Chronic kidney disease among high school students of Kinshasa. BMC Nephrol 2012 May 04;13:24
Date
05/09/2012Pubmed ID
22559052Pubmed Central ID
PMC3464656DOI
10.1186/1471-2369-13-24Scopus ID
2-s2.0-84860533157 (requires institutional sign-in at Scopus site) 10 CitationsAbstract
BACKGROUND: Chronic 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.
METHODS: In 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.
RESULTS: The 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%).
CONCLUSION: In 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.
Author List
Bukabau JB, Makulo JR, Pakasa NM, Cohen EP, Lepira FB, Kayembe PK, Nseka NM, Sumaili EKMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Body Mass Index
Creatinine
Cross-Sectional Studies
Democratic Republic of the Congo
Female
Glomerular Filtration Rate
Humans
Hypertension
Logistic Models
Male
Mathematical Concepts
Multivariate Analysis
Obesity
Prevalence
Proteinuria
Renal Insufficiency, Chronic
Waist Circumference
Young Adult
