scholarly journals CHRONIC KIDNEY DISEASE AMONGST SICKLE CELL ANAEMIA PATIENT AT THE UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL, NORTH EASTERN NIGERIA: A STUDY OF PREVALENCE AND RISK FACTORS

Author(s):  
Audu Abdullahi Bukar ◽  
Mohammad Maina Sulaiman ◽  
Adama Isa Ladu ◽  
Aisha Mohammed Abba ◽  
Mohammed Kabir Ahmed ◽  
...  

ABSTRACTIntroduction: Involvement of the kidneys in patient with sickle cell anaemia is a well recognized chronic complication of this disorder. The index study seeks to determine the prevalence of chronic kidney disease in patients with homozygous sickle cell disease (HbSS) and to identify risk factors associated with its development.Methodology: The subjects consisted of adolescents and adults with HbSS recruited sequentially from the adult haematology outpatient clinic and Day care ward of the unit. Clinical variables including age of diagnosis of SCA, frequency of vaso-occlusive crisis and transfusion therapy, as well as laboratory data including haematological profile, renal function test were obtained from routine blood result. The glomerular filtration rate was estimated (eGFR) using the ‘modification of diet in renal disease’ (MDRD) formula..Results: Two hundred and eighty-four HbSS patients were recruited. The prevalence of CKD amongst them was 38.9%.  Further stratification of the patients based on eGFR showed that sixty-nine (26.8%) had hyperfiltration; 35 (13.6%) stage 1 CKD; 53 (20.6%) stage 2 CKD; 61 (23.7%) stage 3 CKD; 30 (11.7%) stage 4 CKD and 9 (3.5%) had end stage renal disease. There was significant association between eGFR and clinical parameters such as age (r -0.353, p=0.000), SBP (r -0.148, p= 0.021), DBP (r -0.213, p=0.001) and total number of blood received (r -0.276, p=0.000); and laboratory parameters such as  PCV (r 0.371, p=0.000); urea ( r 0.527, p=000 ); creatinine (r 0.625, p=0.000) and uric acid  ( r -0.419, p=0.000).ConclusionThe present study has revealed a high prevalence of CKD amongst patients with SCA in this region. Various clinical and laboratory predictors of eGFR were also identified. Monitoring and detection of early stages of these groups of patients may allow for interventions which may delay progression into advance stages and ESRD.

2018 ◽  
Author(s):  
Joshua S. Hundert ◽  
Ajay K Singh

Management of early renal failure helps in the reduction or prevention of end-stage renal disease. The monitoring of renal function is discussed, and the chapter includes a table that shows commonly used methods for monitoring. Risk factors for chronic renal failure include stroke and cardiac disease. Risk factors for renal disease progression are diabetes mellitus, hypertension, proteinuria, smoking, protein intake, and hyperlipidemia. Complications of chronic renal failure that are addressed include sodium and water imbalance, potassium imbalance, acidosis, calcium and phosphorus imbalance, and anemia. There is also a section that discusses the case for early referral to a nephrologist. Tables present the equations used to estimate the glomerular filtration rate (GFR); stages of chronic kidney disease and the appropriate steps in their management; risk factors for chronic kidney disease in which the testing of proteinuria and estimation of GFR are indicated; appropriate diet for patients who have chronic kidney disease; and guidelines for diagnosing and treating anemia resulting from chronic kidney disease. An algorithm outlines the steps in management of calcium and phosphate in patients with kidney disease. This review contains 3 figures, 10 tables and 50 references Key Words End-stage renal disease, chronic kidney disease, glomerular filtration rate, Modification of Diet in Renal Disease, Proteinuric renal disease, Hyperuricemia


2015 ◽  
Vol 110 ◽  
pp. S919-S920
Author(s):  
Parkpoom Phatharacharukul ◽  
Charat Thongprayoon ◽  
Wisit Cheungpasitporn ◽  
Peter J. Edmonds ◽  
Quanhathai Kaewpoowat ◽  
...  

2018 ◽  
Author(s):  
Joshua S. Hundert ◽  
Ajay K Singh

Management of early renal failure helps in the reduction or prevention of end-stage renal disease. The monitoring of renal function is discussed, and the chapter includes a table that shows commonly used methods for monitoring. Risk factors for chronic renal failure include stroke and cardiac disease. Risk factors for renal disease progression are diabetes mellitus, hypertension, proteinuria, smoking, protein intake, and hyperlipidemia. Complications of chronic renal failure that are addressed include sodium and water imbalance, potassium imbalance, acidosis, calcium and phosphorus imbalance, and anemia. There is also a section that discusses the case for early referral to a nephrologist. Tables present the equations used to estimate the glomerular filtration rate (GFR); stages of chronic kidney disease and the appropriate steps in their management; risk factors for chronic kidney disease in which the testing of proteinuria and estimation of GFR are indicated; appropriate diet for patients who have chronic kidney disease; and guidelines for diagnosing and treating anemia resulting from chronic kidney disease. An algorithm outlines the steps in management of calcium and phosphate in patients with kidney disease. This review contains 3 figures, 10 tables and 50 references Key Words End-stage renal disease, chronic kidney disease, glomerular filtration rate, Modification of Diet in Renal Disease, Proteinuric renal disease, Hyperuricemia


