Etiology of Chronic Kidney Disease in Nigeria and Management Challenges

The prevalence of chronic kidney disease (CKD) is increasing globally and is one of the noncommunicable diseases associated with increase mortality globally in the last two decades. The prevalence of CKD in Nigeria, it is 1.6% to 12.4%. Ninety percent of end-stage renal disease (ESRD) patients are said to die within 3 months of commencing dialysis. Indices are even worse in resource poor countries like Nigeria where prevention and adequate intervention are usually hampered by funds. In regions like Nigeria, it will be cheaper to prevent CKD than treating its complications. Hence, it is important to identify the common etiologies of CKD in Nigeria and prevent or promptly address them before causing irreversible damage to the kidneys. The most common cause of CKD in Nigeria includes hypertension, glomerulonephritis and diabetes mellitus. Many of these etiologies are preventable/treatable and should be looked for as a major way to reduce the incidence of CKD in Nigeria. Challenges identified in Nigeria, propagating CKD include westernization, inadequate manpower, late presentation, diagnostic challenge and poorly equipped facilities. Interventions like encouraging healthy lifestyle, making available essential drugs, training of health personnel, subsidized cost of treatment, legislation and policies to curb drug abuse. Therefore, resource-poor settings should focus on creating more awareness and making legislations and/or policies focused on these preventable causes of CKD as this is more realistic and effective in these settings

Nutritional qualities and consumers acceptance of provitamin a biofortified amahewu complemented with defatted bambara flour.

Master of Science in Human Nutrition. University of KwaZulu-Natal, Pietermaritzburg 2016.Abstract available in PDF file

Indices of Kidney Damage and Cardiovascular Disease Risk Factors in a Semiurban Community of Iloye, South-West Nigeria

Health screening exercises are important, as they enable early detection of diseases in individual subjects and also enable data collection, useful in estimating disease burden in the community. This paper describes the findings of a health screening exercise conducted in a semiurban population of Iloye, by the Rotary Club of Ota, Ogun State, Western Nigeria, as a part of its community-oriented services and projects. Three hundred and twenty six community members were screened during the exercise. There were 189 (57.97%) females and 137 (42.03%) males, with a mean age of 43.5 ± 14.88 yrs. Urinary abnormality and/or creatinine clearance less than 90 mls/min was detected in 147 (45.09%) participants. 99 (30.37%) participants had proteinuria, 16 (4.91%) had haematuria, and 5 (1.53%) participants had both haematuria and proteinuria. Eight (2.45%) participants had GFR less than 60 mls/min. Elevated blood pressure was found in 152 (46.63%), while 3 (0.9%) participants had diabetes, 71 (21.8%) were obese, 16 (4.9%) had hypercholesterolaemia, and 3 (0.9%) had hypertriglyceridaemia. Prevalence of both smoking and alcohol consumption was 6 (1.84%). It was concluded that the prevalence of indices of kidney damage and cardiovascular risk factors is high in Iloye community

Clinical features, predictive factors and outcome of hyperglycaemic emergencies in a developing country

<p>Abstract</p> <p>Background</p> <p>Hyperglycaemic emergencies are common acute complications of diabetes mellitus (DM) but unfortunately, there is a dearth of published data on this entity from Nigeria. This study attempts to describe the clinical and laboratory scenario associated with this complication of DM.</p> <p>Methods</p> <p>This study was carried out in DM patients who presented to an urban hospital in Nigeria with hyperglycaemic emergencies (HEs). The information extracted included biodata, laboratory data and hospitalization outcome. Outcome measures included mortality rates, case fatality rates and predictive factors for HEs mortality. Statistical tests used are <it>χ</it>², Student's t test and logistic regression.</p> <p>Results</p> <p>A total of 111 subjects with HEs were recruited for the study. Diabetes ketoacidosis (DKA) and hyperosomolar hyperglycaemic state (HHS) accounted for 94 (85%) and 17 (15%) respectively of the HEs. The mean age (SD) of the subjects was 53.9 (14.4) years and their ages ranged from 22 to 86 years. DKA occurred in all subjects with type 1 DM and 73 (81%) of subjects with type 2 DM. The presence of HSS was noted in 17 (19%) of the subjects with type 2 DM.</p> <p>Hypokalaemia (HK) was documented in 41 (37%) of the study subjects. Elevated urea levels and hyponatraemia were noted more in subjects with DKA than in those subjects with HHS (57.5%,19% vs 53%,18%). The mortality rate for HEs in this report is 20% and the case fatality rates for DKA and HHS are 18% and 35% respectively.</p> <p>The predictive factors for HEs mortality include, sepsis, foot ulceration, previously undetected DM, hypokalaemia and being elderly.</p> <p>Conclusion</p> <p>HHS carry a higher case fatality rate than DKA and the predictive factors for hyperglycaemic emergencies' mortality in the Nigerian with DM include foot ulcers, hypokalaemia and being elderly.</p

Sorghum–Insect Composites for Healthier Cookies: Nutritional, Functional, and Technological Evaluation

