scholarly journals MON-303 EFFECTIVE MONITORING OF PROGRESSIVE CHRONIC KIDNEY DISEASE AMONG PATIENTS ATTENDING DIABETIC CLINIC AT MUHIMBILI NATIONAL HOSPITAL, TANZANIA

2019 ◽  
Vol 4 (7) ◽  
pp. S423-S424
Author(s):  
G.V. Shirima
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Diabetic Clinic

scholarly journals Effective monitoring of diabetic patients on progressive chronic kidney disease among patients attending diabetic clinic at Muhimbili National Hospital, Tanzania

2021 ◽  
Vol 1 (3) ◽  
pp. 044-052
Author(s):  
Gudila Valentine Shirima ◽  
Paschal Joseph Rugajjo ◽  
Obadia Venance Nyongole ◽  
Francis Furia ◽  
Kimu Marko Njiku
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Clinical Notes ◽  
Renal Functions ◽  
Diabetic Clinic

Background: Diabetic Kidney Disease is a complication of Diabetes Mellitus (DM) following the natural history of diabetes. Worldwide up to 40 % of patients with diabetes mellitus will develop Diabetic Kidney Disease. Kidney Disease Outcome Quality Initiative (KDOQI) guidelines recommends monitoring for proteinuria, blood sugar, renal functions and blood pressure in the patients with DM so that progression to complications including renal failure is prevented. Our study aimed to audit on effective monitoring of progressive chronic kidney disease among patients attending diabetic clinic at Muhimbili National Hospital. Material and methods: This was a retrospective clinical audit which included patients who attended diabetic clinic at Muhimbili National Hospital in 1st January 2017 to 31st December 2017. Simple random sampling technique using software called OpenEpi Random Program was used to get the sample of 120 patients. Patients with missing clinical notes were excluded from the audit. Records of the clinical notes, socio-demographic characteristics and investigations of the selected patients were retrieved from the Jeeva system and recorded using a structured questionnaire. We analyzed our data using Statistical Package for Social Sciences (SPSS) version 20.0 Results: One hundred and fourteen DM patents records were reviewed. Around 79% of the patients involved in the study were aged above 45years, 60% were females. Majority had type 2 DM (76.3%). Minority i.e. 15/114 (13.2%) of the patients had their urine for protein checked in the year 2017 as well as serum creatinine in the last 3months. Seven percent had HbA1c test done i.e. 8/114 (7%). Blood pressure was monitored in 72.8% (83/114) of the patients. Only16 out of 66 patients (24.2%) had blood pressure controlled. Majority of the patients 10/15 (66.7%) who had renal functions records had normal eGFR. Findings on monitoring for proteinuria, renal functions, control of HbA1c and Blood pressure control were all below audit standards. Conclusion: Our study found that there is generally poor monitoring of diabetic outpatient for progressive chronic kidney disease when compared to the KDOQI standards which calls the health care providers to adhere on set SOPs according to the guidelines available aiming at improving services and quality of life to diabetic patient.

scholarly journals Metabolic Bone Disease in Chronic Kidney Disease Patients (CKD-MBD) and its Associated Factors at Muhimbili National Hospital in Dar es salaam, Tanzania: A Cross-Sectional Study

2020 ◽  
Author(s):  
Felix Faustin Mungulluh ◽  
Paschal Ruggajo ◽  
Francis Fredrick Furia
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Metabolic Bone

Abstract Background: Metabolic bone disease in chronic kidney disease patients is associated with high morbidity and mortality, and it has been reported to start early in the course of the disease and worsen as the kidney damage progresses. However, the prevalence and factors associated with metabolic bone disease in chronic kidney disease patients in our setting has not been established, so we aimed to determine the prevalence and factors associated with metabolic bone disease among patients with chronic kidney disease at a tertiary Muhimbili National Hospital in Dar es salaam, Tanzania so as to help physicians recognize the patients at risk, diagnose the problem and prevent complications sooner.Methods: This was a hospital based cross-sectional study involving adult patients with chronic kidney disease attending renal unit Muhimbili National Hospital, a tertiary referral center in Dar es Salaam, Tanzania. Systematic sampling technique was employed to get study participants after being given informed consent. In this study, CKD-MBD was defined basing on the abnormality of serum calcium, phosphate or parathyroid hormone level. Data analysis was done using the SPSS version 23.0 software. Results: A total of 300 participants with chronic kidney disease stage 3 and above were included in this study. Majority were male, 198 (66.0%), with a mean age of 53 years. The prevalence of metabolic bone disease was found to be 75.0%. The most common form of metabolic bone disease was hyperparathyroidism 196 (87.1%), followed by hypocalcemia 174 (77.3%) and hyperphosphatemia 82 (36.4%), which was the least common. Factors which were found to be significantly associated with CKD-MBD were the use of calcium supplements, use of phosphate binders, being on dialysis, a calcium rich diet and a low phosphate diet.Conclusion: Metabolic bone diseases are common in patients with CKD at Muhimbili National Hospital. Patients with CKD should undergo serial assessment of phosphate, calcium and parathyroid hormone level, considered together, so as to diagnose metabolic bone disease early and treat those patients who will be found to have persistently or prolonged abnormalities in these bone mineral biomarkers.

