By Juan Duran
In the Lancet, a systemic review and meta-analysis on current state of chronic kidney disease in Sub-Saharan Africa was published as a call to action for national health policies for the early detection and treatment of end-stage kidney disease. Chronic Kidney Disease (CKD) is currently ranked 18th amongst the leading global causes of death up from 27th in 1990. This rise has been accompanied by an 82% increase in the number of deaths from CKD. This sharp increase is only overshadowed by the rise in mortality of HIV/AIDs (396%) and diabetes (93%) in that time period, making it the third largest increase in mortality amongst the top 25 causes of death.
This systemic review set out to determine the current prevalence rates of CKD in Sub-Saharan Africa, but because of the lack of data, was only able to gather information from 13 out of the 47 countries in the region. From the 90 quality studies out of the 905 that were identified, researchers John Stranifer and colleagues were able to estimate an overall CKD prevalence of 13.9% for the region. The countries included were Cameroon 6.1%, DR Congo 19.8%, Ghana 17%, Cote d’Ivore 2%, Kenya 4%, Mozambique 3%, Nigeria 17.6%, Rwanda 10%, South Africa 14.3%, Sudan 8%, Zambia 13%, and Zimbabwe 30%. To put this into context, the U.S. has a CKD stage 1-4 prevalence of 11.6% (about 26 million people).
Most importantly, what this study illustrated was the immense lack of data on CKD in the region. Yet, despite the lack of information, these results were informative enough to allow researchers to conclude that the CKD burden in Sub-Saharan countries is a legitimate cause for concern. The estimated prevalence is particularly troublesome when held against the backdrop of increasing contributing factors to CKD such as diabetes and high blood pressure in resource-poor countries. The researchers call for better mechanisms to capture data about CKD and better medical services so that physicians are trained to better identify and care for this disorder before it becomes severe. As Noberto Perico of the Instituto di Ricerche Farmacologiche Mario Negri stated, “besides saving young lives, such action would create major health gains and minimize the present health inequity that arises mainly from the unaffordable cost of renal replacement therapy if end-stage kidney disease is not prevented.”
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