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Navise NH, Mokwatsi GG, Gafane-Matemane LF, Fabian J, Lammertyn L. Kidney dysfunction: prevalence and associated risk factors in a community-based study from the North West Province of South Africa. BMC Nephrol 2023; 24:23. [PMID: 36717778 PMCID: PMC9887915 DOI: 10.1186/s12882-023-03068-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 12/21/2022] [Accepted: 01/20/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Globally, the World Health Organization ranks chronic kidney disease (CKD) as one of the top 10 causes of mortality. In South Africa, where noncommunicable diseases have become leading causes of mortality, the true population prevalence of CKD is unknown and associated risk factors remain understudied. This study aimed to describe the prevalence of kidney dysfunction and associated risk factors in a community from the North West province of South Africa. METHODS This cross-sectional study included 1999 participants older than 30 years. Kidney dysfunction was defined as (i) estimated glomerular filtration rate (eGFR) < 90 ml/min/1.73m2, or (ii) urine albuminuria-to-creatinine ratio (uACR) ≥ 3.0 mg/mmol, or a combination (i and ii). Risk factors included age, sex, urban/rural locality, body mass index (BMI), blood pressure (BP), lipid profile, haemoglobin A1c (HbA1C), C-reactive protein (CRP), gamma-glutamyl transferase (GGT), tobacco use, and HIV status. RESULTS Mean age of participants was 48 (42;56) years, and 655/1999 (33%) had eGFR < 90 ml/min/1.73m2 and/or uACR ≥ 3.0 mg/mmol. Compared to those with normal kidney function, participants with eGFR < 90 ml/min/1.73m2 and/or uACR ≥ 3.0 mg/mmol were older, female, had higher measures of adiposity, systolic, diastolic, and mean arterial blood pressure, serum lipids and C-reactive protein (CRP) (all p ≤ 0.024). In multiple regression analyses eGFR was associated with systolic BP (β = 0.11) and HIV infection (β = -0.09), and albuminuria was associated with elevated CRP (β = 0.12) and HIV infection (β = 0.11) (all p < 0.026). In both groups (individuals with and without kidney dysfunction respectively), eGFR was associated with age (β = -0.29, β = -0.49), male sex (β = 0.35, β = 0.28), BMI (β = -0.12, β = -0.09), low-density/high-density lipoprotein cholesterol ratio (β = -0.17, β = -0.09) and CRP (β = 0.10, β = 0.09) (all p < 0.005); and uACR was associated with female sex (β = 0.10, β = -0.14), urban locality (β = -0.11, β = -0.08), BMI (β = -0.11, β-0.11), and systolic BP (β = 0.27, β = 0.14) (all p < 0.017). CONCLUSION In this study from the North West province, South Africa, eGFR < 90 ml/min/1.73m2 and/or uACR ≥ 3.0 mg/mmol was prevalent and associated with modifiable risk factors. The findings may inform screening strategies for kidney disease prevention, focusing on women, obesity, blood pressure control, dyslipidaemia, identifying and treating inflammation, and HIV diagnosis and treatment.
