RESUMEN

Background: Specific research is sparse on renal dysfunction among homogenous group of young adults. This study estimated the prevalence of renal dysfunction among apparently healthy young adults and determine association (if any) between renal dysfunction and some cardiovascular risk factors. Methodology:Undergraduates (18-37 years) of a tertiary institution were studied on 2017 World Kidney Day. Their biodata, blood pressure, anthropometry, total cholesterol and estimated glomerular filtration rate were determined. Data was analyzed using SPSS version 20.0. Results:A total of 640 students were studied (M:F=1:3.8). Their mean age was 23.1±2.8 years. Thirty-three(5.2%) participants had renal dysfunction (eGFR < 60ml/min/1.73m2). The mean age of subjects with renaldysfunction (eGFR < 60ml/min/1.73m2) was significantly higher with an inverse association to renal function (p = 0.005). Two hundred and fifty-seven(40.2%) and 58 (9.1%) participants were pre-hypertensive and hypertensive respectively; overweight, abdominal obesity and hypercholesterolaemia were found among 12.2%, 14.2% and 8.1% of subjects respectively. The mean body mass index (p = 0.009) and serum total cholesterol (p = 0.003) were significantly higher among females. There was a higher prevalence of renal dysfunction among females even though this was not to the significant level (5.9 v 2.2%, p = 0.12). Conclusions:The prevalence of renal dysfunction among young adults is lower than current global estimates. The prevalence of cardiovascular risk factors for CKD were lower than that of older adults with no significant association to renal dysfunction. Increasing age was found to be significantly associated with reduced renal function.

Asunto(s)

RESUMEN

Introduction: Psychosocial problems are common in chronic kidney disease (CKD) patients and are associated with poor overall outcomes; however, their evaluation has not received the deserved attention. This study assessed self-perceived burden on caregivers, psychosocial wellbeing, anxiety and depression among CKD patients, and the impact on their quality of life (QoL) in two hospitals in Nigeria. Methods: This was a cross-sectional study. Self-perceived burden on caregivers, QoL, anxiety, and depression of the patients, were assessed using the Cousineau questionnaire, modified SF-12 questionnaire, Hospital Anxiety and Depression Scale, respectively. Results: There were 141 participants in the study comprising 50 haemodialysis (HD) patients, 41 pre-dialysis CKD patients and 50 controls. The male: female ratio for CKD patients and controls were 1.1 and 1.4 respectively. Prevalence of depressive and anxiety symptoms in the CKD patients were 46.2% and 33.0% respectively. The QoL score was significantly higher in the control group compared to the CKD patients (p= <0.001) and significantly lower in the HD patients compared to the pre-dialysis CKD patients (p= <0.001). Self-perceived burden score was significantly higher in the HD group compared to the pre-dialysis CKD group (p = < 0.001) There was a negative correlation between QoL score and self-perceived burden, hospital anxiety score and hospital depression score (p =<0.001). Conclusion: Psychological disorders and self-perceived burdens are highly prevalent among CKD patients. They have negative impact on their QoL, hence regular evaluation and management of these disorders should be incorporated into the care of CKD patients.

Introduction: Les problèmes psychosociaux sont commun chez les patients atteints d'insuffisance rénale chronique (MRC) et associés à de mauvais résultats globaux, mais leur évaluation n'a pas reçu l'attention méritée. Cette étude a évalué le fardeau autoperçu par les patients sur les soignants, le bien-être psychosocial des patients atteints d'IRC et l'impact sur leur qualité de vie (QoL) dans deux hôpitaux en Nigéria. Méthodes: Il s'agissait d'une étude transversale qui évaluait lefardeau auto-perçu des patients sur les soignants, la qualité de vie, l'anxiété et la dépression à l'aide du questionnaire Cousineau, du questionnaire SF-12 modifié et de l'échelle d'anxiété et de dépression hospitalière respectivement chez les patients atteints d'IRC et les témoins. Résultats: Il y avait 141 participants à l'étude comprenant 50 patients hémodialysés d'entretien (HD), 41 patients atteints d'IRC en pré-dialyse et 50 témoins. Le rapport homme: femme pour les patients atteints d'IRC et le groupe témoin était respectivement de 1,1 et 1,4. La prévalence des symptômes dépressifs et anxieux chez les patients atteints d'IRC était de 46,2% et 33,0% respectivement. Le score de qualité de vie était significativement plus élevé dans le groupe témoin par rapport aux patients atteints d'IRC (p = <0,001). Le score de qualité de vie était significativement plus faible chez les patients HD par rapport aux patients atteints d'IRC en pré- dialyse (p <0,001). Le score d'autoévaluation du fardeau était significativement plus élevé dans le groupe HD que dans le groupe avant la dialyse CKD (p = <0,001) Il y avait une corrélation négative significative entre la qualité de vie et l'auto-perception du fardeau, le score d'anxiété hospitalière et le score de dépression hospitalière (p = < 0,001). Conclusion: Les maux psychologiques sont très répandus chez les patients atteints d'IRC et ont un impact négatif sur leur qualité de vie. Une évaluation et une prise en charge régulières de ces maux doivent être intégrées dans la prise en charge des patients atteints d'IRC. Mots clés: anxiété, dépression, qualité de vie, fardeau pour les soignants, maladie rénale chroniq.