Protein-energy malnutrition (PEM) is a major health concern in sub-Saharan Africa (SSA). Relying on unexploited and regionally available rich sources of proteins such as insects and sorghum might contribute towards addressing PEM among at-risk populations. Insects are high in nutrients, especially protein, and are abundant in SSA. Sorghum is adapted to the tropical areas of SSA and as such it is an appropriate source of energy compared with temperate cereals like wheat. It is necessary to assess whether cookies fortified with sorghum and termite would be suitable for use in addressing PEM in SSA. Whole grain sorghum meal and termite meal were mixed at a 3:1 ratio (w/w sorghum:termite) to form a sorghum&ndash;termite meal blend. Composite cookies were prepared where the sorghum&ndash;termite blend partially substituted wheat flour at 20%, 40%, and 60% (sorghum&ndash;termite blend:wheat flour (w/w). The functional and nutritional qualities of the cookies were assessed. Compared with the control (100% wheat flour), the cookies fortified with sorghum and termite had about double the quantity of protein, minerals, and amino acids. However, with increased substitution level of the sorghum&ndash;termite blend, the spread factor of the cookies decreased. There is a potential to incorporate sorghum and termite in cookies for increased intake of several nutrients by communities that are vulnerable to nutrient deficiencies, especially PEM

Anemia of Chronic of Chronic Kidney Disease – A Review

No Abstrac

Yoruba ontology: Perception of the physical body of the dead and its implications for cadaveric organ transplantation in south-west Nigeria.: Yoruba death ontology: implications for organ transplantation

Introduction: The perception of death differs by region, culture, religion, and ethnic group in Nigeria. These differences can affect the consent rate for cadaveric transplantation. Understanding the Yoruba concept of death and approaching families for consent in a culturally sensitive manner may increase family consent to deceased donor organ harvesting. This literature review explores the Yoruba concept of death and organ transplantation.Methods: Three research questions were formulated and a search strategy was drafted by creating a SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, and Research type) logic search grid. Relevant databases were then examined using the search terms, concepts and keywords so generated. The findings of publications retrieved on Yoruba beliefs regarding death were entered into a summary table based on the themes identified in them. These themes served as the basis for the interpretation synthesis.Results: Fifteen of the eighty-five studies identified initially were deemed contextually relevant to the researchquestions and used in the analysis. These sources revealed that death in the Yoruba belief system signifies the dematerialization of the soul and its transformation from earthly existence into a spiritual one. Consequently, the physical body of the deceased is perceived as becoming dust and of little relevance to the afterlife.Conclusion: In the Yoruba worldview, the state of the physical body after death has no relevance to afterlife and reincarnation. However, transplant teams must consider the circumstances of death when asking for consent. When death is viewed positively, success is more likely

Clinical characteristics of Human Immunodeficiency Virus (HIV) seropositive Nigerian patients undergoing dialysis

Renal failure is a common finding in human immunodeficiency virus infected patients, and it contributes significantly to their morbidity and mortality. Most dialysis centres in Nigeria currently do not accept HIV positive patients for dialysis therapy for many reasons. The prevailing high level of stigmatization of HIV positive patients and the lack of job security for infected staff are two major reasons for the non-acceptance of HIV infected patients for dialysis by these centres. Following a pathetic encounter with an HIV positive patient who required dialysis and the success of his treatment, our centre currently perform dialysis for HIV positive patients on routine basis. In this article, we present our clinical observations on the characteristics of HIV patients dialyzed in our unit between 1st January 2004 and 31st December 2004. A total of 142 patients dialyzed in our centre during this period. 24 (16.9%) were HIV positive. Acute renal failure was significantly more common in the HIV positive patients. [14(31.8%) of 44 patients who presented with acute renal failure. X2 = 8.95,

Nutritional Properties and Consumer’s Acceptance of Provitamin A-Biofortified Amahewu Combined with Bambara (Vigna Subterranea) Flour

Amahewu is a fermented non-alcoholic cereal grain beverage, popular in Southern Africa. This study evaluates the possibility of producing an acceptable provitamin A (PVA)-biofortified maize amahewu, complemented with bambara flour, to contribute towards the alleviation of protein energy malnutrition (PEM) and vitamin A deficiency (VAD). Germinated, roasted, and raw bambara flours, were added at 30% (w/w) substitution level, separately, to either white maize or PVA-biofortified maize flour, and processed into amahewu. Wheat bran (5% w/w) was used as reference inoculum. Amahewu samples were analyzed for nutritional properties and acceptability. The protein and lysine contents of amahewu almost doubled with the inclusion of germinated bambara. Protein digestibility of amahewu samples increased by almost 45% with the inclusion of bambara. PVA-biofortified maize amahewu samples complemented with bambara were extremely liked for their color, aroma, and taste when compared with their white maize counterparts. The principal component analysis explained 96% of the variation and PVA-biofortified maize amahewu samples were differentiated from white maize amahewu samples. The taste of amahewu resulting from roasting and germination of bambara was preferred in PVA-biofortified maize amahewu, compared to white maize amahewu. We conclude that PVA-biofortified maize amahewu, complemented with germinated bambara, has the potential to contribute towards the alleviation of PEM and VAD