From silent to serious: Community-based evidence on risk of chronic kidney disease progression among asymptomatic adults in rural Nigeria

 

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From silent to serious: Community-based evidence on risk of chronic kidney disease progression among asymptomatic adults in rural Nigeria

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Although people with CKD may be initially asymptomatic, they have varying risks of progression to complications like premature death, kidney failure and cardiovascular disease. The rate at which CKD may progress to these complications vary globally but little is known about the risk of progression to adverse CKD outcomes among persons with CKD in Nigeria. Therefore, we evaluated the risk of CKD progression among asymptomatic adults with CKD in a rural Nigerian community using the KDIGO risk-prediction tool.
Multi-stage cluster sampling was used to select 391 asymptomatic adult residents of Ukpor, Anambra State, Nigeria who were then tested for CKD using UACR and eGFR. Albuminuria and eGFR were used to categorize the risk of CKD progression according to the KDIGO risk criteria. Fisher exact test was used to assess the association between sex and risk categories.

Forty-two (10.7%) participants had CKD (mean age: 60.1±17.9 years; females = 815). The mean eGFR and UACR was 66.1±24.7ml/min and 34.6±20.4mg/g respectively. More than a third (35.7%) were at either high-risk or very-high-risk of CKD progression to complications. There was no association between sex and CKD risk category (p>0.05).

In this rural community, the proportion of adults with CKD at either high-risk or very-high-risk of CKD progression was considerably higher than reports from other countries. This emphasizes the substantial risk of CKD progression, forecasts an increase in the rates of kidney failure and demand for kidney replacement therapy. It also underscores the need for regular screening for early detection of CKD.
Kewords