尼日利亚中北部一家三级医院社区成年人患慢性肾病的危险因素。

I. Mbah, P. Eseigbe, O. David, E. D. Kabilis, M. Ihekaike
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引用次数: 0

摘要

背景:慢性肾脏病(CKD)的患病率在全球范围内呈上升趋势,伴随着严重的疾病负担以及终末期肾病(ESRD)的高发病率和死亡率。关于撒哈拉以南非洲慢性肾脏病危险因素患病率的数据很少,尼日利亚北部更是如此。CKD有几个危险因素,包括肥胖、高血压、糖尿病和一些肾毒性药物。通过早期发现和治疗CKD的预防策略已被提倡,尤其是在我们自己的环境中,大多数患者出现较晚,无法负担肾脏替代治疗的费用,而肾脏替代治疗又不容易获得。方法:这项研究是在乔斯宾厄姆大学教学医院(BHUTH)的工作人员中进行的,作为2021年世界肾脏日(WKD)计划筛查活动的一部分,以确定CKD可改变风险因素的患病率。同意本研究的18岁及以上的成年受试者在致敏谈话后被动员起来。评估的参数包括人口统计学、体重指数、血压、蛋白尿、空腹血糖和血肌酐。肾小球滤过率(GFR)使用CKD-EPI肌酸酐方程2021进行估算。使用SPSS 25版对数据进行分析。统计学显著性水平设定为p值<0.05。结果:150名成年志愿者参与了这项研究。参与者的平均年龄为43.3±11.32岁(18-71岁),其中61.3%为女性,38.7%为男性。观察到的CKD危险因素的频率为45名(30.0%)参与者肥胖,44名(29.3%)参与者糖尿病,49名(32.7%)和9名(6.0%)参与者分别出现蛋白尿和糖尿,而多达37名(24.7%)参与者出现血尿。估计肾小球滤过率(eGFR)<60ml/min/1.73m2的参与者人数为55人(36.7%)。年龄较大(p=0.010)、丧偶/离婚(p=0.041)和糖尿病(p=0.006)与eGFR<60ml/min/173m2之间存在独立关联。结论本研究人群CKD危险因素的患病率较高。因此,我们需要在各种诊所进行充分和持续的致敏和常规筛查,通过改变生活方式和风险因素进行早期发现和早期管理,以阻止或减轻尼日利亚日益增长的CKD负担及其伴随的发病率和死亡率。
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Risk factors for chronic kidney disease among adults in a tertiary hospital community in north-central, Nigeria.
Background: The prevalence of chronic kidney disease (CKD) is on the increase globally with an attendant heavy disease burden and high morbidity and mortality from end-stage renal disease (ESRD). Data on the prevalence of risk factors for chronic kidney disease from sub-Saharan Africa are scanty, more so in the northern part of Nigeria. There are several risk factors for CKD which include, obesity, hypertension, diabetes mellitus and some nephrotoxic agents. Preventive strategy through early detection and treatment has been advocated for CKD especially in our own setting where majority of patients present late and cannot afford the cost of renal replacement therapy which again is not readily available. Method: This study was conducted among the staff of Bingham University Teaching Hospital (BHUTH), Jos, as part of a screening exercise during the World Kidney Day (WKD) program of 2021, to determine the prevalence of modifiable risk factors for CKD. Adult subjects of 18 years and above, who consented to the study were mobilized after a sensitization talk. The parameters assessed were demographics, body mass index, blood pressures, proteinuria, fasting plasma glucose and plasma creatinine. Glomerular filtration rate (GFR) was estimated using CKD-EPI Creatinine Equation 2021. Data were analyzed using SPSS version 25. The level of statistical significance was set at a p-value of < 0.05. Results: 150 adult volunteers participated in the study. The mean age of the participants was 43.3±11.32 years (18-71 years), with 61.3% being females and 38.7% were males. The frequency of the risk factors of CKD observed were obesity in 45 (30.0%) of the participants and diabetes mellitus found in 44 (29.3%) of the participants, Proteinuria and glycosuria were found in 49 (32.7%) and 9 (6.0%) of the participants respectively while a whopping 37 (24.7%) of the participants had haematuria. The number of participants found with estimated glomerular filtration rate (eGFR) of <60ml/min/1.73m2 were 55 (36.7%). There was an independent association between older age (p = 0.010), being widowed/divorced (p = 0.041), and having diabetes (p = 0.006) with an eGFR <60ml/min/1.73m2. Conclusion The prevalence of CKD risk factors in this study population was high. Therefore, there is the need for adequate and continuous sensitization and routine screening in our various clinics for early detection and early management by lifestyle and risk factor modification to halt or reduce the growing burden of CKD with its attendant morbidity and mortality in Nigeria.
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