Burden of chronic kidney disease on the African continent

A systematic review and meta-analysis

Arnaud D. Kaze, Titilayo Ilori, Bernard Jaar, Justin Echouffo Tcheugui

Research output: Contribution to journalReview article

Abstract

Background: Accurate contemporary data on the burden of Chronic Kidney Disease (CKD) on the African continent are lacking. We determined the prevalence of CKD in adult populations living in Africa, and variations by stage, gender, estimated Glomerular Filtration Rate (eGFR) equation, and residence. Methods: For this systematic review, we searched multiple electronic databases for original studies on CKD prevalence reported from January 1, 2000 to December 31, 2016. Two reviewers independently undertook quality assessment and data extraction. We stabilized the variance of study-specific estimates with the Freeman-Turkey single arcsine transformation and pooled the data using a random effects meta-analysis models. Results: A total of 98 studies involving 98,432 individuals were included in the final meta-analysis. The overall prevalence was 15.8% (95% CI 12.1-19.9) for CKD stages 1-5 and 4.6% (3.3-6.1) for CKD stages 3-5 in the general population. Equivalent figures were greater at 32.3% (23.4-41.8) and 13.3% (10.7-16.0) in high-risk populations (people with hypertension, diabetes, HIV). CKD prevalence was higher in studies based on the Cockcroft-Gault formula than MDRD or CKD-EPI equations; and in studies from sub-Saharan Africa compared with those from North Africa (17.7, 95% CI 13.7-22.1 vs 6.1, 95% CI 3.6-9.3, p < 0.001). There was substantial heterogeneity across studies (all I2 > 90%) and no evidence of publication bias in main analyses. Conclusion: CKD is highly prevalent across Africa, inviting efforts into prevention, early detection and control of CKD in adults living on the African continent which is particularly important in a resource limited environment. Trial Registration: Prospero Registration ID: CRD42017054445.

Original languageEnglish (US)
Article number125
JournalBMC Nephrology
Volume19
Issue number1
DOIs
StatePublished - Jun 1 2018

Fingerprint

Chronic Renal Insufficiency
Meta-Analysis
Population
Northern Africa
Publication Bias
Africa South of the Sahara
Turkey
Glomerular Filtration Rate
HIV
Databases
Hypertension

Keywords

  • Africa
  • Chronic kidney disease
  • Meta-analysis
  • Prevalence
  • Systematic review

ASJC Scopus subject areas

  • Nephrology

Cite this

Burden of chronic kidney disease on the African continent : A systematic review and meta-analysis. / Kaze, Arnaud D.; Ilori, Titilayo; Jaar, Bernard; Echouffo Tcheugui, Justin.

In: BMC Nephrology, Vol. 19, No. 1, 125, 01.06.2018.

Research output: Contribution to journalReview article

@article{0afc9d3b48364b7592de32612befef0b,
title = "Burden of chronic kidney disease on the African continent: A systematic review and meta-analysis",
abstract = "Background: Accurate contemporary data on the burden of Chronic Kidney Disease (CKD) on the African continent are lacking. We determined the prevalence of CKD in adult populations living in Africa, and variations by stage, gender, estimated Glomerular Filtration Rate (eGFR) equation, and residence. Methods: For this systematic review, we searched multiple electronic databases for original studies on CKD prevalence reported from January 1, 2000 to December 31, 2016. Two reviewers independently undertook quality assessment and data extraction. We stabilized the variance of study-specific estimates with the Freeman-Turkey single arcsine transformation and pooled the data using a random effects meta-analysis models. Results: A total of 98 studies involving 98,432 individuals were included in the final meta-analysis. The overall prevalence was 15.8{\%} (95{\%} CI 12.1-19.9) for CKD stages 1-5 and 4.6{\%} (3.3-6.1) for CKD stages 3-5 in the general population. Equivalent figures were greater at 32.3{\%} (23.4-41.8) and 13.3{\%} (10.7-16.0) in high-risk populations (people with hypertension, diabetes, HIV). CKD prevalence was higher in studies based on the Cockcroft-Gault formula than MDRD or CKD-EPI equations; and in studies from sub-Saharan Africa compared with those from North Africa (17.7, 95{\%} CI 13.7-22.1 vs 6.1, 95{\%} CI 3.6-9.3, p < 0.001). There was substantial heterogeneity across studies (all I2 > 90{\%}) and no evidence of publication bias in main analyses. Conclusion: CKD is highly prevalent across Africa, inviting efforts into prevention, early detection and control of CKD in adults living on the African continent which is particularly important in a resource limited environment. Trial Registration: Prospero Registration ID: CRD42017054445.",
keywords = "Africa, Chronic kidney disease, Meta-analysis, Prevalence, Systematic review",
author = "Kaze, {Arnaud D.} and Titilayo Ilori and Bernard Jaar and {Echouffo Tcheugui}, Justin",
year = "2018",
month = "6",
day = "1",
doi = "10.1186/s12882-018-0930-5",
language = "English (US)",
volume = "19",
journal = "BMC Nephrology",
issn = "1471-2369",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Burden of chronic kidney disease on the African continent

T2 - A systematic review and meta-analysis

AU - Kaze, Arnaud D.

