Determinants of hyperuricemia in non-dialysed chronic kidney disease patients in three hospitals in Cameroon

Abstract

Background: Chronic kidney disease (CKD) poses a substantial health burden in sub-Saharan Africa, with risk factors ranging from communicable to non-communicable diseases. Hyperuricemia has been recently identified as a factor of progression of CKD. Identifying factors associated with hyperuricemia in CKD patients would help determine interventions to reduce CKD mortality, particularly in resources limited countries. We sought to determine the prevalence and factors associated with hyperuricemia in non-dialysed CKD adult patients in Cameroon. Methods: This was a cross-sectional study of non-dialysed CKD patients, conducted in 3 referral nephrology units in Cameroon. Relevant clinical and laboratory data were collected using interviewer-administered questionnaires. Serum uric acid, spot urine protein and spot urine creatinine were assessed. Associations between variables were assessed using multivariate analysis. Level of statistical significance was set at α < 0.05. Results: A sample of 103 participants was included. Mean age of study participants was 55.78 ± 12.58 years, and 59.3% were men. Sixty-nine (67%) had hyperuricemia. Patient’s age (OR: 1.08, 95% CI: 1.03-1.13), estimated glomerular filtration rate (OR: 0.94, 95% CI: 0.90-0.98), spot urine protein-creatinine ratio (OR: 1.83, 95% CI: 1.07-3.12), no hypertension (OR: 0.09, 95% CI: 0.02-0.46), urate lowering therapy (OR: 4.99, 95% CI: 1.54-16.16), loop diuretics (OR: 3.39, 95% CI: 1.01-11.42), obesity (OR: 6.12, 95% CI: 1.15-32.55) and no anaemia (OR: 0.04, 95% CI: 0.00-0.29) were independently significantly associated with hyperuricemia. Conclusions: In this sample of non-dialysed CKD patients in Cameroon, about 7 out of 10 had hyperuricemia. Hyperuricemia was independently associated with patient’s age, estimated glomerular filtration rate, spot urine protein-creatinine ratio, hypertension, urate lowering therapy, loop diuretics, obesity and anaemia. More studies are required to establish causal relationships between these associations.