Persistent hypertension, albuminuria and low glomerular filtration rate in schoolchildren in Kano metropolis, Nigeria
DOI:
https://doi.org/10.7196/SAMJ.2026.v116i1.3859Keywords:
Hypertension, Albuminuria, Low GFR, Screening, ChildrenAbstract
Background. Screening for persistent hypertension, albuminuria and low estimated glomerular filtration rate (eGFR) in children may allow for early detection of kidney disease, paving the way for early intervention to slow disease progression.
Objective. To determine the prevalence of persistent hypertension, albuminuria and low eGFR and their associated factors in schoolchildren.
Method. The study screened 228 schoolchildren (aged 5 - 15 years) from February 2020 to February 2021. Information about participants’ sociodemographic profile and medical history was obtained through questioning. Participants’ height, weight and blood pressure (BP) were measured. Their spot urine was assessed for albumin creatinine ratio (ACR), and blood for serum creatinine and eGFR. Participants with abnormal findings had a repeat assessment after a minimum of 3 months for BP, ACR and eGFR.
Results. The median (range) age was 13.0 (11.1 - 14.0) years, with 117 males and 111 females. Seventy-eight of the children (34%) had at least one abnormality (hypertension 1.8%, albuminuria 28% and low eGFR 9%) at recruitment. At follow-up, 33 (42%) of the 78 children had persistent abnormal findings (hypertension 1.3%, albuminuria 10.1%, low eGFR 6%). Persistent albuminuria was seen more commonly in girls and in children with low eGFR. Older children (>10 years) were more likely to have low eGFR.
Conclusion. A two-point, multiparameter screening of children may reveal high-risk groups for kidney disease that would require further evaluation and long-term follow-up. Such screenings can be integrated into school entry health assessment programmes to allow for early detection of kidney disease.
References
1. Yap HK, Quek CM, Shen Q, Joshi V, Chia KS. Role of urinary screening programmes in children in the prevention of chronic kidney disease. Ann Acad Med Singap 2005;34(1):3-7.
2. Cho BS, Kim SD, Choi YM, Kang HH. School urinalysis screening in Korea: Prevalence of chronic renal disease. Pediatr Nephrol 2001;16(12):1126-1128. https://doi.org/10.1007/s004670100043
3. Lin CY, Huang SM. Childhood albuminuria and chronic kidney disease is associated with mortality and end-stage renal disease. Pediatr Neonatol 2016;57(4):280-287. https://doi.org/10.1016/j. pedneo.2015.09.013
4. Hogg RJ. Screening for CKD in children: A global controversy. Clin J Am Soc Nephrol 2009;4(2):509- 515. https://doi.org/10.2215/CJN.01210308
5. Hsu C-N, Lu P-C, Liao W-T, Tain Y-L. Pediatric chronic kidney disease: Mind the gap between reality and expectations. Children 2025;12(5):614. https://doi.org/10.3390/children12050614
6. Naicker S. End-stage renal disease in Sub-Saharan Africa. Kidney Int Suppl 2013;3(2):161-163. https:// doi.org/10.1038/kisup.2013.4
7. KDIGO CKD Work Group. KDIGO (Kidney Disease: Improving Global Outcomes) 2024 Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int 2024;105(4S):S117-S314. https://doi.org/10.1016/j.kint.2023.10.018
8. Schwartz GJ, Munoz A, Schneider MF, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol 2009;20(3):629-637. https://doi.org/10.1681/ASN.2008030287
9. Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 2017;140(3): e20171904. https://doi.org/10.1542/peds.2017-1904
10. Chang-Chien C, Chuang GT, Tsai IJ, Chiang BL, Yang YH. A large retrospective review of persistent proteinuria in children. J Formos Med Assoc 2018;117(8):711-719. https://doi.org/10.1016/j. jfma.2017.09.004
11. Al-kaabi A, Almaslamani T, Toaimah FH, et al. Urinary screening for renal disease among apparently healthy schoolchildren in Qatar. J Trop Pediatr 2012;58(1):81-84. https://doi.org/10.1093/tropej/fmr037
12. Malla HA, Bhat AM, Shazia B, Rather FA, Najar SM, Wani IA. Prevalence of proteinuria in
schoolchildren (aged 12 - 14 years) in Kashmir valley, India, using dipstick method. Saudi J Kidney Dis
Transpl 2016;27(5):1006-1010. https://doi.org/10.4103/1319-2442.190877
13. Wuhl E, Schaefer F. Therapeutic strategies to slow chronic kidney disease progression. Pediatr Nephrol
2008;23(5):705-716. https://doi.org/10.1007/s00467-008-0789-y
14. Flynn JT, Carroll MK, Ng DK, Furth SL, Warady BA. Achieved clinic blood pressure level and chronic
kidney disease progression in children: A report from the Chronic Kidney Disease in Children cohort.
