The Burden of Diabetic Kidney Disease in Nigeria - A Systematic Review and Meta-Analysis

Abstract

Background: Diabetic Kidney Disease (DKD) is a micro vascular complication of diabetes mellitus. Considering that the burden of diabetes mellitus is rising in Nigeria, there is a need to ascertain the burden of one of its most common complications. The objective of the meta-analysis was to determine the pooled prevalence of DKD in Nigeria and identify its risk factors. Methods: The study is a meta-analysis and it followed the PRISMA guidelines. Google scholar, PubMed, AJOL, SCOPUS, medRxiv and the grey literature were systematically searched using appropriate key terms. Statistical analysis was done with MetaXL. The inverse variance heterogeneity model was used for the metaanalysis and heterogeneity was determined using the I2 statistic and the Cochran’s Q test. Publication bias was checked with the Doi plot and LFK index. Results: Nineteen studies met the eligibility criteria. The total sample size was 56 571. The pooled prevalence of diabetic kidney disease in Nigeria was 28% (95% CI 3-58). The Cochran’s Q was 747 (p<0.001) while the I2 statistic was 97.6%. The Doi plot was drawn and the LFK index was 6.22. The most common risk factors for DKD were suboptimal glycaemic control, hypertension and obesity, duration of diabetes, male gender and advancing age. Conclusion: The prevalence of DKD in Nigeria is high and greater attention should be focused on managing the risk factors so as to alleviate the burden of the disease.