24 research outputs found
The Enormity of Chronic Kidney Disease in Nigeria: The Situation in a Teaching Hospital in South-East Nigeria
Background. The magnitude of the problem of chronic kidney disease (CKD) is enormous, and the prevalence keeps rising. To highlight the burden of CKD in developing countries, the authors looked at end-stage renal disease (ESRD) patients seen at the University of Nigeria Teaching Hospital (UNTH), Enugu, South-East Nigeria. Method. ESRD patients seen from 01/05/1990 to 31/12/2003 were recruited. Records from A&E Department, medical-out-patients, wards and dialysis unit were used. Results. A total of 1001 male versus 537 female patients were reviewed. About 593 male versus 315 female patients had haemodialysis. The mean age was 42.55 ± 15.43 years and 86.5% were <60 years. Primary renal disease could not be determined in 51.6% while hypertension and glomerulonephritis accounted for −17.2% and 14.6%, respectively. Death from renal causes constituted 22.03% of medical deaths. Conclusion. The prognosis for CKD patients in Nigeria is abysmal. Only few patients had renal-replacement-therapy (RRT). The prohibitive cost precludes many patients. This underscores the need for preventive measures to reduce the impact of CKD in the society
High Prevalence and Low Awareness of Hypertension in a Market Population in Enugu, Nigeria
Background. A community-based study put the prevalence of hypertension in Nigeria at 32.8%. Market workers in Nigeria lead sedentary life style and often depend on salt-laden fast food while at work. Method. An unselected population of market workers were screened for hypertension and its risk factors by a pretested, structured questionnaire, clinical examination, and laboratory investigation. Hypertension was defined as BP ≥ 140 and/or ≥ 90 mmHg or being on drug therapy. Results. Forty-two percent of the screened population were hypertensive. Of this number, 70.6% did not know they were hypertensive before the screening. More males than females (P = .022) were hypertensive. Prevalence of hypertension increased with age from 5.4% in the age group <20 years to 80% in the age group ≥70 years. Conclusion. The prevalence of hypertension in market workers in this study was 42%, and the majority of them were unaware of their disease
Prevalence of CKD-MBD in pre-dialysis patients using biochemical markers in Enugu, South-East Nigeria
Background: As kidney function declines, there is a progressive
deterioration in mineral homeostasis with disruption of normal serum
and tissue concentration of phosphorus and calcium, and changes in
circulating levels of hormones-parathyroid hormone (PTH), calcitriol
(1,25(OH)2 D), and Fibroblast growth factor-23 (FGF-23). Objective:
This study was aimed at determining the prevalence of markers of
CKD-MBD in pre-dialysis patients. Methods: We evaluated consecutively
168 subjects made up of 85 CKD patients and 83 healthy controls, who
were attending the renal clinics and medical outpatient of University
of Nigeria Teaching Hospital, Enugu. GFR was estimated and serum
calcium, phosphorus, alkaline phosphatase, PTH, and 25(OH) D levels
assayed. Results: The prevalence of various mineral bone disease
abnormalities were 70% hyper-phosphatemia, 85% hyper-parathyroidism,
and 100% low levels of 25 (OH) D among the patients. Estimated GFR
correlated negatively with both serum phosphorus, and PTH. Age of the
patients ranged from18-76 years with a male to female ratio of 1.7:1.
Chronic Glomerulonephritis (CGN), hypertension and diabetes mellitus
caused CKD in 75% of the patients. There was no significant decrease in
serum calcium levels of patients compared to controls. The patients did
not have pathologically raised alkaline phosphatase, although their
mean level was significantly higher than that of the control group.
