Chronic kidney diseases in mixed ancestry South African populations : prevalence, determinants and concordance between kidney function estimators
Date
2013-04
Authors
Matsha, Tandi E.
Yako, Yandiswa Y.
Van Rensburg, Megan
Hassan, Mogamat S.
Kengne, Andre P.
Erasmus, Rajiv T.
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background: Population-based data on the burden of chronic kidney disease (CKD) in sub-Saharan Africa
is still very limited. We assessed the prevalence and determinants of CKD, and evaluated the
concordance of commonly advocated estimators of glomerular filtration rate (eGFR) in a
mixed ancestry population from South Africa. Methods: Participants were a population-based sample of adults selected from the Bellville-South community in the metropolitan city of Cape Town. eGFR was based on the Cockroft-Gault (CG), Modification of Diet in Kidney Disease (MDRD) and CKD Epidemiology
Collaboration (CKD-EPI) equations (with and without adjustment for ethnicity). Kidney function staging used the Kidney Disease Outcome Quality Initiative (KDOQI) classification. Logistic regressions and kappa statistic were used to investigate determinants of CKD and assess the agreement between different estimators.
Results: The crude prevalence of CKD stage 3–5 was 14.8% for Cockcroft-Gault, 7.6% and 23.9%
respectively for the MDRD with and without ethnicity correction, and 7.4% and 17.3% for the CKD-EPI equations with and without ethnicity correction. The highest agreement between GFR estimators was between MDRD and CKD-EPI equations, both with ethnicity correction, Kappa 0.91 (95% CI: 0.86-0.95), correlation coefficient 0.95 (95% CI: 0.94-0.96). In multivariable logistic regression models, sex, age and known hypertension were consistently associated with CKD stage 3–5 across the 5 estimators
Conclusions: The prevalence of CKD stages greater than 3 is the highest reported in Africa. This study
provides evidence for support of the CKD-EPI equation for eGFR reporting and CKD
classification.
Description
Publication of this article was funded by the Stellenbosch University Open Access Fund.
The original publication is available at http://www.biomedcentral.com/bmcnephrol
The original publication is available at http://www.biomedcentral.com/bmcnephrol
Keywords
CKD-EPI eGFR, Cockroft-Gault eGFR, MDRD eGFR, Kidneys -- Diseases -- Africa, Sub-Saharan, Kidneys -- Diseases -- South Africa, Kidney -- Diseases -- Prevention
Citation
Matsha, T. E. et al. 2013. Chronic kidney diseases in mixed ancestry south African populations: prevalence, determinants and concordance between kidney function estimators. BMC Nephrology, 14:75, doi:10.1186/1471-2369-14-75.