Cardiovascular Risk Factor Profiles and Disease in Black Compared to Other Africans with Chronic Kidney Disease
Table 2
Traditional and nontraditional cardiovascular risk factors and their treatment in black compared to other African chronic kidney disease patients overall and in sensitivity analysis among predialysis and dialysis patients.
Characteristics
Chronic kidney disease patients
All patients
Predialysis patients
Dialysis patients
Intergroup comparisonb
Black African (n = 46)
Other African (n = 69)
Modela
Black African (n = 19)
Other African (n = 48)
Modela
Black African (n = 27)
Other African (n = 21)
Modela
value
Traditional CV risk factors and their treatment
Categorical variables
OR (95% CI)
OR (95% CI)
OR (95% CI)
Hypertension
45 (97.8)
59 (85.5)
9.05 (1.08–75.59)
19 (100)
39 (81.3)
—
26 (96.3)
20 (95.2)
1.51 (0.08–28.03)
0.04
Dyslipidemia
30 (71.4)
53 (85.5)
0.41 (0.15–1.12)
12 (70.6)
41 (91.1)
0.25 (0.06–1.10)
18 (72.0)
12 (70.6)
0.89 (0.21–3.72)
0.1
Diabetes
21 (45.7)
19 (27.5)
3.10 (1.30–7.40)
13 (68.4)
8 (16.7)
13.28 (5.51–50.27)
8 (29.6)
11 (52.4)
0.51 (0.13–2.01)
<0.0001
Antihypertensive treatment
45 (97.8)
59 (85.5)
9.05 (1.08–75.59)
19 (100)
39 (81.3)
—
26 (96.3)
20 (95.2)
1.51 (0.08–28.03)
0.04
ACEI/ARB
36 (81.8)
54 (79.4)
1.07 (0.40–2.87)
15 (83.3)
38 (79.2)
1.41 (0.33–6.03)
21 (80.1)
16 (80.0)
0.70 (0.14–3.47)
1.0
Beta blocker
21 (47.7)
30 (44.4)
1.22 (0.51–2.45)
9 (50.0)
16 (33.3)
2.31 (0.72–7.26)
12 (46.2)
14 (70.0)
0.20 (0.05–0.88)
0.04
Diuretic
20 (44.4)
19 (27.5)
2.56 (1.11–5.94)
11 (61.1)
13 (27.1)
5.52 (1.59–19.17)
9 (33.3)
6 (28.6)
1.34 (0.36–5.05)
0.07
Calcium channel blocker
26 (57.8)
23 (33.8)
2.70 (1.22–6.00)
10 (52.6)
11 (22.9)
3.69 (1.18–11.50)
16 (61.5)
12 (60.0)
1.14 (0.33–3.91)
0.002
Alpha blocker
11 (25.6)
13 (19.1)
1.73 (0.67–4.48)
7 (38.9)
8 (16.7)
5.48 (1.31–22.87)
4 (16.0)
5 (25.0)
0.53 (0.11–2.45)
0.2
Lipid lowering therapy
21 (47.7)
51 (75.0)
0.33 (0.14–0.75)
9 (50.0)
37 (77.1)
0.32 (0.09–1.08)
12 (46.2)
14 (70.0)
0.31 (0.08–1.12)
0.03
Statin
21 (47.7)
51 (75.0)
0.33 (0.14–0.75)
9 (50.0)
37 (77.1)
0.32 (0.09–1.08)
12 (46.2)
14 (70.0)
0.31 (0.08–1.12)
0.03
Ezetimibe
4 (9.1)
7 (10.4)
0.96 (0.26–3.61)
2 (11.1)
5 (10.4)
1.26 (0.21–7.59)
2 (7.7)
2 (10.5)
0.72 (0.09–5.95)
1.0
Insulin
14 (31.1)
12 (17.4)
2.60 (1.03–6.61)
9 (47.4)
5 (10.4)
7.67 (2.07–28.41)
5 (19.2)
7 (33.3)
0.67 (0.16–2.89)
0.007
OGLA
8 (17.8)
6 (8.7)
3.37 (0.98–11.61)
4 (21.1)
4 (8.3)
3.26 (0.64–16.56)
4 (15.4)
2 (9.5)
