scholarly journals Early detection of kidney disease in Ghana - A situational survey of secondary hospitals in the Ashanti Region of Ghana

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Elliot Koranteng Tannor ◽  
Kamarudeen Korku Hussein ◽  
Martin Agyei ◽  
Vincent Boima
Keyword(s):  
Kidney Disease ◽  
Primary Healthcare ◽  
Urine Analysis ◽  
Health Staff ◽  
Healthcare Staff ◽  
Cross Sectional ◽  
Ashanti Region ◽  
District Hospitals ◽  
Patients With Diabetes ◽  
Almost All

Background Patients with kidney disease are referred late to tertiary institutions with increased morbidity and mortality. The accurate diagnoses and management of kidney disease by primary healthcare staff is dependent on the requisite knowledge and availability of adequate laboratory services. We set out to describe the practice pattern of districts Hospitals. Methods We conducted a situational cross-sectional descriptive survey of district hospitals within the Ashanti region of Ghana. A structured questionnaire was designed via google survey and the links sent to medical superintendents and/or administrators for completion. Data was exported onto an Excel sheet and analyzed with Stata 13. Summary statistics with means ± standard deviation and medians with interquartile range were used where appropriate. Percentages and proportions were used for categorical data. Results We surveyed 26 hospitals in the Ashanti region of Ghana. This included 23(88.5%) public facilities. Most 25(96.2%) of hospitals had a dedicated diabetes mellitus clinic and 24(92.3%) had dedicated hypertension clinic. Only 5(19.2%) hospitals routinely requested urinalysis for patients with diabetes and hypertension during visits. Almost all 25(96.2%) hospitals could carry out routine urine analysis in their laboratory but only 16 (61.5%) of the hospitals could run serum urea and creatinine test. Most 25(96.2%) of respondents suggested that the training of health staff for the early diagnosis and management of kidney disease as key to improve care. Conclusion Primary healthcare staff in district hospitals do not routinely screen high risk patients for kidney disease and call for training to manage patients with kidney disease appropriately.

scholarly journals Factors associated with patient activation in an Australian population with comorbid diabetes and chronic kidney disease: a cross-sectional study

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017695 ◽  
Author(s):  
Edward Zimbudzi ◽  
Clement Lo ◽  
Sanjeeva Ranasinha ◽  
Gregory R Fulcher ◽  
Stephen Jan ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Patient Activation ◽  
Cross Sectional Study ◽  
Problem List ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Lower Activation ◽  
Patients With Diabetes ◽  
Reported Health

ObjectiveTo evaluate the extent of patient activation and factors associated with activation in adults with comorbid diabetes and chronic kidney disease (CKD).DesignA cross-sectional study.SettingRenal/diabetes clinics of four tertiary hospitals across the two largest states of Australia.Study populationAdult patients (over 18 years) with comorbid diabetes and CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2).Main outcome measuresPatients completed the Patient Activation Measure, the Kidney Disease Quality of Life and demographic and clinical data survey from January to December 2014. Factors associated with patient activation were examined using χ2or t-tests and linear regression.ResultsThree hundred and five patients with median age of 68 (IQR 14.8) years were studied. They were evenly distributed across socioeconomic groups, stage of kidney disease and duration of diabetes but not gender. Approximately 46% reported low activation. In patients with low activation, the symptom/problem list, burden of kidney disease subscale and mental composite subscale scores were all significantly lower (all p<0.05). On multivariable analysis, factors associated with lower activation for all patients were older age, worse self-reported health in the burden of kidney disease subscale and lower self-care scores. Additionally, in men, worse self-reported health in the mental composite subscale was associated with lower activation and in women, worse self-reported health scores in the symptom problem list and greater renal impairment were associated with lower activation.ConclusionFindings from this study suggest that levels of activation are low in patients with diabetes and CKD. Older age and worse self-reported health were associated with lower activation. This data may serve as the basis for the development of interventions needed to enhance activation and outcomes for patients with diabetes and CKD.

