RISK FACTORS ASSOCIATED WITH HIGH PREVALENCE OF CHRONIC KIDNEY DISEASE
IN RURAL AND SEMI-URBAN COMMUNITIES IN SOUTHEAST NIGERIAN: A SYSTEMATIC
REVIEW OF LITERATURE TOWARD SCREENING AWARENESS FOR PREVENTIVE MEASURES.
Abstract
Aims: Chronic Kidney Disease (CKD) is a worldwide problem with
increasing prevalence. End-stage renal disease accounts for 8% of all
medical admissions and 42% of renal admissions in Nigeria. We review
the literature on risk factors that might have impacted the prevalence
and how awareness level of risk factors screening contributes to CKD.
Design: Systematic literature review. Methods: A search was carried out
on databases, PubMed, Medline and Google by means of (MeSH) terms,
prevalence, demographics, risk factors, history of previous medical
screening, age groups, income and education were indicators.
Multivariate analyses were used to identify correlates. Reviewers
screened 84 articles and 40 full texts were checked following inclusion
criteria (1) publication between January 1985 and December 2018, (2)
availability as full text in English (3) categorization as original
research, review and meta-analysis. Results: A total of 7 articles were
included. The hospital study with a total of 1574 patients were
reviewed. A total of 908 with a mean age of 42.55±15.42 years were
analyzed, prevalence (12.0%). One epidemiological study screened 2186
respondents, 1941 with a mean age of 43.7±13.2 were analyzed. Overall
prevalence of 11.4% (semi-urban 11.7% and rural 11.1%) was observed.
The glomerular filtration rate (GFR) was estimated using CKD-EPI
equation. Another study screened 400 respondents, 328 with a mean of
54.8±13.2 were analyzed. The GFR used was MDRA equation with prevalence
(7.8%). The observed risk factors; older age (P<0.001),
hypertension (P<0.001), use of nephrotoxins
(P<0.001), obesity (P<0.001), history of renal
disease (P<0.001) were independent risk factors that influence
the prevalence, diabetes mellitus (P<0.005), use soaps
containing mercury (P<0.056) and use of bleaching cream
(P=0.138) were not significant, low income and education were
significantly prevalent among the population. Conclusion: The early
onset of the risk factors among younger adults clearly underlines the
need for early screening and intervention.