Abstract
Background: There exists a synergy between chronic kidney disease (CKD) and cardiovascular risk factors (CVRFs) with increased morbidity and poor outcomes.
Objectives: Data relating to this clustering in black homogenous populations is scanty. We
aim to investigate this relationship in Nigerian communities.
Patients and Methods: It was a cross-sectional observation study from semi-urban
communities in South-West Nigeria. We used modified World Health Organization
(WHO) questionnaire on chronic diseases (WHO STEPS) to gather information on
socio-demographic data, biophysical and clinical characteristics. Biochemical analysis of
plasma samples was done.
Results: We analyzed data of 1084 with mean age of 56.3 ± 19.9 years (33.4% female).
Prevalence of stage 3 CKD was 14.2% (3a and 3b were 10.3% and 3% respectively).
Prevalence of hypertension (systolic and diastolic blood pressure) and low high-density
lipoprotein cholesterol (HDL-C) increased as clustering of cardiovascular (CV) risk factors
(CVFRs) increased both in CKD and proteinuria (P < 0.05). CKD prevalence increases
with number of risk factors. There was an inverse relationship between increasing risk
factors and mean estimated glomerular filtration rate (eGFR) (P < 0.05). Clustering at least
2 CVRFs in the population with CKD compared to those without CKD was significantly
higher (76.6% vs. 65.1%, OR: 1.8, 95% CI: 1.2-2.6, P = 0.005). Similarly, in a univariate
analysis, albuminuria had an increased odds of clustering (69.7% vs. 59.6%, OR: 1.9, 95%
CI 0.6-6.2, P = 0.409). Using multivariate logistic analysis, there is significantly increased
odds of clustering when eGFR is <45 mL/min/1.73 m2 (OR: 2.66, 95% CI: 1.12-6.32) and
microalbuminuria 1.74 (95% CI: 1.10-2.75).
Conclusions: Reduced kidney function and proteinuria significantly clustered with CVRFs.
This data suggests that individuals with CV clusters should be screened for CKD or vice
versa and they should be considered for prompt management of their CVRFs.