Towards prevention of chronic kidney disease in Nigeria: a community-based study in Southeast Nigeria

Abstract

Chronic kidney disease (CKD) is a global problem with increasing prevalence. End-stage renal disease (ESRD) accounts for 8% of all medical admissions and 42% of renal admissions in Nigeria. Screening for CKD facilitates early detection, evaluation, and treatment of CKD. There is a dearth of community-based data on the magnitude of CKD in Nigeria. This was an epidemiological study to define CKD and its risk factors in rural and semiurban communities in Southeast Nigeria. Obesity was defined as body mass index (BMI) 430 kg/m 2 . The metabolic syndrome was evaluated using the National Cholesterol Evaluation Programme Adult Treatment Panel III definition; hypertension was defined as systolic blood pressure (SBP) X140 mm Hg and/or diastolic blood pressure (DBP) X90 mm Hg. Diabetes mellitus (DM) was defined as fasting plasma glucose X7.0 mmol/l or 2-h plasma glucose X11.1 mmol/l. Proteinuria was regarded as significant if 1 þ and above, and hematuria was considered present if positive using urine strips. The glomerular filtration rate (GFR) was estimated using the CKD-EPI formula. A total of 2182 respondents aged 25-64 years were screened; 1941 with mean age of 43.7 ± 13.2 years were analyzed. Of this number, 26.1% had hypertension, 5.9% had DM, 10.4% had the metabolic syndrome, 14.9% were obese and 19% had proteinuria and/or hematuria. The prevalence of CKD was 11.4%. This study documented high prevalence of CKD and its risk factors. Routine screening of patients for risk factors for CKD at each contact with the doctor will help to identify early CKD patients who may benefit from preventive measures.

Chronic kidney disease in disadvantaged populations

“…The strong association with farm work has led to suggestions that exposure to agrochemicals, dehydration, and consumption of contaminated water might be responsible [20]. Additionally, the use of traditional herbal medications is common and frequently associated with CKD among the poor [21,22]. In Mexico, CKD prevalence among the poor is two-to threefold higher than that of the general population, and the etiology is unknown in 30 % of ESRD patients.…”

Ethnicity and Chronic Kidney Disease in Disadvantaged Populations – An International Perspective

“…Among 1941 individuals, the prevalence of CKD was 11.4%, 26.1% had hypertension, 5.9% DM, 10.4% metabolic syndrome, 14.9% were obese, and 19% had proteinuria and/or hematuria. 41 In Congo, 42 positive dipstick proteinuria was found in 7% of individuals screened.…”

CKD in disadvantaged populations

“…The strong association with farm workhas led to suggestions that exposure to agrochemicals, dehydration, and consumption of contaminated wáter might be responsible [20]. Additionally, the use of traditional herbal medications is common and frequently associated with CKD among the poor [21,22]. In Mexico, CKD prevalence among the poor is 2-3 times higher than in the general population, and the etiology is unknown in 30 % of ESRD patients [23][24][25][26].…”