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Screening of individuals at increased risk of developing chronic kidney disease (CKD) has been advocated by several guidelines. Among individuals at increased risk are first-degree relatives (FDRs) of patients with CKD. There is a paucity of data on the prevalence and risk of CKD in FDRs of patients with CKD in sub-Saharan African population. This study aimed to screen FDRs of patients with CKD for albuminuria and reduced estimated glomerular filtration rate (eGFR). A cross-sectional survey of 230 FDRs of patients with CKD and 230 individuals without family history of CKD was conducted. Urinary albumin: creatinine ratio (ACR) was determined from an early morning spot urine. Glomerular filtration rate was estimated from serum creatinine. Reduced eGFR was defined as eGFR <60 ml/min/1.73 m2 and albuminuria defined as ACR ≥30 mg/g. A higher prevalence of albuminuria was found in the FDRs compared to the controls (37.0% vs. 22.2%; P < 0.01). Reduced eGFR was more prevalent among the FDRs compared with the controls (5.7% vs. 1.7%, P < 0.03). Hypertension (odds ratio [OR], 2.9) and reduced eGFR (OR, 9.1) were independent predictors of albuminuria while increasing age (OR, 6.7) and proteinuria (OR, 10.7) predicted reduced eGFR in FDRs. The odds of developing renal dysfunction were increased 2-fold in the FDRs of patients with CKD, OR 2.3, 95% confidence interval, 1.29–3.17. We concluded that albuminuria and reduced eGFR are more prevalent among the FDRs of patient with CKD and they are twice as likely to develop kidney dysfunction as healthy controls.

The pattern of AKI in this study is similar to that from other developing countries. In-hospital mortality remains high although most of the causes are preventable.

Hemodialysis (HD) catheters are commonly used as temporary vascular access in patients with kidney failure who require immediate HD. The use of these catheters is limited by complications such as infections, thrombosis resulting in poor blood flow. We studied the complications and outcomes of nontunneled catheters used for vascular access in our dialysis unit. The records of all patients, with renal failure who were dialyzed over a two-year period and had a double lumen nontunneled catheter inserted, were retrieved. Catheter insertion was carried out under ultrasound guidance using the modified Seldinger technique. The demographic data of patients, etiology of chronic kidney disease, and complications and outcomes of these catheters were noted. Fifty-four patients with mean age 43.7 ± 15.8 years had 69 catheters inserted for a cumulative total of 4047 catheter-days. The mean catheter patency was 36.4 ± 37.2 days (range: 1-173 days). Thrombosis occluding the catheters was the most common complication and occurred in 58% of catheters leading to catheter malfunction, followed by infections in18.8% of catheters. During follow-up, 30 (43.5%) catheters were removed, 14 (20.3%) due to catheter malfunction, eight (11.6%) due to infection, five (7.2%) elective removal, and three (4.3%) due to damage. Thrombotic occlusion of catheters was a major limiting factor to the survival of HD catheters. Improvement in catheter patency can be achieved with more potent lock solutions.

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