Strength and limitations of this review
This is review of literature on prevalence, risk factors and awareness
screening in Southeast Nigeria providing an overview of this important
topic. The identification of emerging risk factors has filled a gap in
the assessment of risk factor of CKD. A major drawback in these studies
is that the estimated GFR of those who were observed to have CKD was
only assessed once. Ideally, the assessments should have been repeated 3
months later to find out if the values of the estimated GFR were still
below 60 mL/min/10.73m2 in those with
CKD1. This would have given an accurate prevalence of
CKD with creatinine equations. It is worth noting that one of the
studies did repeat the GFR estimation 3 months later; estimated
GFR<60mL/min/1.73m2 was found in 7.8%
respondents at the first assessment had persistently low GFR at
reassessment 3 months later15. The sharp drop in the
prevalence clearly shows that a good majority of the earlier captured
subjects did not have CKD. A major limitation of the study that repeated
the estimation of GFR 3 months later is that the sample size was small
(328), and the value obtained is not likely to be the true prevalence of
CKD in Nigeria. However, the prevalence of CKD is most likely to be
below 10% and may be close to 4.6% using the MDRD and CKD-EPI
creatinine equation.