review · Journal of Nephrology
This systematic review and meta-analysis investigated the prevalence of protein-energy wasting (PEW), a common and serious complication, among chronic kidney disease (CKD) patients in Africa. The study analysed 25 articles involving 2822 participants from 14 African countries. It found that the overall pooled prevalence of PEW was 47.0% among African CKD patients. PEW was significantly more prevalent in haemodialysis patients (52.0%) compared to non-dialysis CKD patients (34.0%). The research also highlighted that PEW prevalence varied significantly based on the diagnostic criteria used and across different African regions. The findings underscore the high burden of PEW in this population.
Protein-energy wasting is a serious complication for individuals with chronic kidney disease, impacting their health and prognosis. This research reveals a high prevalence of this condition among African CKD patients, indicating a significant health challenge. Understanding this burden is crucial for developing targeted interventions to improve patient care and outcomes.
The abstract identifies an urgent need for region-specific guidelines and multidisciplinary nutritional interventions to address the high prevalence of protein-energy wasting in African CKD patients. This suggests a potential for developing specialised nutritional products, dietary supplements, or tailored dietary programmes. These could be used by healthcare providers, nutritionists, and patients. This research is at an early stage, identifying a critical need rather than offering a specific product or solution.
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BACKGROUND: Protein-energy wasting (PEW) is a frequent and prognostically adverse complication of chronic kidney disease (CKD). Despite its clinical importance, African populations have been underrepresented in prior systematic reviews. This study aimed to estimate the pooled prevalence of PEW among patients with CKD in Africa. METHODS: PubMed, AJOL, and EMBASE were systematically searched for relevant studies published between 1980 and 2025. Meta-analytic techniques were used to estimate the pooled prevalence of PEW among African CKD populations. The study protocol was registered on PROSPERO (CRD420251032894). RESULTS: Twenty-five articles comprising 2822 participants across 14 African countries met the inclusion criteria. The mean age of the participants was 49.7 ± 5.2 years. Thirteen studies (52.0%) were from North Africa, 19 studies (76.0%) had high methodological quality, and 17 studies (68.0%) used Subjective Global Assessment (SGA) for PEW assessment. The overall pooled prevalence of PEW among patients with CKD was 47.0% (95% confidence interval: 39.0%-56.0%; n = 25 studies; I2 = 95.5%, P < .001). The prevalence of PEW was significantly higher in the haemodialysis patients compared with non-dialysis CKD patients (52.0% vs 34.0%; P < .001). The pooled prevalence of PEW in studies that used the International Society of Renal Nutrition and Metabolism criteria was 32.0%; Malnutrition Inflammatory Score was 49.0%, SGA was 42.0%; and SGA adaptation was 76.0%. There was a significant difference in the pooled PEW prevalence across diagnostic criteria (P < .001) and African regions (P < .001). CONCLUSION: PEW is highly prevalent among African patients with CKD. Region-specific guidelines and multidisciplinary nutritional interventions are urgently needed to address this burden.
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DOI: 10.1093/joneph/aajaf084
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