Prevalence of Chronic Kidney Disease and Its Risk Factors Among Adults in a Semi-urban Community of South-East Nigeria

Background: Chronic kidney disease (CKD) is an increasingly prevalent problem worldwide. Treatment of end-stage kidney disease is beyond the reach of an average Nigerian. The prevention and early detection are imperative to reducing its burden.

Aim: The aim of this study was to determine the prevalence of CKD and some of its risk factors among adults in a representative semi-urban Nigerian population.

Subjects And Methods: A cross-sectional study involving 400 randomly selected adults. Participants were assessed using the WHO stepwise approach. Urinary protein-creatinine ratio (PCR) and estimated glomerular filtration rate (GFR) from serum creatinine, among other parameters, were analysed. A PCR ≥200 mg/g was regarded as significant proteinuria while GFR <60 ml/min/1.73 m2 was regarded as reduced GFR. Participants with abnormal PCR and/or reduced GFR were re-evaluated after 3 months to document persistence of these abnormalities. CKD was defined as persistent significant proteinuria and/or reduced GFR for more than 3 months.

Results: Data were complete for 328 participants. Persistent significant proteinuria was found in 5.8% while persistently reduced GFR was obtained in 4.6% of participants. Overall, the prevalence of CKD was 7.8%. The prevalence of some established CKD risk factors was old age, 36.3%; hypertension, 36.9%; diabetes mellitus, 7.9%; and family history of kidney disease, 6.4%. The predictors of CKD included old age (adjusted odds ratio = 3.2; confidence interval: 1.10-8.92; P= 0.02), hypertension: 3.5 (1.93-11.90; P= 0.001), family history of kidney disease; 4.5 (3.91-10.23; P= 0.01), generalised obesity 1.3 (1.20-6.21; P= 0.001) and central obesity 3.8 (1.13-12.68; P= 0.003).

Conclusion: The prevalence of CKD and some of its risk factors were high. Effective control of the modifiable risk factors identified will assist in reducing the burden of CKD.