BMJ Open
Volume 9, Issue 8, 2019

Cross-sectional study of association between psychosocial stressors with chronic kidney disease among migrant and non-migrant Ghanaians living in Europe and Ghana: The RODAM study (Article) (Open Access)

Adjei D.N.* , Stronks K. , Adu D. , Beune E. , Meeks K. , Smeeth L. , Addo J. , Owusu-Dabo E. , Klipstein-Grobusch K. , Mockenhaupt F. , Schulze M. , Danquah I. , Spranger J. , Bahendeka S.K. , Agyemang C.
  • a Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands, Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana
  • b Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
  • c Department of Medicine, School of Medicine and Dentistry, University of Ghana, Korle-Bu Teaching Hospital, Accra, Ghana
  • d Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
  • e Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
  • f Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
  • g Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
  • h Kumasi Centre for Collaborative Research, KNUST, Kumasi, Ghana
  • i Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre, Utrecht University, Utrecht, Netherlands, Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  • j Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Berlin, Germany
  • k Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
  • l Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany, Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitaetsmedizin Berlin, Berlin, Germany
  • m Department of Endocrinology and Metabolism, Charité-University Medicine Berlin, Berlin, Germany, German Centre for Cardiovascular Research (DZHK), Berlin, Germany, Center for Cardiovascular Research (CCR), Charité-University, Berlin, Germany
  • n MKPGMS, Uganda Martyrs University, Kampala, Uganda
  • o Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands

Abstract

Objectives: The association between psychosocial stressors (PS) and chronic kidney disease (CKD) among sub-Saharan African (SSA) populations is unknown. We examined the association between PS and CKD prevalence among rural and urban Ghanaians and Ghanaian migrants living in three European cities. We also assessed if the influence of PS on CKD is partially mediated by primary risk factors (hypertension and diabetes) of CKD. Design: A multi-centred cross sectional data from the Research on Obesity and Diabetes among African Migrants study. Setting: Rural and urban Ghana and three European cities (Amsterdam, Berlin and London). Participants: A random sample of 5659 adults (Europe 3167, rural Ghana 1043 and urban Ghana 1449) aged 25-70 years. Explanatory measures: PS defined by negative life events, perceived discrimination, perceived stress at work/home and depressive symptoms. Three CKD outcomes were considered using the 2012 Kidney Disease: Improving Global Outcomes severity of CKD classification. Comparisons between PS and CKD outcomes were made using logistic regression analyses across all sites. Results: We observed higher proportion of negative life events (68.7%) and perceived permanent stress (15.9%) among Ghanaians living in Ghana than Ghanaians living in Europe. Depressive symptoms (7.5%) and perceived discrimination (29.7%) were more common among Ghanaians living in Europe than Ghanaians living in Ghana. No significant association was observed between any of the PS constructs and CKD outcomes across sites except for positive association between stress at work/home and albuminuria (2.81, 95% CI 1.46 to 5.40) and CKD risk (2.78, 95% CI 1.43 to 5.43) among Ghanaians living in Berlin. Conclusion: Our study found a positive association between stress at work/home and albuminuria and CKD risk. There was no convincing evidence of associations between the other PS constructs and the prevalence of CKD risk. Further studies are needed to identify potential factors driving the high prevalence of CKD among these populations. © 2019 Author(s).

Author Keywords

Chronic kidney disease Migrants psychosocial stressors Europe rodam study Ghana

Index Keywords

albumin depression hypercholesterolemia Europe Waist Circumference human diabetes mellitus mental stress obesity Ghana hypertension Aged creatinine albuminuria cross-sectional study migrant male female risk factor Article major clinical study adult antihypertensive agent disease association chronic kidney failure Ghanaian
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85070189404&doi=10.1136%2fbmjopen-2018-027931&partnerID=40&md5=00e4d06e5adadde96bef0480acd4058e
DOI: 10.1136/bmjopen-2018-027931
ISSN: 20446055
Original Language: English