scholarly journals EVALUATION OF GLOMERULAR FUNCTIONS IN PATIENTS WITH SCA IN MAIDUGURI NORTH-EASTERN NIGERIA: A RECOMMENDATION FOR EARLY ASSESSMENT AND DETECTION OF DYSFUNCTION IN A RESOURCE-POOR SETTING.

2021 ◽  
Vol 15 (1) ◽  
pp. 1-10
Author(s):  
Farouk AG ◽  
◽  
Yauba MS ◽  
Yerima A ◽  
Asheikh MM ◽  
...  

Background: Sickle cell anaemia (SCA) is a disorder of Mendelian autosomal recessive inheritance, characterised by abnormal haemoglobin synthesis resulting in multi-systemic manifestations. The kidneys are largely affected by this disorder, but overt features of kidney disease mostly manifest after the second decade, even though insult and sub-clinical features may occur during childhood. Unfortunately, investigating these sub-clinical features is not routinely done in resource-scarce settings, partly due to the low socioeconomic status of most of our patients and the overwhelmed health care workers. Objectives: To investigate glomerular dysfunction in children with SCA in the context of the resource-poor setting. Methodology: This cross-sectional study was conducted at the University of Maiduguri Teaching Hospital (UMTH), over 6 months. One hundred and ten SCA (Hb SS) children aged 3 – 14 years in steady-state constituted the cases, while 110 non-SCA (Hb AA) age and sex-matched, apparently healthy children formed the control. Anthropometry, blood pressure, urinalysis and serum creatinine of the subjects was done. Glomerular filtration rate (GFR) was estimated using the Schwartz formula. Results: The mean systolic blood pressure (SBP) ± SD of the cases and controls were 96.8±9.34mmHg and 99.14±13.44mmHg respectively, (p = 0.13). The mean diastolic BP ± SD of the cases and controls were 60.18±6.85mmHg and 64.35±8.23mmHg respectively, (p = 0.0001). Glomerular filtration rate was significantly higher among the cases than the controls, 126±32ml/min/1.73m2 and 93±16ml/min/1.73m2 respectively (p <0.001). Proteinuria was higher among the cases (8.2%), with one (0.9%) having nephrotic range proteinuria. Conclusions: The proteinuria and hyperfiltration found in some of the children with SCA in this study suggest that renal function abnormalities can be detected early in this group of children when appropriately and timely investigated.

2021 ◽  
Vol 15 (1) ◽  
pp. 35-44
Author(s):  
Farouk AG ◽  
◽  
Yauba MS ◽  
Yerima A ◽  
Asheikh MM ◽  
...  

Background: Sickle cell anaemia (SCA) is a disorder of Mendelian autosomal recessive inheritance, characterised by abnormal haemoglobin synthesis resulting in multi-systemic manifestations. The kidneys are largely affected by this disorder, but overt features of kidney disease mostly manifest after the second decade, even though insult and sub-clinical features may occur during childhood. Unfortunately, investigating these sub-clinical features is not routinely done in resource-scarce settings, partly due to the low socioeconomic status of most of our patients and the overwhelmed health care workers. Objectives: To investigate glomerular dysfunction in children with SCA in the context of the resource-poor setting. Methodology: This cross-sectional study was conducted at the University of Maiduguri Teaching Hospital (UMTH), over 6 months. One hundred and ten SCA (Hb SS) children aged 3 – 14 years in steady-state constituted the cases, while 110 non-SCA (Hb AA) age and sex-matched, apparently healthy children formed the control. Anthropometry, blood pressure, urinalysis and serum creatinine of the subjects was done. Glomerular filtration rate (GFR) was estimated using the Schwartz formula. Results: The mean systolic blood pressure (SBP) ± SD of the cases and controls were 96.8±9.34mmHg and 99.14±13.44mmHg respectively, (p = 0.13). The mean diastolic BP ± SD of the cases and controls were 60.18±6.85mmHg and 64.35±8.23mmHg respectively, (p = 0.0001). Glomerular filtration rate was significantly higher among the cases than the controls, 126±32ml/min/1.73m2 and 93±16ml/min/1.73m2 respectively (p <0.001). Proteinuria was higher among the cases (8.2%), with one (0.9%) having nephrotic range proteinuria. Conclusions: The proteinuria and hyperfiltration found in some of the children with SCA in this study suggest that renal function abnormalities can be detected early in this group of children when appropriately and timely investigated.


2017 ◽  
Vol 7 (4) ◽  
pp. 324-333 ◽  
Author(s):  
Marcel Tangyi Tamanji ◽  
Divine Amagho Ngwakum ◽  
Olivier Pancha Mbouemboue

Background/Aim: The two-way cause and effect relationship existing between high blood pressure and kidney dysfunction is currently a well-documented phenomenon with patients in either category being almost equally predisposed to the other pathology. Our goal was to assess the renal function capacity of hypertensive patients in our setting. Methods: This cross-sectional descriptive study involved the determination of blood pressure levels and the collection of blood and urine samples for the measurement of renal function markers. Hypertensive patients who came for medical follow-up constituted the study participants, and were enrolled consecutively into the study from February to May 2015. Data analysis was performed using the SPSS 20.0 software, and significant differences were determined at p < 0.05. Results: The prevalence of elevated creatinine and urea levels were 35 and 27%. Eighty percent of the participants had a decreased glomerular filtration rate (≤90 mL/min/1.73 m3), with at least 36% recording less than 60 mL/min/1.73 m3. Proteinuria and glucosuria were recorded in 15% and 8% of the participants, respectively. The mean diastolic pressure was observed to be significantly higher in participants with proteinuria (p = 0.016), and participants' weight directly correlated with systolic blood pressure (p = 0.015). Furthermore, the mean estimated glomerular filtration rate was relatively lower in participants >60 years compared to those <60 years (p < 0.001). Conclusion: Renal function is often perturbed in hypertensive patients, and good blood pressure control may reduce the progression of renal impairment. Thus, a systematic evaluation of renal function in addition to blood pressure control in hypertensive patients is indispensable towards effectively reducing the occurrence of renal events and preventing end-stage renal disease.


2018 ◽  
Vol 127 (07) ◽  
pp. 455-460 ◽  
Author(s):  
Karel Kostev ◽  
Alexander Lucas ◽  
Louis Jacob

Abstract Background The goal of this study was to analyze the frequency of blood pressure (BP) and estimated glomerular filtration rate (eGFR) testing in type 2 diabetes mellitus (T2DM) patients followed in general and diabetological practices in Germany. Methods The study included individuals who had at least two concultations due to T2DM diagnosis (ICD-10: E11) between January and December 2016. Patients were followed in 557 general and diabetological practices. The primary outcome was the frequency of BP and eGFR testing in T2DM patients in 2016. The association between several demographic and clinical variables and the odds of receiving≥2 BP and≥1 eGFR tests in the year 2016 was analyzed using multivariate logistic regression models. Results A total of 43,509 individuals were available for analysis. The mean age of the population was 68.6 years (SD=12.4 years). The mean number of measurements was 2.9 (SD=3.5) for BP and 0.4 (SD=1.1) for eGFR. 52.3% of patients were tested at least twice for BP and 15.3% of them at least once for eGFR in 2016. Older patients, individuals followed in diabetological practices, people receiving antihyperglycemic medications, and those affected by chronic conditions (i. e. hypertension, renal complications, or neuropathy) displayed higher odds of receiving≥2 BP and≥1 eGFR tests, whereas patients with a diabetes duration of>1 year displayed lower odds. Conclusions The frequency of BP and eGFR testing was low in T2DM patients in Germany in 2016. Several demographic and clinical variables were associated with this frequency.


Folia Medica ◽  
2012 ◽  
Vol 54 (4) ◽  
pp. 5-13 ◽  
Author(s):  
Bilyana H. Teneva

Abstract In liver cirrhosis patients awaiting liver transplantation, it is prognostically equally important to assess the renal function before and after transplantation. This is evidenced by the inclusion of serum creatinine in the Model for End-Stage Liver Disease (MELD) score. Most of the causes of renal failure in liver cirrhosis are functional, the acute kidney damage including prerenal azotemia, acute tubular necrosis and hepatorenal syndrome. A major index of the renal function, the glomerular filtration rate (GFR) is determined in a specific way in patients with liver cirrhosis. Clinically, serum creatinine is considered the best indicator of kidney function, although it is rather unreliable when it comes to early assessment of renal dysfunction. Most of the patients with liver cirrhosis have several concomitant conditions, which are the reason for the false low creatinine levels, even in the presence of moderate to severe kidney damage. This also holds for the creatinine clearance and creatinine-based estimation equations for assessment of the glomerular filtration rate (the Cockroft-Gault and MDRD formulas), which overestimate the real glomerular filtration. Clearance of exogenous markers is considered a gold standard, but the methods for their determination are rather costly and hard to apply. Alternative serum markers (e.g., cystatin C) have been used, but they should be better studied in cases of liver cirrhosis assessment.


1983 ◽  
Vol 245 (5) ◽  
pp. R743-R748 ◽  
Author(s):  
R. W. Davis ◽  
M. A. Castellini ◽  
G. L. Kooyman ◽  
R. Maue

Renal and hepatic function were studied during voluntary dives in Weddell seals by measuring the clearance rate of inulin and indocyanine green (ICG). Inulin is cleared exclusively by the kidneys and measures renal glomerular filtration rate (GFR). ICG is cleared by the liver and is blood flow dependent at concentrations used. Studies were conducted from a portable hut with a trapdoor placed over an isolated hole in the sea ice near McMurdo Station, Antarctica. An intravertebral extradural catheter was inserted percutaneously under light anesthesia in subadult seals weighing 130-200 kg. When released into the ice hole, the seals made voluntary dives, but always had to return to breathe. Serial blood samples were taken after single injections of inulin and ICG and analyzed within 24 h. The mean half time (t 1/2) for inulin clearance while resting at the surface was 27.3 +/- 13.0 min (n = 43) and the mean t 1/2 for ICG clearance was 18.3 +/- 7.3 min (n = 23). The mean resting GFR was 3.6 ml X min-1 X kg-1 (range 3.2-3.9, n = 3). Inulin and ICG clearance rates did not change from resting levels during dives shorter than the seal's aerobic dive limit (ADL). Inulin clearance decreased over 90% during dives longer than the ADL, but there was no significant reduction in ICG clearance during dives lasting up to 23 min. It appears that normal renal GFR and hepatic blood flow continue during natural aerobic dives. During dives that exceed the ADL, GFR is reduced but hepatic blood flow may be maintained.


Sign in / Sign up

Export Citation Format

Share Document