Muhulo Muhau Mungamba, Felix P Chilunga, Eva L van der Linden, Erik Beune, Engwa A Godwill, Charles F Hayfron-Benjamin, Karlijn Meeks, Samuel N Darko, Sampson Twumasi-Ankrah, Ellis Owusu-Dabo, Liffert Vogt, Bert-Jan H van den Born, Benedicta N Chungag, Charles Agyemang
{"title":"非洲移民和非移民中慢性肾病的发病率、长期预测因素和进展：基于跨大陆人群的前瞻性RODAM队列研究","authors":"Muhulo Muhau Mungamba, Felix P Chilunga, Eva L van der Linden, Erik Beune, Engwa A Godwill, Charles F Hayfron-Benjamin, Karlijn Meeks, Samuel N Darko, Sampson Twumasi-Ankrah, Ellis Owusu-Dabo, Liffert Vogt, Bert-Jan H van den Born, Benedicta N Chungag, Charles Agyemang","doi":"10.1136/bmjgh-2024-016786","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Limited longitudinal data exist on chronic kidney disease (CKD) in African populations undergoing epidemiological transitions. We investigated incidence, long-term predictors and progression of CKD among Ghanaians residing in Ghana and Ghanaian migrants in the Netherlands (Amsterdam).</p><p><strong>Methods and findings: </strong>We analysed data from 2183 participants in the transcontinental population-based prospective Research on Obesity and Diabetes among African Migrants cohort, followed for approximately 7 years. CKD incidence and its progression to end-stage kidney disease (ESKD) were defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. CKD incidence was calculated using age- and sex standardisation for those without CKD at baseline. Long-term predictors of CKD incidence were identified using one-step robust Poisson regression. CKD progression to ESKD from baseline was also assessed using robust Poisson regressions. Overall age- and sex standardised CKD incidence was 11.0% (95% CI 9.3% to 12.3%) in the population, with Ghanaians residing in Amsterdam at (7.6%; 5.7% to 9.5%) and Ghanaians residing in Ghana at (12.9%; 10.9% to 14.9%). Within Ghana, rural Ghanaians had similar CKD incidence to urban Ghanaians (12.5%; 8.5% to 15.5% vs 12.3%; 8.2% to 15.8%). Residence in Amsterdam was associated with lower CKD incidence compared with Ghana after adjustments (incidence rate ratio=0.32; 0.13-0.77). CKD incidence predictors were advanced age, female sex, alcohol consumption, uric acid levels and hypertension. CKD progression to ESKD was 2.3% among Ghanaians residing in Ghana and 0.0% among Ghanaians residing in Amsterdam.</p><p><strong>Conclusion: </strong>One-tenth of Ghanaians developed CKD over 7 years, with higher incidence in Ghana compared with Europe. Age, female sex, alcohol use, uric acid levels and hypertension were predictive factors. CKD progression to ESKD was minimal. High CKD incidence among Ghanaians, especially those residing in Ghana, calls for in-depth assessment of contributing factors and targeted interventions.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 1","pages":""},"PeriodicalIF":7.1000,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749268/pdf/","citationCount":"0","resultStr":"{\"title\":\"Incidence, long-term predictors and progression of chronic kidney disease among African migrants and non-migrants: the transcontinental population-based prospective RODAM cohort study.\",\"authors\":\"Muhulo Muhau Mungamba, Felix P Chilunga, Eva L van der Linden, Erik Beune, Engwa A Godwill, Charles F Hayfron-Benjamin, Karlijn Meeks, Samuel N Darko, Sampson Twumasi-Ankrah, Ellis Owusu-Dabo, Liffert Vogt, Bert-Jan H van den Born, Benedicta N Chungag, Charles Agyemang\",\"doi\":\"10.1136/bmjgh-2024-016786\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Limited longitudinal data exist on chronic kidney disease (CKD) in African populations undergoing epidemiological transitions. We investigated incidence, long-term predictors and progression of CKD among Ghanaians residing in Ghana and Ghanaian migrants in the Netherlands (Amsterdam).</p><p><strong>Methods and findings: </strong>We analysed data from 2183 participants in the transcontinental population-based prospective Research on Obesity and Diabetes among African Migrants cohort, followed for approximately 7 years. CKD incidence and its progression to end-stage kidney disease (ESKD) were defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. CKD incidence was calculated using age- and sex standardisation for those without CKD at baseline. Long-term predictors of CKD incidence were identified using one-step robust Poisson regression. CKD progression to ESKD from baseline was also assessed using robust Poisson regressions. Overall age- and sex standardised CKD incidence was 11.0% (95% CI 9.3% to 12.3%) in the population, with Ghanaians residing in Amsterdam at (7.6%; 5.7% to 9.5%) and Ghanaians residing in Ghana at (12.9%; 10.9% to 14.9%). Within Ghana, rural Ghanaians had similar CKD incidence to urban Ghanaians (12.5%; 8.5% to 15.5% vs 12.3%; 8.2% to 15.8%). Residence in Amsterdam was associated with lower CKD incidence compared with Ghana after adjustments (incidence rate ratio=0.32; 0.13-0.77). CKD incidence predictors were advanced age, female sex, alcohol consumption, uric acid levels and hypertension. CKD progression to ESKD was 2.3% among Ghanaians residing in Ghana and 0.0% among Ghanaians residing in Amsterdam.