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. 2023 Mar 21;24(1):62.
doi: 10.1186/s12882-023-03109-1.

The prevalence of chronic kidney disease in South Africa - limitations of studies comparing prevalence with sub-Saharan Africa, Africa, and globally

Sudesh Hariparshad  1 , Rajendra Bhimma  2 , Louansha Nandlal  3 , Edgar Jembere  4 , Saraladevi Naicker  5 , Alain Assounga  6
Affiliations

The prevalence of chronic kidney disease in South Africa - limitations of studies comparing prevalence with sub-Saharan Africa, Africa, and globally

Sudesh Hariparshad et al. BMC Nephrol. .

Abstract

Background: Chronic kidney disease (CKD) is a globally significant non-communicable disorder. CKD prevalence varies between countries and within a country. We compared the prevalence rates of CKD in South Africa with sub-Saharan Africa, Africa, and globally.

Methods: We registered a systematic review with the International Prospective Register of Systematic Reviews for prevalence studies reporting CKD stages III-V from 2013 to 2021. The analysis sought to explain any significant differences in prevalence rates. The R statistical package was used for data analysis. Comparisons included measures of effect size due to the large sample sizes analysed. We also compared sex differences in prevalence rates, common aetiologies, and type of study methodologies employed.

Results: Eight studies were analysed, with two from each region. The matched prevalence rates of CKD between the various regions and South Africa showed significant differences, except for one comparison between South Africa and an African study [p = 0.09 (95% CI - 0.04-0.01)]. Both sub-Saharan African studies had a higher prevalence than South Africa. One study in Africa had a higher prevalence, while the other had a lower prevalence, whilst one Global study had a higher prevalence, and the other had a lower prevalence compared to South Africa. The statistical differences analysed using the Cramer's V test were substantially less than 0.1. Thus, differences in comparisons were largely due to differences in sample sizes rather than actual differences.

Conclusion: Variable prevalence rates between regions included disparities in sample size, definitions of CKD, lack of chronicity testing and heterogeneous laboratory estimations of eGFR. Improved consistency and enhanced methods for diagnosing and comparing CKD prevalence are essential.

Keywords: Africa; Albuminuria; Chronic kidney disease; Cohort; Cross-sectional; Epidemiology; Global; Meta-analysis; Nephropathy; Prevalence; Proteinuria; Renal impairment; Renal insufiency; South Africa; Stage III-V CKD; Sub-saharan Africa; Systematic reviews.

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Conflict of interest statement

The authors have no conflict of interest.

Figures

Fig. 1
Fig. 1
Selection of papers for analysis of the prevalence of CKD from South Africa, sub-Saharan Africa, Africa and Globally
See this image and copyright information in PMC

References

    1. Jager KJ, Kovesdy C, Langham R, Rosenberg M, Jha V, Zoccali C. A single number for advocacy and communication-worldwide more than 850 million individuals have kidney diseases. Oxford University Press; 2019. pp. 1803–5. 10.1093/ndt/gfz174 - PubMed
    1. Bikbov B, Purcell CA, Levey AS, Smith M, Abdoli A, Abebe M, et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the global burden of Disease Study 2017. The Lancet. 2020;395(10225):709–33. doi: 10.1016/S0140-6736(20)30045-3. - DOI - PMC - PubMed
    1. Levin A, Tonelli M, Bonventre J, Coresh J, Donner J-A, Fogo AB, et al. Global kidney health 2017 and beyond: a roadmap for closing gaps in care, research, and policy. The Lancet. 2017;390(10105):1888–917. doi: 10.1016/S0140-6736(17)30788-2. - DOI - PubMed
    1. Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS, et al. Global prevalence of chronic kidney disease–a systematic review and meta-analysis. PLoS ONE. 2016;11(7):e0158765. doi: 10.1371/journal.pone.0158765. - DOI - PMC - PubMed
    1. Black C, van der Veer SN. Unlocking the value of variation in CKD prevalence. Am Soc Nephrol. 2016;1874–7. 10.1681/asn.2015111280 - PMC - PubMed

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