Mungamba Muhulo Muhau, Chilunga Felix P, van der Linden Eva L, Beune Erik, Godwill Engwa A, Hayfron-Benjamin Charles F, Meeks Karlijn, Darko Samuel N, Twumasi-Ankrah Sampson, Owusu-Dabo Ellis, Vogt Liffert, van den Born Bert-Jan H, Chungag Benedicta N, Agyemang Charles
Public and Occupational Health, University of Amsterdam, Amsterdam, The Netherlands
Human Biology, Walter Sisulu University, Mthatha, South Africa.
BMJ Glob Health. 2025 Jan 20;10(1):e016786. doi: 10.1136/bmjgh-2024-016786.
Limited longitudinal data exist on chronic kidney disease (CKD) in African populations undergoing epidemiological transitions. We investigated incidence, long-term predictors and progression of CKD among Ghanaians residing in Ghana and Ghanaian migrants in the Netherlands (Amsterdam).
We analysed data from 2183 participants in the transcontinental population-based prospective Research on Obesity and Diabetes among African Migrants cohort, followed for approximately 7 years. CKD incidence and its progression to end-stage kidney disease (ESKD) were defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. CKD incidence was calculated using age- and sex standardisation for those without CKD at baseline. Long-term predictors of CKD incidence were identified using one-step robust Poisson regression. CKD progression to ESKD from baseline was also assessed using robust Poisson regressions. Overall age- and sex standardised CKD incidence was 11.0% (95% CI 9.3% to 12.3%) in the population, with Ghanaians residing in Amsterdam at (7.6%; 5.7% to 9.5%) and Ghanaians residing in Ghana at (12.9%; 10.9% to 14.9%). Within Ghana, rural Ghanaians had similar CKD incidence to urban Ghanaians (12.5%; 8.5% to 15.5% vs 12.3%; 8.2% to 15.8%). Residence in Amsterdam was associated with lower CKD incidence compared with Ghana after adjustments (incidence rate ratio=0.32; 0.13-0.77). CKD incidence predictors were advanced age, female sex, alcohol consumption, uric acid levels and hypertension. CKD progression to ESKD was 2.3% among Ghanaians residing in Ghana and 0.0% among Ghanaians residing in Amsterdam.
One-tenth of Ghanaians developed CKD over 7 years, with higher incidence in Ghana compared with Europe. Age, female sex, alcohol use, uric acid levels and hypertension were predictive factors. CKD progression to ESKD was minimal. High CKD incidence among Ghanaians, especially those residing in Ghana, calls for in-depth assessment of contributing factors and targeted interventions.
在经历流行病学转变的非洲人群中，关于慢性肾脏病（CKD）的纵向数据有限。我们调查了居住在加纳的加纳人和在荷兰阿姆斯特丹的加纳移民中CKD的发病率、长期预测因素和病情进展情况。
我们分析了基于人群的跨大陆前瞻性非洲移民肥胖与糖尿病研究队列中2183名参与者的数据，随访时间约为7年。CKD发病率及其进展至终末期肾病（ESKD）采用肾脏病改善全球预后（KDIGO）标准进行定义。对基线时无CKD的参与者，采用年龄和性别标准化计算CKD发病率。使用一步稳健泊松回归确定CKD发病率的长期预测因素。也采用稳健泊松回归评估从基线开始CKD进展至ESKD的情况。总体年龄和性别标准化的CKD发病率在该人群中为11.0%（95%CI 9.3%至12.3%），其中居住在阿姆斯特丹的加纳人为（7.6%；5.7%至9.5%），居住在加纳的加纳人为（12.9%；10.9%至14.9%）。在加纳境内，农村加纳人的CKD发病率与城市加纳人相似（分别为12.5%；8.5%至15.5%和12.3%；8.2%至15.8%）。调整后，与加纳相比，居住在阿姆斯特丹与较低的CKD发病率相关（发病率比=0.32；0.13 - 0.77）。CKD发病率的预测因素为高龄、女性、饮酒、尿酸水平和高血压。居住在加纳的加纳人CKD进展至ESKD的比例为2.3%，居住在阿姆斯特丹的加纳人则为0.0%。
十分之一的加纳人在7年期间患上CKD，加纳的发病率高于欧洲。年龄、女性、饮酒、尿酸水平和高血压是预测因素。CKD进展至ESKD的情况极少。加纳人，尤其是居住在加纳的人CKD发病率较高，这需要对促成因素进行深入评估并开展针对性干预。
