High burden of chronic kidney disease of unknown cause among patients receiving renal replacement therapy in Northeast Nigeria: A cross-sectional survey of haemodialysis units.

Background: Chronic kidney disease (CKD) is emerging as a significant public health concern in northeastern Nigeria, particularly in states such as Yobe and Borno. Despite its increasing impact, there is a lack of data characterizing this public health issue. This study aims to explore the prevalence, spatial distribution, and risk factors for CKD among patients receiving haemodialysis (HD) in the region.

Methodology: A cross-sectional survey of HD centres in Yobe, Borno, and Jigawa States of Nigeria was conducted. Questionnaire responses were obtained on demographic, social, and clinical data. Spatial analyses were conducted to determine the geographic distribution of the cases.

Results: We identified 376 patients receiving HD services across 4 centres. Of these, 207 (55.1%) were male and the mean age was 46.56 ± 16.4. Most patients reside in urban areas (67.6%). The main pre-dialysis occupations included civil service (100 [26.6%]), agriculture (65 [17.3%]), and trading (58 [15.4%]). 'Hypertension' (195 [51.9%]) was the most common self-reported primary renal disease, followed by unknown causes (70 [18.6%]) and Diabetic Kidney Disease (30 [8%]). Regional analysis demonstrated a particularly high burden of disease in Bade and Jakusko Local Government Areas.

Conclusion: Spatial analysis suggests the existence of a CKD hotspot geographically associated with communities along the River Yobe, raising the possibility of an important environmental cause of disease. This study also highlights the lack of access to adequate diagnosis and geographical clustering of CKD burden in this region. These findings further reinforce the need for population-representative studies to characterize the burden of CKD alongside strategic healthcare interventions and collaboration among stakeholders aimed at improving access to care.xs.