The epidemiology of chronic kidney disease (CKD) in rural East Africa: A population-based study

Muiru, Anthony N.; Charlebois, Edwin D.; Balzer, Laura B.; Kwarisiima, Dalsone; Elly, Assurah; Black, Doug; Okiror, Samuel; Kabami, Jane; Atukunda, Mucunguzi; Snyman, Katherine; Petersen, Maya; Kamya, Moses R.; Havlir, Diane V.; Estrella, Michelle M.; Hsu, Chi‐yuan

doi:10.1371/journal.pone.0229649

Cited by 33 publications

(49 citation statements)

References 58 publications

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“…As such, the development of validated height-independent approaches to estimate bSCr in LMIC would simplify AKI diagnosis. Recently, there have been efforts to measure creatinine and evaluate the burden of kidney disease in adults in sub-Saharan Africa [ 13 – 16 ], but data from pediatric populations are lacking [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Methods to estimate baseline creatinine and define acute kidney injury in lean Ugandan children with severe malaria: a prospective cohort study

et al. 2020

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Background Acute kidney injury (AKI) is increasingly recognized as a consequential clinical complication in children with severe malaria. However, approaches to estimate baseline creatinine (bSCr) are not standardized in this unique patient population. Prior to wide-spread utilization, bSCr estimation methods need to be evaluated in many populations, particularly in children from low-income countries. Methods We evaluated six methods to estimate bSCr in Ugandan children aged 6 months to 12 years of age in two cohorts of children with severe malaria (n = 1078) and healthy community children (n = 289). Using isotope dilution mass spectrometry (IDMS)-traceable creatinine measures from community children, we evaluated the bias, accuracy and precision of estimating bSCr using height-dependent and height-independent estimated glomerular filtration (eGFR) equations to back-calculate bSCr or estimating bSCr directly using published or population-specific norms. Results We compared methods to estimate bSCr in healthy community children against the IDMS-traceable SCr measure. The Pottel-age based equation, assuming a normal GFR of 120 mL/min per 1.73m2, was the more accurate method with minimal bias when compared to the Schwartz height-based equation. Using the different bSCr estimates, we demonstrated the prevalence of KDIGO-defined AKI in children with severe malaria ranged from 15.6–43.4%. The lowest estimate was derived using population upper levels of normal and the highest estimate was derived using the mean GFR of the community children (137 mL/min per 1.73m2) to back-calculate the bSCr. Irrespective of approach, AKI was strongly associated with mortality with a step-wise increase in mortality across AKI stages (p < 0.0001 for all). AKI defined using the Pottel-age based equation to estimate bSCr showed the strongest relationship with mortality with a risk ratio of 5.13 (95% CI 3.03–8.68) adjusting for child age and sex. Conclusions We recommend using height-independent age-based approaches to estimate bSCr in hospitalized children in sub-Saharan Africa due to challenges in accurate height measurements and undernutrition which may impact bSCr estimates. In this population the Pottel-age based GFR estimating equation obtained comparable bSCr estimates to population-based estimates in healthy children.

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Section: Introductionmentioning

confidence: 99%

Methods to estimate baseline creatinine and define acute kidney injury in lean Ugandan children with severe malaria: a prospective cohort study

et al. 2020

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“…To categorize the overall scores into wealth quintiles, the standardized z-score was used: poorest, poorer, middle, richest, and richest [ 24 ]. The factors examined in this study are based on previous studies related to renal failure [ 11 , 12 , 20 , 21 ].…”

Section: Methodsmentioning

confidence: 99%

“…The causes, consequences, and costs of renal failure have implications for public health policy in Burundi. Increasing economic and utilization of healthcare disparities, epidemiological transition, migration, unsafe working conditions and environmental hazards, natural disasters, and pollution may hinder attempts to reduce the morbidity and mortality from renal failure [ 11 , 12 , 20 , 21 ]. The sustainable development goals (SDGs) emphasize the importance of mapping the actions toward achieving all of the targets that have the potential to improve understanding, measurement, prevention, and control of diseases [ 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Renal Failure among Women of Reproductive Age in Burundi: Estimating the Prevalence and Associated Factors Using Population-Based Data

