SYTEMATIC ANALYSIS OF COMMUNITY STUDIES OF RISK FACTORS AND PREVALENCENCE OF CHRONIC KIDNEY DISEASE IN NIGERIA (2006-2014)
Main Article Content
Keywords
Chronic kidney disease burden, systematic analysis, community reports, Nigeria
Abstract
Introduction: Chronic kidney disease (CKD) is a global health problem, responsible with a high magnitude of human suffering, huge economic loss and high mortality. The low and middle income countries such as Nigeria are equally and possibly more affected. The true prevalence rates of CKD is not known in Nigeria and some other LMIC countries due to absence of renal registries. Most of available data are single center based hospital data of renal admissions. For proper renal policy formulation, there is need for reliable data on the magnitude of the problem of CKD/ESRD in developing countries such as Nigeria. We conducted a systematic analysis of community based CKD screening reports conducted in all geographic regions of Nigeria between 2006 to 2014, to determine the aggregate prevalence of risk factors and prevalence of CKD in Nigeria.
Study objectives: To determine the aggregate prevalence of traditional risk factors and the prevalence of CKD in Nigeria to serve as a reliable date for renal policy formulation and planning in Nigeria.
Study design: A retrospective systematic analysis of reports of community based CKD screening reports in Nigeria.
Study methodology: Reports of community based CKD screening reports in all parts of Nigeria from 2006 to 2014, were manually and electronically searched. The aggregate percentage prevalence of CKD risk factors and percentage prevalence of CKD were determined.
Results: Thirty (30) reports of CKD screening exercises, within the study period were accessed and found suitable for subsequent analysis. The studies were in 16(53.3%) rural and 14(46.7%) communities respectively, with a total of 17,107(99-1941) subjects, age range 14-84years. The aggregate mean age of subjects in all the studies was 43.4 ±4.4 years (range of mean ages: 28.3-51.5) years, and gender ratio of 1:1.5. Geographic distribution of study sites were North-west 3(10.0%), North-central 3(10.0%), North-east 1(3.3%), South-west 5(16.7%), South-east 3(10.0%) and South-south 15(50.0%). The aggregate percentage prevalence of risk factors of CKD were Obesity 27.5% (12.2-62.7%); Proteinuria 20.3% (3.7-69.1%); Hypertension 32.1% (13.6-57.3%) and diabetes mellitus 4.9 % (2-11.2%). respectively. The aggregate percentage prevalence of CKD (e-GFR <60mls/min/1.73m2) in accordance with kidney disease outcome quality initiative (KDOQI) 1 definition, was 11.7% (1.2-32.6%). Statistically significant difference was found in the prevalence of CKD between the rural and urban communities (16.4% vs 7.0%; p<0.001) but not in the risk factors. The estimated adult burden of CKD in Nigeria is 14 million people while that of ERSD is 240,000 adults.
Conclusions: The aggregate crude prevalence of CKD of 11.7% derived from a pool of 30 community based CKD screening reports across Nigeria is very likely to be closest to the true prevalence of CKD in Nigeria. We recommend government sponsored large scale multi-regional surveys of prevalence of CKD in Nigeria and the development of Renal registry for renal health planning.
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