Screening for chronic kidney disease in an urban population in Nigeria

Chronic kidney disease has been reported to be on the increase globally and worse in the developing countries. Early detection has been associated with a better outcome. The objective of the study is to screen for kidney disease and its risk factors in the urban population in Nigeria.

This is a cross-sectional nonrandomized study of residents of Enugu metropolis of Nigeria. Ethical approval was obtained from the ethical committee of the hospital. The study population was consecutive subjects aged 18 years and above who gave consent to the study. The details of the study were explained to the participants and informed consent obtained. The biodata, relevant clinical parameters, and blood and urine samples were obtained from each participant. The serum creatinine and urine protein of each participant were assessed. The estimated glomerular filtration rate (eGFR) was calculated using the modification of diet in renal disease epidemiology formula. Kidney disease is defined as eGFR <60 ml/min/1.73 m² and/or proteinuria. The data obtained were analyzed using SPSS software version 20. The results were presented in tables and charts as frequencies, mean and standard deviation. P < 0.05 was considered statistically significant.

Four hundred and sixty-six participants participated in the study, 77.3% were females with a male: female ratio of 1:3.4. The age range was 18-90 years with a mean of 35.7 ± 12.7 years; 11.8%, 1.3%, and 0.6% had hypertension, diabetes mellitus, and kidney disease, respectively. Systolic blood pressures (BPs) of 140 mmHg and above and diastolic BP of 90 mmHg and above were found in 20% and 18.5% of the participants, respectively. Furthermore, 16.9% of the participants had a random blood glucose >11 mmol/l. The range of serum creatinine was 27.3-1029.1 μmol/l with a median of 69.1umol/l. eGFR <60 ml/min/1.73 m² was found in 6.6% and proteinuria in 18.2%; however, 23.1% of the participants had kidney disease detected by eGFR <60 ml/min/1.73 m² and/or proteinuria. Age, male sex, BP, and body mass index were found to have a statistically significant inverse relationship with kidney function.

Prevalence of kidney disease in an urban population in Nigeria is high. The risk factors were hypertension, increasing age, male sex, and obesity.