scholarly journals Rastreamento de doença renal em pacientes com Diabetes Mellitus na atenção primaria de saúde [Kidney disease screening in patients with Diabetes Mellitus in primary health care] [Seguimiento de enfermedad renal en pacientes con Diabetes Mellitus en la atención primaria de salud]

2018 ◽  
Vol 26 ◽  
pp. e21495
Author(s):  
Edli Araújo Pinheiro Carvalho ◽  
Clarissa Cordeiro Alves Arrelias ◽  
Maria Lucia Zanetti ◽  
Carla Regina De Sousa Teixeira ◽  
Francineide Pereira da Silva Pena ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Kidney Disease ◽  
Cross Sectional Study ◽  
Creatinine Ratio ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Albumin Creatinine Ratio ◽  
Primary Care Health ◽  
Patients With Diabetes ◽  
Care Health

Objetivo: determinar a ocorrência de albuminúria aumentada em pacientes com Diabetes Mellitus tipo 2. Método: estudo quantitativo e transversal. A amostra de conveniência foi constituída por 46 pacientes, atendidos em um serviço de atenção primaria de saúde, no município de Macapá, Amapá, em 2012. A coleta de dados ocorreu no período de março a julho de 2012, utilizou-se formulário para registro das variáveis demográficas (sexo e idade) e clínicas (tratamento para o Diabetes Mellitus, hemoglobina glicada A1c, albuminúria de 24 horas e índice albumina-creatinina). Os dados foram analisados por meio de estatística descritiva. O projeto foi aprovado por Comitê de Ética em Pesquisa. Resultados: dos 46 participantes, 4,3% apresentaram albuminas aumentada no exame de urina de 24 horas e 19,6%, no índice albumina-creatinina. Conclusão:os resultados ratificam a importância do rastreamento anual de doença renal com vistas ao diagnóstico e tratamento precoce, no intuito de retardar a progressão da doença.ABSTRACTObjective: to determine the occurrence of elevated albumin in patients with type 2 Diabetes Mellitus. Method: this quantitative, cross-sectional study considered a convenience sample of 46 patients treated at a primary care health service in Macapá, Amapá, in 2012. Data were collected from March to July 2012, using a form to record demographic (sex and age) and clinical variables (treatment for DM, HbA1c, 24-hour albuminuria and albumin-creatinine ratio). Data were analyzed using descriptive statistics. The project was approved by the research ethics committee. Results: of the 46 patients with diabetes investigated, 4.3% had elevated albumin in 24-hour urinalysis and a 19,6% albumin-creatinine ratio. Conclusion: these results confirm the importance of annual screening for kidney disease with a view to early diagnosis and treatment in order to slow the progression of the disease.RESUMENObjetivo: determinar la presencia de albuminuria elevada en pacientes con Diabetes Mellitus tipo 2. Método: estudio cuantitativo y transversal. La muestra de conveniencia fue constituida por 46 pacientes, atendidos en un servicio de salud de atención primaria en la ciudad de Macapá, Amapá, en 2012. La recolección de datos tuvo lugar en el período de marzo a julio de 2012, se utilizó el formulario para el registro de las variables demográficas (sexo y edad) y clínicas (tratamiento para la Diabetes Mellitus, la Hemoglobina glicosilada A1c, la albuminuria de 24 horas y la relación albúmina-creatinina). Los datos se analizaron por medio de estadística descriptiva. El proyecto fue aprobado por Comité de Ética en Investigación. Resultados: de los 46 pacientes investigados, el 4,3% presentó aumento de albuminas en el análisis de orina de 24 horas y el 19,6% en la tasa albúmina-creatinina. Conclusión: los resultados confirman la importancia del seguimiento anual de la enfermedad renal con vistas al diagnóstico y el tratamiento precoz, con el fin de retardar la progresión de la enfermedad.

scholarly journals HUBUNGAN PRE-MENOPAUSE DENGAN KEJADIAN HIERTENSI PADA WANITA DI RT 11 RW 05 KELURAHAN BANJARBENDO SIDOARJO

