Department of Family Medicine and Rural Health, Faculty of Medicine and Health Sciences, Mthatha, South Africa.
Department of Public Health, Faculty of Medicine and Health Sciences, Mthatha, South Africa.
PLoS One. 2024 Sep 9;19(9):e0292416. doi: 10.1371/journal.pone.0292416. eCollection 2024.
The colliding epidemic of infectious and non-communicable diseases in South Africa could potentially increase the prevalence of kidney disease in the country. This study determines the prevalence of kidney damage and known risk factors in a rural community of the Eastern Cape province, South Africa.
This observational cross-sectional study was conducted in the outpatient department of the Mbekweni Community Health Centre in the Eastern Cape between May and July 2022. Relevant data on demography, medical history, anthropometry and blood pressure were obtained. The glomerular filtration rate was estimated using the Chronic Kidney Disease Epidemiology Collaboration Creatinine (CKD-EPICreatinine) equation and the re-expressed four-variable Modification of Diet in Renal Disease (MDRD) equation, without any adjustment for black ethnicity. Prevalence of kidney damage was defined as the proportion of individuals with low eGFR (<60mL/min per 1.73m2). The presence of proteins in the spot urine samples was determined with the use of test strips. We used the logistic regression model analysis to identify the independent risk factors for significant kidney damage.
The mean (±standard deviation) age of the 389 participants was 52.3 (± 17.5) years, with 69.9% female. The prevalence of significant kidney damage was 17.2% (n = 67), as estimated by the CKD-EPICreatinine, with a slight difference by the MDRD equation (n = 69; 17.7%), while the prevalence of proteinuria was 7.2%. Older age was identified as a significant risk factor for CKD, with an odds ratio (OR) = 1.08 (95% confidence interval [CI]: 1.06-1.1, p < 0.001). Hypertension was strongly associated with proteinuria (OR = 4.17, 95% CI 1.67-10.4, p<0.001).
This study found a high prevalence of kidney damage (17.2%) and proteinuria (7.97%) in this rural community, largely attributed to advanced age and hypertension, respectively. Early detection of proteinuria and decreased renal function at community health centres should trigger a referral to a higher level of care for further management of patients.
传染病和非传染性疾病在南非的同时流行，可能会导致该国肾脏疾病的患病率上升。本研究旨在确定南非东开普省一个农村社区的肾脏损伤患病率和已知危险因素。
本观察性横断面研究于 2022 年 5 月至 7 月在东开普省 Mbekweni 社区卫生中心的门诊部进行。收集人口统计学、病史、人体测量学和血压相关数据。使用慢性肾脏病流行病学合作（CKD-EPI）肌酐方程和重新表达的四变量肾脏病饮食改良（MDRD）方程估算肾小球滤过率，不考虑黑种人种族的调整。肾脏损伤的患病率定义为肾小球滤过率低（<60mL/min/1.73m2）的个体比例。使用测试条确定尿液样本中蛋白质的存在。我们使用逻辑回归模型分析来确定显著肾脏损伤的独立危险因素。
389 名参与者的平均（±标准差）年龄为 52.3（±17.5）岁，女性占 69.9%。根据 CKD-EPI 肌酐方程估计，显著肾脏损伤的患病率为 17.2%（n=67），而根据 MDRD 方程则略高（n=69；17.7%），蛋白尿的患病率为 7.2%。年龄较大被确定为 CKD 的显著危险因素，优势比（OR）=1.08（95%置信区间[CI]：1.06-1.1，p<0.001）。高血压与蛋白尿密切相关（OR=4.17，95%CI 1.67-10.4，p<0.001）。
本研究在这个农村社区发现了较高的肾脏损伤（17.2%）和蛋白尿（7.97%）患病率，主要分别归因于年龄较大和高血压。在社区卫生中心早期发现蛋白尿和肾功能下降应促使将患者转诊至更高水平的医疗机构，以进一步管理。
