{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:00:56Z","timestamp":1785841256564,"version":"3.56.0"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,3,27]],"date-time":"2019-03-27T00:00:00Z","timestamp":1553644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Data on the changing levels in renal morbidity and mortality are scant globally. We sought to assess trends in renal disease mortality and attributable causes over a 20 year period in Ghana.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis of 20 year autopsy records of the Pathology Departments of leading teaching hospitals in Ghana, (Korle\u2010Bu Teaching Hospital (KBTH) in Accra and Komfo Anokye Teaching Hospital (KATH) in Kumasi) from January 1994 to December 2013. Data comprising autopsies from in\u2010patients, community cases and coroners\u2019 cases were used. We defined primary cause of death as death directly due to renal disease and secondary cause of death as death in which renal disease was a comorbid or contributing factor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over the period, there were a total of 94 309 deaths, of which 5608 were attributed to renal disease (5.9\/100). Mortality rate remained fairly the same from 1994 to 2009 (5.0%), but doubled from 2010 to 2013 (10.8%). Similar trends were observed among males and females during the same period. However, males had slightly higher mortality rates (6.6%; 95% CI: 46.1%\u20136.8%) compared to females (5.6%; 95% CI: 5.4%\u20135.8%; <jats:italic>P<\/jats:italic> = 0.271). The major leading attributable causes of renal disease death include end stage renal disease 45.0% and acute pyelonephritis accounting for 20.9% of the cases. Hypertensive heart disease accounted for 30.0% of all secondary cause of death while congestive heart disease and septicaemia accounted for 13.0% and 12.0%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We observed marked increase in the renal disease mortality rate during the last few years predominantly driven by chronic and infectious related renal diseases as a main cause, and hypertensive heart disease and congestive heart failure as the main secondary causes. Measures geared towards prevention, treatment and managing such conditions may impact on the reduction of renal disease mortality rate among Ghanaian populations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.13255","type":"journal-article","created":{"date-parts":[[2018,3,25]],"date-time":"2018-03-25T17:37:12Z","timestamp":1521999432000},"page":"387-394","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["20 year trends in renal disease mortality in Ghana: A review of autopsies"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2306-5723","authenticated-orcid":false,"given":"David N","family":"Adjei","sequence":"first","affiliation":[{"name":"Department of Public Health, Academic Medical Center, Amsterdam Public Health research institute University of Amsterdam  Amsterdam The Netherlands"},{"name":"Department of Medical Laboratory Sciences School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dwomoa","family":"Adu","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Medicine and Dentistry University of Ghana and Korle\u2010Bu Teaching Hospital  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solomon E","family":"Quayson","sequence":"additional","affiliation":[{"name":"Department of Pathology, School of Biomedical and Allied Health Sciences College of Health Sciences, University of Ghana  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan WPF","family":"Kardaun","sequence":"additional","affiliation":[{"name":"Department of Public Health, Academic Medical Center, Amsterdam Public Health research institute University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac J","family":"Erskine","sequence":"additional","affiliation":[{"name":"Department of Pathology, School of Biomedical and Allied Health Sciences College of Health Sciences, University of Ghana  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac S","family":"Lartey","sequence":"additional","affiliation":[{"name":"Department of Pathology Komfo Anokye Teaching Hospital  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Agyemang","sequence":"additional","affiliation":[{"name":"Department of Public Health, Academic Medical Center, Amsterdam Public Health research institute University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2015.25"},{"key":"e_1_2_8_3_1","first-page":"117","article-title":"Regional, and national age\u2010sex specific all\u2010cause and cause\u2010specific mortality for 240 causes of death, 1990\u20132013: A systematic analysis for the Global Burden of Disease Study 2013","author":"Global G","year":"2015","journal-title":"Lancet"},{"key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1681\/ASN.V122218","article-title":"Renal function and intensive lowering of blood pressure in hypertensive participants of the hypertension optimal treatment (HOT) study","author":"Ruilope LM","year":"2001","journal-title":"J. Am. Soc. Nephrol."