BackgroundThe importance of oral health care in the management of patients with systemic diseases including chronic kidney disease (CKD) has been affirmed. Many CKD patients have related oral lesions, however, attention to oral health care has been lacking, especially in the developing countries with higher burden of renal diseases.MethodsOne hundred and eighty patients, 90 cases and 90 controls were recruited, interviewed and examined. Oral mucosa assessment was based on the WHO Guide to Epidemiology and Diagnosis of Oral Mucosal Diseases. Urinalysis and blood creatinine levels were determined. Glomerular filtration rate (GFR) of each patient was calculated from the blood creatinine using Cockcroft and Gault formula.ResultsOral lesions were present in 86 out of 90 (96.5%) CKD patients compared with 15 out of 90 (16.7%) controls (p < 0.001). Abnormal lip hyperpigmentation was the most frequently seen lesion in 81 out of 90 (90%) CKD patients. Other significant findings were gum bleeding, xerostomia, candidiasis, burning mouth and abnormal taste. In the controls (without CKD), the mean GFR was lower in subjects with oral lesions compared with those without oral lesions p < 0.001.ConclusionsCKD and reduced GFR in subjects without CKD are risk factors for oral lesions. The higher prevalence of oral lesions in CKD patients necessitates mandatory oral screening to identify patients with deteriorating renal function. The management of such lesions will enhance the overall well-being of CKD patients in developing countries.

1478,96 ± 771,12 mmol / L, 22,33 ± 7,42 mmol / L, 3,38 ± 2,22 ml / min, 1,8 ± 0,5 mmol / L, 1,61 ± 0,65 mmol / L, 30,2 ± 6,1 g / L, 124,33 ± 63,37 UI / L, 22,66 ± 24,72, 45,14 ± 43,8, 37,7 ± 22,3, respectivement. Il

The effects of aqueous extract of Ocimum gratissimum leaf (AOGL) on the renal function of rats with gentamicin-induced nephrotoxicity were investigated. This study involved the use of forty five (45) adult male Wistar rats (housed in separate metabolic cages) such that graded doses of OAGL were administered to the experimental groups (p.o.) for 28 days after exposure to gentamicin toxicity (100 mg/kg i.p.) for 1 week. At the end of the study, comparisons of some indices of renal function as well as antioxidant status (GSH and TBARS) were made between the control, toxic and AOGL-treated groups at P < 0.05. The result showed that gentamicin treatment caused significant increase (P < .05) in urine output, urea, creatinine, total protein, relative kidney weight, and TBARS, as well as significant decrease (P < .05) in urine creatinine and GSH levels. Post-treatment with graded doses of AOGL caused significant increase in food consumption, GSH, urine, and plasma creatinine, as well as significant decrease (P < .05) in relative kidney weight, TBARS, and urine total protein. There was an appreciable difference in the kidney histology of the AOGL-treated groups when compared with the toxic control. Hence, the extract has therapeutic potential in the management of gentamicin-induced kidney injury, although a risk profile of renal dysfunction is not unlikely from 28 days of administration as evident by the decrease in creatinine clearance.

Abstract:Introduction: Autosomal Dominant Polycystic Kidney Disease (ADPKD) is presumably rare in Africa. Knowledge about the disease in Nigeria is limited as demonstrated by scanty articles on the subject. Objectives: To determine the pattern of clinical presentation and outcome of ADPKD among ADPKD patients. Method: ADPKD subjects were prospectively studied between January 1996 and December 2010. Their demographics, clinical and investigation parameters were documented. Dependency on dialysis, renal transplant and death were the final outcomes. Results: Forty one patients (M:F=1.3:1) with mean age of 48.6±4.6 years were studied. ADPKD was diagnosed at 2.73 cases per annum. Family history of ADPKD and hypertension were present in 56.1% and 82.9% respectively. Their mean systolic and diastolic blood pressures were 166.9 ±23.6 and 104 ±21.2 respectively. Nocturia (78.0%) and loin pain (68.3%) were the most common presenting symptoms. Liver cysts (31.7%) and aortic regurgitation (22.0%) were the predominant extra-renal manifestations. Twenty three (56.1%) received haemodialysis; no renal transplantation. Death rate was 51.2%. Presence of uraemia and intra-cerebral aneurysm contributed significantly to mortality. Conclusion: ADPKD may not be so rare in Nigeria. Awareness campaign to change attitude of family members to screening and further studies using newer criteria for diagnosis of ADPKD should be conducted.