scholarly journals Metabolic Bone Disease in Chronic Kidney Disease Patients (CKD-MBD) and its Associated Factors at Muhimbili National Hospital in Dar es salaam, Tanzania: A Cross-Sectional Study

2020 ◽  
Author(s):  
Felix Faustin Mungulluh ◽  
Paschal Ruggajo ◽  
Francis Fredrick Furia
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Metabolic Bone

Abstract Background: Metabolic bone disease in chronic kidney disease patients is associated with high morbidity and mortality, and it has been reported to start early in the course of the disease and worsen as the kidney damage progresses. However, the prevalence and factors associated with metabolic bone disease in chronic kidney disease patients in our setting has not been established, so we aimed to determine the prevalence and factors associated with metabolic bone disease among patients with chronic kidney disease at a tertiary Muhimbili National Hospital in Dar es salaam, Tanzania so as to help physicians recognize the patients at risk, diagnose the problem and prevent complications sooner. Methods: This was a hospital based cross-sectional study involving adult patients with chronic kidney disease attending renal unit Muhimbili National Hospital, a tertiary referral center in Dar es Salaam, Tanzania. Systematic sampling technique was employed to get study participants after being given informed consent. In this study, CKD-MBD was defined basing on the abnormality of serum calcium, phosphate or parathyroid hormone level. Data analysis was done using the SPSS version 23.0 software. Results: A total of 300 participants with chronic kidney disease stage 3 and above were included in this study. Majority were male, 198 (66.0%), with a mean age of 53 years. The prevalence of metabolic bone disease was found to be 75.0%. The most common form of metabolic bone disease was hyperparathyroidism 196 (87.1%), followed by hypocalcemia 174 (77.3%) and hyperphosphatemia 82 (36.4%), which was the least common. Factors which were found to be significantly associated with CKD-MBD were the use of calcium supplements, use of phosphate binders, being on dialysis, a calcium rich diet and a low phosphate diet. Conclusion: Metabolic bone diseases are common in patients with CKD at Muhimbili National Hospital. Patients with CKD should undergo serial assessment of phosphate, calcium and parathyroid hormone level, considered together, so as to diagnose metabolic bone disease early and treat those patients who will be found to have persistently or prolonged abnormalities in these bone mineral biomarkers.

scholarly journals Metabolic Bone Disease in Chronic Kidney Disease Patients (CKD-MBD) and its Associated Factors at Muhimbili National Hospital in Dar es salaam, Tanzania: A Cross-Sectional Study

2020 ◽  
Author(s):  
FELIX FAUSTIN MUNGULLUH ◽  
Paschal Ruggajo ◽  
Francis F. Furia
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Metabolic Bone

Abstract Background: Metabolic bone disease in chronic kidney disease patients is associated with high morbidity and mortality, and it has been reported to start early in the course of the disease and worsen as the kidney damage progresses. However, the prevalence and factors associated with metabolic bone disease in chronic kidney disease patients in our setting has not been established, so we aimed to determine the prevalence and factors associated with metabolic bone disease among patients with chronic kidney disease at a tertiary Muhimbili National Hospital in Dar es salaam, Tanzania so as to help physicians recognize the patients at risk, diagnose the problem and prevent complications sooner.Methods: This was a hospital based cross-sectional study involving adult patients with chronic kidney disease attending renal unit Muhimbili National Hospital, a tertiary referral center in Dar es Salaam, Tanzania. Systematic sampling technique was employed to get study participants after being given informed consent. In this study, CKD-MBD was defined basing on the abnormality of serum calcium, phosphate or parathyroid hormone level. Data analysis was done using the SPSS version 23.0 software.Results: A total of 300 participants with chronic kidney disease stage 3 and above were included in this study. Majority were male, 198 (66.0%), with a mean age of 53 years. The prevalence of metabolic bone disease was found to be 75.0%. The most common form of metabolic bone disease was hyperparathyroidism 196 (87.1%), followed by hypocalcemia 174 (77.3%) and hyperphosphatemia 82 (36.4%), which was the least common. Factors which were found to be significantly associated with CKD-MBD were the use of calcium supplements, use of phosphate binders, being on dialysis, a calcium rich diet and a low phosphate diet.Conclusion: Metabolic bone diseases are common in patients with CKD at Muhimbili National Hospital. Patients with CKD should undergo serial assessment of phosphate, calcium and parathyroid hormone level, considered together, so as to diagnose metabolic bone disease early and treat those patients who will be found to have persistently or prolonged abnormalities in these bone mineral biomarkers.

scholarly journals Screening for chronic kidney disease in rural Malawi: results from a diabetic clinic