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Affiliation(s)
- Nonkululeko Hellen Navise
- grid.25881.360000 0000 9769 2525Hypertension in Africa Research Team (HART), North-West University, Private Bag x6001, Potchefstroom, South Africa
| | - Gontse Gratitude Mokwatsi
- grid.25881.360000 0000 9769 2525Hypertension in Africa Research Team (HART), North-West University, Private Bag x6001, Potchefstroom, South Africa ,grid.25881.360000 0000 9769 2525MRC Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Lebo Francina Gafane-Matemane
- grid.25881.360000 0000 9769 2525Hypertension in Africa Research Team (HART), North-West University, Private Bag x6001, Potchefstroom, South Africa ,grid.25881.360000 0000 9769 2525MRC Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - June Fabian
- grid.11951.3d0000 0004 1937 1135Wits Donald Gordon Medical Centre, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Leandi Lammertyn
- grid.25881.360000 0000 9769 2525Hypertension in Africa Research Team (HART), North-West University, Private Bag x6001, Potchefstroom, South Africa ,grid.25881.360000 0000 9769 2525MRC Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
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Mokwatsi GG, Hoshide S, Kanegae H, Fujiwara T, Negishi K, Schutte AE, Kario K. Direct Comparison of Home Versus Ambulatory Defined Nocturnal Hypertension for Predicting Cardiovascular Events. Hypertension 2020; 76:554-561. [DOI: 10.1161/hypertensionaha.119.14344] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The home blood pressure monitoring (HBPM) method that measures blood pressure during sleep hours was reported to be comparable to ambulatory blood pressure monitoring (ABPM) in measuring nighttime blood pressure and detecting nocturnal hypertension. The aim of this study was to directly compare the prognostic power of nocturnal hypertension detected by HBPM versus ABPM for predicting future cardiovascular events. We analyzed nighttime blood pressure (measured by HBPM and ABPM) data of 1005 participants who were included in the J-HOP study (Japan Morning Surge-Home Blood Pressure). During a follow-up period of 7.6±3.4 years, 80 cardiovascular disease events occurred. The majority (91.8%) of our study population were hypertensive, and 80.7% of participants were using antihypertensive medication. Nighttime home systolic blood pressure (SBP) was higher compared to nighttime ambulatory SBP (123.0±14.6 versus 120.3±14.4 mm Hg,
P
<0.001). Nocturnal hypertension was defined as nighttime home or ambulatory SBP of ≥120 mm Hg. The number of participants with nocturnal hypertension defined by HBPM and ABPM was 564 (56.1%) and 469 (46.7%), respectively. Nocturnal hypertension defined by HBPM was associated with increased risk of future cardiovascular events: total cardiovascular events (coronary artery disease and stroke events; 1.78 [1.00–3.15]) and stroke (2.65 [1.14–6.20]), independent of office SBP. These results were absent with nocturnal hypertension defined by ABPM. This is the first comparison prospective study illustrating that uncontrolled nocturnal hypertension defined by HBPM (independent of office SBP) is a predictor of future cardiovascular events.
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Affiliation(s)
- Gontse Gratitude Mokwatsi
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (G.G.M., S.H., T.F., K.N., K.K.)
- Hypertension in Africa Research Team (HART), Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa (G.G.M., A.E.S.)
| | - Satoshi Hoshide
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (G.G.M., S.H., T.F., K.N., K.K.)
| | - Hiroshi Kanegae
- Gengi Plaza Medical Center for Health Care, Tokyo, Japan (H.K.)
| | - Takeshi Fujiwara
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (G.G.M., S.H., T.F., K.N., K.K.)
| | - Keita Negishi
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (G.G.M., S.H., T.F., K.N., K.K.)
| | - Aletta Elisabeth Schutte
- Hypertension in Africa Research Team (HART), Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa (G.G.M., A.E.S.)
| | - Kazuomi Kario
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (G.G.M., S.H., T.F., K.N., K.K.)
