Abstract
BackgroundChronic kidney disease (CKD) is a major worldwide health problem. However, its burden among adolescents and young adults is unknown, especially in sub-Saharan Africa. The aim of this study was to investigate its prevalence in the school environment. The concordance of usual formulas used to estimate renal function was also assessed.MethodsIn an epidemiological cross sectional study, a random sample of 524 pupils (263 boys, mean age of 18.7 ± 1.4 years) from school environment of Kinshasa were studied. Recorded parameters of interest were anthropometric, proteinuria, serum creatinine and estimated glomerular filtration rate (eGFR) according to the Schwartz formula using uncalibrated creatinine levels from one random measurement. CKD was defined as the presence of kidney damage (daily proteinuria ≥ 300 mg) and/or reduced kidney function (eGFR < 60 ml/min/1.73 m2). Concordances between eGFR according to Schwartz, Cockcroft-Gault (C-G) indexed for BSA and modification of diet in renal disease (MDRD) study equations were computed using the kappa coefficient.ResultsThe prevalence of CKD by the Schwartz formula was 1.5%. By stage, 0.8% had CKD stage 1 (proteinuria with normal eGFR) and 0.8% had CKD stage 3 (eGFR, 30 to 59 ml/min/1.73 m2). The prevalence of proteinuria ≥ 300 mg/day was 1% (one case had 2.7g/day). Agreement between eGFR according to Schwartz formula and the MDRD formula was excellent (kappa: 88.8%). Although correlations between all formulas were excellent (0.99; 0.87, and 0.89), agreement was poor between eGFR according to Schwartz and C-G indexed BSA equation (kappa: 52.7%) and, poorer with C-G unadjusted for BSA (kappa: 26.9%).ConclusionIn the large African city of Kinshasa, 2% of high school students have CKD. This high prevalence rate emphasizes the need for appropriate detection and prevention measures in this vulnerable young age population group.
Highlights
Chronic kidney disease (CKD) is a major worldwide health problem
Depending on the method used to estimate the estimated glomerular filtration rate (eGFR), 1.5%, 1.7%, 2.9% and 7.6% had CKD according to the Schwartz, modification of diet in renal disease (MDRD), CG indexed body surface area (BSA) and CG formulas, respectively
The difference observed in the prevalence of CKD according to Schwartz versus CG equations may derive from the body weight measurement, a variable that is not included in the Schwartz formula [12]
Summary
Chronic kidney disease (CKD) is a major worldwide health problem. Chronic kidney disease (CKD) is a worldwide public health concern [1]. Epidemiological studies in both western and developing countries have reported an increase of its incidence and prevalence in recent years [1,2]. Detection can be effective in developed countries, but it is problematic in developing one’s like the Democratic Republic of Congo (DRC) where recent reports have shown that majority of patients are only detected at late stages [7]. About 75% CKD patients admitted to the Renal Unit of the University Hospital of Kinshasa are at stages 4 and 5 of kidney disease [8]
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