CKD in Kenya

1. CKD IN KENYA
CKD in USA:
• Only 0.7% of the population have stage 4 & 5
• 99.3% have early stages of CKD and are healthy
without any symptoms
• 20 Million Americans have CKD;
• 20 million more are at risk for developing CKD.

2. SLOWING PROGRESSION OF CKD
DIABETES AND CKD
KENYA RENAL ASSOCIATION
SYMPSIUM
PROF. M. S. ABDULLAH
AGA KHAN UNIVERSITY HOSPITAL
3rd. NOVEMBER, 2007

3. Chronic Kidney Disease (K/DOQI)
693,000
630,000
903,000
42,000
21,000
No of cases
in adults in
Kenya

4. CKD IN KENYA
Risk Factors for CKD:
►Diabetes
► Hypertension
►Older age
►Family history of kidney disease, HTN DM
►Male gender
►Racial/Ethnic background
► Tobacco use

5. CKD IN KENYA
Routine observations for CKD are:
• Serum creatinine and calculate eGFR
• Routinely work out GFR for all at risk patients
• Blood pressure
• Height, age, gender,
• Glucose
• Urinalysis
• Microalbuminuria/proteinuria

6. CKD IN KENYA
Strategies to reduce progression:
• Increase physician / doctors awareness of CKD
• Increase public awareness about CKD
• Education to the at-risk group to look after
themselves to slow down progression
• Regular free screening campaigns for the at-risk
groups
• Close cooperation between practitioners and
nephrologists

7. CKD IN KENYA
- Some risk factors can be modified by life style
changes or pharmacotherapy
- These include diabetes, hypertension, obesity,
dyslipidemia, inflammation, anemia smoking and life
style modification
- Life style modification includes exercise, salt
reduction, weight reduction and stop smoking
- Early intervention can avert many cases from going
to ESRD prematurely
- Late referrals account for many unnecessary
problems with negative impact

8. CKD IN KENYA
• NICE guidelines for management of DM (2002)
recommend annual serum creatinine estimation
• SIGN guidelines for management of DM (2005)
recommend microalbumin estimations once a year
in addition to serum creatinine.
• Formula-based GFR rather than just serum
creatinine should now be preferred to assess CKD
• MDRD formula is most preferred (corrects for body
surface area – BSA)
• Cockcroft and Gault formula can however be used
• Screen only the at risk populations for CKD