Prevalence of Chronic KIdney Disease in Hypertensive Patients

This will be Cross sectional or prevalent study targeting diagnosed hypertensives aged 40 and above years, in middle to low socio-economic settings of Karachi. This proposed study will be nested in the existing Wellcome Trust funded study. The parent study is designed to determine the impact of a unique community versus high risk approach to control BP in Karachi, Pakistan In that ongoing Factorial design, individuals aged ≥40 who are found hypertensive in the 12 clusters (each containing 250 households) are being randomized to different interventions for their BP control. All participants enrolled in that study had urine examination for proteinuria and serum creatinine measurements at baseline to assess their renal status. For the proposed study the identified hypertensive (from parent study) who had either shown proteinuria and or had elevated serum creatinine (more then 1.2 for females and 1.4 mg/dl for males) at baseline will be approached. Serum creatinine levels exceeding above mentioned cut-off levels, are only reached when GFR is\<60ml/min/m². As mentioned above in order to classify these subjects as having chronic kidney disease these abnormalities must be demonstrated to persist for at least three months. A repeat serum creatinine measurement and urine examination for proteinuria will be performed in the present study, by obtaining blood sample and urine sample respectively from these subjects. As a period of three months have already passed since the baseline investigations were done, all subjects who will show persistent abnormalities in either or both test will fall into chronic kidney disease group. The repeated testing to confirm presence of CKD will include, measurement of serum creatinine and urinary albumin/creatinine ratio (\>30mg/g) in an untimed urine specimen. This method has been recommended as the preferred screening strategy. A set questionnaire will be filled by interviewing the patient and risk factors for the presence of renal disease will be analyzed based on this information. The data collection will be done through structured questionnaire and diagnosis will be made on the basis of their persistently elevated kidney biomarkers.