What is the prevalence of chronic kidney disease among hypertensive non-diabetic Egyptian patients attending primary healthcare?

BACKGROUND: Although chronic kidney disease (CKD) is considered the major cause of morbidity and mortality in hypertension, the recognition and prevention of CKD remain deficient. CKD is one of the major health challenges in Egypt. CKD affects approximately 13% of the adult population, resulting in significant morbidity, mortality, and health care costs. Patients with more progressive stage 3 or stage 4 CKD experience a high rate of cardiovascular events and death compared to earlier stages of CKD. AIM: This study was performed to determine the prevalence and risk factors of CKD among hypertensive non-diabetic patients attending primary health care (PHC) centers in Cairo. METHODOLOGY: The study type is a cross-sectional study. Study setting: Two PHC centers: Saraya El-kobba and El-Sharabya. Sampling method: Recruitment of participants was done in one day weekly. Any known essential hypertensive patients aged 18 or more registered in the two PHC centers in Cairo. RESULTS: The prevalence of CKD was 33% among the hypertensive non-diabetic patients. Among CKD participants, the prevalence is more common in females (59.7%) than males (40.3%), in those who completed primary education and in the illiterates and low socioeconomic class. Surprisingly, it is more common in patients with positive family history of CKD and patients with ischemic heart disease and the antihypertensive drugs use. CONCLUSION: CKD has a high prevalence among hypertensive non-diabetic patients, and it has a significant morbidity and mortality among those patients.

Screening and early detection of chronic kidney disease at primary healthcare.

Chronic kidney disease (CKD) represents a global public health concern and results in poor health outcomes. While the burden of CKD is accurately well defined in developed countries, increasing evidence indicates that the CKD burden may be even greater in developing countries. Primary care has an essential role in the early identification of CKD and the prompt integrated management between primary and secondary CKD care, with participation of the patient, should be done in high quality. Systematic screening for CKD in at-risk individuals is strongly indicated for timely intervention when needed and to perceive the impact of such policies on CKD incidence. Furthermore, failure to recognize a patient in stages 1-3 of CKD may result in high incidence of CKD complications and kidney failure, often leaving the patient unsuitable for different renal replacement therapies, such as dialysis and transplantation. Therefore, primary care early referral and consultation with a nephrologist can give a better chance for different dialysis procedures and minimize the rate of hospitalization and mortality.