The epidemiology of end-stage renal disease in Nigeria: the way forward

Abstract

The incidence of CKD (Chronic kidney disease) in Nigeria has been shown by various studies to range between 1.6 and 12.4%. We have shown that the burden of renal disease in Nigeria is probably significantly higher than any previous study on end-stage renal disease (ESRD) has documented, as most studies are hospital-based and fail to include the many patients who do not have access to hospital care. The increased prevalence of ESRD among blacks in the United States and South Africa compared with other races also suggests that ESRD may be more prevalent in Africa than in the United States and other developed nations. Common causes of CKD in Nigerian adults are glomerulonephritis and hypertension, while common causes in children are glomerulonephritis and posterior urethral valves. In the United States, diabetes and hypertension are the commonest causes of CKD and glomerulonephritis plays a less important role. Access to renal replacement therapy (RRT) in Nigeria is limited, and mortality rates are very high, ranging between 40 and 50%. Important steps towards improving the situation are the development of prevention programmes and increased funding to ensure increased availability of RRT. To achieve this, health policies concerning CKD must be formulated, and the lack of a renal registry makes it difficult for this to be done. There is need for the development of a functional organizational structure for the reporting of CKD in Nigeria, the Nigerian Renal Registry.

Challenges of providing maintenance hemodialysis in a resource poor country: Experience from a single teaching hospital in Lagos, Southwest Nigeria

“…The commonest causes of ESRD among our patient population were hypertension and glomerulonephritis; together accounting for about 60% of cases. This finding is similar to that reported from other parts of Nigeria, and sub‐Saharan Africa . However, diabetes was responsible for a significant proportion of cases of ESRD in this study being the third commonest cause of ESRD; a finding similar to that reported by Egha et al .…”

“…and Ojogwu et al. in two separate studies None of the ESRD patients had an arteriovenous fistula created prior to commencement of hemodialysis as recommended by the Kidney Disease Quality Outcomes Initiative and Fistula First Initiative guidelines . In fact, repeated cannulation of the femoral vein was the initial vascular access for dialysis in all the patients with only a small proportion migrating to a nontunneled internal jugular catheter after it became technically difficult to access the circulation via cannulation of the femoral vein.…”

Screening for risk factors of chronic kidney disease in a community in Niger Delta Nigeria

“…In Nigeria, it ranked with chronic glomerulonephritis as the most commonly implicated among the causes of CKD. [14] About 40% of the subjects in this study had elevated BP, this was high when compared with reports of various studies in other Niger Delta communities in the country. [15][16][17] However, Akpa et al [18] reported a similar prevalence rate (40.8%) in a survey of a Niger Delta community in Rivers state.…”

“…This is consistent with other study on hypertension and other noncommunicable diseases. [9][10][11][12][13][14][15][16][17][18] …”

“…It is the 3 rd most common cause of CKD in Nigeria accounting for about a fifth of patients with CKD. [14] Also, about 23% of the diabetic population subsequently develops CKD, and this is, usually, influenced by the duration of DM, degree of glycemic control, comorbid state and genetics. [19] In Nigeria, the national prevalence of diabetes mellitus had been reported in 1992 to be 2.7%, [20] which contrast the prevalence rate of 8.1% in this study.…”