3.24 (0.40–26.49)
0.5
Continuous variables
Partial R
Partial R
Partial R
Systolic blood pressure
148 (24)
137 (18)
0.271
0.004
145 (25)
135 (16)
0.265
0.03
150 (24)
141 (21)
0.185
0.2
0.02
Diastolic blood pressure (mmHg)
84 (13)
82 (10)
0.032
0.7
80 (10)
82 (8)
−0.150
0.2
86 (13)
82 (15)
0.083
0.6
0.2
Mean blood pressure (mmHg)
105 (14)
100 (11)
0.175
0.06
101 (13)
100 (9)
0.093
0.5
107 (14)
102 (14)
0.155
0.3
0.07
Total cholesterol (mmol/l)
4.3 (1.2)
4.2 (1.2)
0.005
1.0
4.2 (1.2)
4.2 (1.1)
−0.006
1.0
4.3 (1.2)
4.3 (1.3)
−0.001
1.0
1.0
LDL cholesterol (mmol/l)
2.3 (0.9)
2.4 (1.0)
−0.047
0.6
2.2 (0.7)
2.3 (0.9)
−0.094
0.5
2.4 (1.0)
2.5 (1.1)
−0.038
0.8
0.8
HDL cholesterol (mmol/l)
1.14 (0.43)
1.14 (0.42)
−0.007
0.9
1.03 (0.37)
1.12 (0.42)
−0.087
0.5
1.22 (0.45)
1.18 (0.41)
0.058
0.7
0.5
Non-HDL cholesterol (mmol/l)
3.1 (1.1)
3.1 (1.0)
−0.017
0.8
3.2 (1.3)
3.1 (1.0)
0.025
0.9
3.1 (1.1)
3.3 (1.1)
−0.086
0.6
0.9
Triglycerides (mmol/l)
1.3 (0.9–1.8)
1.5 (1.1–2.1)
−0.080
0.4
1.5 (1.1–1.9)
1.4 (1.1–2.2)
0.033
0.8
1.4 (0.8–1.8)
1.6 (1.2–1.8)
−0.127
0.4
0.4
Cholesterol-HDL cholesterol ratio
3.8 (2.7–5.2)
3.8 (3.1–4.8)
−0.022
0.6
3.7 (3.1–5.4)
3.8 (3.1–4.9)
0.073
0.6
3.8 (2.6–5.1)
3.9 (3.1–4.8)
−0.122
0.4
0.9
Triglycerides-HDL cholesterol ratio
1.2 (0.7–2.0)
1.4 (0.9–2.1)
−0.050
0.8
1.7 (1.2–2.3)
1.5 (1.0–2.1)
0.102
0.4
1.0 (0.6–2.0)
1.3 (0.9–2.4)
−0.111
0.5
0.2
Haemoglobin A1C (%)
5.6 (5.1–7.0)
5.5 (5.2–6.3)
0.106
0.3
6.9 (5.7–8.3)
5.6 (5.3–6.2)
0.429
<0.0001
5.4 (4.9–5.7)
5.4 (4.9–7.3)
−0.094
0.5
0.004
Framingham score
23.4 (21.7)
22.6 (16.5)
0.223
0.01
27.9 (23.3)
21.8 (16.3)
0.327
0.008
20.2 (20.2)
24.3 (14.0)
0.046
0.8
0.5
Heart rate (beats per minute)
79 (14)
72 (14)
0.196
0.04
76 (15)
72 (15)
0.067
0.6
81 (13)
72 (12)
0.350
0.02
0.05
Antihypertensives (n)
2.5 (1.1)
2.0 (1.2)
0.215
0.02
2.8 (1.2)
2.0 (1.2)
0.388
0.001
2.3 (1.1)
2.5 (1.1)
−0.149
0.3
0.008
Nontraditional CV risk factors and their treatment
Categorical variables
OR (95% CI)
OR (95% CI)
OR (95% CI)
High phosphate
34 (77.3)
31 (44.9)
3.99 (1.67–9.54)
9 (52.9)
12 (25.0)
3.31 (1.01–10.89)
25 (92.6)
19 (90.5)
1.20 (0.15–9.92)
<0.0001
Phosphate binder
22 (52.4)
25 (37.3)
1.71 (0.77–3.81)
4 (23.5)
8 (16.7)
1.55 (0.39–6.10)
18 (72.0)
17 (89.5)
0.27 (0.05–1.52)
<0.0001
Vitamin D replacement
27 (67.5)
31 (47.7)
2.27 (0.98–5.28)
9 (50.0)
14 (31.1)
1.96 (0.62–6.17)
18 (81.8)
17 (85.0)
1.06 (0.19–6.03)
<0.0001
Erythropoietin stimulating agent
29 (63.0)
25 (36.2)
3.00 (1.36–6.62)
6 (31.6)
5 (10.4)
