The Pan African Medical Journal (Aug 2019)

Prevalence and factors associated with chronic kidney disease among medical inpatients at the Kenyatta National Hospital, Kenya, 2018: a cross-sectional study

  • Valerian Mwenda,
  • Jane Githuku,
  • Gladwell Gathecha,
  • Benjamin Maranga Wambugu,
  • Zeinab Gura Roka,
  • Willis Owino Ong'or

DOI
https://doi.org/10.11604/pamj.2019.33.321.18114
Journal volume & issue
Vol. 33, no. 321

Abstract

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INTRODUCTION: The burden of chronic kidney disease (CKD) is increasing worldwide. Few studies in low and low-middle income countries have estimated the prevalence of CKD. We aimed to estimate prevalence and factors associated with CKD among medical inpatients at the largest referral hospital in Kenya. METHODS: we conducted a cross-sectional study among medical inpatients at the Kenyatta National Hospital. We used systematic random sampling and collected demographic information, behavioural risk factors, medical history, underlying conditions, laboratory and imaging workup using a structured questionnaire. We estimated glomerular filtration rate (GFR) in ml/min/1.73m2 classified into 5 stages; G1 (? 90), G2 (60-89), G3a (45-59), G3b (30-44), G4 (15-29) and G5 (15, or treated by dialysis/renal transplant). Ethical approval was obtained from Kenyatta National Hospital/University of Nairobi ethics committee (P510/09/2017). We estimated prevalence of CKD and used logistic regression to determine factors independently associated with CKD diagnosis. RESULTS: we interviewed 306 inpatients; median age 40.0 years (IQR 24.0), 162 (52.9%) were male, 155(50.7%) rural residents. CKD prevalence was 118 patients (38.6%, 95% CI 33.3-44.1); median age 42.5 years (IQR 28.0), 74 (62.7%) were male, 64 (54.2%) rural residents. Respondents with CKD were older than those without (difference 4.4 years, 95% CI 3.7-8.4 years, P = 0.032). Fifty two (44.1%) of the patients had stage G2, 17 (14.4%) had end-stage renal disease; 64(54.2%) had haemoglobin ? 8g/dl while 33 (28.0%) had hyponatremia. Male sex (aOR 2.63, 95% CI 1.49-4.63), history of anaemia (aOR 1.80, 95% CI 1.02-3.19), proteinuria (aOR 5.16, 95% CI 2.09-12.74), hematuria (aOR 7.68, 95% CI 2.37-24.86), hypertension (aOR 2.71, 95% CI 1.53-4.80) and herbal medications use (aOR 1.97, 95% CI 1.07-3.64) were independently associated with CKD. CONCLUSION: burden of CKD was high among this inpatient population. Haematuria and proteinuria can aid CKD diagnosis. Public awareness on health hazards of herbal medication use is necessary.

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