Renal transplantation and quality of life in Tanzania

2020 ◽  
Vol 31 (1) ◽  
pp. 1-15
Author(s):  
Onesmo A. Kisanga ◽  
Francis F. Furia ◽  
Paschal J. Ruggajo ◽  
Eden E. Maro

Background: Renal replacement therapy (RRT), which includes dialysis and kidney transplantation, is the treatment of choice for patients with end stage renal failure (ESRF). Most sub-Saharan African countries have not developed renal transplantation services and are relying on referring patients to overseas countries. This study was carried out to describe renal transplantation experience in Tanzania.Methods: Forty-four renal transplant recipients were recruited in this study. Standardized questionnaire and Swahili version of standard form – 36 (SF-36) were used to collect socio-demographic information, clinical data, laboratory test results and health related quality of life information.Results: Ages of transplant recipient ranged from 21 to 66 years with mean age of 45.9 ± 10.5 years. The leading causes of end stage renal failure among participants was hypertension 58.8% (25/44) followed by glomerulonephritis 15.9% (7/44). Twentyeight (63.6%) of transplantations were paid by the government. Most of the donors (97.7%) were living out of which 26 (59.1%) were siblings and 11 (25%) were second-degree relatives (cousins and nephews). Most common complication noted following transplantation was diabetes mellitus 9 (20.5%) and 3 (6.8%) had chronic rejection. Mental health was the domain with highest mean score (75.6 ± 14.3) and role physical had the least mean score (44 ± 45.6).Conclusions:  Hypertension was the leading cause of ESRF in this study. Most of the donors were siblings and the costs of transplantation were largely covered by the government. There is a need for concerted effort to establish local kidney transplantation services in Tanzania. Keywords: Renal transplantation, quality of life in transplantation, Tanzania.

2007 ◽  
Vol 54 (4) ◽  
pp. 79-81
Author(s):  
D. Milutinovic ◽  
C. Topuzovic ◽  
J. Hadzi-Djokic

In our patient, with a small contacted bladder and end stage renal failure, bladder augmentation (clam ileocystoplasty) was done in conjunction with renal transplantation. Our patient has stable renal and bladder function 46 months after kidney transplantation.


2020 ◽  
Vol 3 (1) ◽  
pp. 27-35
Author(s):  
Meryem Benbella ◽  
Aziza Guennoun ◽  
Mohamed Belrhiti ◽  
Tarik Bouattar ◽  
Rabia Bayahia ◽  
...  

Introduction:  The choice of dialysis modality has become an important decision that affects not only the country's health policy in the management of chronic end stage renal failure, but also the quality of life of patients and their survival. Peritoneal dialysis is an alternative for the treatment of these patients. The objective of our work is to report the epidemiological, clinical and biological results in the unit of PD, UHC of Rabat and to clarify the obstacles to the development of PD in Morocco.  Material and Methods:  We conducted a descriptive retrospective study in our PD unit from July 2006 to July 2017, including all patients who were in PD by choice or necessity and enrolled in the French Peritoneal Dialysis Registry (RDPLF).  Results: In 10 years, 159 patients were placed in PD, with an average age of 50.44 +/- 17.42 years and a sex ratio of 1.36. The indication for placement of setting in PD was by choice in 34% of the cases, social in 52% and medical in 14% of cases. Mechanical complications were dominated by catheter migrations. Infectious complications were represented by peritonitis, caused by poor of hygiene in 42% of cases. Conclusion: The obstacles to the development of PD are the lack of knowledge of the technique by the patients, as well as the prejudices or myths about the technique.


1993 ◽  
Vol 9 (4) ◽  
pp. 490-504 ◽  
Author(s):  
Paul McNamee ◽  
Eddy van Doorslaer ◽  
Rob Segaar

AbstractRecombinant human erythropoietin is an efficacious therapy in treatment of the anemia of end-stage renal failure. However, the scale of impact on quality of life and medical care resources remains uncertain. By reviewing the literature we evaluate cost-effectiveness of recombinant human erythropoietin and show how previous studies may have implicitly overestimated cost-effectiveness.


Author(s):  
Elzbieta Wlodarczyk ◽  
Ondřej Viklický ◽  
Klemens Budde ◽  
Marie Kolářová ◽  
Leon Bergfeld ◽  
...  

Despite an increasing quality of life after renal transplantation, the number of recipients undertaking paid professional work remains relatively low. Employment after kidney transplantation became a new important marker of clinically significant health recovery. Furthermore, for social and economic reasons, returning to work and participation in social life may be considered as an objective parameter that demonstrate the effectiveness of transplantation. The objectives of the following study were to evaluate the factors that determine resuming paid work after renal transplantation, to assess a patient’s decision about returning to professional activity by comparative analysis of renal transplant recipients from Poland, Czech Republic and Germany, and to identify groups of patients exposed to professional exclusion in those EU countries. Five hundred renal transplant recipients from three EU countries were included into the study. The two main research methods used in the study were the SF-36 questionnaire, constructed and validated to assess the quality of life after kidney transplantation and a questionnaire constructed for the purposes of this study. Multifactorial analysis identified several risk factors associated with professional exclusions after kidney transplantation, namely young or advanced age, female gender, lack of education, place of residence in rural areas, long period of illness, and lack of occupational activity before transplantation. Despite the high standards of social care and rehabilitation support, patients in Germany failed to take up professional activity after kidney transplantation in more cases than those in Poland and Czech Republic. Surprisingly, the objective function of the kidney (creatinine level) and the multidimensional assessment of quality of life (SF-36 survey) did not have a significant association with the employment status after renal transplantation.


2004 ◽  
Vol 20 (3) ◽  
pp. 258-268 ◽  
Author(s):  
Graham Mowatt ◽  
Luke Vale ◽  
Alison MacLeod

Background:Home hemodialysis offers potential advantages over hospital hemodialysis, including the opportunity for more frequent and/or longer dialysis sessions. Expanding home hemodialysis services may help cope with the increasing numbers of people requiring hemodialysis.Methods:We sought comparative studies or systematic reviews of home versus hospital/satellite unit hemodialysis for people with end-stage renal failure (ESRF). Outcomes included quality of life and survival. We searched MEDLINE, EMBASE, HealthSTAR, CINAHL, PREMEDLINE, and BIOSIS. Two reviewers independently extracted data and assessed the quality of the studies included.Results:Twenty-seven studies of variable quality were included. People on home hemodialysis generally experienced a better quality of life and lived longer than those on hospital hemodialysis. Their partners, however, found home hemodialysis more stressful. Four studies using a Cox proportional hazards model to compare home with hospital hemodialysis reported a lower mortality risk for home hemodialysis. Of two studies using a Cox model to compare home with satellite unit hemodialysis, one reported a similar mortality risk, whereas the other reported a lower mortality risk for home hemodialysis.Conclusions:Home hemodialysis was generally associated with better outcomes than hospital hemodialysis and (more modestly so) satellite unit hemodialysis, in terms of quality of life, survival, and other measures of effectiveness. People on home hemodialysis, however, are a highly selected group. Home hemodialysis also provides the opportunity for more frequent and/or longer dialysis sessions than would otherwise be possible. It is difficult to disentangle the true effects of home hemodialysis from such influencing factors.


2000 ◽  
Vol 15 (9) ◽  
pp. 1425-1430 ◽  
Author(s):  
Lawrence P. McMahon ◽  
Kim Mason ◽  
Sandford L. Skinner ◽  
Caroline M. Burge ◽  
Leanne E. Grigg ◽  
...  

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