Markers and risk factors for chronic kidney disease in sub-Saharan Africans: baseline levels and 12-month trajectories in newly referred patients in Cameroon

BMC Nephrology

Choukem Siméon Pierre¹  Halle Marie Patrice²  Doualla Marie Solange³  Ashuntantang Enow Gloria⁴  Kaze Folefack François⁵  Djantio Hilaire⁶  Kengne Andre Pascal⁷ 

[1] Department of Internal Medicine Douala General Hospital Cameroon, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang;Department of internal medicine Douala General Hospital Cameroon Faculty of medicine and pharmaceutical science, University of Douala;Department of internal medicine Douala General Hospital Cameroon, Faculty of medicine and pharmaceutical science, University of Douala;Department of internal medicine Yaounde general hospital Cameroon, Faculty of medicine and biomedical sciences, University of Yaoundé I;Faculty of medicine and biomedical sciences, University of Yaoundé I;Higher Institute of Health Sciences, Université des Montagnes;Non-Communicable Diseases Research Unit, South African Medical Research Council;

关键词: Risk factor;    Chronic kidney disease;    Trajectory;    Cameroon;   

DOI  :  10.1186/s12882-020-01760-6

来源: DOAJ

【 摘 要 】

Abstract Background Little is known about the changes in disease makers and risk factors in patients with chronic kidney disease (CKD) under nephrological care in Africa. This study aimed to evaluate the baseline level of markers of CKD and their 12-month time-trend in newly referred patients in a tertiary hospital in Cameroon. Methods This was a retrospective cohort study including 420 patients referred for CKD between 2006 and 2012 to the nephrology unit of the Douala General Hospital in the littoral region of Cameroon. Their disease and risk profile was assessed at baseline and every 3 months for 1 year. Estimated glomerular filtration rate (eGFR) was based on MDRD and Schwartz equations. CKD was diagnosed in the presence of eGFR< 60 ml/min/1.73 m2 and/or proteinuria> 1+ and/or abnormal renal ultrasound persisting for ≥3 months. Data analysis used mixed linear regressions. Results Of the 420 patients included, 66.9% were men and mean age was 53.8 (15.1) years. At referral, 37.5% of the participants were at CKD Stage 3, 30.8% at stage 4 and 26.8% at stage 5. There was 168 (40%) diabetic and 319 (75.9%) hypertensive patients. After some improvement during the first 3 months, eGFR steadily decreased during the first year of follow-up, and this pattern was robust to adjustment for many confounders. Systolic and diastolic blood pressure levels significantly fluctuated during the first twelve months of follow-up. Changes in the levels of other risk factors and markers of disease severity over time were either borderline or non-significant. Conclusion Patients with CKD in African settings are referred to the nephrologist at advanced stages. This likely translates into a less beneficial effects of specialised care on the course of the disease.

【 授权许可】

Unknown