Abstract:
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients
with ‘traditional’ chronic kidney disease (CKD). However, chronic kidney disease of uncer tain aetiology (CKDu), a tubular interstitial nephropathy is typically minimally proteinuric
without high rates of associated hypertension or vascular disease and it is unknown if the
rates of CVD are similar. This study aimed to identify the prevalence and the risk of CVD in
patients with CKDu. This cross-sectional study included patients with confirmed CKDu who
were attending two renal clinics in CKDu endemic-area. A detailed medical history, blood
pressure, electrocardiogram (resting and six minutes vigorous walking), echocardiograms,
appropriate laboratory parameters and medical record reviews were used to collect data at
baseline. The WHO/Pan American Health Organization, cardiovascular risk calculator was
employed to determine the future risk of CVD. The clinics had recorded 132 number of
patients with CKDu, of these 119 consented to participation in the study. The mean age
was 52 (± 9.5) years and mean eGFR was 51.1 (± 27.61); a majority (81.5% (n = 97)) were
males. Thirty-four patients (28.6%) had evidence of ischaemic heart disease (IHD). Tropo nin-I (p = 0.02), Age >50 years (p = 0.01) and hyperuricemia (p = 0.01) were significantly
associated with IHD in CKDu. Left ventricular hypertrophy was reported in 20.2% (n = 24).
According to the risk calculator, 97% of the enrolled patients were at low risk (<10%) for
experiencing a cardiovascular event within the next 10 years. Patients with CKDu have low
prevalence and risk for CVD, implying that a majority are likely to survive to reach end-stage
kidney disease. Our findings highlight the need for developing strategies to minimize the
progression of CKDu to end-stage renal disease.