Asunto(s)

RESUMEN

BACKGROUND: Metabolic Syndrome (MS) is a non-communicable disease of global significance. The presence of MS denotes increased risk of cardiovascular disease. The global prevalence of MS is on the increase because of lifestyle changes like consumption of high calorie, low fibre foods coupled with reduced physical activity OBJECTIVES: To determine the prevalence of MS and its components and to estimate atherosclerotic cardiovascular disease (ASCVD) risk in a population of market women. METHODS: A cross-sectional, observational study among female traders in a market in South-western Nigeria. MS was determined using the harmonized NCEP-ATPIII and IDF criteria. The ASCVD risk estimator by the American College of Cardiologists and American Heart Association was used to assess ASCVD risk. RESULTS: One hundred and sixty-nine female traders aged 23 to 80 years with a mean age of 52.8±13.2 years were involved in the study. Overweight and obesity were seen in 61 (36.5%) and 57 (34.1%) participants respectively. Prevalence of MS was 34.9% and the most frequent components of MS were hypertension (62.1%), low HDL-cholesterol (53.8%) and elevated serum triglycerides (18.3%). MS was associated with increasing age (p= 0.010) and BMI (p= 0.009). Significant 10-year ASCVD risk was found in 63 (52.1%) out of 121 participants eligible for ASCVD risk estimation. Significant 10-year ASCVD risk was found in 33(67%) out of 59 participants with MS. CONCLUSION: This study demonstrated significant risk for cardiovascular disease in a population of market women. A more active lifestyle, appropriate diet and treatment of hypertension, diabetes and dyslipidaemia should be encouraged.

Asunto(s)

RESUMEN

BACKGROUND: Numerous studies indicate that immunization against vaccine-preventable infectious diseases lowers mortality among Chronic Kidney Disease/dialysis patients and improve their quality of life. However, their knowledge and practice of this appears to be poor in Nigeria and parts of Africa. OBJECTIVES: We set out to determine subjects' awareness of vaccination against preventable infectious diseases and its impact on their participation in vaccination programs. METHODS: A prospective, cross-sectional study. Data was collated using questionnaires, laboratory results and dialysis entries and analyzed using IBM SPSS Statistics19. RESULTS: One hundred and twenty-four participants (mean age, 48.26±14.45 years) undergoing maintenance haemodialysis were studied. Sixty-two subjects (50.4%), 15.3% and 16.9% had heard of Hepatitis B Virus, S. pneumoniae and H. influenza virus respectively. Thirty-four (54.6%) of the participants first heard of these infections from sources other than healthcare personnel. Of the three common infections, study participants only received formal counselling on Hepatitis B Virus (HBV) infection. Majority had never heard of S. pneumoniae or H. influenzae. Seven (5.7%) had completed their HBV immunisation schedule only. Better educated participants were more aware of necessary vaccination against Hepatitis B Virus (p=0.000) S. pneumoniae (p=0.005) and H. influenza virus (p = 0.003). A significantly higher proportion of participants who received health-personnel driven formal education commenced vaccination against Hepatitis B virus (p=0.000). CONCLUSION: Awareness and practice of vaccination against infectious diseases by haemodialysis patients was found to be poor. Defective system and practice of information dissemination by healthcare workers was remarkably contributory.

Asunto(s)

RESUMEN

BACKGROUND: Although sickle cell disease has become a recognized etiology of chronic kidney disease (CKD), the sickle cell trait (SCT) variant was until recently believed to be a benign carrier state with little or no effect on the health of affected individuals. However, recent studies now appear to suggest an association between SCT and CKD. OBJECTIVE: The objective of the study is to determine the association between SCT (hemoglobin AS) and renal dysfunction among young Nigerian adults. METHODOLOGY: This was a cross-sectional, descriptive study among apparently healthy undergraduates of Adeyemi College of Education, Ondo, southwest Nigeria. Their hemoglobin genotypes were determined using standard alkaline electrophoresis; their blood pressure, anthropometry, serum total cholesterol (TC), creatinine, and estimated glomerular filtration rate (eGFR) were determined. Data analyzed using Statistical Package for Social Sciences (SPSS) 20 were significant at P < 0.05. RESULTS: Six hundred and two subjects with HbAS (SCT, n = 465) and HbAA (non-SCT, n = 137) were studied. Their age range was 18-30 years with male-to-female ratio 1:3.8. There was no difference in the prevalence of renal dysfunction between SCT and non-SCT subjects (5.1% vs. 5.2%, P = 0.591). There was no increased risk of CKD among subjects with SCT (PR, 0.99 at 95% CI [0.417-2.348]). CONCLUSION: SCT was not associated with increased risk of renal dysfunction among young adults in Nigeria. Further studies are needed to clarify the controversy, especially in Nigeria, with a relatively higher prevalence of SCT.

