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ORIGINAL ARTICLE
Year : 2013  |  Volume : 10  |  Issue : 1  |  Page : 18-21

Hypertension and renal function deterioration in black Africans with autosomal polycystic kidney disease


1 Department of Internal Medicine and Nephrology, Faculty of Health Sciences, University Gaston Berger of Saint-Louis, Saint-Louis, Senegal
2 Department of Nephrology, University Hospital Aristide Le Dantec, Dakar, Senegal
3 Dialysis Unit, ABC Polyclinic, Dakar, Senegal

Correspondence Address:
Sidy M Seck
Faculty of Health Sciences, University Gaston Berger of Saint-Louis, Route de Ngallèle, BP: 234, Saint-Louis
Senegal
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Source of Support: None, Conflict of Interest: None


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Background: High blood pressure (HBP) is a leading cause of end-stage renal disease (ESRD) in black African populations and it is frequently associated with autosomal polycystic kidney disease (ADPKD). We assessed the impact of HBP on progression of renal disease in black Africans with ADPKD. Objectives and Methods: We performed a retrospective study between 1995 and 2010 in nephrology out-patient clinic. ADPKD was diagnosed according to recent unified criteria add reference and seventh Joint National Committee classification was used for HBP definition. Statistical analyzes were performed with Stata 12 (Statacorp LP, TX, USA). Results: We included 71 patients (39 males and 32 females) with a mean age of 47±5 years. Prevalence of hypertension was 71.8% and it was present at diagnosis of ADPKD in 48 patients (67.6%). Median delay between HBP and ADPKD diagnosis was 25.6 months. Mean systolic/diastolic blood pressure was 168±30/96±16 mm Hg. After median follow-up of 1823 days, adjusted incidence rate of ESRD in hypertensive and normotensive patients was respectively 0.05 events/100,000 patient-years and 0.03 events/100,000 patient-years (P=0.02). Anti-hypertensive therapy included angiotensin-converting-enzyme (ACE) inhibitors in 51% of patients, but less than 1/3 normalized their blood pressure. At univariate analysis, ESRD was correlated with age, gender, body mass index, HBP and proteinuria. Multiple logistic regression analysis identified age (odds ratio (OR)=1.14; P=0.06) and HBP (OR=1.67; P=0.02) as associated with ESRD. Conclusion: Hypertension with organ damage is frequent in black African patients with ADPKD. Age and HBP at diagnosis were the main factors associated with ESRD.


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