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Kruger R, Monyeki MA, Schutte AE, Smith W, Mels CMC, Kruger HS, Pienaar AE, Gafane-Matemane LF, Breet Y, Lammertyn L, Mokwatsi GG, Kruger A, Deacon E, Hanssen H. The Exercise, Arterial Modulation and Nutrition in Youth South Africa Study (ExAMIN Youth SA). Front Pediatr 2020; 8:212. [PMID: 32411640 PMCID: PMC7201091 DOI: 10.3389/fped.2020.00212] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 04/09/2020] [Indexed: 12/13/2022] Open
Abstract
Background: The impact of a sedentary and unhealthy lifestyle on cardiovascular health is well-documented, however the current obesity and hypertension trends among children is concerning. The ExAMIN Youth SA study aims to investigate the impact of lifestyle behaviors (physical fitness/activity, dietary intake and psychosocial factors) involved in early vascular aging among South African children. Methods: This study is an analytical, multidisciplinary, observational cohort study in a school-based setting. We aim to phenotype a cohort of ~1,000 primary school children (black and white boys and girls between ages 5-9 years) based on current clinical childhood conditions including hypertension and obesity. The primary phenotype is large artery stiffness and retinal microvascular diameters, both biomarkers of early vascular aging. The risk factors and mediators of early vascular aging and also responsible for the clinical conditions include physical inactivity, unhealthy diet, and life stress. Additionally, urinalysis and salivary analyses will be performed to identify biomarkers related to the pathophysiology of early vascular aging. Discussion: In line with the growing prevalence of obesity and hypertension responsible for the development of early vascular aging from childhood to adulthood, this study will address the critical areas in which we observe unfavorable arterial modulation related to dietary behaviors, physical inactivity, and early life stress. Implementation of novel biological markers may further contribute to our understanding of early cardiovascular adaptations in childhood, and aid in the development of primary prevention programs. Trial registration: The study was retrospectively registered on ClinicalTrials.gov on 15 August 2019 (NCT04056377).
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Affiliation(s)
- Ruan Kruger
- Hypertension in Africa Research Team (HART); North-West University, Potchefstroom, South Africa.,MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Makama Andries Monyeki
- Physical Activity, Sport and Recreation Research Focus Area; North-West University, Potchefstroom, South Africa
| | - Aletta Elisabeth Schutte
- Hypertension in Africa Research Team (HART); North-West University, Potchefstroom, South Africa.,MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.,School of Public Health and Community Medicine, University of New South Wales and The George Institute for Global Health, Sydney, NSW, Australia
| | - Wayne Smith
- Hypertension in Africa Research Team (HART); North-West University, Potchefstroom, South Africa.,MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Catharina Martha Cornelia Mels
- Hypertension in Africa Research Team (HART); North-West University, Potchefstroom, South Africa.,MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Herculina Salomé Kruger
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.,Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Anita Elizabeth Pienaar
- Physical Activity, Sport and Recreation Research Focus Area; North-West University, Potchefstroom, South Africa
| | - Lebo Francina Gafane-Matemane
- Hypertension in Africa Research Team (HART); North-West University, Potchefstroom, South Africa.,MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Yolandi Breet
- Hypertension in Africa Research Team (HART); North-West University, Potchefstroom, South Africa.,MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Leandi Lammertyn
- Hypertension in Africa Research Team (HART); North-West University, Potchefstroom, South Africa.,MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Gontse Gratitude Mokwatsi
- Hypertension in Africa Research Team (HART); North-West University, Potchefstroom, South Africa.,MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Ankebé Kruger
- Physical Activity, Sport and Recreation Research Focus Area; North-West University, Potchefstroom, South Africa
| | - Elmari Deacon
- Optentia Research Focus Area, North-West University, Potchefstroom, South Africa
| | - Henner Hanssen
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Mokwatsi GG, Schutte AE, Mels CMC, Kruger R. Correction: Morning blood pressure surge in young black and white adults: The African-PREDICT Study. J Hum Hypertens 2018; 33:172. [PMID: 30455468 DOI: 10.1038/s41371-018-0121-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In the article "Morning blood pressure surge in young black and white adults: The African-PREDICT Study" by Gontse Gratitude Mokwatsi, Aletta Elisabeth Schutte, Catharina Martha Cornelia Mels and Ruan Kruger which appeared in 'Journal of Human Hypertension' (2018) volume 32, DOI 10.1038/s41371-018-0089-3, the authors regret that they mentioned erroneously that none of their study participants had an exaggerated morning blood pressure surge. They would like to point out that 40 participants in their study population had an exaggerated sleep-trough surge whereas 128 had an exaggerated dynamic surge.
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Affiliation(s)
| | - Aletta Elisabeth Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Catharina Martha Cornelia Mels
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Ruan Kruger
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa. .,Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
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