Abstract: PO2309
Microscopic Hematuria and Leukocyturia Are Highly Prevalent in East Africa and Associated with CKD
Session Information
- CKD: Drugs, Diet, and Other Determinants
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Muiru, Anthony N., University of California San Francisco, San Francisco, California, United States
- Kabami, Jane, The Infectious Diseases Research Collaboration (IDRC), Kampala, Uganda
- Kamya, Moses, The Infectious Diseases Research Collaboration (IDRC), Kampala, Uganda
- Havlir, Diane, University of California San Francisco, San Francisco, California, United States
- Charlebois, Edwin, University of California San Francisco, San Francisco, California, United States
- Estrella, Michelle M., University of California San Francisco, San Francisco, California, United States
- Hsu, Chi-yuan, University of California San Francisco, San Francisco, California, United States
Background
Microscopic hematuria and leukocyturia may reflect parenchymal kidney disease; there have been few population-based studies of these urinary abnormalities in Africa.
Methods
We included a population-based sample of 3,686 East Africans. We defined hematuria and leukocyturia as heme and leukocyte esterase dipstick positive (≥1+), respectfully. We used sampling weights to estimate the community-based prevalence of hematuria and leukocyturia and used weighted multivariable log-link Poisson models to assess the association of potential risk factors with these abnormalities, and separately, the association of urine abnormalities with CKD (eGFR <60 mL/min/1.73m2 or dipstick proteinuria ≥1+).
Results
Most participants with leukocyturia did not have hematuria or proteinuria; there was minimal overlap between hematuria and proteinuria (Figure). With sample weighting, the mean age was 38 years; 52% were female. The prevalence of hematuria was 3.7% in eastern Uganda, 2.8% in southwestern Uganda and 2.8% in Kenya. The prevalence of leukocyturia was 11.2% in eastern Uganda, 8.7% in southwestern Uganda and 1.6% in Kenya. Table 1 shows associations of potential risk factors with urine abnormalities. Both hematuria and leukocyturia were independently associated with prevalent CKD (aPR=2.7; 95% CI 1.4-4.9, and aPR=3.5; 95% CI 2.2-5.7, respectively).
Conclusion
Hematuria and leukocyturia are common in rural East Africa, with considerable regional difference. These urinary abnormalities may represent a unique pattern of kidney disease in this region.
| Variables | Hematuria aPR (95% CI) | Leukocyturia aPR (95% CI) |
| Eastern Uganda (vs. Kenya) | 0.96 (0.47-1.94) | 9.79 (5.82-16.48) |
| Southwest Uganda (vs. Kenya) | 0.90 (0.41-1.97) | 8.44 (4.55-15.63) |
| Female | 12.3 (4.57-33.22) | 1.73 (1.09-2.76) |
| Age (Years)≥ 60 (vs. 18–29 years) | 0.51 (0.19-1.36) | 1.71 (1.06-2.78) |
| Primary school education (vs. Secondary school and beyond) | 0.64 (0.31-1.33) | 2.17 (1.03-4.60) |
| Any alcohol use | 2.56 (1.23-5.33) | 0.57 (0.30-1.11) |
| Any NSAIDs use | 0.59 (0.36-0.98) | 1.04 (0.72-1.52) |
| adjusted prevalence ratio (aPR); Adjusted for region, demographics (age, sex), wealth index, farming occupation, history of diabetes, hypertension, HIV, use of NSAIDs and traditional herbal medicines | ||
Funding
- NIDDK Support