肾脏病学与治疗学杂志

Chronic Kidney Disease amongst Patients with Chronic Hepatitis B Virus in a Low Income Country Setting

Abstract

Halle Marie Patrice, Eloumou Bagnaka Servais Albert, Nda Mefo’o Jean Pierre, Kanouo Yolande, Djantio Hilaire, Fouda Hermine, Malongue Agnes, Doualla Marie Solange and Luma Namme Henry

Background: Hepatitis B virus (HBV) infection and chronic kidney disease (CKD) are major public health issue. Patients with HVB are at risk of CKD. Data on the prevalence of CKD in HBV-infected patients in Sub Saharan Africa (SSA) are inexistent. This study aimed to determine the prevalence and associated factors of CKD in HBV-infected patients in Cameroon.

Methods: We carried out a cross sectional study from March to August 2017 in Cameroon, including consenting patients aged >18 years followed up for chronic HBV. Data collected in medical records were: Socio demographic, Comorbidities, HBV-related data and biological data. Morning urine and blood were collected for dipstick analysis and creatinine dosage. GFR was estimated using the four-variable MDRD and CKD-EPI equations. Patients with eGFR<60 ml/min/1.73 m² and/or urinary abnormalities underwent a second measurement 3 months later. Definition and classification of CKD were based on the KDIGO 2012. Logistic regression was used to determine factors associated to proteinuria and CKD. A p value <0.05 was considered significant.

Results: We included 272 participants, mean age of 37.33 ± 9.73 years, 65.8% males. Prevalence of proteinuria was 12.1%, 7.7% for haematuria and 3.7% for leucocyturia. Prevalence of CKD was 19.9% (54/272) using CKDEPI- formula and 18.4% (50/272) with MDRD, with 8.1% (22/272) at CKD stage 1, 8.9% (24/272) for stage 2, 2.6% (7/272) stage 3, 0.3% (1/272) stage 4. Factors associated to proteinuria were chronic use of herbal medicine (p=0.007), haematuria (p=0.009), while age ≥50 years (p=0.004), duration of HBV infection ≥5 years (p=0.039) and chronic use of herbal medicine (p=0.040), were factors associated to CKD.

Conclusion: CKD is frequent amongst HBV patients in Cameroon. Older age, used of traditional herbs and longer duration of the infection were factors associated to CKD. There is need for renal function evaluation during follow up of HBV infected patient in our setting.