Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2018 Jun 1;19(1):125.
doi: 10.1186/s12882-018-0930-5.

Burden of chronic kidney disease on the African continent: a systematic review and meta-analysis

Arnaud D Kaze  1   2 , Titilayo Ilori  3 , Bernard G Jaar  4   5   6   7 , Justin B Echouffo-Tcheugui  8
Affiliations
Meta-Analysis

Burden of chronic kidney disease on the African continent: a systematic review and meta-analysis

Arnaud D Kaze et al. BMC Nephrol. .

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.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Competing interests

Dr. Bernard Jaar is a Section Editor of BMC Nephrology.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Selection of articles for inclusion in the systematic review
Fig. 2
Fig. 2
Prevalence of CKD in general populations of adults living on the African continent by region
Fig. 3
Fig. 3
Prevalence of CKD in general populations of adults living in Africa. Black boxes represent the effect estimates (prevalence) and the horizontal bars are for the 95% confidence intervals (CIs). The diamond is for the pooled effect estimate and 95% CI and the dotted vertical line centered on the diamond has been added to assist visual interpretation
Fig. 4
Fig. 4
Prevalence of CKD stages 3 to 5 in general populations of adults living in Africa. Black boxes represent the effect estimates (prevalence) and the horizontal bars are for the 95% confidence intervals (CIs). The diamond is for the pooled effect estimate and 95% CI and the dotted vertical line centered on the diamond has been added to assist visual interpretation
Fig. 5
Fig. 5
Prevalence of CKD in high-risk populations of adults living in Africa. Black boxes represent the effect estimates (prevalence) and the horizontal bars are for the 95% confidence intervals (CIs). The diamond is for the pooled effect estimate and 95% CI and the dotted vertical line centered on the diamond has been added to assist visual interpretation
Fig. 6
Fig. 6
Prevalence of CKD stages 3 to 5 in high-risk populations of adults living in Africa. Black boxes represent the effect estimates (prevalence) and the horizontal bars are for the 95% confidence intervals (CIs). The diamond is for the pooled effect estimate and 95% CI and the dotted vertical line centered on the diamond has been added to assist visual interpretation
See this image and copyright information in PMC

References

    1. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015 A systematic analysis for the global burden of disease study 2015. Lancet (London, England) 2016;388(10053):1603–1658. doi: 10.1016/S0140-6736(16)31460-X. - DOI - PMC - PubMed
    1. World Kidney Day: Chronic Kidney Disease. 2015;http://www.worldkidneyday.org/faqs/chronic-kidney-disease/ (accessed: Jan 24, 2017).
    1. Peralta CA, Risch N, Lin F, Shlipak MG, Reiner A, Ziv E, Tang H, Siscovick D, Bibbins-Domingo K. The Association of African Ancestry and elevated creatinine in the coronary artery risk development in young adults (CARDIA) study. Am J Nephrol. 2010;31(3):202–208. doi: 10.1159/000268955. - DOI - PMC - PubMed
    1. Kiberd BA, Clase CM. Cumulative risk for developing end-stage renal disease in the US population. Journal of the American Society of Nephrology : JASN. 2002;13(6):1635–1644. doi: 10.1097/01.ASN.0000014251.87778.01. - DOI - PubMed
    1. Daar AS, Singer PA, Persad DL, Pramming SK, Matthews DR, Beaglehole R, Bernstein A, Borysiewicz LK, Colagiuri S, Ganguly N, et al. Grand challenges in chronic non-communicable diseases. Nature. 2007;450(7169):494–496. doi: 10.1038/450494a. - DOI - PubMed

MeSH terms