Etiological Patterns of End-Stage Chronic Kidney Disease among Haemodialysis Patients in Southwestern Nigeria: A Multicenter Retrospective Study

Abstract

Background: Chronic kidney disease (CKD) is a progressive condition characterised by irreversible deterioration of renal function and represents a major global public health concern. In sub-Saharan Africa, late presentation and limited access to preventive care contribute significantly to the burden of end-stage kidney disease (ESKD). This study provides a descriptive profile of the etiological patterns and sociodemographic characteristics of patients newly initiated on haemodialysis in Southwestern Nigeria. To describe the etiological distribution and sociodemographic characteristics of CKD among patients receiving haemodialysis in selected tertiary health institutions in Southwestern Nigeria.

Materials and Methods: A multicenter retrospective descriptive study was conducted using secondary data extracted from haemodialysis registers of seven tertiary hospitals across Southwestern Nigeria between September 2017 and August 2022. All newly
initiated adult haemodialysis patients with complete records were included (n = 1,250). Data were analysed using descriptive statistics and presented as frequencies, percentages, means, and standard deviations.

Results: A total of 1,250 patients were analysed. The mean age was 48.57 ± 16.62 years, with the highest proportion occurring among individuals aged 41–60 years (41.4%). Males accounted for 70% of cases (male-to-female ratio 2.3:1). Hypertension was the leading etiological factor (50.2%), followed by glomerulonephritis (22.2%) and diabetes mellitus (17.1%). Obstructive uropathy accounted for 4.6% of cases, while combined hypertension and diabetes contributed 2.1%. Hypertension remained the predominant cause throughout the study period, with a gradual increase in diabetesrelated CKD observed in later years. 

Conclusion: CKD requiring haemodialysis in Southwestern Nigeria predominantly affects middle-aged adults and is largely driven by hypertension, with an emerging contribution from diabetes mellitus. Strengthening early detection and effective management of hypertension and diabetes at the primary healthcare level is essential to reduce progression to endstage kidney disease in the region.