2018 ◽  
Author(s):  
Joshua S. Hundert ◽  
Ajay K Singh

Management of early renal failure helps in the reduction or prevention of end-stage renal disease. The monitoring of renal function is discussed, and the chapter includes a table that shows commonly used methods for monitoring. Risk factors for chronic renal failure include stroke and cardiac disease. Risk factors for renal disease progression are diabetes mellitus, hypertension, proteinuria, smoking, protein intake, and hyperlipidemia. Complications of chronic renal failure that are addressed include sodium and water imbalance, potassium imbalance, acidosis, calcium and phosphorus imbalance, and anemia. There is also a section that discusses the case for early referral to a nephrologist. Tables present the equations used to estimate the glomerular filtration rate (GFR); stages of chronic kidney disease and the appropriate steps in their management; risk factors for chronic kidney disease in which the testing of proteinuria and estimation of GFR are indicated; appropriate diet for patients who have chronic kidney disease; and guidelines for diagnosing and treating anemia resulting from chronic kidney disease. An algorithm outlines the steps in management of calcium and phosphate in patients with kidney disease. This review contains 3 figures, 10 tables and 50 references Key Words End-stage renal disease, chronic kidney disease, glomerular filtration rate, Modification of Diet in Renal Disease, Proteinuric renal disease, Hyperuricemia


2018 ◽  
Author(s):  
Joshua S. Hundert ◽  
Ajay K Singh

Management of early renal failure helps in the reduction or prevention of end-stage renal disease. The monitoring of renal function is discussed, and the chapter includes a table that shows commonly used methods for monitoring. Risk factors for chronic renal failure include stroke and cardiac disease. Risk factors for renal disease progression are diabetes mellitus, hypertension, proteinuria, smoking, protein intake, and hyperlipidemia. Complications of chronic renal failure that are addressed include sodium and water imbalance, potassium imbalance, acidosis, calcium and phosphorus imbalance, and anemia. There is also a section that discusses the case for early referral to a nephrologist. Tables present the equations used to estimate the glomerular filtration rate (GFR); stages of chronic kidney disease and the appropriate steps in their management; risk factors for chronic kidney disease in which the testing of proteinuria and estimation of GFR are indicated; appropriate diet for patients who have chronic kidney disease; and guidelines for diagnosing and treating anemia resulting from chronic kidney disease. An algorithm outlines the steps in management of calcium and phosphate in patients with kidney disease. This review contains 3 figures, 10 tables and 50 references Key Words End-stage renal disease, chronic kidney disease, glomerular filtration rate, Modification of Diet in Renal Disease, Proteinuric renal disease, Hyperuricemia


2007 ◽  
Vol 107 (4) ◽  
pp. c177-c181 ◽  
Author(s):  
Maarten W. Taal ◽  
Mhairi K. Sigrist ◽  
Apostolos Fakis ◽  
Richard J. Fluck ◽  
Christopher W. McIntyre

2011 ◽  
Vol 119 (1) ◽  
pp. c35-c40 ◽  
Author(s):  
José Vinhas ◽  
Luis Gardete-Correia ◽  
José Manuel Boavida ◽  
João Filipe Raposo ◽  
Ana Mesquita ◽  
...  

Author(s):  
Nchimunya Machila ◽  
◽  
Chishala Chabala ◽  
Chisambo Mwaba ◽  
Catherine Chunda-Liyoka ◽  
...  

Background: Improved medical care has led to the improved life expectancy of sickle cell anaemia (SCA) patients hence complications associated with SCA such as chronic kidney disease (CKD) are being seen more frequently. Globally, nephropathy of varying severity occurs in 5 to 18 % of the SCA population across all age groups with a third of the adults proceeding to develop CKD while over 30 % of paediatric SCA patients have CKD in Africa. The mortality rate in SCA patients CKD is high. This study sought to determine the prevalence and risk factors of CKD in SCA, information that was not available in Zambia prior to this study. This information will guide in targeting and timing of screening for CKD in SCA in children in our population. Objectives: To determine the prevalence of haematuria, proteinuria, abnormal estimated glomerular filtration rate (eGFR), CKD, and risk factors of CKD among the steady-state SCA patients aged 5 to 16 years at the University Teaching Hospital (UTH), Lusaka. Methodology: This was a prospective cross-sectional study of 197 children aged 5 to 16 years with SCA at the UTH - Lusaka conducted from August 2014 to July 2015. Demographic and clinical data were collected using a structured questionnaire. Urine and blood samples were used to determine the urine albumin creatinine ratio (ACR) and full blood count /blood biochemistry respectively. CKD was defined and determined using the Kidney Disease Outcome Quality Initiative 2012 guidelines employing urine ACR, dipstick urinalysis and eGFR. In this study, spot urine ACR and dipstick urinalysis were done and repeated three months later if initial tests were abnormal. Data was analysed using SPSS version 21. Chi-square and t-test were used to compare proportions between groups. Relation between study variables and CKD were examined using logistic regression. Results: The mean age of the participants was 9.6 years (SD ±3.6). Male to female ratio was 1:1. The median age at diagnosis of SCA was 22 months (IQR = 44). The prevalence of haematuria, proteinuria and CKD among the study participants was 14.2%, 36% and 36 % respectively. Low haemoglobin and elevated mean corpuscular volume (MCV) were associated with CKD-AOR 0.62, 95% CI; 0.46-0.84 and 1.04, 95% CI; 1.01 – 1.08 respectively. Recurrent admissions (due to VOCs, severe anaemia and febrile illness) were also risk factors associated with CKD- AOR 0.52, 95% CI; 0.27-0.98. CKD was not associated with age at enrolment, sex, age at diagnosis of SCA, recurrent Vaso-occlusive crisis (VOCs) or abnormal liver function tests. Conclusion: The prevalence of CKD among the SCA patients at UTH- Lusaka is high (36%) with lower Haemoglobin, elevated MCV and recurrent admissions being risk factors for developing CKD. SCA patients should be screened for CKD routinely at least once a year. Interventions such as the early introduction of hydroxyurea, proactive blood transfusions and ACE inhibitors can reduce the risk of CKD and its progression to end-stage renal disease.


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