Conclusion: Low 25 (OH) D levels (insufficiency/deficiency),
hyperparathyroidism, and hyper-phosphatemia were the obvious markers of
CKD-MBD in our pre-dialysis patients. These should be evaluated at
presentation in these patients
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Background. A community-based study put the prevalence of hypertension in Nigeria at 32.8%. Market workers in Nigeria lead sedentary life style and often depend on salt-laden fast food while at work. Method. An unselected population of market workers were screened for hypertension and its risk factors by a pretested, structured questionnaire, clinical examination, and laboratory investigation. Hypertension was defined as BP ≥ 140 and/or ≥ 90 mmHg or being on drug therapy. Results. Forty-two percent of the screened population were hypertensive. Of this number, 70.6% did not know they were hypertensive before the screening. More males than females (P = .022) were hypertensive. Prevalence of hypertension increased with age from 5.4% in the age group <20 years to 80% in the age group ≥70 years. Conclusion. The prevalence of hypertension in market workers in this study was 42%, and the majority of them were unaware of their disease
A community-based study of hypertension and cardio-metabolic syndrome in semi-urban and rural communities in Nigeria
<p>Abstract</p> <p>Background</p> <p>The prevalence of cardio-metabolic syndrome (CMS) is increasing worldwide. In people of African descent, there is higher prevalence of hypertension and complications than other races. Bearing in mind these facts, we looked at the CMS in the general population and the population with hypertension. Using the new International Diabetes Federation (IDF) definitions of CMS, we studied its prevalence in semi-urban and rural communities in South-east Nigeria in relation to hypertension.</p> <p>Method</p> <p>This is a cross sectional population based study involving 1458 adults aged from 25 to 64 years. Diagnosis of CMS was based on the new IDF criteria using the anthropometric measurements for Europids as there is none yet for blacks. Hypertension was defined according to the WHO/ISH criteria.</p> <p>Results</p> <p>The overall prevalence of CMS was 18.0% in the semi-urban community as against 10.0% in the rural community increasing to 34.7% and 24.7% respectively in the population with hypertension. The prevalence of co-morbidities - hyperglycaemia, abdominal obesity, and hypertriglceridaemia were 13.9%, 41.1% and 23.9% while in the hypertensive populations they were 21.2%, 55.0% and 31.3% in the general population in both communities combined. Except for low HDL cholesterol, every other co-morbidity was higher in hypertensive population than the general population.</p> <p>Conclusion</p> <p>The high prevalence of CMS in the semi-urban population especially for the population with hypertension underscores the double burden of disease in developing countries. The lesson is while infections and infestations are being tackled in these countries the non-communicable diseases should not be neglected.</p
Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c
Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose
diabetes, but may identify different people as having diabetes. We used data from 117
population-based studies and quantified, in different world regions, the prevalence of
diagnosed diabetes, and whether those who were previously undiagnosed and detected
as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed
prediction equations for estimating the probability that a person without previously
diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa.
The age-standardised proportion of diabetes that was previously undiagnosed, and
detected in survey screening, ranged from 30% in the high-income western region to 66%
in south Asia. Among those with screen-detected diabetes with either test, the agestandardised
proportion who had elevated levels of both FPG and HbA1c was 29-39%
across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and
middle-income regions, isolated elevated HbA1c more common than isolated elevated
FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and
underestimate diabetes prevalence. Our prediction equations help allocate finite
resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and
surveillance.peer-reviewe
Proteinuria in newly-diagnosed HIV patients in Southeast Nigeria: a hospital based study
Background: The aim of this study is to determine the prevalence of proteinuria in newly diagnosed HIV subjects in southeast Nigeria using 24-hour urine protein.Methods: This was a prospective study on the prevalence of proteinuria in newly-diagnosed HIV subjects in Owerri, southeast Nigeria. Three hundred and seventy five newly diagnosed HIV subjects and 136 non-HIV controls. Subjects were recruited from the HIV clinic and Medical Outpatient Department (MOPD) of Federal Medical Centre, Owerri. An interviewer structured questionnaire was administered and relevant data collected. Investigations performed included HIV screening, and confirmatory test, 24-Hour Urine Protein (24HUP), Creatinine Clearance. Significant 24HUP was taken as ≥ = 0.150g.Results: Three hundred and seventy five HIV subjects and 136 control subjects took part in the study. The mean age of the subjects was 39±11 years. Significant Proteinuria (≥ = 150mg/day) was present in 122 (32.5%) of the HIV subjects and 20 (14.7%) of the controls (p=0.019). In addition, 68 (18.1%) of HIV and 8 (5.9%) of non-HIV control subjects had proteinuria in the range of 0.150g - 0.300g/day. While 54 (14.4%) of HIV subjects and (11) 8.1% of non-HIV controls, had proteinuria in the range of 0.300g - 3.499g/day, p<0.001.Conclusion: Prevalence of significant proteinuria is high in newly diagnosed HIV-seropositive and assessment of proteinuria is recommended in newly diagnosed HIV subjects. This will help in identifying chronic kidney disease subjects, and also encourage early initiation of treatment.Keywords: Human Immunodeficiency Virus (HIV), Proteinuria, 24-Hour Urine Protein (24HUP), Creatinine Clearance (Ccr
Chronic kidney disease burdenin Low-Resource settings: Regional perspectives
The burden of chronic kidney disease (CKD) has increased exponentially worldwide but more so in low- and middle-income countries. Specific risk factors in these regions expose their populations to an increased risk of CKD, such as genetic risk with APOL1 among populations of West African heritage or farmers with CKD of unknown etiology that spans various countries across several continents to immigrant/indigenous populations in both low- and high-income countries. Low- and middle-income economies also have the double burden of communicable and noncommunicable diseases, both contributing to the high prevalence of CKD. The economies are characterized by low health expenditure, sparse or nonexistent health insurance and welfare programs, and predominant out-of-pocket spending for medical care. This review highlights the challenges in populations with CKD from low-resource settings globally and explores how health systems can help ameliorate the CKD burden