A study of some peculiar tropical risk factors for proteinuriaas marker of chronic kidney disease in a rural community in Ondo state, south-west Nigeria

Abstract

Background: The role of herbal remedies and Non-Steroidal Anti-inflammatory Drugs in the development and progression of chronic kidney disease are yet to be fully studied in our environment despite their indiscriminate use. We set out to determine the prevalence and pattern of use of herbal remedies and NSAIDs and their relationship (if any) to chronic kidney disease.
Methods: Adults at a screening exercise in a village in Ondo State, Nigeria were studied. Their bio-data, history of herbal usage and NSAIDs, cigarette smoking, alcohol intake, diabetes mellitus and essential hypertension were obtained. Their blood pressure and anthropometry were measured. Urinalysis was conducted with Combi-Uriscreen®. Data was analysed using SPSS 20.
Results: One hundred and sixteen subjects were studied (M:F, 1:1.8). 51.7% were farmers. Their mean age was 42.5±14.7 years (range, 17-78 years). Their mean systolic and diastolic blood pressures were 125.2±20.4mmHg and  77.3±12.3mmHg respectively. Their mean body mass index was 26.2±6.0 kg/m2. Usage of herbs was found among 78.4% of subjects. 68.1% used NSAIDs, 11.2% had a history of cigarette smoking, 25.0% used alcohol, 50.0% had  pre-hypertension, 28.0% had essential hypertension and 7.8% had diabetes  mellitus. Undiagnosed hypertension was present in 24.1%. Proteinuria (ranging between 100mg/dl and 500mg/dl) was present in 12.5% of the subjects. Central obesity was present in 21.9% of the subjects. There was a significant association between proteinuria and use of herbs (p=0.023, chi square 5.188), use of NSAIDs (p=0.01, chi square 6.722), and pre-hypertension (p=0.039, chi square 4.261).
Conclusion: The rates of use of herbal remedies and NSAIDs in the rural community are high. Our study suggests that they may cause significant proteinuria among users. There is therefore a need to conduct more high powered studies on this subject.

Keywords:herbal concoction, renal failure, tropics, proteinuria, Nigeria