The Ghana Renal Registry – a first annual report
Abstract
There are few data on the treatment of kidney disease in sub-Saharan Africa and no formal reports of kidney replacement therapy (KRT) in Ghana. We report data from the newly established Ghana Renal Registry on the prevalence, causes, and modality of treatment of kidney disease in Ghana. Using the web-based data capture system of the African Renal Registry, data were obtained for patients who had KRT in Ghana between January and December 2017. A total of 201 patients started KRT, giving an incidence rate of 6.9 per million population (pmp). There were 687 patients on KRT, a prevalence rate of 23.6 pmp. The median age of prevalent patients was 45.5 years and 63.6% were male. Hypertensive kidney disease was the most common primary kidney disease, reported in 39.9%. The overwhelming majority of patients (96.2%) were treated with haemodialysis, 3.5% had a kidney transplant, and only two were on continuous ambulatory peritoneal dialysis. The incidence and prevalence of KRTtreated kidney failure in Ghana is low, and the patients are younger than those on KRT in high- and upper-middleincome countries. The major cause of kidney failure is hypertensive kidney disease and the vast majority of the patients are treated with haemodialysis.
References
Stanifer JW, Jing B, Tolan S, Helmke N, Mukerjee R, Naicker S, Patel U: The epidemiology of chronic kidney disease in sub-Saharan Africa: a systematic review and meta-analysis. The Lancet Global health 2014, 2(3):e174-181.
Kaze AD, Ilori T, Jaar BG, Echouffo-Tcheugui JB: Burden of chronic kidney disease on the African continent: a systematic review and meta-analysis. BMC Nephrol 2018, 19(1):125.
Adjei DN, Stronks K, Adu D, Beune E, Meeks K, Smeeth L, Addo J, Owuso-Dabo E, Klipstein-Grobusch K, Mockenhaupt FP et al: Chronic kidney disease burden among African migrants in three European countries and in urban and rural Ghana: the RODAM cross-sectional study. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2018.
Anand S, Bitton A, Gaziano T: The gap between estimated incidence of end-stage renal disease and use of therapy. PloS one 2013, 8(8):e72860.
Ashuntantang G, Osafo C, Olowu WA, Arogundade F, Niang A, Porter J, Naicker S, Luyckx VA: Outcomes in adults and children with end-stage kidney disease requiring dialysis in sub-Saharan Africa: a systematic review. The Lancet Global Health 2017, 5(4):e408-e417.
Ulasi, II, Ijoma CK: The enormity of chronic kidney disease in Nigeria: the situation in a teaching hospital in South-East Nigeria. Journal of tropical medicine 2010, 2010:501957.
Arogundade FA, Sanusi AA, Hassan MO, Akinsola A: The pattern, clinical characteristics and outcome of ESRD in Ile-Ife, Nigeria: is there a change in trend? Afr Health Sci 2011, 11(4):594-601.
Davids MR, Jardine T, Marais N, Jacobs C: South African Renal Registry 2016. African Journal of Nephrology 2018, 21(1):61-72.
Ekrikpo UE, Kengne AP, Bello AK, Effa EE, Noubiap JJ, Salako BL, Rayner BL, Remuzzi G, Okpechi IG: Chronic kidney disease in the global adult HIV-infected population: A systematic review and meta-analysis. PloS one 2018, 13(4):e0195443.
MR Davids, M Benghanem Gharbi. Global considerations in kidney disease: Africa. In Brenner & Rector's The Kidney, 11th edition. Philadelphia, PA: Elsevier; 2019. pp 2493-2516.
Davids MR, Jardine T, Marais N, Jacobs JC, Sebastian S. South African Renal Registry Annual Report 2018. African Journal of Nephrology, 2020; 23(1):185-196.
Davids MR, Eastwood JB, Selwood NH, Arogundade FA, Ashuntantang G, Benghanem Gharbi M, Jarraya F, MacPhee IA, McCulloch M, Plange-Rhule J et al: A renal registry for Africa: first steps. Clin Kidney J 2016, 9(1):162-167.
Venkat-Raman G, Tomson CR, Gao Y, Cornet R, Stengel B, Gronhagen-Riska C, Reid C, Jacquelinet C, Schaeffner E, Boeschoten E et al: New primary renal diagnosis codes for the ERA-EDTA. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2012, 27(12):4414-4419.
