BackgroundThe aim of this study was to identify and discuss published population-based studies carried out in Nigeria that have information on the prevalence of chronic kidney disease (CKD) and have also used the Kidney Disease Outcomes Quality Initiative (KDOQI) practice guidelines in defining CKD, with emphasis on the performance of three estimating equations for glomerular filtration rate (GFR) – Modification of Diet in Renal Disease (MDRD), Cock-croft–Gault, and CKD epidemiology collaboration (CKD-EPI) creatinine equation.Materials and methodsA systematic literature search was carried out in Google, MEDLINE, PubMed, and AJOL database, with the aim of identifying relevant population-based studies with information on the prevalence of CKD in a location in Nigeria.ResultsSeven cross-sectional population-based studies were identified. Two of the studies used the Cockcroft–Gault and observed a prevalence of 24.4% and 26%. Four of the studies used the MDRD and the prevalences observed were 12.3%, 14.2%, 2.5%, and 13.4%. One of the studies used the CKD-EPI equation and the prevalence was 11.4%. The male to female ratios of CKD prevalence in six studies were 1:1.9, 0.8:1, 1:1.6, 1:2, 1:1.8, 1:1.4, and the observed risk factors in the studies were old age, obesity, diabetes mellitus, hypertension, family history of hypertension, family history of renal disease, low-income occupation, use of traditional medication, low hemoglobin, and abdominal obesity.ConclusionThe prevalence of CKD was high but variable in Nigeria, influenced by the equation used to estimate the GFR. MDRD and CKD-EPI results are agreeable. There is a need for more population-based studies, with emphasis on repeating the GFR estimation after 3 months in subjects with GFR <60 mL/min/1.7 m2.
SummaryBackground:Cardiac complications of human immunodeficiency virus (HIV) infection are important causes of morbidity and mortality. We set out to determine the electrocardiographic (ECG) abnormalities in treatment-naïve HIV-positive patients in Enugu, south-east Nigeria.Methods:This was a cross-sectional study involving 250 HIV-positive and 200 HIV-negative subjects. Demographic and anthropometric data, relevant investigations and ECG results were compared between the groups.Results:An abnormal ECG was present in 70% of the HIV-positive patients, sinus bradycardia in 64%, QTC prolongation in 48%, T-wave inversion in 21.6%, Wolf–Parkinson– White syndrome in 0.8%, abnormal P waves in 12.8%, 1st degree heart block in 2.4%, ST depression in 30%, and left-axis deviation in 1.6%. Underweight was associated with ECG abnormalities (p = 0.001). The HIV-positive patients had more ECG abnormalities than the HIV-negative subjects (p = 0.001).Conclusion:Electrocardiographic abnormalities were common in treatment-naïve HIV-positive patients in Enugu, Nigeria. The 70% prevalence of ECG abnormalities in treatment-naïve HIV-positive patients was high. There is a need to evaluate HIV-positive patients at onset for cardiac and non-cardiac abnormalities detectable by ECG.
Human immunodeficiency virus (HIV) infection is a common cause of chronic kidney disease (CKD) in Sub-Saharan Africa. This study aims at identifying the prevalence and predictors of CKD in newly diagnosed HIV patients in Owerri, South East Nigeria. This was a cross-sectional study consisting of 393 newly diagnosed HIV-seropositive subjects and 136 age- and sex-matched seronegative subjects as controls. CKD was defined as 24-hour urine protein (24-HUP) ≥0.3 g and/or glomerular filtration rate (GFR) < 60 ml/min. Subjects were recruited from the HIV clinic and the Medical Outpatient Department of Federal Medical Centre, Owerri. Clinical and anthropometric data were collected. Relevant investigations were performed, including HIV screening and relevant urine and blood investigations. The mean age of the HIV subjects was 38.84 ± 10.65 years. CKD was present in 86 (22.9%) HIV subjects and 11 (8.l %) controls. Low waist circumference (WC), high serum creatinine, high spot urine protein/creatinine ratio (SUPCR), high 24-HUP/creatinine Ratio (24-HUPCR), high 24-HUP/osmolality Ratio (24-HUPOR) predicted CKD in HIV subjects. CKD prevalence is high (22.9%) among newly diagnosed HIV patients in South East Nigeria. The predictors of CKD included WC, serum creatinine, SUPCR, 24-HUPCR, and 24-HUPOR.
