Lipid profile in pre-dialysis chronic kidney disease patients in southern Nigeria

Background: Dyslipidaemia is one of the cardiovascular risk factors responsible for cardiovascular disease and rapid progression of chronic kidney disease (CKD) to end stage renal disease. Early detection and management of dyslipidaemia will reduce cardiovascular burden and retard progression of CKD.Aims: To determine the prevalence and pattern of dyslipidaemia in pre-dialysis CKD patients in a tertiary hospital in southern Nigeria.Methods: This was a case-control study that involved 105 consecutive pre-dialysis CKD patients recruited over two years and 105 age and sex matched control subjects. Data obtained from participants included demographics, body mass index, and aetiology of CKD. Blood sampling was done for the determination of creatinine and fasting serum lipids. P values < 0.05 were taken as significant.Results: The mean age of the CKD and control subjects were 46.98±16.81 and 47.57±15.97 years respectively with a male:female ratio of 1.7:1. The median atherogenic index of plasma (AIP), low density lipoprotein-cholesterol and triglyceride (TG) were significantly higher in the CKD patients while mean high density lipoprotein cholesterol (HDL-C) was significantly lower in the CKD patients (p <0.001). The overall prevalence of dyslipidaemia in the CKD patients was 60% which was significantly higher than 39% in the control (p=0.002). The prevalence of high AIP, elevated TG and reduced HDL C increased with worsening renal function. Dyslipidaemia was commoner in female CKD patients (p=0.02) and those who were ≥ 45years (p=0.94).Conclusion: Dyslipidaemia is common in pre-dialysis CKD especially in female and older patients. Some lipid abnormalities increased with worsening kidney function.Keywords: dyslipidaemia, pre-dialysis, chronic kidney disease, Nigeri

Serum C-reactive protein levels in pre-dialysis chronic kidney disease patients in southern Nigeria

Background: Cardiovascular disease is the major cause of hospitalization and mortality in chronic kidney disease (CKD). C- reactive protein (CRP) is a marker of cardiovascular disease and predictor of mortality in CKD patients. CKD patients with elevated CRP should be identified early with institution of measures to treat cardiovascular risk factors in order to reduce attendant mortality.Aims: Determination of serum CRP levels in CKD patients and associated factors.Methods: This was a case-control study involving 80 consecutive CKD patients and 40 control subjects without CKD. Data obtained from participants included demographics, body mass index (BMI), and aetiology of CKD. Serum CRP levels, albumin, creatinine and lipid profile were determined. Cases and controls were compared. P values <0.05 were taken as significantResults: The mean age of the CKD subjects was 49.09±16.85 years. The median CRP value was significantly higher in the CKD group compared to controls (p=<0.001). Low, average and high cardiovascular event risk according to CRP values were present in 51(63.8%), 13(16.2%) and 16(20%) of the CKD patients respectively. Cardiovascular event risk was significantly higher in CKD subjects (p <0.001). Serum creatinine, BMI, triglyceride and atherogenic index of plasma correlated positively with CRP. Estimated glomerular filtration rate (eGFR), high density lipoprotein-cholesterol and albumin correlated negatively with CRP. Elevated serum CRP was significantly predicted by low eGFR and high BMI on multivariate analysis.Conclusion: Chronic kidney disease patients have increased cardiovascular event risk. Interventions aimed at reducing weight and treating dyslipidaemia should be instituted early in order to reduce this risk.Keywords: C-reactive protein, chronic kidney disease, Nigeri

Hyperuricemia in predialysis chronic kidney disease patients in Southern Nigeria

Background: Cardiovascular disease (CVD) is the leading cause of hospitalization and death in chronic kidney disease (CKD) patients. Hyperuricemia has emerged as one of the nontraditional cardiovascular risk factors. Studies have shown that hyperuricemia plays a major role in the development of CVD and rapid progression of CKD to end-stage renal disease. Objective: The aim was to determine the prevalence and pattern of hyperuricemia in predialysis CKD patients attending a teaching hospital in Southern Nigeria. Methodology: One hundred and twenty consecutive predialysis CKD patients and 40 control subjects with normal renal function were recruited over 2 years. Data obtained from participants included demographics, body mass index, blood pressure reading, and etiology of CKD. Blood sampling was done for the determination of serum uric acid, creatinine, and fasting serum lipids. P < 0.05 were taken as significant. Results: The mean age of the CKD subjects was 48.8 ± 16.6 years with a male:female ratio of 1.7:1. The prevalence of hyperuricemia in the CKD subjects was 47.5% and this was significantly higher than 15% observed in the control group (P ≤ 0.001). The prevalence of hyperuricemia was highest in CKD stage 3b. Hyperuricemia was more prevalent in younger predialysis CKD subjects and those with hypertensive nephropathy. There was no significant association between hyperuricemia, obesity, gender and dyslipidemia in this study. Conclusion: Hyperuricemia is highly prevalent in young predialysis CKD patients even in the early stages. Measures to reduce hyperuricemia should be put in place especially lifestyle and dietary modification

Quality of life in patients on continuous ambulatory peritoneal dialysis in an African setting

To determine the quality of life (QOL) of patients on continuous ambulatory peritoneal dialysis (CAPD), we studied all the CAPD patients attending their monthly follow-up care clinics at three tertiary hospitals in Johannesburg by administering the World Health Organization QOL-Bref questionnaire. The patients were grouped according to age, duration of peritoneal dialysis and gender. Data were analyzed to determine the significant differences in the QOL scores among the subgroups. There were 114 patients [64 males (56.1%), with a mean age of 42.4 ± 11.3 years) and 38 healthy control subjects (22 males (57.9%), with a mean age of 42.1 ± 12.4 years]. Twenty-one patients (18.4%) had hemoglobin <10 g/dL, while 16 patients (14%) had serum albumin <3 g/dL. The mean QOL scores in the physical, psychological, social relationships and environment domains of the CAPD patients were 55.7 ± 15.0, 56.6 ± 16.4, 55.3 ± 24.7 and 56.3 ± 16.6, respectively. The CAPD patients had significantly lower QOL scores compared with controls, and those aged <30 years had better scores in the physical and psychological domains, gender and hemoglobin concentration. Serum albumin levels did not have a significant impact on the QOL of the CAPD patients