RISK FACTORS OF CHRONIC KIDNEY DISEASE AMONG PATIENTS ATTENDING OLABISI ONABANJO UNIVERSITY TEACHING HOSPITAL SAGAMU, OGUN STATE

Abstract

Chronic kidney disease is a slow progressive loss of kidney function over a period of several years. Chronic kidney failure is much more common than what people realize and often go undetected and undiagnosed until the disease is well advanced and kidney failure is imminent. Global statistics show the incidence of CKD is increasing by 6 -7 % every year. It is estimated that about 36 million Nigerians are suffering from one stage of CKD as one in seven Nigerians have kidney disease. Studies had shown that CKD is common among people over 60 years old, but presently CKD is now seen among the middle age and even frequent among young adult. Lack of awareness on CKD is a major challenge noting that when people have adequate knowledge on the disease and the risk factors of the disease they will know how to prevent the disease. Despite the identified risk factors, there is still an increase in the incidence and prevalence of CKD, therefore a review of the risk factor of CKD has become necessary. Hence this study aimed at determining the risk factors of CKD among patients attending Olabisi Onabanjo University Teaching Hospital. Methods The research was a case control study, 150 cases and 300 controls were selected using systematic sampling technique. Selection of cases and controls was by a retrospective review of records of in-patients at the clinics/admissions from January 2008 to December 2012 in OOUTH, Sagamu. A semi-structured pro-forma was used to extract information on sociodemographic variables and risk factors associated with chronic kidney diseases. Data was analyzed using descriptive statistics, Chi-square and multivariate logistic regression at 5% level of significance. The mean age of the cases was 40.6±14.4 years and the controls were 38.6±15.8. The highest numbers of cases (24.7%) were between ages 20 - 29 years. Three hundred and two (67.l %) of the subjects were males, 207(46%) had secondary education, 218(48.4%) of the subjects were unskilled workers and 286(63.6%) of the subjects were married. One hundred and twenty one (80.7%) of the cases and 224(74.7%) of the controls had education lower than tertiary, the odds of having education lower than tertiary was 42% higher among the cases of CKD compared with the controls (OR-1.42, CI-0.88-2.30). One hundred and thirty (86. 7%) of the cases and 106 (3 5 .3 % ) of the controls ingest herbal concoction, respectively, CKD patients were 12 times more likely to ingest herbal concoction compared with the controls (OR-11.90, CI-7.02-20.15). The number of cases 90(60%) with high blood pressure was significantly more than the number of controls 106(23.6%), (x2=165.961; p-value <0.001). The odds of presence of high blood pressure were higher among the cases of CKD compared with the controls (OR-26.63, CI- 14.61 -48.53). Ten (6.7%) of the cases were HIV positive compared with 2(0.7%) of the controls, the odds of positive HIV status were higher among the cases of CKD compared with the controls (OR- 10.64, CI-2.30-49.22). Ninety eight (64.0%) had history of chronic use of analgesic compared with 10(3.3%) of the controls. Chronic kidney disease patients were 52 times more likely to have exposure to chronic use of analgesics compared with the controls (OR-51.56, CI-25.27-105.19). Result of logistic regression revealed that the predictors of chronic kidney disease were being married (AOR-0.49, CI-0.25-0.98), alcohol consumption (AOR-0.39, CI- 0.18-0.83), ingestion of herbal concoction (AOR-10.68, CI-4.88-23.34), elevated systolic (AOR-3.73, CI-1.72-8.08) and diastolic blood pressure (AOR-2.63, CI-1.29-5.35) at presentation, and history of high blood pressure (AOR-6.55, CI-3.07-13.97) and addition of salt to cooked food prior consumption (AOR-4.22, CI-2.07-8.61). This study revealed that CKD is still a problem of Public Health importance with high fatality and mostly found among married adult in their productive age. Most CKD patients have elevated blood pressure, they consume alcohol and ingest herbal concoction. In order to curtail the menace of CKD, this study had provided information that there should be increase awareness and campaign on the causes and risk factors of CKD, hypertensive patients should adhere to their anti-hypertensive and individual should disengage from ingestion of herbal concoction and reduce alcohol consumption.