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撒哈拉以南非洲一家半城市三级医院慢性肾脏病的流行病学趋势

Epidemiology Trend of Chronic Kidney Disease in a Semi-Urban Tertiary Hospital in Sub-Saharan Africa.

作者信息

Ovwasa Henry, Aiwuyo Henry O, Okoye A Ogochukwu C, Unuigbe Evelyn, Rajora Nilum

机构信息

Family Physician, Milk River Health Center, Alberta, CAN.

Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA.

出版信息

Cureus. 2023 Mar 30;15(3):e36912. doi: 10.7759/cureus.36912. eCollection 2023 Mar.

DOI:10.7759/cureus.36912
PMID:37128545
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10148672/
Abstract

Background The global burden of chronic kidney disease (CKD) has been on an alarming increase in the last two decades. The morbidity and mortality associated with CKD are even worse in Nigeria, like other developing countries, due to multiple socioeconomic and demographic factors in the country. CKD contributes to the increasing need for hospital admission. Hypertension and chronic glomerulonephritis have been the leading causes of CKD in Nigeria. However, diabetic nephropathy has recently gained more significance as a cause of CKD in developing countries. Aim and methods This study aimed to describe the current trend in the burden and population characteristics of CKD in Southern Nigeria. This is a cross-sectional, hospital-based study. The study recruited adult patients with prehemodialysis CKD seen in renal clinics over a two-year period (November 2014 to October 2016). Data were obtained using a questionnaire and from the clinic register. All participants were clinically assessed, including history, anthropometric measurements, and urinary albumin-creatinine ratio. Results A total of 1,549 patients were seen at the Medical Outpatient Clinic over the study period. CKD accounted for 9.7% of medical outpatient clinic attendance. The mean age of participants was 49±13 years. The leading causes of CKD were diabetes mellitus (32%), chronic glomerulonephritis (30%), and hypertension (22%). Among the participants, CKD stages 3, 4, and 5 were prevalent in 26.7%, 43.3%, and 14.7%, respectively. Conclusion and recommendation CKD is very prevalent among medical clinic patients. Diabetic nephropathy seems to be a more significant cause of CKD than was previously reported. Late presentation of patients to nephrologists remains an obstacle to improving CKD outcome in Nigeria. There is need for more intensive preventive measures and early intervention.

摘要

背景

在过去二十年中,全球慢性肾脏病(CKD)负担呈惊人增长态势。与其他发展中国家一样,由于尼日利亚存在多种社会经济和人口因素,该国CKD相关的发病率和死亡率更为严峻。CKD导致住院需求不断增加。高血压和慢性肾小球肾炎一直是尼日利亚CKD的主要病因。然而,糖尿病肾病作为发展中国家CKD的病因,近年来变得愈发重要。

目的与方法

本研究旨在描述尼日利亚南部CKD负担及人群特征的当前趋势。这是一项基于医院的横断面研究。该研究纳入了在两年期间(2014年11月至2016年10月)在肾脏诊所就诊的成年血液透析前CKD患者。数据通过问卷调查和诊所登记获得。所有参与者均接受临床评估,包括病史、人体测量和尿白蛋白肌酐比值。

结果

在研究期间,门诊共诊治了1549例患者。CKD占门诊就诊人数的9.7%。参与者的平均年龄为49±13岁。CKD的主要病因是糖尿病(32%)、慢性肾小球肾炎(30%)和高血压(22%)。在参与者中,CKD 3期、4期和5期的患病率分别为26.7%、43.3%和14.7%。

结论与建议

CKD在门诊患者中非常普遍。糖尿病肾病似乎是CKD比先前报道更为重要的病因。患者向肾病专家的延迟就诊仍然是尼日利亚改善CKD结局的障碍。需要采取更强化的预防措施和早期干预。

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