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A team of collaborators consisting of medical specialists and engineers from UKZN as well as medical scientists from Sefako Makgatho Health Sciences University (SMU) and the University of the Witwatersrand, joined forces to conduct a study to improve kidney function amongst the sub-Saharan African population.

The study, an international first, won the Best Abstract in its Category and 2nd overall Best Abstract at the African Association of Nephrology (AFRAN) Congress in Mombasa, Kenya.

Chronic Kidney Disease (CKD) is highly prevalent in Africa and accounts for 13.4% of all mortalities. Recent studies have forecast that by 2030, more than 70% of patients with end-stage renal disease will be living in low-income countries, such as those in sub-Saharan Africa. Compounding risk factors in these populations include widespread communicable conditions such as HIV, infectious glomerulonephritis, schistosomiasis and leishmaniasis.

CKD is also prevalent in high-risk populations with hypertension, diabetes and other non-communicable diseases. Hence, prevention, early detection and control of CKD in adults living on the African continent is particularly important in a resource limited environment.

One of the key indicators in diagnosing CKD is measuring the glomerular filtration rate (eGFR) to check how well the kidneys are working. It estimates how much blood passes through the glomeruli each minute. Glomeruli are the tiny filters in the kidneys that filter waste from the blood.

Existing serum creatinine-based eGFR equations are inaccurate among sub-Saharan Africans. These equations that are currently based on the African-American population, result in GFR overestimation in the sub-Saharan African population. The collaborative study aimed to develop a GFR estimating equation in Africans by modifying the Modification of Diet in Renal Disease (MDRD) equation to improve GFR prediction.

Seventy-six adult Black African CKD patients from the Inkosi Albert Luthuli Central and King Edward VIII hospitals were enrolled in the study. GFR prediction equations were developed from multivariable linear regression analysis models using the whole dataset. The result was the development of an accurate African modified equation to measure GFR.

The project was part of a doctoral study by former UKZN staff member and alumnus, Dr Nomandla Madala, who is currently the Head of Internal Medicine at SMU. Professor Alain Assounga, UKZN’s Head of Nephrology commented on the cutting-edge findings: ‘We produced an equation for the estimation of glomerular filtration rate developed in Africans which we called the African eGFR equation. This equation improves the current accuracy of the estimation of renal function from 63% to 75% for Africans. We are ecstatic about our findings as this will improve early detection rates in sub-Saharan Africa.

‘I must acknowledge our amazing team of experts that contributed to this novel, ground-breaking study. They include Drs Nomandla Madala, and Monica Oluwakorede Oluyede, and Professors Saraladevi Naicker, Jules-Raymond Tapamo, and Guy Honoré.’

Words: MaryAnn Francis

Photograph: Supplied