Background: The profiles of patients with chronic kidney disease (CKD) in rural areas have long been thought to
differ from those of their urban counterparts. However, there have been few local studies to confirm this.
Methods: A retrospective review was conducted to compare the characteristics of patients with CKD from rural
and urban areas in the South African province of KwaZulu-Natal, who were referred to Inkosi Albert Luthuli Central
Hospital (IALCH) from April 2012 to April 2013.
Results: A total of 529 patients were included. The mean age of those from rural areas was lower than that of urban
participants (40.6 vs. 53.4 years) and all these patients were Black. The rural patients had lower estimated glomerular
filtration rates (mean values of 16.3 vs. 25.4 mL/min/1.73 m², P < 0.001). Regarding comorbidity, rural patients had
higher rates of HIV infection (47.9% vs. 18.3%) but lower rates of hypertension (69.6% vs. 83.9%) and diabetes
(20.3% vs. 54.1%) than the urban patients.
Conclusions: Patients with CKD referred from rural areas differed significantly from their urban counterparts. Rural
patients presented at a younger age, had a higher prevalence of HIV infection, and had more advanced kidney
disease at referral. Poor socio-economic circumstances limiting access to health care and less screening for CKD may
have contributed to delayed referrals from rural areas.