Prevalence of Chronic Kidney Disease in a Nigerian Family Practice Population

Abstract

Background: Chronic kidney disease (CKD) is a global public health problem, with greater burden and prohibitive cost of care especially in developing countries. Objectives: The objective of this study was to determine the prevalence of chronic kidney disease and its associated risk factors among patients attending the Family Practice Clinic, Wesley Guild Hospital, Ilesa, Nigeria. Method: Consecutive newly registered patients, who attended the Family Practice Clinic of Wesley Guild Hospital, Ilesa from August 2005 to January 2006, were recruited and studied. Relevant data were collected by using interviewer-administered questionnaire, spot urinary ACR (albumin-creatinine ratio) determination of the subjects with Microalbustix™ reagent strip and serum creatinine concentration. The glomerular filtration rate (GFR) of each subject was estimated using Modification of Diet in Renal Disease (MDRD) formula. A repeat urine test was done at 3 months to identify subjects with persistent microalbuminuria. Results: The age of study subjects ranged from 20 to 74 years with the mean age of 50.52 + 13.03 years. There were 68 males and 182 females in the sample population showing a male to female ratio of 1: 2.7. One hundred and thirteen of the 250 subjects (45.2%) were found to have pathologic albuminuria on initial screening, while 31(12.4%) had persistent albuminuria at 3 months. Also, 51(20.4%) subjects had estimated low GFR on initial screening and 26 (10.4%) had persistent low GFR at 3 months. Significant risk factors for CKD in the study subjects were increasing age, elevated blood pressure, history of diabetes mellitus (DM), habitual analgesics and herbal intake as well as abnormal waist to hip ratio (p<0.05). Conclusions: The prevalence of CKD in the study population is high and its association with modifiable risk factors is demonstrated. Family Physicians have a unique opportunity to identify and address these factors among their patients. Routine screening for CKD at Family Practice clinics is indicated to reduce the burden of renal disease in the population.