Burden and distribution of chronic kidney disease in sub-Saharan Africa : a systematic review with meta-analysis

Abstract

BACKGROUND : Chronic kidney disease (CKD) is fast becoming a leading non-communicable disease in sub-Saharan Africa. Efforts directed at mitigating CKD will thrive on precise and accurate estimation of CKD burden, which often varies widely owing to study characteristics like methods of estimating Glomerular Filtration Rate (GFR) and study population. OBJECTIVE : To determine the burden of CKD and distribution of this burden in sub-Saharan Africa based on study characteristics. METHODS : Involved systematic review of articles peer-reviewed literature published in English. Review was conducted consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Data sources for review include MEDLINE, PubMed, CINAHL, Academic Search Complete, African wide information and articles that reported prevalence of chronic kidney disease in sub-Saharan Africa. Bias risk assessment was conducted using mixed-method appraisal tool. Random-effect model of meta-analysis was employed to quantify effects of variation study characteristics on burden of chronic kidney disease in sub-Saharan Africa. RESULTS : Showed statistically significant difference in CKD prevalence by study population (F=2.547, p=.019) and epidemiological significance difference in GFR estimate method with Schwartz approach (35%). Conclusion: CKD remains a public health issue in sub-Saharan Africa and the distribution varies widely according to region, study population and method of estimating GFR.