Asunto(s)

RESUMEN

Although the incidence of pregnancy-related acute kidney injury (PRAKI) is declining in developing countries, it still remains a major cause of maternal and fetal morbidity and mortality. The aim of this study was to determine the etiologies, short-term outcomes, and their predictors in patients with PRAKI managed in a tertiary health facility in Southwest Nigeria over a four-year period. This was a four-year retrospective review of clinical records of patients managed for PRAKI in University of Medical Sciences Teaching Hospital, Ondo State, Nigeria. Thirty-two women with a mean age of 31.09 ± 7.50 years had PRAKI during the period reviewed. Twenty-four (75%) patients were multiparous and PRAKI was most common in the postpartum period (56.3%). Twenty-three patients (71.9%) were in RIFLE Stage 3, 24 (75%) received blood transfusion, 5 (15.6%) required intensive care unit (ICU) care, 24 (75%) needed dialysis while 19 (59.4%) had hemodialysis. The common causes of PRAKI were obstetric hemorrhage in 16 (50%), sepsis in seven (21.9%), and eclampsia in six (18.8%). Maternal and fetal mortality were 34.4% and 50% respectively. Seventeen (53.1%) had full renal recovery and only one (3.1%) became dialysis dependent. Significant factors that were associated with maternal mortality were admission to ICU (P = 0.01), hypotension (P = 0.02), and impaired consciousness (P <0.001) PRAKI is still relatively common and significantly contributes to maternal and perinatal mortality in Nigeria. Obstetric hemorrhage which is the most common cause of PRAKI is preventable and treatable. There is a need for physicians to effectively prevent and manage obstetric hemorrhage.

Asunto(s)

RESUMEN

Co-occurrence of aminoglycoside-induced ototoxicity and nephrotoxicity is rare, possibly as a result of divergent mechanisms of tissue damage despite similarities in the anatomy of the inner ear and the proximal renal tubular epithelium. We present the case of a 63-year-old hypertensive woman who developed nonoliguric acute exacerbation of chronic renal failure and sudden onset of sensorineural deafness after receiving daily injections of gentamicin. Coexisting ototoxicity and nephrotoxicity from aminoglycosides can occur, though rare. Adverse effects of aminoglycosides are better prevented by a careful exercise of discretion by prescribers.

RESUMEN

A little over 30 cases on co-existing nephrotic syndrome and autosomal dominant polycystic kidney disease (ADPKD) have been reported from different regions of the world since 1957. We present a case report on co-existence of nephrotic syndrome (secondary to lupus nephritis) with ADPKD in a 24-year-old woman from Nigeria. She was positive for anti-double stranded DNA. Renal histology showed International Society of Nephrology/Renal Pathology Society Class II lupus nephritis. The co-existence of nephrotic syndrome and ADPKD may have been overlooked in Africa in the past. There is a need to screen for nephrotic syndrome in patients with ADPKD among clinicians in the African setting.

Asunto(s)

RESUMEN

BACKGROUND: Kidney transplantation (KT) is now the preferred renal replacement therapy in suitable patients with end-stage renal disease but organ availability is a major limiting factor. AIMS: To evaluate the willingness of caregivers (CGs) and healthcare workers (HWs) to donate a kidney and possible motivating factors in our setting. METHODS: This cross-sectional study was done at Mother and Child Hospital, Kidney Care Centre Ondo and Babcock University Teaching Hospital, all in Southern Nigeria. Participants' willingness to donate a kidney was assessed using Likert and Visual Analogue Scales (VAS). The data were analyzed using SPSS version 20.0. Student t test was used to compare weighted mean scores. Multivariate analysis done; P < .05 was taken as significant. RESULTS: A total of 563 CGs and HWs took part in the study. Sixty percent of them were aware of kidney donation (KD) but only 43.7% had a favorable attitude towards it, and these were predominantly HWs (63.4% vs 33.1%, P < .001). A quarter of the participants were adequately willing to donate a kidney; HWs were significantly more willing than CGs (45.4% vs 15.8%, P < .001). On VAS, the mean willingness score of HWs was higher than that of CGs (t = 7.13, P < .001). Factors strongly influencing the willingness of CGs to donate include their educational level (P = .028, OR = 4.86, 95% CI: 1.19-19.91) social class (P = .012, OR = 6.17 95% CI: 1.5-24.8) and having a relative with kidney disease (P = .019; OR = 3.07 95% CI: 1.25-12.00). Willingness correlated with awareness of KD among CGs (r = 0.534, P < .001). CONCLUSION: There is a low level of willingness alongside negative attitudes toward kidney donation among our participants.

Asunto(s)