},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041031"},{"key":"e_1_2_8_6_1","first-page":"927","article-title":"Trends in the prevalence of chronic kidney disease in Korean adults: The Korean National Health and Nutrition Examination Survey from 1998 to 2009","author":"Kang H\u2010T","year":"2012","journal-title":"Nephrol. Dial. Transplant."},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70002-6"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jhh.1000726"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2014.18.274.4192"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2017.1348955"},{"key":"e_1_2_8_11_1","first-page":"443","article-title":"Hypertension and end\u2010stage renal failure in tropical Africa","author":"Matekole M","year":"1993","journal-title":"J. Hum. Hypertens."},{"key":"e_1_2_8_12_1","first-page":"1853","article-title":"Patterns of renal disease in Cape Town South Africa: A 10\u2010year review of a single\u2010centre renal biopsy database","author":"Okpechi I","year":"2010","journal-title":"Nephrol. Dial. Transpl."},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/0886022X.2011.565140"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfp765"},{"key":"e_1_2_8_15_1","first-page":"261","article-title":"Clinical or postmortem? The importance of the autopsy; a retrospective study","author":"Costache M","year":"2014","journal-title":"Maedica"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.4081\/jphia.2011.e7"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.4314\/gmj.v49i2.9"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-4-353"},{"key":"e_1_2_8_19_1","volume-title":"International Statistical Classification of Diseases and Related Health Problems","author":"Organization WH","year":"2004"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-6-159"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-016-0709-0"},{"key":"e_1_2_8_22_1","article-title":"Variations in hypertension awareness, treatment, and control among Ghanaian migrants living in Amsterdam, Berlin, London, and nonmigrant Ghanaians living in rural and urban Ghana\u2010the RODAM study","author":"Agyemang C","year":"2017","journal-title":"J. Hypertens."},{"key":"e_1_2_8_23_1","first-page":"820","article-title":"The profile of adult nephrology patients admitted to the Renal Unit of the Universitas Tertiary Hospital in Bloemfontein, South Africa from 1997 to 2006","author":"Rensburg BWJ","year":"2009","journal-title":"Nephrol. Dial. Transpl."},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-84843-3_39"},{"key":"e_1_2_8_25_1","article-title":"Di\u00e1lise cr\u00f4nica no Brasil\u2010relat\u00f3rio do censo brasileiro de di\u00e1lise, 2011","author":"Sesso RDCC","year":"2012","journal-title":"Jornal Brasileiro de Nefrologia."},{"key":"e_1_2_8_26_1","first-page":"13","article-title":"Mortalidad seg\u00fan el Registro de pacientes en Di\u00e1lisis Cr\u00f3nica de Argentina 2004\u20132005","author":"Marinovich S","year":"2009","journal-title":"Nefrolog\u00eda"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2006121347"},{"key":"e_1_2_8_28_1","first-page":"24","article-title":"Magnitude of the problem of CRF in Nigerians","author":"Akinsola A","year":"2004","journal-title":"Afr. J. Nephrol."},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.14.1737"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(89)80173-8"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(12)80091-6"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.4103\/1596-3519.172559"},{"key":"e_1_2_8_33_1","first-page":"788","article-title":"Renal insufficiency in arterial hypertension in black Africa","author":"Lengani A","year":"1994","journal-title":"Presse Med."},{"key":"e_1_2_8_34_1","first-page":"594","article-title":"The pattern, clinical characteristics and outcome of ESRD in Ile\u2010Ife, Nigeria: Is there a change in trend?","author":"Arogundade F","year":"2011","journal-title":"Afr. Health Sci."},{"key":"e_1_2_8_35_1","first-page":"192","article-title":"Mortality in patients with chronic kidney disease undergoing hemodialysis in a public hospital of Peru","author":"Herrera\u2010A\u00f1azco P","year":"2015","journal-title":"Jornal Brasileiro de Nefrologia."},{"key":"e_1_2_8_36_1","first-page":"626","article-title":"Medicolegal autopsies in North Central Nigeria","author":"Mandong B","year":"2006","journal-title":"East Afr. Med. J."},{"key":"e_1_2_8_37_1","first-page":"83","article-title":"The declining autopsy rate and clinicians\u2019 attitudes","author":"Loughrey M","year":"2000","journal-title":"Ulster Med. J."}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnep.13255","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.13255","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nep.13255","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.13255","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T11:58:23Z","timestamp":1694347103000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.13255"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,27]]},"references-count":36,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1111\/nep.13255"],"URL":"https:\/\/doi.org\/10.1111\/nep.13255","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,27]]},"assertion":[{"value":"2018-03-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}