The epidemiology of chronic kidney disease (CKD) in rural East Africa: A population-based study.
BACKGROUND:Chronic kidney disease (CKD) may be common among individuals living in sub-Saharan Africa due to the confluence of CKD risk factors and genetic predisposition. METHODS:We ascertained the prevalence of CKD and its risk factors among a sample of 3,686 participants of a population-based HIV...
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doaj-4b87dcf78e8447ad874711a6099c1bfd2021-03-03T21:38:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01153e022964910.1371/journal.pone.0229649The epidemiology of chronic kidney disease (CKD) in rural East Africa: A population-based study.Anthony N MuiruEdwin D CharleboisLaura B BalzerDalsone KwarisiimaAssurah EllyDoug BlackSamuel OkirorJane KabamiMucunguzi AtukundaKatherine SnymanMaya PetersenMoses KamyaDiane HavlirMichelle M EstrellaChi-Yuan HsuBACKGROUND:Chronic kidney disease (CKD) may be common among individuals living in sub-Saharan Africa due to the confluence of CKD risk factors and genetic predisposition. METHODS:We ascertained the prevalence of CKD and its risk factors among a sample of 3,686 participants of a population-based HIV trial in rural Uganda and Kenya. Prevalent CKD was defined as a serum creatinine-based estimated glomerular filtration rate <60 mL/min/1.73m2 or proteinuria (urine dipstick ≥1+). We used inverse-weighting to estimate the population prevalence of CKD, and multivariable log-link Poisson models to assess the associations of potential risk factors with CKD. RESULTS:The estimated CKD prevalence was 6.8% (95% CI 5.7-8.1%) overall and varied by region, being 12.5% (10.1-15.4%) in eastern Uganda, 3.9% (2.2-6.8%) in southwestern Uganda and 3.7% (2.7-5.1%) in western Kenya. Risk factors associated with greater CKD prevalence included age ≥60 years (adjusted prevalence ratio [aPR] 3.5 [95% CI 1.9-6.5] compared with age 18-29 years), HIV infection (aPR 1.6 [1.1-2.2]), and residence in eastern Uganda (aPR 3.9 [2.6-5.9]). However, two-thirds of individuals with CKD did not have HIV, diabetes, or hypertension as risk factors. Furthermore, we noted many individuals who did not have proteinuria had dipstick positive leukocyturia or hematuria. CONCLUSION:The prevalence of CKD is appreciable in rural East Africa and there are considerable regional differences. Conventional risk factors appear to only explain a minority of cases, and leukocyturia and hematuria were common, highlighting the need for further research into understanding the nature of CKD in sub-Saharan Africa.https://doi.org/10.1371/journal.pone.0229649 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anthony N Muiru Edwin D Charlebois Laura B Balzer Dalsone Kwarisiima Assurah Elly Doug Black Samuel Okiror Jane Kabami Mucunguzi Atukunda Katherine Snyman Maya Petersen Moses Kamya Diane Havlir Michelle M Estrella Chi-Yuan Hsu |
spellingShingle |
Anthony N Muiru Edwin D Charlebois Laura B Balzer Dalsone Kwarisiima Assurah Elly Doug Black Samuel Okiror Jane Kabami Mucunguzi Atukunda Katherine Snyman Maya Petersen Moses Kamya Diane Havlir Michelle M Estrella Chi-Yuan Hsu The epidemiology of chronic kidney disease (CKD) in rural East Africa: A population-based study. PLoS ONE |
author_facet |
Anthony N Muiru Edwin D Charlebois Laura B Balzer Dalsone Kwarisiima Assurah Elly Doug Black Samuel Okiror Jane Kabami Mucunguzi Atukunda Katherine Snyman Maya Petersen Moses Kamya Diane Havlir Michelle M Estrella Chi-Yuan Hsu |
author_sort |
Anthony N Muiru |
title |
The epidemiology of chronic kidney disease (CKD) in rural East Africa: A population-based study. |
title_short |
The epidemiology of chronic kidney disease (CKD) in rural East Africa: A population-based study. |
title_full |
The epidemiology of chronic kidney disease (CKD) in rural East Africa: A population-based study. |
title_fullStr |
The epidemiology of chronic kidney disease (CKD) in rural East Africa: A population-based study. |
title_full_unstemmed |
The epidemiology of chronic kidney disease (CKD) in rural East Africa: A population-based study. |
title_sort |
epidemiology of chronic kidney disease (ckd) in rural east africa: a population-based study. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2020-01-01 |
description |
BACKGROUND:Chronic kidney disease (CKD) may be common among individuals living in sub-Saharan Africa due to the confluence of CKD risk factors and genetic predisposition. METHODS:We ascertained the prevalence of CKD and its risk factors among a sample of 3,686 participants of a population-based HIV trial in rural Uganda and Kenya. Prevalent CKD was defined as a serum creatinine-based estimated glomerular filtration rate <60 mL/min/1.73m2 or proteinuria (urine dipstick ≥1+). We used inverse-weighting to estimate the population prevalence of CKD, and multivariable log-link Poisson models to assess the associations of potential risk factors with CKD. RESULTS:The estimated CKD prevalence was 6.8% (95% CI 5.7-8.1%) overall and varied by region, being 12.5% (10.1-15.4%) in eastern Uganda, 3.9% (2.2-6.8%) in southwestern Uganda and 3.7% (2.7-5.1%) in western Kenya. Risk factors associated with greater CKD prevalence included age ≥60 years (adjusted prevalence ratio [aPR] 3.5 [95% CI 1.9-6.5] compared with age 18-29 years), HIV infection (aPR 1.6 [1.1-2.2]), and residence in eastern Uganda (aPR 3.9 [2.6-5.9]). However, two-thirds of individuals with CKD did not have HIV, diabetes, or hypertension as risk factors. Furthermore, we noted many individuals who did not have proteinuria had dipstick positive leukocyturia or hematuria. CONCLUSION:The prevalence of CKD is appreciable in rural East Africa and there are considerable regional differences. Conventional risk factors appear to only explain a minority of cases, and leukocyturia and hematuria were common, highlighting the need for further research into understanding the nature of CKD in sub-Saharan Africa. |
url |
https://doi.org/10.1371/journal.pone.0229649 |
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