World Population Prospects 2017 [https://population.un.org/wpp/Download/Standard/Population/]
Kramer A, Pippias M, Noordzij M, Stel VS, Afentakis N, Ambuhl PM, Andrusev AM, Fuster EA, Arribas Monzon FE, Asberg A et al: The European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report 2015: a summary. Clin Kidney J 2018, 11(1):108-122.
Hole B, Gilg J, Casula A, Methven S, Castledine C: Chapter 1 UK Renal Replacement Therapy Adult Incidence in 2016: National and Centre-specific Analyses. Nephron 2018:13-46.
Addo J, Agyemang C, Smeeth L, de-Graft Aikins A, Edusei AK, Ogedegbe O: A review of population-based studies on hypertension in Ghana. Ghana Med J 2012, 46(2 Suppl):4-11.
Osafo C, Mate-Kole M, Affram K, Adu D: Prevalence of chronic kidney disease in hypertensive patients in Ghana. Renal failure 2011, 33(4):388-392.
El Minshawy O: End-stage renal disease in the El-Minia Governorate, upper Egypt: an epidemiological study. Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 2011, 22(5):1048-1054.
Banaga AS, Mohammed EB, Siddig RM, Salama DE, Elbashir SB, Khojali MO, Babiker RA, Elmusharaf K, Homeida MM: Causes of end stage renal failure among haemodialysis patients in Khartoum State/Sudan. BMC Res Notes 2015, 8:502.
Matekole M, Affram K, Lee SJ, Howie AJ, Michael J, Adu D: Hypertension and end-stage renal failure in tropical Africa. J Hum Hypertens 1993, 7(5):443-446.
Tzur S RS, Shemer R, Yudkovsky G, Selig S, Tarekegn A, Bekele E, Bradman N, Wasser WG, Behar DM et al: Missense mutations in the APOL1 gene are highly associated with end stage kidney disease risk previously attributed to the MYH9 gene. Hum Genet 2010, 128(3):345-350.
Genovese G, Friedman DJ, Ross MD, Lecordier L, Uzureau P, Freedman BI, Bowden DW, Langefeld CD, Oleksyk TK, Knob AU et al: Association of Trypanolytic ApoL1 Variants with Kidney Disease in African-Americans. Science 2010, 329:841-845.
Ulasi, II, Tzur S, Wasser WG, Shemer R, Kruzel E, Feigin E, Ijoma CK, Onodugo OD, Okoye JU, Arodiwe EB et al: High Population Frequencies of APOL1 Risk Variants Are Associated with Increased Prevalence of Non-Diabetic Chronic Kidney Disease in the Igbo People from South-Eastern Nigeria. Nephron Clinical practice 2013, 123(1-2):123-128.
Kasembeli AN, Duarte R, Ramsay M, Mosiane P, Dickens C, Dix-Peek T, Limou S, Sezgin E, Nelson GW, Fogo AB et al: APOL1 Risk Variants Are Strongly Associated with HIV-Associated Nephropathy in Black South Africans. Journal of the American Society of Nephrology : JASN 2015, 26(11):2882-2890.
Freedman BI, Limou S, Ma L, Kopp JB: APOL1-Associated Nephropathy: A Key Contributor to Racial Disparities in CKD. American journal of kidney diseases : the official journal of the National Kidney Foundation 2018, 72(5 Suppl 1):S8-s16.
Dodu SR: Diabetes in the tropics. Br Med J 1967, 2(5554):747-750.
Asamoah-Boaheng M, Sarfo-Kantanka O, Tuffour AB, Eghan B, Mbanya JC: Prevalence and risk factors for diabetes mellitus among adults in Ghana: a systematic review and meta-analysis. International health 2019, 11(2):83-92.
Atun R, Davies JI, Gale EAM, Barnighausen T, Beran D, Kengne AP, Levitt NS, Mangugu FW, Nyirenda MJ, Ogle GD et al: Diabetes in sub-Saharan Africa: from clinical care to health policy. Lancet Diabetes Endocrinol 2017, 5(8):622-667.
National and Sub-National HIV and AIDS Estimates and Projections [http://www.ghanaids.gov.gh/gac1/pubs/2017-2022_national_and_sub%20national_Estimates_Report.pdf]
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