Prevalence and determinants of chronic kidney disease in rural and urban Cameroonians: a cross-sectional study

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Abstract
BACKGROUND: Chronic kidney disease (CKD) is a global public health problem that disproportionally affects people of African ethnicity. We assessed the prevalence and determinants of CKD and albuminuria in urban and rural adults Cameroonians. METHODS: This was a cross-sectional study of 6-month duration (February to July 2014), conducted in the health district of Dschang (Western Region of Cameroon), using a multistage cluster sampling. All adults diagnosed with albuminuria ([greater than or equal to]30mg/g) and/or decreased estimated glomerular filtration rate (eGFR) (<60ml/min/1.73m 2 ) were re-examined three months later. Logistic regression models were used to relate baseline characteristics with prevalent CKD. RESULTS: We included 439 participants with a mean age of 47+/-16.1years; with 185 (42.1%) being men and 119 (27.1%) being urban dwellers. There was a high prevalence of hypertension (25.5%), diabetes (9.8%), smoking (9.3%), alcohol consumption (59.7%), longstanding use of herbal medicine (90.9%) and street medications (87.5%), and overweight/obesity (53.3%) which were predominant in rural area. The prevalence of CKD was 13.2% overall, 14.1% in rural and 10.9% in urban participants. Equivalents figures for CKD stages G3-G4 and albuminuria were 2.5%, 1.6% and 5.0%; and 12.1%, 14.1% and 6.7% respectively. Existing hypertension and diabetes were associated with all outcomes. Elevated systolic blood pressure and the presence of hypertension and diabetes were the predictors of albuminuria and CKD while urban residence was associated with CKD stages G3-G4. CONCLUSION: The prevalence of CKD and albuminuria was high in this population, predominantly in rural area, and driven mostly by the commonest risk factors.
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