Sumaili Ernest K, Krzesinski Jean-Marie, Cohen Eric P, Nseka Nazaire M
Service de néphrologie, cliniques universitaires de Kinshasa, université de Kinshasa, BP 123 KIN XI, Kinshasa, République démocratique du Congo.
Nephrol Ther. 2010 Jul;6(4):232-9. doi: 10.1016/j.nephro.2010.03.008. Epub 2010 Apr 20.
Chronic kidney disease (CKD) is a worldwide public health problem. Little is known about its burden in Africa. This paper reviews the knowledge of CKD in Kinshasa, summarizing four studies undertaken in the general population and traditional health system of Kinshasa. CKD was defined by either kidney damage (proteinuria> or =300 mg/day) or reduced kidney function (eGFR<60 ml/min/1.73 m(2)). In the general population, the prevalence of CKD all stage is 12.4 %. Our work shows also the high prevalence of proteinuria among subjects who do not have diabetes or hypertension, the lack of early detection and management of CKD risk factors in the traditional health care system leading to late referral or premature deaths, and the limits of renal replacement treatment. CKD affects young people in the DRC, in contrast to the United States, where CKD is more prevalent in older people. Major determinants of CKD in our studies were hypertension, diabetes, overweight, age, lower socioeconomic status, and Human immunodeficiency virus (HIV) infection. Glomerular nephropathy (mainly focal segmental glomerulosclerosis) remains the leading cause of end stage renal disease. An annual screening of the population for proteinuria and CKD risk factors is feasible and will, it is hoped, provide the basis for building a nationwide prevention strategy.
慢性肾脏病(CKD)是一个全球性的公共卫生问题。人们对其在非洲的负担知之甚少。本文回顾了金沙萨地区有关CKD的知识,总结了在金沙萨普通人群和传统卫生系统中开展的四项研究。CKD的定义为肾脏损伤(蛋白尿≥300毫克/天)或肾功能减退(估算肾小球滤过率[eGFR]<60毫升/分钟/1.73平方米)。在普通人群中,CKD各阶段的患病率为12.4%。我们的研究还表明,在没有糖尿病或高血压的人群中蛋白尿患病率很高;传统卫生保健系统缺乏对CKD危险因素的早期检测和管理,导致转诊延迟或过早死亡;以及肾脏替代治疗的局限性。与美国不同,在美国CKD在老年人中更为普遍,而在刚果民主共和国CKD影响年轻人。我们研究中CKD的主要决定因素包括高血压、糖尿病、超重、年龄、社会经济地位较低以及人类免疫缺陷病毒(HIV)感染。肾小球肾病(主要是局灶节段性肾小球硬化症)仍然是终末期肾病的主要原因。每年对人群进行蛋白尿和CKD危险因素筛查是可行的,有望为制定全国性的预防策略提供依据。