Cardiovascular Risk Factor Burden and Association With CKD in Ghana and Nigeria

Timothy O Olanrewaju^{1

2}, Charlotte Osafo³, Yemi R Raji⁴, Manmak Mamven⁵, Samuel Ajayi⁴, Titilayo O Ilori⁶, Fatiu A Arogundade⁷, Ifeoma I Ulasi⁸, Rasheed Gbadegesin⁹, Rulan S Parekh¹⁰, Bamidele Tayo¹¹, Adebowale A Adeyemo¹², Olanrewaju T Adedoyin¹³, Adindu A Chijioke¹, Clement Bewaji¹⁴, Diederick E Grobbee², Peter J Blankestijn¹⁵, Kerstin Klipstein-Grobusch^{2

16}, Babatunde L Salako⁴, Dwomoa Adu³, Akinlolu O Ojo¹⁷; of H3Africa Kidney Disease Research Network Investigators

Affiliations

¹ Division of Nephrology, Department of Medicine, University of Ilorin, Ilorin, Nigeria.
² Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
³ University of Ghana Medical School, College of Health Sciences, University of Ghana, Ghana.
⁴ Department of Medicine, University of Ibadan, Ibadan, Nigeria.
⁵ Department of Medicine, University of Abuja, Abuja, Nigeria.
⁶ Section of Nephrology, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA.
⁷ Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria.
⁸ Department of Medicine, College of Health Sciences, University of Nigeria, Enugu, Nigeria.
⁹ Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA.
¹⁰ Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
¹¹ Department of Public Health Sciences, Loyola University Parkinson School of Health Sciences and Public Health, Maywood, Illinois, USA.
¹² Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA.
¹³ Department of Pediatrics, University of Ilorin, Ilorin, Nigeria.
¹⁴ Department of Biochemistry, University of Ilorin, Ilorin, Nigeria.
¹⁵ Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
¹⁶ Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹⁷ University of Kansas School of Medicine, Kansas City, Kansas, USA.

PMID: 36938080
PMCID: PMC10014339
DOI: 10.1016/j.ekir.2022.11.021

Cardiovascular Risk Factor Burden and Association With CKD in Ghana and Nigeria

Timothy O Olanrewaju et al. Kidney Int Rep. 2022.

. 2022 Dec 6;8(3):658-666.

doi: 10.1016/j.ekir.2022.11.021. eCollection 2023 Mar.

Authors

Affiliations

¹ Division of Nephrology, Department of Medicine, University of Ilorin, Ilorin, Nigeria.
² Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
³ University of Ghana Medical School, College of Health Sciences, University of Ghana, Ghana.
⁴ Department of Medicine, University of Ibadan, Ibadan, Nigeria.
⁵ Department of Medicine, University of Abuja, Abuja, Nigeria.
⁶ Section of Nephrology, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA.
⁷ Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria.
⁸ Department of Medicine, College of Health Sciences, University of Nigeria, Enugu, Nigeria.
⁹ Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA.
¹⁰ Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
¹¹ Department of Public Health Sciences, Loyola University Parkinson School of Health Sciences and Public Health, Maywood, Illinois, USA.
¹² Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA.
¹³ Department of Pediatrics, University of Ilorin, Ilorin, Nigeria.
¹⁴ Department of Biochemistry, University of Ilorin, Ilorin, Nigeria.
¹⁵ Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
¹⁶ Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹⁷ University of Kansas School of Medicine, Kansas City, Kansas, USA.

PMID: 36938080
PMCID: PMC10014339
DOI: 10.1016/j.ekir.2022.11.021

Abstract

Introduction: Cardiovascular disease is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD); however, the burden of cardiovascular risk factors in patients with CKD in Africa is not well characterized. We determined the prevalence of selected cardiovascular risk factors, and association with CKD in the Human Heredity for Health in Africa Kidney Disease Research Network study.

Methods: We recruited patients with and without CKD in Ghana and Nigeria. CKD was defined as estimated glomerular filtration rate of <60 ml/min per 1.73 m² and/or albuminuria as albumin-to-creatinine ratio <3.0 mg/mmol (<30 mg/g) for ≥3 months. We assessed self-reported (physician-diagnosis and/or use of medication) hypertension, diabetes, and elevated cholesterol; and self-reported smoking as cardiovascular risk factors. Association between the risk factors and CKD was determined by multivariate logistic regression.

Results: We enrolled 8396 participants (cases with CKD, 3956), with 56% females. The mean age (45.5 ± 15.1 years) did not differ between patients and control group. The prevalence of hypertension (59%), diabetes (20%), and elevated cholesterol (9.9%), was higher in CKD patients than in the control participants (P < 0.001). Prevalence of risk factors was higher in Ghana than in Nigeria. Hypertension (adjusted odds ratio [aOR] = 1.69 [1.43-2.01, P < 0.001]), elevated cholesterol (aOR = 2.0 [1.39-2.86, P < 0.001]), age >50 years, and body mass index (BMI) <18.5 kg/m² were independently associated with CKD. The association of diabetes and smoking with CKD was modified by other risk factors.

Conclusion: Cardiovascular risk factors are prevalent in middle-aged adult patients with CKD in Ghana and Nigeria, with higher proportions in Ghana than in Nigeria. Hypertension, elevated cholesterol, and underweight were independently associated with CKD.

Keywords: Africa; cardiovascular risk factors; cholesterol; chronic kidney disease; diabetes; hypertension.

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Figures

**Figure 1**
Prevalence of cardiovascular risk factors stratified by age groups (years) among CKD patients, Human Heredity for Health in Africa Kidney Disease Research Network.

**Figure 2**
Prevalence of cardiovascular risk factors stratified by sex among CKD patients, Human Heredity for Health in Africa Kidney Disease Research Network.

See this image and copyright information in PMC

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Cardiovascular Risk Factor Burden and Association With CKD in Ghana and Nigeria

Affiliations

Cardiovascular Risk Factor Burden and Association With CKD in Ghana and Nigeria

Authors

Affiliations

Abstract

Figures

References

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