ABSTRACT
In Nigeria, there is paucity of data on malnutrition among chronic kidney disease (CKD) patients especially before the initiation of dialysis therapy, necessitating this study. The study subjects consisted of 96 CKD patients recruited from the renal unit of our hospital. Forty age-and sex-matched controls were also studied. Nutritional status was assessed using Subjective Global Assessment (SGA), weight change over six months of follow-up, body mass index, mid-upper arm circumference, triceps skinfold thickness, and serum albumin concentration. A three-day food diary was used to determine the average daily protein intake of the patients. Sixty-six CKD patients completed the study. The age range of CKD patients was 23-65 years with a mean of 47.1 ± 13.2 years while the age range of the controls was 23-65 years with a mean of 44.1 ± 14.3 years. Out of the 66 CKD patients studied, four lost >10% of their body weight. The body mass index (BMI) was low (<20 kg/m2) in eight (12.1%) of CKD patients, while three (7.5%) subjects in the control population had BMI of <20 kg/m2. The serum albumin was less than 3 g/dL in seven (10.6%) of the CKD patients, SGA identified malnutrition in 30 (46%) of the CKD patients. The prevalence of malnutrition in predialysis CKD patients was high in this study.
Subject(s)
Kidney Failure, Chronic/complications , Malnutrition/epidemiology , Nutritional Status , Protein-Energy Malnutrition/etiology , Renal Insufficiency, Chronic/complications , Adult , Aged , Body Mass Index , Female , Humans , Kidney Failure, Chronic/epidemiology , Kidney Failure, Chronic/therapy , Male , Malnutrition/diagnosis , Malnutrition/etiology , Middle Aged , Nigeria/epidemiology , Nutrition Assessment , Prospective Studies , Renal Dialysis/adverse effects , Renal Insufficiency, Chronic/epidemiology , Renal Insufficiency, Chronic/therapy , Serum Albumin , Severity of Illness Index , Young AdultABSTRACT
BACKGROUND: Chronic kidney disease (CKD) is an increasingly prevalent problem worldwide. Treatment of end-stage kidney disease is beyond the reach of an average Nigerian. The prevention and early detection are imperative to reducing its burden. AIM: The aim of this study was to determine the prevalence of CKD and some of its risk factors among adults in a representative semi-urban Nigerian population. SUBJECTS AND METHODS: A cross-sectional study involving 400 randomly selected adults. Participants were assessed using the WHO stepwise approach. Urinary protein-creatinine ratio (PCR) and estimated glomerular filtration rate (GFR) from serum creatinine, among other parameters, were analysed. A PCR ≥200 mg/g was regarded as significant proteinuria while GFR <60 ml/min/1.73 m2 was regarded as reduced GFR. Participants with abnormal PCR and/or reduced GFR were re-evaluated after 3 months to document persistence of these abnormalities. CKD was defined as persistent significant proteinuria and/or reduced GFR for more than 3 months. RESULTS: Data were complete for 328 participants. Persistent significant proteinuria was found in 5.8% while persistently reduced GFR was obtained in 4.6% of participants. Overall, the prevalence of CKD was 7.8%. The prevalence of some established CKD risk factors was old age, 36.3%; hypertension, 36.9%; diabetes mellitus, 7.9%; and family history of kidney disease, 6.4%. The predictors of CKD included old age (adjusted odds ratio = 3.2; confidence interval: 1.10-8.92; P= 0.02), hypertension: 3.5 (1.93-11.90; P= 0.001), family history of kidney disease; 4.5 (3.91-10.23; P= 0.01), generalised obesity 1.3 (1.20-6.21; P= 0.001) and central obesity 3.8 (1.13-12.68; P= 0.003). CONCLUSION: The prevalence of CKD and some of its risk factors were high. Effective control of the modifiable risk factors identified will assist in reducing the burden of CKD.
