Trajectories of serum creatinine and associated factors in an outpatient chronic kidney disease cohort in Burkina Faso: a latent class analysis

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Résumé

Introduction Chronic kidney disease (CKD) progression varies considerably between individuals. Identifying these trajectories in sub-Saharan Africa could significantly improve patient management. Objective: To identify CKD progression trajectories and analyze associated factors in a cohort of patients in Burkina Faso. Patients and methods We conducted a retrospective study including 123 patients aged ≥18 years, followed at a nephrology outpatient clinic between January 1, 2014, and December 31, 2017. Renal function was modeled using serial serum creatinine measurements. We used a latent class model to identify serum creatinine trajectories. The optimal model was selected based on the lowest Akaike Information Criterion (AIC) and clinical interpretability. Multivariable logistic regression analysis was used to identify factors associated with each trajectory. Results The mean age was 55.5 ± 15.9 years, with a sex ratio of 1.9. Most patients (65.9%) had low socioeconomic status. Three distinct trajectories were identified: rapid progression (Class 1, 15.45%), stable (Class 2, 31.7%), and moderate progression (Class 3, 52.85%). Anemia was a strong independent predictor across all classes. Rural residence was associated with a lower risk of rapid progression, while chronic NSAID use specifically increased the odds of moderate progression. The relationship with age was non-linear, with advanced age being linked to a stable trajectory rather than rapid decline. This suggests that age-associated comorbidities play a more significant role than age itself. Conclusion CKD progression in this setting is characterized by heterogeneous trajectories, shaped by clinical and socioeconomic factors. These findings are the first step towards developing context-specific predictive tools that will enable the personalized, risk-stratified management of CKD in West Africa.

Mots-clés

Chronic Kidney Disease, Progression, Serum Creatinine Trajectories, Latent Class Analysis, Burkina Faso, Sub-Saharan Africa