Prevalence and burden of chronic kidney disease among the general population and high-risk groups in Africa: a systematic review

Abstract

ObjectivesWhile increasing attention is paid to the rising prevalence of chronic diseases in Africa, there is little focus on chronic kidney disease (CKD). This systematic review assesses CKD burden among the general population and high-risk groups on the entire African continent.Design, setting and participantsWe searched Medline and PubMed databases for articles published between 1 January 1995 and 7 April 2017 by sensitive search strategies focusing on CKD surveys at the community level and high-risk groups. In total, 7918 references were evaluated, of which 7766 articles were excluded because they did not meet the inclusion criteria. Thus, 152 studies were included in the final analysis.Outcome measurementThe prevalence of CKD in each study group was expressed as a range and pooled prevalence rate of CKD was calculated as a point estimate and 95% CI. No meta-analysis was done. Data were presented for different populations.ResultsIn the community-level studies, based on available medium-quality and high-quality studies, the prevalence of CKD ranged from 2% to 41% (pooled prevalence: 10.1%; 95% CI 9.8% to 10.5%). The prevalence of CKD in the high-risk groups ranged from 1% to 46% (pooled prevalence: 5.6%; 95% CI 5.4% to 5.8%) in patients with HIV (based on available medium-quality and high-quality studies), 11%–90% (pooled prevalence: 24.7%; 95% CI 23.6% to 25.7%) in patients with diabetes (based on all available studies which are of low quality except four of medium quality) and 13%–51% (pooled prevalence: 34.5%; 95 % CI 34.04% to 36%) in patients with hypertension (based on all available studies which are of low quality except two of medium quality).ConclusionIn Africa, CKD is a public health problem, mainly attributed to high-risk conditions as hypertension and diabetes. The poor data quality restricts the validity of the findings and draws the attention to the importance of designing future robust studies.

The Challenges of Dental Care during the Hemodialysis: Case Report

“…The HD was conducted thrice weekly for four hours each day in the last three years. In the first bloody dental procedure, the protocol of hematologic monthly analysis showed the following results: Ca xP 37.37;Ca 10.1mg/dL;P 3.7 mg/dL; RBC 2.8 million cells/mcL; hematocrit 28.5%, Hb= 8.7 g/dL; leucocytes 13,090 cells/mm 3 and periodontitis in all teeth except 33 and 34. This general aspect could be observed in panoramic x ray shown in Figure 1.…”

“…CRD can be seen since childhood, but it becomes more frequent with the aging, as older persons are more susceptible to pathologies such as diabetes or hypertension, which are strongly related to a progressive restriction on kidney function [2,3]. Moreover, the main cause of CRD are pyelonephritis, glomerulonephritis, renal polycystic disease, interstitial nephritis, autoimmune disease, and intoxication by medicine abuse.…”

“…CRD can be initially controlled through restriction of proteins, potassium, and liquids in diet, with the aim to reduce uremia and to aid the lowering capacity of kidney to excrete wastes. As the disease progresses, dialysis or even renal transplantation would be necessary [2,3,6].…”

“…It can be done for a lifetime, but it is not considered the definitive cure for the patient. On the other hand, kidney transplantation is considered as the ultimate solution, but the risk of organ rejection must always be considered [3,4,5].…”

“…Aside from the changes in oral environmental, poor oral hygiene can mainly result in dental caries and periodontal disease [1,8,9]. When dental treatment is in progress, the use of drugs, risk of bleeding, and infections mandates CRD patients to become significant dentistry patients [1,3,4,10]. Therefore, the help of nephrologist, blood complete examination, and monitoring of blood pressure are vital for the patient.…”