THE PREVALENCE AND SEVERITY OF PERSISTENT PROTEINURIA IN SCHOOL CHILDREN IN ILE IFE, NIGERIA

Abstract

The presence of excessive urinary proteins has been associated with persistent and
progressive kidney damage in both children and adults. Persistent proteinuria has been
recognized as one of the early markers of chronic kidney disease (CKD). Early intervention
has been shown to either stop or slow the progression to end stage renal disease.
This study was conducted with the aim of determining the prevalence and severity of
persistent proteinuria over three months in primary school children in Ile-Ife. It sought to
determine the prevalence of hypertension and the relationship (if any) between the
prevalence and severity of persistent proteinuria and hypertension. It was a cross-sectional
study carried out over a period of six months.
The subjects were the 1,335 primary school pupils, aged six to fourteen years recruited from
both public and private nursery and primary schools. They were selected from twelve
primary schools in the two Local Government Areas (LGA) of Ile-Ife, after meeting the
recruitment criteria. A multi stage random sampling method was employed to select these
subjects from a total of 96,301 pupils in the two LGA. A physical examination, blood
pressure measurements and urine testing were carried out on all the recruited pupils
according to standard protocols.
Initially 34 (2.6%) of the subjects recruited had significant proteinuria with a M:F ratio of
1:1.6 following first screening. Those with significant proteinuria had repeated dipstick done
every four weeks over the next three months and it was persistent in six (0.4%) of them, with
a M:F ratio of 1:1.5. The severity of the persistent proteinuria was in the range of 30mg/dL to
100mg/dL i.e a non-nephrotic ranged proteinuria.
A total of 33 pupils were hypertensive, with prevalence of 2.5%, and 90% of them were
female. Twenty pupils had stage 1 hypertension while the remaining 13 had stage 2
hypertension. There was no association between persistent proteinuria and hypertension in
this study. Subjects with persistent proteinuria and those with hypertension were referred to
the paediatric nephrology unit of the Obafemi Awolowo University Teaching Hospital Ile Ife
for further evaluation and treatment.
In conclusion, among the six subjects that had persistent proteinuria over a period of three
months, three of them (50%) had worsened level of proteinuria from 30mg/dL to 100mg/dL.
Children with undetected persistent proteinuria stand the risk of further glomerular damage
due to worsened level of proteinuria over time.

THE PREVALENCE AND SEVERITY OF PERSISTENT PROTEINURIA IN SCHOOL CHILDREN IN ILE IFE, NIGERIA