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Chiyembekezo Kachimanga ◽  
Richard Kamwezi ◽  
Emily B. Wroe ◽  
Lawrence Nazimera ◽  
Enoch Ndarama ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diabetic Clinic

scholarly journals Shared Decision-making between health care providers and patients at a Tertiary Hospital Diabetic Clinic in Tanzania

2020 ◽  
Author(s):  
Oswald Vedasto ◽  
Baraka Morris ◽  
Francis Fredrick Furia
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Health Care Providers ◽  
Shared Decision ◽  
Care Providers ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Diabetic Clinic ◽  
Participation In Decision Making

Abstract Background Patients’ participation in decision making regarding their treatment play an important role in treatment outcome through improvement in self-care and adherence to treatment. There is scarcity of information regarding shared decision making in sub-Saharan Africa. This study was conducted to assess participation of patients and health care providers in decision-making process in the diabetic clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania.Methods This study employed a phenomenological study design using in-depth interview technique. Study participants were diabetic patients visiting the clinic and healthcare providers working in the diabetic clinic at Muhimbili National Hospital. Data was collected using interview guide with open ended questions using an audio digital recorder. Content analysis method was used during analysis whereby categories were reached through the process of coding with assistance by Nvivo 12 software. Results Several themes were identified in this study including some form of participation in decision making of patients, use of decision aids in the clinic and belief and values regarding patients’ engagement in decision making. Several factors were identified as barriers to shared decision making as noted from participants interview, these included lack of time, literacy level, beliefs and values. Decision aids were reported to be important for improving patient’s knowledge and subsequently their involvement in decisions that were made although it was also noted that these were not prepared by the health care providers in the clinic and they were not adequately provided.Conclusion Some form of participation in decision making was observed in the diabetic clinic at Muhimbili national Hospital, and barriers identified for shared decision-making included time, literacy, beliefs and values.

scholarly journals Clinical characteristics of anemia in chronic kidney disease of patients of the National Hospital in 2018

2019 ◽  
Vol 6 (1) ◽  
pp. 11-20
Author(s):  
Ruth Peralta ◽  
Federico Gamarra Fleitas ◽  
María Noel Gómez Fernández ◽  
Jazmín Vaesken Rojas ◽  
Roger David Frutos López ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Characteristics ◽  
National Hospital

Potential drug-drug interactions among patients with chronic kidney disease admitted at National Hospital: a retrospective study in Tanzania

2020 ◽  
Author(s):  
Wigilya Mikomangwa ◽  
Jephter E. Malifa ◽  
Hamu Mlyuka ◽  
Ritah Mutagonda ◽  
Manase Kilonzi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Drug Interactions ◽  
P Value ◽  
Potential Drug ◽  
National Hospital ◽  
Prescribed Medicines ◽  
Prolonged Hospital ◽  
Social Demographic

Abstract Background: Drug related problems such as drug-drug interactions (DDI) are likely to occur in chronic kidney disease (CKD) patients due to polypharmacy practice. The DDI increases the risk of morbidity, mortality, prolonged hospital and cost of treatment. In most cases, the potential drug-drug interactions (pDDI) are not checked during prescribing or dispensing of polypharmacy for CKD patients in developing countries like Tanzania. Therefore, we documented the pattern and potential drug-drug interactions (DDIs) among CKD patients admitted at Muhimbili National Hospital (MNH).Methods: The study retrospectively reviewed 198 files for CKD patients admitted at MNH between January 2017 and December 2018. The social-demographic characteristics and comorbidities were documented using a checklist. Prescriptions with polypharmacy were reviewed and prescribed medicines were documented. Medscape drug interaction checker was used for pDDIs. The SPSS version 23.0 was used to carry out statistical analysis. Results: The study involved a total of 306 prescriptions with polypharmacy with a mean(±SD) of 6.21(±1.22) medicines per prescription. Majority of patients (77.2%) were in stage 5 of chronic kidney disease. Frequently prescribed medicines were pantoprazole 135(44.1%), furosemide 133(43.5%), ferrotone 101(33.0%), calcium carbonate 91(29.7%), amlodipine 121(39.5%), nifedipine 83(27.1%), bisoprolol 46(15.0%) and clonidine 38(12.4). The prevalence of pDDIs was 94.1%. The total of 1743 potential drug-drug interactions was observed with a mean of 6.03(±2.12) interactions per prescription. Majority of the pDDIs were moderate (67.5%) whereas, 29.5%, 2.6% and 0.3 were minor, serious and contraindicated respectively. The occurrence of pDDIs was associated with stroke (P-value=0.038), diabetes mellitus (p-value=0.049) and hypertension with diabetes mellitus (p-value=0.047).Conclusion: The prevalence of pDDIs was high among the CKD patients. The determinants of pDDIs among CKD patients were hypertension, diabetes mellitus and stroke. Interaction checkers should be incorporated in health system to guide the prescribing and dispensing of medicine for CKD patients.

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