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. Review CriteriaA search was carried out on the different databases by means of the (MeSH) terms prevalence, risk factors, history of risk factor screening, demographics, income, education and preventions strategies. Reviewers screened 84 papers and 40 full text 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, reviews, meta-analysis.