSPITAL IN KENYA

Abstract

Hypertension affects and progressively reduces the filtering function of the kidney leading to chronic kidney disease. There are many incidences of people with high blood pressure hence chronic kidney disease is expected to be common. Chronic kidney disease is diagnosed by renal function tests in the serum and urine. Diabetes also causes chronic kidney disease and is fairly common hence coexistence with hypertension has synergistic insult on the kidney. The prevalence of hypertension in Kenya is approximated to be 44.5% among the male population and 35.1% among the female population. On the other hand, the prevalence of diabetes is 10% and is reported to be independent of age and gender distributions. Information about the extent of kidney disease among hypertensive diabetics in our setting is lacking therefore there is need for studies to fill this gap. The objective of the study was to establish whether hypertension hightens kidney dysfunction in diabetic patients. The study was cross-sectional and was carried out at Moi Teaching and Referral Hospital, Eldoret, Kenya between December 2011 and April 2012. Three hundred and twenty four (324) hypertensive diabetics and non-hypertensive diabetics meeting the inclusion criteria were consecutively selected and requested for consent before their recruitment into the study. Serum and urine samples were obtained from the patients and analysed using Diacetylmonoxime, Jaffe’s, Sulphosalicyclic acid and Urinometer methods to obtain creatinine, urea, protein and glucose levels respectively. . These data together with demographic characteristics including age, sex and weight obtained from the hospital records were entered into the Computer using SPSS version 17 (Levesque, 2007). Analysis consisted of descriptive statistics for the variables and quantitative correlation between the hypertensive and non hypertensive diabetics at 95% confidence level using Chi-square. Significant difference in serum urea was observed between the two study groups with hypertensive diabetics having a mean of 57.8 mg/dl while the non-hypertensive group had a mean of 17.3 mg/dl. Hypertensive study group had significantly higher creatine levels compared to that of non-hypertensive control group (1.55 mg/dl/2.43mg/dl, P= 0.05). On the other hand, 19.24 mg/dl and 15.3 mg/dl urea levels were observed in the Hypertensive and non-hypertensive study groups respectively. Although not significant, the study observed a general increasing trend of all the serum and urine study parameters from the non-hypertensive’s to pre-hypertensive with highest levels being observed in the high blood pressure subjects.