3.69 (0.95–14.35)
23 (85.2)
20 (95.2)
0.34 (0.03–3.81)
<0.0001
Intravenous iron
26 (56.5)
24 (34.8)
2.50 (1.14–5.48)
5 (26.3)
5 (10.4)
3.07 (0.75–12.59)
21 (77.8)
19 (90.5)
0.44 (0.08–2.61)
<0.0001
Sevelamer
1 (2.0)
0 (0)
—
0 (0)
0 (0)
—
1 (4.0)
0 (0)
—
Continuous variables
Partial R
Partial R
Partial R
Dialysis duration (months)
30 (12–48)
36 (12–48)
−0.090
0.6
—
—
—
—
30 (12–36)
36 (12–42)
−0.138
0.4
—
Phosphate (mmol/l)
1.2 (0.8–1.6)
1.2 (1.0–1.6)
−0.022
0.8
1.3 (0.9–1.6)
1.2 (0.9–1.4)
0.076
0.6
1.3 (0.8–1.7)
1.6 (1.1–2.1)
−0.268
0.07
0.04
Calcium (mmol/l)
2.3 (2.1–2.4)
2.3 (2.2–2.4)
−0.205
0.03
2.2 (2.1–2.4)
2.3 (2.2–2.4)
−0.120
0.4
2.2 (2.0–2.4)
2.3 (2.2–2.4)
−0.254
0.09
0.2
Calcium × phosphate
2.5 (1.8-3.8)
2.8 (2.2-3.7)
−0.100
0.3
3.0 (2.0–3.6)
2.9 (2.2–3.1)
0.010
0.9
2.9 (1.8–3.8)
3.7 (2.6–4.6)
−0.364
0.01
0.02
Intact PTH (pg/ml)
287 (141–531)
84 (64–334)
0.270
0.007
232 (92–370)
70.0 (50–111)
0.426
0.001
369 (172–686)
621 (197–801)
−0.149
0.4
<0.0001
Haemoglobin (g/dl)
10.7 (9.6–12.5)
12.6 (10.7–14.2)
−0.202
0.03
11.5 (10.0–14.9)
13.5 (10.6–15.1)
−0.072
0.6
10.6 (9.5–11.9)
11.0 (10.7–12.5)
−0.199
0.2
0.001
Transferrin saturation (%)
22.0 (17.4–29.0)
22.9 (17.5–30.2)
−0.037
0.7
24.1 (13.7–30.6)
21.0 (17.0–29.0)
−0.144
0.3
22.6 (20.0–30.0)
25.0 (18.5–28.9)
−0.013
0.9
0.3
Ferritin (ng/ml)
325 (113–573)
166 (51–365)
0.203
0.03
191 (113–490)
115 (38–224)
0.198
0.1
364 (124–725)
361 (168–609)
0.029
0.8
0.001
Albumin (g/l)
36.8 (8.0)
38.6 (5.5)
−0.157
0.1
35.3 (9.2)
38.9 (5.4)
−0.235
0.06
37.8 (7.0)
38.0 (5.9)
−0.025
0.9
0.2
Vitamin D (nmol/l)
19.0 (8.8)
19.8 (9.3)
−0.050
0.6
15.5 (5.4)
20.9 (9.9)
−0.269
0.03
21.4 (9.9)
17.4 (7.2)
0.204
0.2
0.07
Uric acid (mmol/l)
0.31 (0.24–0.40)
0.37 (0.28–0.46)
−0.184
0.06
0.38 (0.32–0.48)
0.42 (0.35–50.8)
−0.157
0.2
0.28 (0.21–0.32)
0.28 (0.17–0.34)
0.029
0.9
<0.0001
Hs-C-reactive protein (mg/l)
8.2 (2.6–28.1)
6.0 (2.0–15.5)
0.073
0.5
4.7 (1.3–22.3)
4.1 (2.0–15.1)
−0.050
0.7
12.3 (4.1–32.1)
7.7 (1.9–25.4)
0.181
0.2
0.4
Data are expressed as mean (SD), median (interquartile range), or number (percentage). aAdjusted for age and sex; bfor differences among black and other African predialysis and black and other African dialysis patients. Significant associations are shown in bold. CV, cardiovascular; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; OGLA, oral glucose lowering agents; LDL, low-density lipoprotein; HDL, high-density lipoprotein; PTH, intact parathyroid hormone; hs, high sensitivity.
