Prevalence of chronic kidney disease in a Nigerian family practice population
Prevalence of chronic kidney disease in a Nigerian family practice population
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DOI：
10.1080/20786204.2009.10873828
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发表时间：
2009-01-01
影响因子：
1
通讯作者：
Bello
中科院分区：
文献类型：
--
作者：
Afolabi, M. O.;Abioye-Kuteyi, E. A.;Bello
背景资料：慢性肾脏病（CKD）是一个全球性的公共卫生问题，特别是在发展中国家，其负担更大，护理费用高昂。本研究确定了慢性肾脏病的患病率，并确定其相关的危险因素，在参加家庭诊所，韦斯利公会医院，Ilesa，尼日利亚。方法：招募并研究了2005年8月至2006年1月参加家庭诊所韦斯利公会医院，Ilesa的新登记的患者。通过使用访谈者管理的问卷，并通过使用Microalbustix（TM）试剂条和使用其血清肌酐浓度确定受试者的现场尿ACR（白蛋白-肌酐比）来收集相关数据。使用肾脏疾病饮食改良（MDRD）公式估计每例受试者的肾小球滤过率（GFR）。在初次筛查后3个月进行重复尿检，以确定持续性微量白蛋白尿的受试者。结果：研究受试者的年龄范围为20至74岁，平均年龄为50.52 ± 13.03岁。样本人口中有68名男性和182名女性，男女比例为1：2.7。250例受试者中有113例（45.2%）在初始筛选时发现有病理性白蛋白尿，而31例（12.4%）在3个月后出现持续性白蛋白尿。此外，51例受试者（20.4%）在初始筛选时估计GFR较低，26例（10.4%）在3个月后GFR持续较低。研究对象中CKD的重要危险因素是年龄增加、血压升高、糖尿病（DM）史、习惯性摄入镇痛药和草药以及腰臀比异常（p < 0.05）。持续异常ACR和低GFR之间的相关性未达到统计学显著性（p = 0.053）。习惯性镇痛剂摄入量（p = 0.002）和年龄组（p = 0.0027）是真正的预测CKD之间的研究subjects.Conclusions：CKD的患病率在研究人群中是高的，它与可修改的危险因素被证明。家庭医生有一个独特的机会，以确定和解决这些因素在他们的病人。在家庭诊所进行CKD常规筛查可降低人群的肾脏疾病负担。
Background: Chronic kidney disease (CKD) is a global public health problem, with a greater burden and prohibitive cost of care particularly in developing countries. This study determined the prevalence of chronic kidney disease and identified its associated risk factors in patients attending the Family Practice Clinic, Wesley Guild Hospital, Ilesa, Nigeria.Method: Consecutive newly-registered patients who attended the Family Practice Clinic of Wesley Guild Hospital, Ilesa from August 2005 to January 2006 were recruited and studied. Relevant data were collected by using an interviewer-administered questionnaire, and determining the spot urinary ACR (albumin-creatinine ratio) of the subjects by using Microalbustix (TM) reagent strips and using their serum creatinine concentration. The glomerular filtration rate (GFR) of each subject was estimated using the Modification of Diet in Renal Disease (MDRD) formula. A repeat urine test was done three months after the initial screening to identify subjects with persistent microalbuminuria.Results: The age of the study subjects ranged from 20 to 74 years, with a mean age of 50.52 + 13.03 years. There were 68 males and 182 females in the sample population, showing a male to female ratio of 1:2.7. One hundred and thirteen of the 250 subjects (45.2%) were found to have pathologic albuminuria at the initial screening, while 31 (12.4%) had persistent albuminuria three months later. Also, 51 subjects (20.4%) had estimated low GFR at the initial screening and 26 (10.4%) had persistent low GFR three months later. Significant risk factors for CKD in the study subjects were increasing age, elevated blood pressure, history of diabetes mellitus (DM), habitual intake of analgesics and herbs, and an abnormal waist to hip ratio (p < 0.05). The association between persistent abnormal ACR and low GFR did not reach statistical significance (p = 0.053). Habitual analgesic intake (p = 0.002) and age group (p = 0.0027) were true predictors of CKD among the study subjects.Conclusions: The prevalence of CKD in the study population was high and its association with modifiable risk factors was demonstrated. Family physicians have a unique opportunity to identify and address these factors in their patients. Routine screening for CKD in family practice clinics is indicated to reduce the burden of renal disease in the population.