Estimated glomerular filtration rate in apparently healthy term neonates in Nigeria

Background: Glomerular filtration rate (GFR) is the best measure of renal function. However, the ideal exogenous markers are not routinely used to estimate GFR in clinical settings. Outside Africa, GFR estimates for neonates have been calculated from formulae using creatinine as well as cystatin C. There is a paucity of data on estimated GFR in neonates in Africa. This study was conducted to estimate GFR in healthy term African neonates using cystatin C-based equations.Methods: One hundred and thirteen apparently healthy term babies with normal Apgar scores were recruited at birth. Cystatin C was measured in cord blood at birth and in venous samples from neonates on the third day of life. GFR was estimated using the Filler and Lepage as well as the Zappitelli et al. cystatin C-based equations. These estimates were compared with a reference GFR estimate of 41 ± 15 mL/min/1.73 m2.Results: The median (interquartile range) estimated GFR values based on cord blood and day 3 venous samples using the Filler and Lepage equation were 44.67 (36.35–72.44) and 51.29 (38.90–72.44) mL/min/1.73 m2, respectively. When the Zappitelli equation was applied, the estimates were 38.18 (31.84–61.34) and 43.82 (33.75–61.34) mL/min/1.73 m2, respectively. The GFR estimates derived from both equations did not differ in respect of the gestational age, sex and postnatal ages of the babies.Conclusions: GFR estimates using the Zappitelli equation had values that were closely related to reference GFR measures for neonates whereas the GFR estimates using the Filler and Lepage equation had higher values

Pulmonary functions of children with sickle cell anaemia in steady state in Lagos, Nigeria

Background: Respiratory disorders are responsible for considerable morbidity and mortality in children with sickle cell anaemia (SCA). Spirometry is a useful tool for the detection and monitoring of respiratory disorders, but it is under-utilized by healthcare workers who care for children with sickle cell anaemia. Most of the studies assessing pulmonary functions in sickle cell anaemia were conducted among adults. Objective: To describe the lung functions profile of children with sickle cell anaemia in steady state. Methodology: In this study, spirometric indices of 100 children with SCA (HbSS) aged five years to 12 years were compared with 100 matched normal children (HbAA) in the control group. Results: Irrespective of gender, the mean Peak Expiratory Flow Rate (PEFR) values were significantly higher among the HbAA controls than their HbSS counterparts. The mean Forced Expiratory Volume in one second (FEV1) values of males and all subjects irrespective of gender were also significantly higher among the controls compared to HbSS subjects. The mean Forced Vital Capacity (FVC) values were higher among HbSS subjects than the HbAA controls, but the observed differences were not significant. The mean FEV1/FVC values were also not significantly different between the SCA subjects and the controls. The overall prevalence of restrictive pulmonary abnormalities among the HbSS group was 6.0% whereas none of the HbAA group had restrictive pulmonary disorders. Conclusion: Children with SCA, irrespective of gender, have significantly lower PEFR and FEV1. Restrictive lung abnormalities occur exclusively among subjects with SCA

Skinfold Thickness Measurement in Term Nigerian Neonates: Establishing Reference Values

Skin fold thickness (SFT) measurement is a reliable, cheap, simple, noninvasive method of body fat estimation at all ages including the neonatal period. Objective. To determine reference values of biceps, triceps, subscapular, and suprailiac skinfold thickness measurements in term Nigerian newborns. Method. A prospective cross-sectional study over a six-month period (Dec 2010–May 2011) was carried out on term and healthy neonates delivered between 37 and 41 weeks. The anthropometric measurements were taken within the first 48 hours of life including the skinfold thickness. The skinfold thickness measurements were taken at four sites, namely, triceps, biceps, subscapular, and suprailiac, using Harpenden skinfold calipers. The mean of two readings was recorded. Result. A total of one thousand one hundred and sixty-eight neonates were studied. The birth weight ranged between 2000 g and 5000 g with a mean birth weight of the neonates at 3259±470 g. The mean birth weight of the males (3339±0.45) was significantly higher than that of females (3200±0.44) (p<0.0001). Female neonates had higher mean values of triceps, subscapular, and suprailiac skinfold thickness (p<0.001, resp.) while male neonates had higher mean value of biceps skinfold thickness (p=0.008). Females also had higher mean values of the sum of skinfold thicknesses at all four sites and the sum at the two truncal sites at every stratified gestational age. Conclusions. The sex specific percentile chart developed for skinfold thickness measurements can be used to detect deviation from the reference population such that infants who are at risk of nutritional or health problems are identified early, and intervention is instituted promptly