2018 ◽  
Vol 9 (1) ◽  
Author(s):  
Farida Umamah ◽  
Aprillia Lestari
Keyword(s):  
Sampling Technique ◽  
Simple Random Sampling ◽  
Health Staff ◽  
Chi Square ◽  
Cross Sectional ◽  
Study Results ◽  
Chi Square Test ◽  
Analytic Design ◽  
Almost All ◽  
The Relationship

The relationship between pre-menopause women with incidence of hypertension in RT 11 RW 05 Banjarbendo village Sidoarjo. Menopause women have increasing blood pressure is higher than pre-menopause women, it caused by decreasing of hormonal levels. Initial data showed in February 2015 in RT 11 RW 05 Banjarbendo village was obtained 6 out of 10 women or 60% women had symptoms of hypertension in pre- menopause women. The purpose of this study is to analyze the relationship between pre- menopause women with incidence of hypertension in RT 11 RW 05 Banjarbendo village Sidoarjo.It use analytic design, with cross sectional approach. The population were 61 women. The sample were 52 respondents taken by simple random sampling technique. The independent variable was the incidence of hypertension and the dependent variable was the incidence of pre-menopause. Data were collected by using check list. Analyzed by chi square test ( α = 0.05 ) . Study results showed almost all pre–menopause women and most women them had hypertension. Results test ρ = 0.001 < α = 0.05. so H0 is rejected and H1 is accepted . The conclusion of this study is there is relationship between Pre-menopause with incidence of hypertension In women In RT 11 RW 05 Banjarbendo village Sidoarjo. Suggested for women to understand and have knowledge about the signs of pre-menopause and the incidence of hypertension and Health staff to provide information to the women about the signs of pre-menopause and hypertension .

scholarly journals Patient and Provider Characteristics Associated With Sodium–Glucose Cotransporter 2 Inhibitor Prescription in Patients With Diabetes and Proteinuric Chronic Kidney Disease

2020 ◽  
Author(s):  
Ian E. McCoy ◽  
Jialin Han ◽  
Maria E. Montez-Rath ◽  
Glenn M. Chertow ◽  
Jinnie J. Rhee
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Sglt2 Inhibitor ◽  
Primary Care Providers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Provider Characteristics ◽  
Sodium Glucose Cotransporter ◽  
Patients With Diabetes

Despite accumulating evidence of cardiorenal benefits from sodium–glucose cotransporter 2 (SGLT2) inhibitors, prescription of agents in this drug class may be limited by concerns regarding adverse effects and interdisciplinary care coordination. To investigate these potential barriers, we performed a cross-sectional study of SGLT2 inhibitor prescriptions in 2017 in 3,779 adults with type 2 diabetes and proteinuric chronic kidney disease from a nationwide database. Only 173 (5%) of these patients received an SGLT2 inhibitor in 2017. Younger age, renin-angiotensin-aldosterone system inhibitor prescription, and higher estimated glomerular filtration rate were associated with SGLT2 inhibitor prescription. Primary care providers were responsible for the majority of the prescriptions. Continued efforts should be made to track and improve SGLT2 inhibitor use in indicated populations.

Groundwater in New Valley and kidney disease

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Howaida A Elshinnawy ◽  
Tamer W Elsaid ◽  
Hussein A Hussein
Keyword(s):  
Kidney Disease ◽  
Rural Community ◽  
Urine Analysis ◽  
General Information ◽  
Cross Sectional ◽  
Mdrd Equation ◽  
Groundwater Samples ◽  
Groundwater Supply ◽  
Nile Water ◽  
Groundwater Consumption

