撒哈拉以南非洲高血压患者中的慢性肾脏病：一项系统评价和荟萃分析。
Chronic kidney disease among patients with hypertension in sub-Saharan Africa: a systematic review and meta-analysis.
作者信息
Yirga Gebrie Kassaw, Aytenew Tigabu Munye, Kassaw Amare, Hiruy Endalk Getasew, Shiferaw Kirubel, Baye Astewle Andargie, Kerebeh Gashaw, Mekonnen Gebrehiwot Berie, Ewunetu Mengistu, Amare Abraham Tsedalu, Birlie Tekalgn Amera, Wassie Fentahun Dires, Diress Tadila, Abeje Getu, Eshetie Yeshiambaw, Abere Yirgalem, Bantie Berihun
机构信息
1Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
出版信息
BMC Public Health. 2025 May 1;25(1):1603. doi: 10.1186/s12889-025-22828-8.
INTRODUCTION
Chronic kidney disease is defined by the presence of kidney damage or decreased kidney function for at least three months, irrespective of the cause. Hypertensive kidney disease is one of the long-term complications of poorly controlled hypertension. It is the second leading cause of developing chronic kidney disease, next to diabetic mellitus.
METHODS
The literature was searched using an international electronic database (PubMed, Google Scholar, Hinari, and Open Google) to get significant studies on chronic kidney disease among hypertensive patients. This study is conducted to determine the pooled prevalence and associated factors of chronic kidney disease among hypertensive patients up to May 20, 2024. Heterogeneity between studies was checked using I test statistics, and small study effects were checked using graphical and Egger's statistical tests at a 5% significance level. Subgroup analysis and sensitivity analysis were checked. A random-effects model was used to guess the pooled effect size across studies.
RESULT
In this meta-analysis, 16 studies in sub-Saharan Africa were included with a total of 6648 participants who fulfilled the inclusion criteria. The estimated prevalence of CKD among hypertension patients was found to be 29.01% (95% CI: 23.03-34.99, I = 97.10%) in sub-Saharan Africa. Age greater than 60 years old (OR = 2.36; 95% CI: 1.02-3.71, I2 = 99.11%), uncontrolled blood pressure (OR = 6.57; 95% CI: 2.44-10.71, I = 97.38%), hypertensive patients with diabetes comorbidity (OR = 3.27; 95% CI: 1.65-4.89, I = 95.79%), Bing overweight (OR = 2.75; 95% CI: 1.04-4.46, I = 98.22%), and proteinuria (OR = 4.64, 95% CI: 4.09-5.18, I = 0.00%).
CONCLUSION
Hypertension is one of the major causes of chronic kidney disease. Most patients living with hypertension develop CKD over time in sub-Saharan Africa. The highest prevalence of CKD among hypertension was observed in West Africa and Middle Africa.
引言
慢性肾脏病的定义是存在肾脏损伤或肾功能下降至少三个月，无论其病因如何。高血压肾病是高血压控制不佳的长期并发症之一。它是继糖尿病之后导致慢性肾脏病的第二大主要原因。
方法
使用国际电子数据库（PubMed、谷歌学术、Hinari和开放谷歌）检索文献，以获取关于高血压患者慢性肾脏病的重要研究。本研究旨在确定截至2024年5月20日高血压患者中慢性肾脏病的合并患病率及相关因素。使用I检验统计量检查研究间的异质性，并在5%的显著性水平下使用图形和埃格统计检验检查小研究效应。进行亚组分析和敏感性分析。使用随机效应模型来推测各研究的合并效应量。
结果
在这项荟萃分析中，纳入了撒哈拉以南非洲地区的16项研究，共有6648名参与者符合纳入标准。在撒哈拉以南非洲地区，高血压患者中慢性肾脏病的估计患病率为29.01%（95%置信区间：23.03 - 34.99，I² = 97.10%）。年龄大于60岁（比值比 = 2.36；95%置信区间：1.02 - 3.71，I² = 99.11%）、血压未控制（比值比 = 6.57；95%置信区间：2.44 - 10.71，I² = 97.38%）、合并糖尿病的高血压患者（比值比 = 3.27；95%置信区间：1.65 - 4.89，I² = 95.79%）、超重（比值比 = 2.75；95%置信区间：1.04 - 4.46，I² = 98.22%）以及蛋白尿（比值比 = 4.64，95%置信区间：4.09 - 5.18，I² = 0.00%）。
结论
高血压是慢性肾脏病的主要病因之一。在撒哈拉以南非洲地区，大多数高血压患者随着时间的推移会发展为慢性肾脏病。在西非和中非观察到高血压患者中慢性肾脏病的患病率最高。
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