Related Experiment Video
Updated: Jun 23, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Causes of Chronic Kidney Disease and Their Associations with Cardiovascular Risk and Disease in a Sub-Saharan
Nkosingiphile Matthew Sandile Twala1, Grace Tade2, Patrick Hector Dessein2,3
1Department of Medicine, Chris Hani Baragwanath Hospital and Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
Insights
Hypertensive nephropathy is the leading cause of chronic kidney disease (CKD) in Sub-Saharan Africa. Cardiovascular risk and disease vary significantly among different CKD causes in this population.
Area of Science:
- Nephrology
- Cardiology
- Public Health
Background:
- Chronic kidney disease (CKD) causes in Sub-Saharan Africa are largely unknown.
- Cardiovascular (CV) risk and disease prevalence may differ based on CKD etiology.
Purpose of the Study:
- To identify the presumed causes of CKD in a Sub-Saharan African population.
- To investigate the relationship between CKD etiologies and CV risk and disease.
Main Methods:
- Prospective, cross-sectional study of 743 patients in a low-income Sub-Saharan population.
- Examined CKD causes, pulse pressure, systolic blood pressure, and cardiovascular disease prevalence.
- Utilized mediation analysis to assess the impact of CKD etiologies on CV parameters.
Main Results:
- Hypertensive nephropathy (HNP) was the most common cause (60.2%), followed by diabetic nephropathy (DNP) (24.4%), HIV-associated CKD (20.0%), and glomerular disease (13.6%).
- Patients with HNP and/or DNP exhibited higher pulse pressure and systolic blood pressure compared to other etiologies.
- Cardiovascular disease was more prevalent in patients with HNP and concurrent HNP and DNP.
Conclusions:
- Hypertensive nephropathy is the predominant cause of CKD in this African cohort.
- Significant differences in cardiovascular risk and disease exist across various CKD etiologies.
Introduction:
The causes of chronic kidney disease (CKD) in people living in Sub-Saharan Africa await identification. Also, whether cardiovascular risk and disease extent differ among patients with different CKD etiologies is uncertain.
Methods:
In this prospective cross-sectional study, we examined the presumed causes of chronic kidney disease (CKD) and their relationships with cardiovascular risk and disease in 743 consecutive patients from a sub-Saharan low-income population.
Results:
Hypertensive nephropathy (HNP) (60.2%), diabetic nephropathy (DNP) (24.4%), HIV associated CKD (20.0%) and glomerular disease (13.6%) comprised the major CKD etiologies upon enrolment at the hospital nephrology clinic. Pulse pressure was larger in patients with concurrent HNP and DNP than in those with HNP only (p<0.001). Pulse pressure and systolic blood pressure were larger in HNP or/and DNP patients than those with HIV associated CKD and glomerular disease (p=0.04 to <0.001). Cardiovascular disease was more prevalent in patients with HNP and concurrent HNP and DNP than those from other etiologic categories (p<0.05). HNP and DNP were associated with pulsatile pressures (pulse pressure and systolic blood pressure) independent of one another (p<0.01). In adjusted product of coefficient mediation analysis, mean arterial or distending pressure accounted fully for the potential impact of HNP on pulsatile pressures (103.9-115.7%) but not for that of DNP on the respective pressures (-2.0%-(-)7.5%).
Conclusion:
HNP is by far the most prevalent presumed cause of CKD in this African population. Cardiovascular risk and disease differ markedly across CKD etiological categories.
Related Concept Videos
01:10Nephrons
01:18Hypertension and Regulation of Blood Pressure
01:20Renal Corpuscle
Glomerulus: Structure and Function
The glomerulus is a tiny, intricate network of capillaries located at the beginning of the nephron. It's enveloped by the Bowman's capsule and receives its blood supply from an afferent arteriole, which divides into numerous...
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:22Heart Failure Drugs: Diuretics
01:27Dialysis
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...