Pediatric Nephrol 2021;36(6):1551-1559. https://doi.org/10.1007/s00467-020-04833-8
15. Barletta GM, Flynn J, Mitsnefes M, et al. Heart rate and blood pressure variability in children with chronic kidney disease: A report from the CKiD study. Pediatr Nephrol 2014;29(6):1059-1065. https://
doi.org/10.1007/s00467-013-2737-8
16. Rahman AJ, Qamar FN, Ashraf S, Khowaja ZA, Tariq SB, Naeem H. Prevalence of hypertension in healthy schoolchildren in Pakistan and its relationship with body mass index, proteinuria and hematuria. Saudi J Kidney Dis Transpl 2013;24(2):408-412. https://doi.org/10.4103/1319-2442.109619
17. Song P, Zhang Y, Yu J, et al. Global prevalence of hypertension in children: A systematic review and meta- analysis. JAMA Pediatr 2019;173(12):1154-1163. https://doi.org/10.1001/jamapediatrics.2019.3310
18. Rai PK, Rai P, Bedi S. Prevalence patterns of chronic kidney disease among schoolchildren and adolescents in a school in Varanasi, India. Open Acc J Urol Nephrol 2019;4(1):000154. https://doi. org/10.23880/oajun-16000154
19. Bazie EA, Ali MMA, Hamza HB, Ismail AM, Salih MSM, Haroun BE. Screening of proteinuria and hematuria in asymptomatic children in basic school Kosti City in White Nile (Kosti City). J Med Biological Sci Res 2015;1(9):118-123.
20. Alao MA, Asinobi OA, Ibrahim OR, Lagunju IA. Spot urine protein-to-creatinine ratio compared with dipstick proteinuria as a primary screening tool for renal disease in a community setting. Saudi J Kidney Dis Transpl 2021;32(6):1655-1665. https://doi.org/10.4103/1319-2442.352426
21. Van den Belt SM, Heerspink HJL, Gracchi V, et al. Early proteinuria lowering by angiotensin- converting enzyme inhibition predicts renal survival in children with CKD. J Am Soc Nephrol 2018;29(8):2225-2233. https://doi.org/10.1681/ASN.2018010036
22. Odetunde OI, Odetunde OA, Neboh EE, Okafor HU, Njeze NR, Azubuike JC. Urinary screening for asymptomatic renal disorders in pre-school children in Enugu Metropolis, South-East Nigeria: Useful or useless. Saudi J Kidney Dis Transplant 2015;26(6):1241-1245. https://doi.org/10.4103/1319-2442.168656
23. Butt L, Unnersjo-Jess D, Hohne M, et al. A molecular mechanism explaining albuminuria in kidney disease. Nat Metab 2020;2(5):461-474. https://doi.org/10.1038/s42255-020-0204-y
Downloads
Published
Issue
Section
License
Copyright (c) 2026 A Mudi, A Abdu
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Licensing Information
The SAMJ is published under an Attribution-Non Commercial International Creative Commons Attribution (CC-BY-NC 4.0) License. Under this license, authors agree to make articles available to users, without permission or fees, for any lawful, non-commercial purpose. Users may read, copy, or re-use published content as long as the author and original place of publication are properly cited.
Exceptions to this license model is allowed for UKRI and research funded by organisations requiring that research be published open-access without embargo, under a CC-BY licence. As per the journals archiving policy, authors are permitted to self-archive the author-accepted manuscript (AAM) in a repository.
Publishing Rights
Authors grant the Publisher the exclusive right to publish, display, reproduce and/or distribute the Work in print and electronic format and in any medium known or hereafter developed, including for commercial use. The Author also agrees that the Publisher may retain in print or electronic format more than one copy of the Work for the purpose of preservation, security and back-up.