Aim:To determine the effects of a polyphenol-rich extract of the leaves of Vernonia amygdalina (PEVA) on the feeding pattern of rats that are exposed to cadmium (Cd) toxicity.Materials and Methods:Thirty male Wistar rats, weighing 160-180 g, were divided into 6 groups of 5 rats each as follows; Group 1 received distilled water orally (0.2 ml a 100 g rats), daily, throughout the period of study. Group 2 received Cd alone (in the form of CdSO4) at 5 mg/kg/day via intraperitoneal route for 5 consecutive days. Group 3 were pre-treated with Cd as Group 2 and thereafter left untreated for a period of 4-week. After the oral lethal dose of PEVA was determined, Groups 4, 5, and 6 received graded doses of PEVA at 100, 200 and 400 mg/kg/day (0.2 ml per 100 g rats), respectively via oral route for 4 weeks after they were pre-treated with Cd as Group 2. Blood samples were collected for some plasma biochemical assays while urine samples were collected using metabolic cages.Results:PEVA administration significantly increased (P < 0.05) the body weight and feeding patterns that were significantly reduced (P < 0.05) by Cd toxicity. PEVA also significantly reinstated the plasma antioxidant status, as well as glucose and urine volume of the rats toward control values (P < 0.05).Conclusion:PEVA can be an herbal alternative in the treatment or management of subjects manifesting alterations in feeding pattern and urine volume that is Cd-induced.

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Aims and objectives:The study determined the relationship between chronic kidney disease (CKD) and changes in salivary flow and the complications of reduced salivary flow among African subjects with CKD compared with the controls. Materials and methods:One hundred and eighty patients, 90 CKD and 90 controls were recruited, interviewed and examined. Stimulated and unstimulated saliva collection was done with standardized spitting method. Urinalysis and blood creatinine levels were determined and glomerular filtration rate (GFR) of each patient was calculated from the blood creatinine using Cockcroft and Gault formula. Statistical analysis was done using STATA 11 software. Results:The mean stimulated and unstimulated whole salivary flow rate among CKD subjects were 4.07 ± 1.91 and 2.34 ± 0.99 ml/5 min respectively and is significantly lower than that of the controls which were 8.05 ± 3.95 ml/5 min and 3.82 ± 2.27 ml/5 min for stimulated and unstimulated flow rates. Oral signs of reduced salivary flow were found in 80% of CKD patients. The commonest oral finding was taste abnormalities others are burning sensation, halitosis and difficulty in mastication. Conclusion:Patients with CKD had reduced stimulated and unstimulated salivary flow rate. Reduced salivary flow was associated with oral lesions in majority (80%) of CKD patients, the commonest finding being taste abnormalities.

BACKGROUND: The introduction of erythropoietin has transformed the management of anaemia in CKD, with considerable benefits which includes enhanced quality of life, increased exercise capacity and improved cardiac function. There is paucity of data on the beneficial effects of this treatment from this environment. OBJECTIVE: The aim of this work was to study the pattern and response of anaemia and its response to treatment with recombinant human erythropoietin(r-HuEpo) in CKD patients in Nigeria. METHODS: This was a prospective study in which 20 CKD patients who satisfied the inclusion criteria were recruited consecutively. Subcutaneous r-HuEpo was administered to each of the study patients, starting with a weekly dose of 50 iu/Kg and titrated according to haemoglobin (Hb) response, which was monitored fortnightly throughout the study period with the aim of achieving a target Hb of 11g/dl. RESULTS: The patients studied were anaemic with mean Hb of 7.36 ± 1.05 g/dl. The anemia was normocytic normochromic in 85% of the patients. All the patients responded to treatment with r-HuEpo with the mean Hb rising from 6.74g/dl ± 0.70 to 11.64g/dl ± 0.37 and 7.64 g/dl ± 1.19 to 11.98 g/dl ± 0.45 g/dl in those on maintenance haemodialysis and pre-dialysis patients respectively. The patients reached the target Hb of 11g/dl within 8 weeks in predialytic CKD patients and within 10 weeks in those on maintenance haemodialysis. CONCLUSION: Anaemia is mostly normocytic normochromic in CKD patients in our environment and r-HuEpo therapy is effective in correcting the anaemia. WAJM 2009; 28(5): 295-299.