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Review
. 2021 Oct 11:2021:7243523.
doi: 10.1155/2021/7243523. eCollection 2021.

Prevalence of Chronic Kidney Disease as a Marker of Hypertension Target Organ Damage in Africa: A Systematic Review and Meta-Analysis

Samuel O Ajayi  1   2 , Udeme E Ekrikpo  3 , Anyiekere M Ekanem  4 , Yemi R Raji  1 , Okechukwu S Ogah  1 , Dike B Ojji  5 , Ugochi S Okpechi-Samuel  6 , Kwazi C Z Ndlovu  2   7 , Aminu K Bello  8 , Ikechi G Okpechi  2   7   8
Affiliations
Review

Prevalence of Chronic Kidney Disease as a Marker of Hypertension Target Organ Damage in Africa: A Systematic Review and Meta-Analysis

Samuel O Ajayi et al. Int J Hypertens. .

Abstract

Introduction: Hypertension is a major global cause of cardiovascular disease and death with rising worldwide prevalence, particularly in low-income countries. With low awareness, poor treatment, and low control of hypertension in Africans, there is an increased number of patients with target organ damage (TOD), especially chronic kidney disease (CKD), as a consequence of hypertension. The aim of our study is to assess the prevalence of CKD from studies in Africa reporting TOD related to hypertension.

Methods: We performed a search of PubMed/MEDLINE, Web of Science, EBSCOhost, and African Journals Online (AJOL) for studies reporting on CKD as TOD in patients with hypertension. The pooled estimate of CKD was then presented by subregions, age group, eGFR equations, and urban or rural location.

Results: We identified 1,334 articles from which 12 studies were included for quantitative analysis. The studies included 5297 participants from 6 countries (Ghana, Nigeria, Uganda, Tanzania, Democratic Republic of Congo, and South Africa). The pooled prevalence of CKD was 17.8% (95% CI 13.0-23.3%), and CKD was significantly more prevalent in West Africa (21.3% (95% CI: 16.1-27.0); p < 0.0001) and in studies conducted in urban settings (p < 0.001). CKD prevalence was not significantly different by type of GFR equation or age.

Conclusion: This study reports a high prevalence of CKD related to hypertension with a higher prevalence in urban than rural areas. This emphasizes the role of hypertension in causing kidney damage, and the need for strategies to improve awareness, treatment, and control of hypertension in Africans. This study is registered with PROSPERO registration number CRD42018089263.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram for study selection.
Figure 2
Figure 2
Forest plot and meta-analysis of estimates of CKD prevalence according to eGFR equations. MDRD, modification of diet in renal disease; CG, Cockcroft–Gault; CKDEPI, Chronic Kidney Disease Epidemiology Collaboration.
Figure 3
Figure 3
Forest plot showing the prevalence of CKD in urban, rural, and mixed populations. ES, effect size; CI, confidence interval.
Figure 4
Figure 4
Forest plot and meta-analysis of prevalence of CKD in subregions of Africa. ES, effect size; CI, confidence interval.
See this image and copyright information in PMC

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