Ekholuenetale

Adeyoju

Onuoha

et al. 2021

International Journal of Nephrology

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Background. Renal failure is a leading cause of morbidity and mortality in many resource-constrained settings. In developing countries, little has been known about the prevalence and predisposing factors of renal failure using population-based data. The objective of this study was to examine the prevalence and associated factors of renal failure among women of reproductive age in Burundi. Methods. We used nationally representative cross-sectional data from the 2016-2017 Burundi Demographic and Health Survey (BDHS). Data on 17,269 women of reproductive age were included. The outcome variable was a renal failure as determined by the patient’s report. Percentage, chi-square test, and multivariable logistic regression model were used to analyze the data. The results from the logistic regression model were presented as adjusted odds ratio (AOR) and confidence interval (95% CI). The significance level was set at p < 0.05 . Results. The overall prevalence of renal failure was 5.0% (95% CI: 4.4%, 5.7%). Higher-aged women were more likely to have a renal failure when compared with women aged 15–19 years. Rural dwellers were 1.65 times as likely to have a renal failure when compared with women in the urban residence (AOR = 1.65; 95% CI: 1.24, 2.20). Women who had secondary + education had a 39% reduction in the odds of renal failure when compared with women with no formal education (AOR = 0.61; 95% CI: 0.46, 0.81). Health insurance coverage accounted for a 23% reduction in the odds of renal failure when compared with women who were not covered by health insurance (AOR = 0.77; 95% CI: 0.63, 0.93). Women who had a terminated pregnancy were 1.50 times as likely to have a renal failure when compared with women with no history of terminated pregnancy (AOR = 1.50; 95% CI: 1.24, 1.82). Furthermore, women with a history of contraceptive use were 1.32 times as likely to have a renal failure when compared with women without a history of contraceptive use (AOR = 1.32; 95% CI: 1.11, 1.57). Conclusion. Lack of formal education, having no health insurance coverage, and ever used anything or tried to delay or avoid getting pregnant were the modifiable risk factors of renal failure. The nonmodifiable risk factors were old age, rural residence, certain geographical regions, and having a history of pregnancy termination. Understanding the risk factors of renal failure will help to instigate early screening, detection, and prompt treatment initiation. In addition, early detection of the risk factors can help to reduce the adverse health impact including maternal death.

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“…По обобщенным результатам 19 популяционных исследований из 13 европейских стран скорректированная распространенность ХБП 1-5 стадий варьировала от 3,31% (3,30-3,33%) в Норвегии до 17,3% (16,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18),1%) в северо-восточной Германии, скорректированная распространенность ХБП 3-5 стадий варьировала от 1,0% (0,7-1,3%) в центральной Италии до 5,9% (5,2-6,6%) в северо-восточной Германии [5]. Распространенность ХБП С1-5 в Восточной Африке составляет 6,8% (5,7-8,1%) и варьирует по регионам: 12,5% (10,1-15,4%) в восточной части Уганды, 3,9% (2,2-6,8%) на юго-западе Уганды и 3,7% (2,7-5,1%) в западной Кении [6]. Распространенность ХБП С1-5 в центральном Китае составляет 16,8% (15,8-17,8%) [7].…”

Section: распространенность хронической болезни почекunclassified

“…Rational Pharmacotherapy in Cardiology 2020;16(6) / Рациональная Фармакотерапия в Кардиологии 2020;16(6) …”

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Chronic Kidney Disease: Current State of the Problem

Батюшин

2020

Racionalʹnaâ farmakoterapiâ v kardiologii

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Chronic kidney disease (CKD) is characterized by increasing prevalence, catalyzing properties in relation to cardiovascular and general mortality, and, in most cases, is asymptomatic, which means late diagnostic verifiability. The global average prevalence of CKD is 13.4%, and CKD C3-5 is 10.6%. The main causes of CKD C5 are diabetes mellitus (DM, 46.9%), hypertension (28.8%) and to a lesser extent, glomerulonephritis (7.1%) and polycystic diseases (2.8%), while other causes account for a total of 14.4%. Despite the simple diagnosis of CKD, one of the key problems of modern therapeutic and pediatric clinics is its low detection rate at the early stages, which, according to some data, reaches 96.6%. This review provides data on the criteria for the diagnosis of CKD, as well as more detailed consideration of the course of CKD in patients with DM, hypertension, and heart failure. Attention is paid to the medicinal origin of CKD, as well as to the development of anxiety and depressive disorders in CKD. General issues of treatment of patients with CKD are considered in detail. Lifestyle changes are an important part of the fight against the development and progression of CKD. Currently, Smoking, alcohol, and physical inactivity have been shown to have a harmful effect on the risk of developing and progressing CKD. Diet plays a certain preventive role. The main drugs with nephroprotective properties are angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists. Both classes of drugs are effective in proteinuric forms of nephropathies and in combination/association of CKD with diabetes or hypertension. The review also provides data on the nephroprotective properties of mineralocorticoid receptor antagonists, endothelin receptor antagonists, and sodium-glucose co-transporter-2 inhibitors. Given the high importance of identifying and effectively treating patients with CKD, it is necessary to focus on early detection of CKD, especially in high-risk groups. It is necessary to raise public awareness by creating and implementing programs for primary prevention of CKD, as well as awareness of patients, motivating them to follow the doctor's recommendations for a long time, including as part of the implementation of a non-drug strategy to combat CKD. It is important to use the full range of methods of drug therapy for CKD, including measures of universal nephroprotection. It should be remembered that the cost of late diagnosis of CKD is a reduction in life expectancy, primarily due to high rates of cardiovascular mortality, disability, and high-cost medication and kidney replacement therapy.

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The epidemiology of chronic kidney disease (CKD) in rural East Africa: A population-based study

Cited by 33 publications

References 58 publications

Methods to estimate baseline creatinine and define acute kidney injury in lean Ugandan children with severe malaria: a prospective cohort study

Methods to estimate baseline creatinine and define acute kidney injury in lean Ugandan children with severe malaria: a prospective cohort study

Renal Failure among Women of Reproductive Age in Burundi: Estimating the Prevalence and Associated Factors Using Population-Based Data

Chronic Kidney Disease: Current State of the Problem

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