尼日利亚西南部奥孙州慢性肾脏病患病率、危险因素及模式的社区研究。

A community study of the prevalence, risk factors and pattern of chronic kidney disease in Osun State, South West Nigeria.

作者信息

Oluyombo R, Ayodele O E, Akinwusi P O, Okunola O O, Akinsola A, Arogundade F A, Sanusi A A, Onayade A

机构信息

Department of Medicine, Obafemi Awolowo University, Ile-Ife, Osun State.

出版信息

West Afr J Med. 2013 Apr-Jun;32(2):85-92.

PMID:23913494

Abstract

BACKGROUND

Chronic kidney disease (CKD) is a global public health concern. Nigeria, like other African countries has paucity of hard data derived from community based studies.

AIMS

We set out to determine the awareness, level of knowledge, prevalence of chronic kidney disease and its associated risk factors in Nigerian community.

METHODS

We used a pre-tested structured questionnaire to draw information on sociodemography, knowledge and risk factors of CKD from 468 residents aged ≥ 18 years. Clinical examination, blood glucose, serum creatinine, urinalysis and urinary albumin: creatinine ratio (ACR) was carried out. Glomerular filtration rate (eGFR) was estimated using Modification for Diet in Renal Disease equation. CKD was defined as eGFR < 60 ml/min and/or macroalbuminuria (ACR ≥ 300 mg/g or dipstick proteinuria).

RESULTS

A total of 454 residents, mainly farmers, with a mean age of 45.8 ± 19.0 years and M: F ratio of 0.8:1 completed the study. Only 33.7% had heard of kidney disease; the level of knowledge of CKD was adjudged good, fair and poor in 25.5%, 42.2% and 30.6% respectively. There was higher prevalence of CKD in those with poor knowledge (p=0.023). Smoking habit, habitual analgesic intake, alcohol and herbal concoction use was 7%, 20%, 19% and 75% respectively. The prevalence of hypertension was 30%, diabetes mellitus (3.7%), obesity by waist circumference (14.6%) and haematuria (3.1%). Estimated GFR < 60 ml/min was present in 12.3% while macroalbuminuria was present in 8.9%. The overall prevalence of CKD was 18.8%, with CKD stages 1, 2, 3 and 4 accounting for 2.4%, 4.1%, 11.8% and 0.5% respectively. Age (p=0.00; OR 1.09), female gender (p=0.006; OR 4.87), systolic blood pressure P<0.001; OR 1.04) and diabetes (p=0033; OR 15.76) were predictive of CKD.

CONCLUSION

The prevalence of CKD and its risk factors are high in this rural community of South Western Nigeria. Majority had moderately impaired kidney function. This underscores the need for primary and secondary preventive programmes.

摘要

背景

慢性肾脏病（CKD）是一个全球公共卫生问题。与其他非洲国家一样，尼日利亚缺乏基于社区研究得出的可靠数据。

目的

我们旨在确定尼日利亚社区中慢性肾脏病的知晓率、知识水平、患病率及其相关危险因素。

方法

我们使用预先测试的结构化问卷，从468名年龄≥18岁的居民中获取有关社会人口统计学、慢性肾脏病知识和危险因素的信息。进行了临床检查、血糖、血清肌酐、尿液分析以及尿白蛋白：肌酐比值（ACR）检测。使用肾脏病饮食改良方程估算肾小球滤过率（eGFR）。慢性肾脏病定义为eGFR<60 ml/分钟和/或大量蛋白尿（ACR≥300 mg/g或试纸法检测蛋白尿）。

结果

共有454名居民（主要是农民）完成了研究，平均年龄为45.8±19.0岁，男女比例为0.8:1。只有33.7%的人听说过肾脏病；慢性肾脏病知识水平被判定为良好、中等和较差的分别占25.5%、42.2%和30.6%。知识水平较差的人群中慢性肾脏病患病率更高（p=0.023）。吸烟习惯、习惯性服用镇痛药、饮酒和使用草药制剂的比例分别为7%、20%、19%和75%。高血压患病率为30%，糖尿病为3.7%，根据腰围判断的肥胖为14.6%，血尿为3.1%。估计肾小球滤过率<60 ml/分钟的比例为12.3%，大量蛋白尿的比例为8.9%。慢性肾脏病的总体患病率为18.8%，其中1期、2期、3期和4期慢性肾脏病分别占2.4%、4.1%、11.8%和0.5%。年龄（p=0.00；比值比1.09）、女性（p=0.006；比值比4.87）、收缩压（P<0.001；比值比1.04）和糖尿病（p=0.033；比值比15.76）是慢性肾脏病的预测因素。