Abstract Background This study was performed to assess the possible association between groundwater and kidney disease in new valley governorate . Methods This hospital-based cross-sectional observational study was conducted at the Department of Nephrology, Ain Shams University, Cairo, Egypt, during the period from August 2018 to January 2019. After obtaining verbal consent from all participants; the general information of each participant was recorded, full history taken and general examination was done for each participant, then urine samples and serum blood samples taken for urine analysis, serum urea and serum creatinine, then estimated glomulurar filtratin rate (eGFR) was calculated for healthy subjects groups using MDRD Equation; after that three different groundwater samples and Nile water sample collected and analyzed for different solutes and heavy metals contents. Result Our data suggests that rural community as in Eldakhla; which depends on groundwater supply may affected by more risk of CKD than urban community as in Cairo city, which depends on Nile water supply. Conclusion there are increased prevalence of CKD in New Valley governorate and this may be due to groundwater consumption .

scholarly journals Depression and Associated Factors Among the Patients with Type 2 Diabetes in Rwanda

1970 ◽  
Vol 29 (6) ◽  
Author(s):  
Madeleine MUKESHIMANA ◽  
And Geldine CHIRONDA
Keyword(s):  
Communicable Disease ◽  
Severe Depression ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
District Hospitals ◽  
Co Morbidity ◽  
Prevalence Of Depression ◽  
Patients With Diabetes

Background: Various studies have found a greater prevalence of depression among patients having one or more chronic non communicable disease like diabetes mellitus than in the general population. This co-morbidity is linked with serious health consequences such as high mortality and morbidity, debility, low quality of life and increased health costs. The aim was to determine the prevalence of depression among patients with diabetes attending three selected district hospitals in Rwanda. Sociodemographic factors associated with depression were also explored.Methods: It was a descriptive cross sectional study. A sample of 385 was selected randomly to participate in the study and 339 complete the questionnaires making a response rate of 88%. The Patient Health Questionnaire-9 (PHQ-9) was used to screen depression. Descriptive and inferential analysis were done.Results: The majority of respondents 83.8% (n=284) had depression. Among them 17.9% (n=61) had moderately severe to severe depression while 81.9% (n=223) had minimal to moderate depression. A statistically significant association was found between age and depression (p=0.01) also between gender and depression (p=0.02). Significance was determined at P<0.05.Conclusion: we found a high prevalence of depression among patients with diabetes. The regular screening of depression among these patients is recommended. 

scholarly journals Clinical Predictors of Nondiabetic Kidney Disease in Patients with Diabetes: A Single-Center Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Francesco Fontana ◽  
Rossella Perrone ◽  
Francesco Giaroni ◽  
Gaetano Alfano ◽  
Silvia Giovanella ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Kidney Biopsy ◽  
Kidney Diseases ◽  
Lower Proportion ◽  
Diabetic Patients ◽  
Histopathological Diagnosis ◽  
Single Center ◽  
Clinical Predictors ◽  
Cross Sectional ◽  
Patients With Diabetes

Background. Although diabetic kidney disease (DKD) could affect up to one-third of patients with diabetes mellitus (DM), these patients can develop kidney diseases different from DKD, or these conditions can superimpose on DKD. Several potential predictors of nondiabetic kidney disease (NDKD) have been proposed, but there are no definitive indications available for kidney biopsy in diabetic patients. Methods. We designed a single-center, cross-sectional, and retrospective cohort study to identify clinical and laboratory factors associated with a diagnosis of NDKD after native kidney biopsy in diabetic patients and to investigate differences in time to end-stage kidney disease (ESKD) in patients with a diagnosis of DKD and NDKD. Results. Of 142 patients included in our analysis, 89 (62.68%) had a histopathological diagnosis of NDKD or mixed NDKD + DKD. Patients in the NDKD group had significantly lower HbA1C, lower prevalence of diabetic retinopathy (DR), and less severe proteinuria, and there was a lower proportion of patients with nephrotic syndrome; the DKD group had significantly lower proportion of patients with hematological conditions. In the multivariate binary logistic regression, only absence of DR and presence of a hematological condition significantly predicted NDKD after adjustment for age and sex. Time to ESKD was significantly higher in patients with NDKD or mixed forms than in those with DKD. Conclusions. After a careful selection, more than half of kidney biopsies performed in diabetic patients can identify NDKD (alone or with concomitant DKD). Absence of DR and coexistence of a hematological condition (especially MGUS) were strong predictors of NDKD in our cohort.

