Associations of Chronic Kidney Disease in a Cohort of Stable First-degree Relatives of Chronic Kidney Disease Patients at a Tertiary Health Facility in South Eastern Nigeria

Abstract

Background: First degree relatives (FDRs) of chronic kidney disease (CKD) patients have a greater prevalence of the risk factors for CKD than the general population and should be screened for kidney disease. There is paucity of data on the occurrence of CKD and its risk factors in the stable FDRs of CKD patients. This study was aimed at determining the associations between the various risk factors for CKD and hitherto undiagnosed CKD among the FDRs of the CKD patients. Methodology: This was an observational prospective study involving 150 FDRs of CKD patients carried out in Nnewi, South-eastern Nigeria. Simple sampling technique was used to select the CKD probands while a stratified sampling technique was used to enroll the FDRs of the CKD subjects. The subjects were screened for CKD using urine albumin creatinine ratio (uACR) and estimated glomerular filtration rate (eGFR). These were repeated after three months for the FDRs with initial abnormal results (uACR ≥ 30mg/g and/or eGFR < 60ml/min/1.73m2) based on the definition of CKD. Also, the risk factors for CKD that included hypertension, diabetes mellitus (DM), obesity, age, gender, cigarette smoking, heavy alcohol consumption, hyperuricaemia, herbal medication use and dyslipidaemia were assessed. Results: Age, gender, hypertension, cigarette smoking, heavy alcohol consumption, dyslipidaemia, hypercholestrolaemia and hyperuricaemia were found to have significant association with the occurrence of CKD in the FDRs of CKD patients (P ˂ 0.001; P < 0.038; P ˂ 0.001; P = 0.008; P ˂ 0.001; P ˂ 0.01 & P ˂ 0.001 respectively). There was no significant association between CKD and DM and herbal medication use (P = 0.782 & P = 0.081 respectively). Logistic regression analysis showed that age (P = 0.009, OR 1.079, 95% C.I = 1.019 – 1.141), hypertension (P = 0.004, OR 10.602, 95% C.I = 2.085 – 53.920), and heavy alcohol consumption (P = 0.003, OR 12.657, 95% C.I = 2.316 – 69.159) were independent predictors for CKD among the FDRs. Conclusion: Age, gender, hypertension, significant cigarette smoking, heavy alcohol consumption, dyslipidaemia, hypercholaestrolaemia and hyperuricaemia were significantly associated with the prevalence of CKD in FDRs of CKD patients while age, hypertension and heavy alcohol consumption were independent predictors of CKD in this group of subjects.