AU - Ilori, Titilayo

AU - Jaar, Bernard

AU - Echouffo Tcheugui, Justin

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Background: Accurate contemporary data on the burden of Chronic Kidney Disease (CKD) on the African continent are lacking. We determined the prevalence of CKD in adult populations living in Africa, and variations by stage, gender, estimated Glomerular Filtration Rate (eGFR) equation, and residence. Methods: For this systematic review, we searched multiple electronic databases for original studies on CKD prevalence reported from January 1, 2000 to December 31, 2016. Two reviewers independently undertook quality assessment and data extraction. We stabilized the variance of study-specific estimates with the Freeman-Turkey single arcsine transformation and pooled the data using a random effects meta-analysis models. Results: A total of 98 studies involving 98,432 individuals were included in the final meta-analysis. The overall prevalence was 15.8% (95% CI 12.1-19.9) for CKD stages 1-5 and 4.6% (3.3-6.1) for CKD stages 3-5 in the general population. Equivalent figures were greater at 32.3% (23.4-41.8) and 13.3% (10.7-16.0) in high-risk populations (people with hypertension, diabetes, HIV). CKD prevalence was higher in studies based on the Cockcroft-Gault formula than MDRD or CKD-EPI equations; and in studies from sub-Saharan Africa compared with those from North Africa (17.7, 95% CI 13.7-22.1 vs 6.1, 95% CI 3.6-9.3, p < 0.001). There was substantial heterogeneity across studies (all I2 > 90%) and no evidence of publication bias in main analyses. Conclusion: CKD is highly prevalent across Africa, inviting efforts into prevention, early detection and control of CKD in adults living on the African continent which is particularly important in a resource limited environment. Trial Registration: Prospero Registration ID: CRD42017054445.

AB - Background: Accurate contemporary data on the burden of Chronic Kidney Disease (CKD) on the African continent are lacking. We determined the prevalence of CKD in adult populations living in Africa, and variations by stage, gender, estimated Glomerular Filtration Rate (eGFR) equation, and residence. Methods: For this systematic review, we searched multiple electronic databases for original studies on CKD prevalence reported from January 1, 2000 to December 31, 2016. Two reviewers independently undertook quality assessment and data extraction. We stabilized the variance of study-specific estimates with the Freeman-Turkey single arcsine transformation and pooled the data using a random effects meta-analysis models. Results: A total of 98 studies involving 98,432 individuals were included in the final meta-analysis. The overall prevalence was 15.8% (95% CI 12.1-19.9) for CKD stages 1-5 and 4.6% (3.3-6.1) for CKD stages 3-5 in the general population. Equivalent figures were greater at 32.3% (23.4-41.8) and 13.3% (10.7-16.0) in high-risk populations (people with hypertension, diabetes, HIV). CKD prevalence was higher in studies based on the Cockcroft-Gault formula than MDRD or CKD-EPI equations; and in studies from sub-Saharan Africa compared with those from North Africa (17.7, 95% CI 13.7-22.1 vs 6.1, 95% CI 3.6-9.3, p < 0.001). There was substantial heterogeneity across studies (all I2 > 90%) and no evidence of publication bias in main analyses. Conclusion: CKD is highly prevalent across Africa, inviting efforts into prevention, early detection and control of CKD in adults living on the African continent which is particularly important in a resource limited environment. Trial Registration: Prospero Registration ID: CRD42017054445.

KW - Africa

KW - Chronic kidney disease

KW - Meta-analysis

KW - Prevalence

KW - Systematic review

UR - http://www.scopus.com/inward/record.url?scp=85047953428&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85047953428&partnerID=8YFLogxK

U2 - 10.1186/s12882-018-0930-5

DO - 10.1186/s12882-018-0930-5

M3 - Review article

VL - 19

JO - BMC Nephrology

JF - BMC Nephrology

SN - 1471-2369

IS - 1

M1 - 125

ER -