Chronic Kidney Disease Screening Practice Among High-Risk Patients During Follow-Up in Sub-Saharan Africa: A Systematic Review

Abstract

Background: Screening for Chronic Kidney Disease (CKD) for high-risk patients is essential to provide early detection, management, and delayed progression. In Sub-Saharan Africa (SSA), CKD screening remains variable and inadequate. Therefore, the review question was: what is the current practice of screening for CKD in high-risk patients (hypertension and diabetes) attending chronic care follow-up visits in SSA? Methods: The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines. The review included studies published from 2010 to August 2025. Inclusion criteria included screening practices or early detection of chronic kidney diseases among high-risk patients during routine care in SSA. The review followed the JBI Condition, Context, and Population (CoCoPop) protocol. Two independent reviewers screened, appraised, and extracted data using the standardized JBI SUMARI data extraction form. Narrative synthesis of the findings was carried out to understand CKD screening practice in SSA. Results: Out of 856 records identified, twelve studies from SSA focused on high-risk patients screened for CKD who met criteria and were included. Serum creatinine was the most common method used to screen CKD during routine follow-up of high-risk patients, followed by albuminuria and estimated glomerular filtration rate(eGFR). The prevalence of CKD screening during routine care varies from 8.4% to 38.5%. Older age, being a female, duration of diabetes and/or hypertension, and co-existence of hypertension and diabetes were identified as factors associated with CKD screening practice. Conclusion and recommendations: Routine follow-up of high-risk patients demonstrated that CKD screening was effective in early patient identification. Most of the included studies relied on one-time screening, which may not accurately represent the true prevalence; therefore, confirmatory CKD screening should be conducted. Finally, healthcare providers should prioritize older age, female gender, duration of the high-risk conditions, and concomitance of hypertension and diabetes.