title: A community study of the prevalence, risk factors and pattern of chronic kidney disease in Osun State, South West Nigeria.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is a global public health concern. Nigeria, like other African countries has paucity of hard data derived from community based studies.
  
  
  OBJECTIVE
  We set out to determine the awareness, level of knowledge, prevalence of chronic kidney disease and its associated risk factors in Nigerian community.
  
  
  METHODS
  We used a pre-tested structured questionnaire to draw information on sociodemography, knowledge and risk factors of CKD from 468 residents aged ≥ 18 years. Clinical examination, blood glucose, serum creatinine, urinalysis and urinary albumin: creatinine ratio (ACR) was carried out. Glomerular filtration rate (eGFR) was estimated using Modification for Diet in Renal Disease equation. CKD was defined as eGFR < 60 ml/min and/or macroalbuminuria (ACR ≥ 300 mg/g or dipstick proteinuria).
  
  
  RESULTS
  A total of 454 residents, mainly farmers, with a mean age of 45.8 ± 19.0 years and M: F ratio of 0.8:1 completed the study. Only 33.7% had heard of kidney disease; the level of knowledge of CKD was adjudged good, fair and poor in 25.5%, 42.2% and 30.6% respectively. There was higher prevalence of CKD in those with poor knowledge (p=0.023). Smoking habit, habitual analgesic intake, alcohol and herbal concoction use was 7%, 20%, 19% and 75% respectively. The prevalence of hypertension was 30%, diabetes mellitus (3.7%), obesity by waist circumference (14.6%) and haematuria (3.1%). Estimated GFR < 60 ml/min was present in 12.3% while macroalbuminuria was present in 8.9%. The overall prevalence of CKD was 18.8%, with CKD stages 1, 2, 3 and 4 accounting for 2.4%, 4.1%, 11.8% and 0.5% respectively. Age (p=0.00; OR 1.09), female gender (p=0.006; OR 4.87), systolic blood pressure P<0.001; OR 1.04) and diabetes (p=0033; OR 15.76) were predictive of CKD.
  
  
  CONCLUSIONS
  The prevalence of CKD and its risk factors are high in this rural community of South Western Nigeria. Majority had moderately impaired kidney function. This underscores the need for primary and secondary preventive programmes.
authors.affiliation: Department of Medicine, Obafemi Awolowo University, Ile-Ife, Osun State.
authors.forename: R
authors.initials: R
authors.lastname: Oluyombo
authors.forename: O E
authors.initials: OE
authors.lastname: Ayodele
authors.forename: P O
authors.initials: PO
authors.lastname: Akinwusi
authors.forename: O O
authors.initials: OO
authors.lastname: Okunola
authors.forename: A
authors.initials: A
authors.lastname: Akinsola
authors.forename: F A
authors.initials: FA
authors.lastname: Arogundade
authors.forename: A A
authors.initials: AA
authors.lastname: Sanusi
authors.forename: A
authors.initials: A
authors.lastname: Onayade
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult