Kidney disease in Uganda: a community based study

Abstract

BackgroundChronic kidney disease (CKD) is a major cause of morbidity and mortality in Sub-Saharan Africa (SSA). The majority of studies on CKD in SSA have been conducted among HIV-infected populations and mainly from large health facilities. We determined the prevalence of CKD and its predictors among populations in communities in central Uganda.MethodsA cross-sectional study was conducted in Wakiso district using multi-stage sampling. Data was collected on age, sex, socio-economic status, history of alcohol intake, diabetes mellitus, hypertension and smoking. Measurement of blood pressure, weight and height to determine body mass index (BMI) and investigations including HIV testing, fasting blood sugar, creatinine and urinalysis were conducted. Logistic regression was used to estimate the strength of the association between variables and the presence of CKD estimated using the Cockcroft Gault formula.ResultsA total of 955 participants aged 18–87 years were enrolled into the study. The median age was 31 years (Interquartile range 24–42) and majority (67%) were female. Up to 21.4% (204/955) had abnormal renal function with CKD stage 1 in 6.2% (59/955), stage 2 in 12.7% (121/955), stage 3 in 2.4% (23/955), CKD stage 4 in 0% and CKD stage 5 in 0.1% (1/995). Female gender OR 1.8 (95% Confidence Interval [CI] 1.2–2.8), age >30 years OR 2.2(95% CI 1.2–3.8) and high social economic status OR 2.1 (95% CI 1.3–3.6) were associated with increased risk of CKD while BMI > 25Kg/m2 was protective against CKD OR 0.1 (95% CI 0.04–0.2). Traditional risk factors such as HIV-infection, diabetes mellitus, smoking and alcohol intake were not found to be significantly associated with CKD.ConclusionWe found a high prevalence of kidney disease in central Uganda. Interestingly the traditional risk factors associated with CKD previously documented, were not associated with CKD.

The epidemiology of chronic kidney disease (CKD) in rural East Africa: A population-based study

“…Although comparing available studies is difficult due to differences in CKD definition, our results are consistent with two other community-based studies from East Africa, one from central Uganda [43], and another from northern Tanzania [44]. These two studies yielded a similar prevalence of CKD (7-10%), which was also predominantly driven by proteinuria [43,44]. In West and Central Africa, community-based CKD prevalence estimates have ranged from 6-19% [45][46][47][48][49], with highest prevalence reported in Southwestern Nigeria [49].…”

“…Although comparing available studies is difficult due to differences in CKD definition, our results are consistent with two other community-based studies from East Africa, one from central Uganda [43], and another from northern Tanzania [44]. These two studies yielded a similar prevalence of CKD (7-10%), which was also predominantly driven by proteinuria [43,44].…”

Chronic Kidney Disease in Cameroon: A scoping review

“…Kaze et al [50] reported history of diabetes mellitus as a strong associated factor to CKD which was convergent to the ndings of Bahrey et al [51]. Female sex was also an associated factor of CKD and this was comparable to ndings in a study in Uganda [55]. Although hypertension and diabetes mellitus were notable associated factors, these were also identi ed as main etiological factors along with chronic glomerulonephritis and HIV.…”

Prevalence of chronic kidney disease in Nigeria: systematic review of population-based studies

“…Zhang and Rothenbacher 12 in a review of population-based studies on the prevalence of CKD observed that several studies had higher prevalence of CKD in females. Kalyesubula et al 29 in a community-based study on kidney disease in Uganda also recorded a higher prevalence of CKD in the female gender. The fact that men have more muscle mass than women, and the differences in hormone metabolism and glomerular structure are assumed to play a role in the differences in prevalence of CKD observed between male and female gender.…”