Chronic kidney disease among patients with hypertension in sub-Saharan Africa: a systematic review and meta-analysis

Abstract

Chronic kidney disease is defined by the presence of kidney damage or decreased kidney function for at least three months, irrespective of the cause. Hypertensive kidney disease is one of the long-term complications of poorly controlled hypertension. It is the second leading cause of developing chronic kidney disease, next to diabetic mellitus. The literature was searched using an international electronic database (PubMed, Google Scholar, Hinari, and Open Google) to get significant studies on chronic kidney disease among hypertensive patients. This study is conducted to determine the pooled prevalence and associated factors of chronic kidney disease among hypertensive patients up to May 20, 2024. Heterogeneity between studies was checked using I2 test statistics, and small study effects were checked using graphical and Egger’s statistical tests at a 5% significance level. Subgroup analysis and sensitivity analysis were checked. A random-effects model was used to guess the pooled effect size across studies. In this meta-analysis, 16 studies in sub-Saharan Africa were included with a total of 6648 participants who fulfilled the inclusion criteria. The estimated prevalence of CKD among hypertension patients was found to be 29.01% (95% CI: 23.03–34.99, I2 = 97.10%) in sub-Saharan Africa. Age greater than 60 years old (OR = 2.36; 95% CI: 1.02–3.71, I2 = 99.11%), uncontrolled blood pressure (OR = 6.57; 95% CI: 2.44–10.71, I2 = 97.38%), hypertensive patients with diabetes comorbidity (OR = 3.27; 95% CI: 1.65–4.89, I2 = 95.79%), Bing overweight (OR = 2.75; 95% CI: 1.04–4.46, I2 = 98.22%), and proteinuria (OR = 4.64, 95% CI: 4.09–5.18, I2 = 0.00%). Hypertension is one of the major causes of chronic kidney disease. Most patients living with hypertension develop CKD over time in sub-Saharan Africa. The highest prevalence of CKD among hypertension was observed in West Africa and Middle Africa.