Prevalence and Risk Factors of Chronic Kidney Disease among Hypertensive Patients Attending at a Tertiary Care Hospital in Bangladesh

Abstract

Background: Chronic kidney disease (CKD) is a common complication of hypertension and contributes substantially to cardiovas-cular morbidity, premature mortality and healthcare burden. Early identification of CKD and its associated factors among hyperten-sive patients is essential for timely intervention and prevention of disease progression.

Objective: To determine the prevalence of CKD and identify factors associated with CKD among hypertensive patients attending at a tertiary care hospital.

Methods: This cross-sectional study was conducted in the Department of Nephrology, Bangladesh Medical University (BMU), Dhaka, Bangladesh from March 2025 to February 2026. A total of 118 adult hypertensive patients were enrolled through consecu-tive sampling. Sociodemographic characteristics, clinical history, anthropometric measurements, blood pressure, comorbidities, proteinuria and relevant laboratory parameters were assessed. The estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI creatinine equation and CKD was classified according to KDIGO GFR categories. Associations with CKD were evaluated using appropriate statistical tests, followed by univariate and multivariable logistic regression analyses.

Results: The mean age of study patients was 56.77±10.56 years, with slight male predominance. CKD was present in 40 (33.9%) participants, while 78 (66.1%) had no CKD. Among participants with CKD, G3a was the most common stage (30.0%), followed by G3b (22.5%), G4 (17.5%), G2 (15.0%) then G1 and G5 (7.5% each). Participants with CKD were older and had higher BMI, longer duration of hypertension, higher systolic and diastolic blood pressure and used more antihypertensive drugs than those without CKD. They also had significantly higher serum creatinine, urine albumin-creatinine ratio (ACR), fasting blood glucose (FBS), HbA1c and triglyceride levels, together with lower eGFR and hemoglobin levels. In multivariable analysis, age ≥60 years (AOR 5.36; 95% CI 1.53–18.75), hypertension duration ≥5 years (AOR 16.05; 95% CI 3.73–69.09), uncontrolled blood pressure (AOR4.38; 95% CI 1.34–14.38), diabetes mellitus (AOR 5.07; 95% CI 1.51–16.97) and proteinuria (AOR 10.57; 95% CI 2.77–40.31) were independent predictors of CKD. The model explained 44.7% to 61.9% of the variation in CKD status.

Conclusion: CKD was common among hypertensive patients, affecting approximately one-third of the participants. Older age, prolonged hypertension, uncontrolled blood pressure, diabetes mellitus and proteinuria were significant independent predictors. Regular renal function assessment, strict blood pressure control, screening for proteinuria and optimal diabetes management may facilitate early detection and reduce CKD progression.

CME J 2026; 5(2): 09-17