The Prevalence of Chronic Kidney Disease (CKD) and its Associated Factors: A Cross-Sectional Study among Civil Servants at the Secretariat Complex in Rivers State, Southern Nigeria

Abstract

Background: Chronic kidney disease (CKD) is a global public health burden that causes significant morbidity and mortality and has been linked to end-stage renal disease (ESRD) with few to no treatment options. Early detection is particularly difficult in developing countriesdue to poor diagnostic protocols, as early symptoms are not unique to the condition. The goal ofthis study was to determine the prevalence of CKD and associated risk factors among civil servants in Rivers State. Methods: The study employed a quantitative cross-sectional design with active screening for chronic kidney disease and associated factors. 300 participants were selected using a multistage sampling procedure, and data were collected using a self-administered questionnaire titled “Prevalence of chronic kidney disease and its associated factors,” as well as measured and recorded clinical and biological variables such as height, weight, blood pressure, fasting blood sugar, serum creatinine, and urine protein levels. The estimated glomerular filtration rate (eGFR) was calculated using the CKD EPI 2021 equations, with chronic kidney disease (CKD) defined as an eGFR of less than 60 mL/min/1.73 m² and/or proteinuria (1+ or higher on a urine dipstick) from a single measurement. Body mass index (BMI) was calculated based on height and weight. Data were analyzed using SPSS version 27. Descriptive statistics were summarized as means ± standard deviation for continuous variables and frequencies with percentages for categorical variables. Bivariate analysis was conducted using chi-square tests and independent samples t-tests. Variables with p ≤ 0.20 at bivariate analysis and those of clinical relevance were entered into a multivariable binary logistic regression model. Adjusted odds ratios (AORs) with 95% confidenceintervals (CIs) were reported. Statistical significance was set at p < 0.05.The prevalence of CKD was 18.2%, with proteinuria at 9.8%, diabetes at 19.3%, high blood pressure at 34.5%, and overweight and obesity at 67.2%. In amultivariable logistic regression analysis, diabetes was independently associated with CKD, with affected participants being almost four times more likely to have CKD compared to those without diabetes (AOR = 3.86;95% CI: 1.87–7.97; p < 0.001)after adjusting for age, sex, BMI, blood pressure, marital status, educational level, and family history of kidney disease. Marital status and educational level also showed significant associations with CKD (AOR=p = 0.012 and p = 0.005, respectively). Blood pressure, BMI, age, sex, and family history of kidney disease were not independently associated with CKD after adjustment for cofounders.Conclusion: According tothe study’s findings, health education about CKD-associated factors and strategies for reducing them would be extremely beneficial to the study population.