</p><p><strong>Conclusion: </strong>One-tenth of Ghanaians developed CKD over 7 years, with higher incidence in Ghana compared with Europe. Age, female sex, alcohol use, uric acid levels and hypertension were predictive factors. CKD progression to ESKD was minimal. 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引用次数: 0
摘要
背景：在流行病学转变的非洲人群中，慢性肾脏疾病（CKD）的纵向数据有限。我们调查了居住在加纳的加纳人以及在荷兰（阿姆斯特丹）的加纳移民的CKD的发病率、长期预测因素和进展。方法和研究结果：我们分析了来自2183名参与者的数据，这些参与者来自横贯大陆的非洲移民群体中肥胖和糖尿病的前瞻性研究，随访了大约7年。使用肾脏疾病：改善全球预后（KDIGO）标准定义CKD发病率及其进展到终末期肾脏疾病（ESKD）。对基线时无CKD的患者，使用年龄和性别标准化来计算CKD发病率。采用一步稳健泊松回归确定CKD发病率的长期预测因素。从基线到ESKD的CKD进展也使用稳健泊松回归进行评估。总体年龄和性别标准化CKD发病率为11.0% (95% CI 9.3%至12.3%)，其中居住在阿姆斯特丹的加纳人为7.6%；5.7%至9.5%)和居住在加纳的加纳人(12.9%；10.9%至14.9%)。在加纳，农村加纳人的CKD发病率与城市加纳人相似(12.5%；8.5%对15.5%对12.3%；8.2%至15.8%)。调整后，与加纳相比，居住在阿姆斯特丹的CKD发病率较低(发病率比=0.32；0.13 - -0.77)。CKD发病率预测因子为高龄、女性、饮酒、尿酸水平和高血压。居住在加纳的加纳人CKD进展为ESKD的比例为2.3%，居住在阿姆斯特丹的加纳人为0.0%。结论：加纳有十分之一的人在7年内患上CKD，与欧洲相比，加纳的发病率更高。年龄、女性、饮酒、尿酸水平和高血压是预测因素。CKD进展为ESKD的情况极少。加纳人，特别是居住在加纳的加纳人CKD发病率高，需要深入评估影响因素和有针对性的干预措施。
Incidence, long-term predictors and progression of chronic kidney disease among African migrants and non-migrants: the transcontinental population-based prospective RODAM cohort study.
Background: Limited longitudinal data exist on chronic kidney disease (CKD) in African populations undergoing epidemiological transitions. We investigated incidence, long-term predictors and progression of CKD among Ghanaians residing in Ghana and Ghanaian migrants in the Netherlands (Amsterdam).
Methods and findings: We analysed data from 2183 participants in the transcontinental population-based prospective Research on Obesity and Diabetes among African Migrants cohort, followed for approximately 7 years. CKD incidence and its progression to end-stage kidney disease (ESKD) were defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. CKD incidence was calculated using age- and sex standardisation for those without CKD at baseline. Long-term predictors of CKD incidence were identified using one-step robust Poisson regression. CKD progression to ESKD from baseline was also assessed using robust Poisson regressions. Overall age- and sex standardised CKD incidence was 11.0% (95% CI 9.3% to 12.3%) in the population, with Ghanaians residing in Amsterdam at (7.6%; 5.7% to 9.5%) and Ghanaians residing in Ghana at (12.9%; 10.9% to 14.9%). Within Ghana, rural Ghanaians had similar CKD incidence to urban Ghanaians (12.5%; 8.5% to 15.5% vs 12.3%; 8.2% to 15.8%). Residence in Amsterdam was associated with lower CKD incidence compared with Ghana after adjustments (incidence rate ratio=0.32; 0.13-0.77). CKD incidence predictors were advanced age, female sex, alcohol consumption, uric acid levels and hypertension. CKD progression to ESKD was 2.3% among Ghanaians residing in Ghana and 0.0% among Ghanaians residing in Amsterdam.
Conclusion: One-tenth of Ghanaians developed CKD over 7 years, with higher incidence in Ghana compared with Europe. Age, female sex, alcohol use, uric acid levels and hypertension were predictive factors. CKD progression to ESKD was minimal. High CKD incidence among Ghanaians, especially those residing in Ghana, calls for in-depth assessment of contributing factors and targeted interventions.
期刊介绍：
BMJ Global Health is an online Open Access journal from BMJ that focuses on publishing high-quality peer-reviewed content pertinent to individuals engaged in global health, including policy makers, funders, researchers, clinicians, and frontline healthcare workers. The journal encompasses all facets of global health, with a special emphasis on submissions addressing underfunded areas such as non-communicable diseases (NCDs). It welcomes research across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialized studies. The journal also encourages opinionated discussions on controversial topics.
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