title: Relationship between hypertension, diabetes and proteinuria in rural and urban households in Yemen.
abstract: Little information is available on the meanings of proteinuria in low-resource settings. A population-based, cross-sectional survey was performed in Yemen on 10 242 subjects aged 15-69 years, stratified by age, gender and urban/rural residency. Hypertension is defined as systolic blood pressure (BP) of 140 mm Hg and/or diastolic BP of 90 mm Hg, and/or self-reported use of antihypertensive drugs; diabetes is diagnosed as fasting glucose of 126 mg dl(-1) or self-reported use of hypoglycaemic medications; proteinuria is defined as +1 at dipstick urinalysis. Odds ratios (ORs) for associations were determined by multivariable logistic regression models. Prevalence (weighted to the Yemen population aged 15-69 years) of hypertension, diabetes and proteinuria were 7.5, 3.7 and 5.1% in urban, and 7.8, 2.6 and 7.3% in rural locations, respectively. Proteinuria and hypertension were more prevalent among rural dwellers (adjusted ORs 1.56; 95% confidence limit (Cl) 1.31-1.86, and 1.23; 1.08-1.41, respectively), diabetes being less prevalent in rural areas (0.70; 0.58-0.85). Differently from hypertension and diabetes, proteinuria was inversely related with age. Most importantly, 4.6 and 6.1% of urban and rural dwellers, respectively, had proteinuria in the absence of hypertension and diabetes. The approach of considering kidney damage as a consequence of hypertension and diabetes might limit the effectiveness of prevention strategies in low-income countries.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Florence, Azienda Ospedaliero Universitaria Careggi (AOUC), Florence, Italy. pamodesti@unifi.it
authors.forename: P A
authors.initials: PA
authors.lastname: Modesti
authors.forename: M
authors.initials: M
authors.lastname: Bamoshmoosh
authors.forename: S
authors.initials: S
authors.lastname: Rapi
authors.forename: L
authors.initials: L
authors.lastname: Massetti
authors.forename: S
authors.initials: S
authors.lastname: Bianchi
authors.forename: D
authors.initials: D
authors.lastname: Al-Hidabi
authors.forename: H
authors.initials: H
authors.lastname: Al Goshae
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011507:Proteinuria / Q000453:epidemiology*; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*; D015006:Yemen / Q000453:epidemiology; D055815:Young Adult