Background and Objectives: Human immunodeficiency virus infection (HIV) is a global healthcare problem. Progression of HIV infection is commonly associated with decreasing weight. In the early phases of HIV infection, factors associated with weight changes are not completely known. This study evaluated the body mass index (BMI) and its potential risk factors in drug-naïve HIV subjects in Owerri, Eastern Nigeria. Methodology: This was a cross-sectional study of HIV subjects. BMI was determined. Relevant investigations were performed. Potential risk factors of BMI were analyzed at different BMI categories. Association of variables with BMI and the strength of variables to predict BMI, underweight and obesity were determined. Results: The mean BMI of the HIV subjects was 26.2 ± 5.4 kg/m 2. Underweight was present in 24 (6.1%), overweight in 150 (38.4%) and obesity in 84 (21.5%) of the HIV subjects. High spot urine creatinine (SUCr), high 24-hour urine osmolality (24HUOsm), high serum cholesterol and high hemoglobin predicted BMI in HIV subjects. Low 24HUOsm predicted under weight, whereas low 24-hour urine protein (24 HUP) and high 24HUOsm predicted obesity in HIV subjects. Conclusion: The prevalence of underweight was low (6.1%), overweight high (38.4%) and obesity high (21.5%) in HIV subjects. High SUCr, high 24HUOsm, high serum cholesterol and high hemoglobin were predictors of BMI in HIV subjects. Low 24HUOsm was a predictor of underweight, while low 24HUP and high 24HUOsm were predictors of obesity in HIV subjects. Abnormalities of serum lipids, renal function, and anemia were common in HIV subjects who were underweight and in those obese. Underweight HIV subjects should be evaluated at the early stages for dyslipidemia, renal damage and anemia.
Background and objectives: Human immunodeficiency virus (HIV) infection is a global healthcare problem. Low CD4 cells count, an index of immunosuppression, is associated with escalating activity and progression of HIV infection. The factors which influence low CD4 cells count have not been completely identified nor are they evaluated in routine clinical practice. The aim of this study was to determine the prevalence of low CD4 cells count and to evaluate the factors which might influence immunosuppression in treatment-naïve HIV subjects in Southeast Nigeria.Methodology: This was a cross-sectional study involving treatment-naïve HIV subjects. Anthropometric and demographic data were obtained and CD4 cells count and other relevant investigations performed. The data were compared between those who have low CD4 cells count, defined, here, as CD4 <200 cells/ml, and those with CD4 ≥ 200 cells/ml. Potential risk factors of low CD4 cells count were determined. Results:The mean age of the subjects was 39+11 years. Females were made up 283 (72.0%) and males 110 (28.0%). The median value of the CD4 cells count was 391. Low CD4 cells count was prevalent in 49 (12.5%) of the subjects. There was significant association between CD4 cells count and body mass index (df=2, p=0.017), as well as serum low density lipoprotein cholesterol (df=1, p=0.027) and anemia (df=3, p=0.025). Significant, but poor, correlation was observed between CD4 cells count and 24 h urine protein (r=-0.117, p=0.023), creatinine clearance (r=-0.122, p=0.018), as well as hemoglobin (r=0.224, p<0.001). Creatinine clearance was a predictor of low CD4 cells count, p=0.001. Conclusion:The prevalence of low CD4 cells count was high in this study. Abnormal weight, dyslipidemia and proteinuric renal damage were common among treatment-naïve subjects who have low CD4 cells count. referrals from the neighboring states. Owerri, where the hospital situates, has a local municipal population of about 125,337, whereas the state population is conservatively put at 3,927,563 [18].The criteria for inclusion in this study were age range of 16-65 years and treatment-naïve HIV-positive status. Pregnancy, adrenal disease, renal or terminal illness and malignancy were the exclusion criteria. From each of the study subjects, informed written consent was obtained. The Ethics Committee of the hospital gave approval for the study.From each of the subjects anthropometric and demographic data were obtained with the aid of a questionnaire administered by our laboratory technicians who explained to them the aim of the study. The place of domicile and origin, gender and age of the subjects were obtained. Weight and height were taken and BMI rendered as weight/ height 2 (kg/m 2 ). Blood pressure was measured [19].Clear instructions were given to all the subjects on how to collect 24 h urine sample. For each subject, a day-time random spot urine sample and blood samples were collected at the end of the 24 h urine sample collection [19][20][21].From the random spot urine samples coll...
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