scholarly journals Conditions, pathogenesis, and progression of diabetic kidney disease and early decliner in Japan

2020 ◽  
Vol 8 (1) ◽  
pp. e000902 ◽  
Author(s):  
Yui Yoshida ◽  
Kosuke Kashiwabara ◽  
Yosuke Hirakawa ◽  
Tetsuhiro Tanaka ◽  
Shinsuke Noso ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Diabetic Kidney Disease ◽  
Cross Sectional ◽  
Diabetic Kidney ◽  
Patients With Diabetes

ObjectiveGlomerular filtration rate (GFR) decreases without or prior to the development of albuminuria in many patients with diabetes. Therefore, albuminuria and/or a low GFR in patients with diabetes is referred to as diabetic kidney disease (DKD). A certain proportion of patients with diabetes show a rapid progressive decline in renal function in a unidirectional manner and are termed early decliners. This study aimed to elucidate the prevalence of DKD and early decliners and clarify their risk factors.Research design and methodsThis combination cross-sectional and cohort study included 2385 patients with diabetes from 15 hospitals. We defined DKD as a urinary albumin to creatinine ratio (ACR) ≥30 mg/gCr and/or estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m². We classified patients into four groups based on the presence or absence of albuminuria and a decrease in eGFR to reveal the risk factors for DKD. We also performed a trajectory analysis and specified the prevalence and risk factors of early decliners with sequential eGFR data of 1955 patients in five facilities.ResultsOf our cohort, 52% had DKD. Above all, 12% with a low eGFR but no albuminuria had no traditional risk factors, such as elevated glycated hemoglobin, elevated blood pressure, or diabetic retinopathy in contrast to patients with albuminuria but normal eGFR. Additionally, 14% of our patients were early decliners. Older age, higher basal eGFR, higher ACR, and higher systolic blood pressure were significantly associated with early decliners.ConclusionsThe prevalence of DKD in this cohort was larger than ever reported. By testing eGFR yearly and identifying risk factors in the early phase of diabetes, we can identify patients at high risk of developing end-stage renal disease.

scholarly journals Predictors of Neonatal Deaths in Ashanti Region of Ghana: A Cross-Sectional Study

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Gertrude Nancy Annan ◽  
Yvonne Asiedu
Keyword(s):  
Birth Weight ◽  
Health System ◽  
Public Health Problem ◽  
Sub Saharan Africa ◽  
Health Staff ◽  
Related Factors ◽  
Cross Sectional ◽  
Neonatal Deaths ◽  
Ashanti Region ◽  
Mother And Baby Unit

Background. Neonatal mortality continues to be a public health problem, especially in sub-Saharan Africa. This study was conducted to assess the maternal, neonatal, and health system related factors that influence neonatal deaths in the Ashanti Region, Ghana. Methods. 222 mothers and their babies who were within the first 28 days of life on admission at Mother and Baby unit (MBU) at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ashanti Region of Ghana, were recruited through systematic random sampling. Data was collected by face to face interviewing using open and closed ended questions. A logistic regression analysis was conducted to determine the influence of proximal and facility related factors on the odds of neonatal death. Results. Out of the 222 mothers, there were 115 (51.8%) whose babies did not survive. Majority, 53.9%, of babies died within 1–4 days, 31.3% within 5–14 days, and 14.8% within 15–28 days. The cause of death included asphyxia, low birth weight, congenital anomalies, infections, and respiratory distress syndrome. Neonatal deaths were influenced by proximal factors (parity, duration of pregnancy, and disease of the mother such as HIV/AIDS), neonatal factors (birth weight, gestational period, sex of baby, and Apgar score), and health related factors (health staff attitude, supervision of delivery, and hours spent at labour ward). Conclusion. This study shows a high level of neonatal deaths in the Ashanti Region of Ghana. This finding suggests the need for health education programmes to improve on awareness of the dangers that can militate against neonatal survival as well as strengthening the health system to support mothers and their babies through pregnancy and delivery and postpartum to help improve child survival.

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