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Kidney Week

Abstract: PO2309

Microscopic Hematuria and Leukocyturia Are Highly Prevalent in East Africa and Associated with CKD

Session Information

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.

VariablesHematuria
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)
Female12.3 (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 use2.56 (1.23-5.33)0.57 (0.30-1.11)
Any NSAIDs use0.59 (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