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Abstract: FR-PO957

Food Insecurity and High Blood Pressure Among Individuals with CKD in West Africa

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention


  • Neupane, Raghavee, Boston University School of Public Health, Boston, Massachusetts, United States
  • Ilori, Titilayo O., Boston Medical Center, Boston, Massachusetts, United States
  • Zhao, Runqi, Boston Medical Center, Boston, Massachusetts, United States
  • Waikar, Sushrut S., Boston Medical Center, Boston, Massachusetts, United States
  • Kwakyi, Edward Papa Kwabena, University of Ghana School of Medicine and Dentistry, Accra, Greater Accra, Ghana
  • Chern, Jessica, Boston Medical Center, Boston, Massachusetts, United States
  • Ulasi, Ifeoma I., University of Nigeria, Nsukka, Enugu, Nigeria
  • Solarin, Adaobi, Lagos State University Teaching Hospital, Lagos, Lagos, Nigeria
  • Adu, Dwomoa, University of Ghana School of Medicine and Dentistry, Accra, Greater Accra, Ghana
  • Mamven, Manmak, University of Abuja, Abuja, Federal Capital Territory, Nigeria
  • Gbadegesin, Rasheed A., Duke Medicine, Durham, North Carolina, United States

Based on the Diet, CKD, and ApolipoproteinL1 (DCA) study data, this cross-sectional study examines the relationship of food insecurity with estimated glomerular filtration rate (eGFR) and systolic and diastolic blood pressure (SBP and DBP). Very few studies have yet studied these associations in sub-Saharan African populations. Understanding the impact of food insecurity is crucial to guide care for patients with CKD.


We recruited 570 participants with CKD (eGFR < 60mL/min/1.73m2, or albuminuria > 30 mg/g) from 7 centers in the H3Africa Kidney Disease study. We measured food insecurity using a standardized question, “Did you cut meals size/skip meals because there was insufficient money during the past year?”

We used mixed-effect linear regression models with clinical centers as random intercepts. Outcomes were eGFR (CKD-EPI 2009 equation), SBP, and DBP. We analyzed factors associated with food insecurity using logistic regression with a random intercept for the clinical center.


The mean age for our population was 48.7 (SD = 17.5), and 47% were female. The prevalence of food insecurity in the DCA cohort was 28%, with the highest in Southeast Nigeria (69%, p<0.0001). Individuals with CKD stages 3-5 had the lowest prevalence of food insecurity (25%).

The overall study population had no significant association of food insecurity with eGFR, SBP, or DBP (Table 1). Higher BMI (OR: 0.90–0.98, p<0.01), higher education (OR: 0.25–1, p=0.05), and higher income (OR: 0.003–0.38, p=0.01) were all associated with lower odds of food insecurity.


Our study shows a higher prevalence of food insecurity in Southeast Nigeria and a lower prevalence of food insecurity in patients with more advanced CKD. Investigating the true effect of food security on kidney function or cardiovascular disease in sub-Saharan Africa merits further study.

Associations between Food Insecurity, eGFR and Blood Pressure
 Unadjusted ModelFully Adjusted Model*
OutcomeBeta Coefficient (95% CI)p-valueBeta Coefficient (95% CI)p-value
eGFR8.26 (0.37 to 16.23)0.045.51 (-1.09 to 12.00)0.11
Systolic BP0.45 (-4.07 to 4.82)0.841.88 (-2.53 to 6.13)0.40
Diastolic BP1.76 (-1.26 to 4.82)0.262.31 (-0.79 to 5.45)0.15

*Adjusted for age, sex, education, income, smoking, diabetes, obesity, and SBP (for eGFR), Clinical Center as Random Effect


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