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Background: Many shortcomings associated with haemodialysis for instance, intradialysis blood pressure changes, often lead to inadequate dialysis dose. Measures are needed to improve on this.Objectives: To determine the risk factors and clinical correlates of intradialysis blood pressure variations.Methods: Maintenance haemodialysis sessions for 232 consented patients with end stage kidney disease who had 1248 sessions were studied. Data collected was from history, examination findings, serum electrolytes and hematocrit. Blood pressure reading was taken manually at rest. Statistical analysis was with SPSS 22. Chi square and t-test were used to compare proportions and means respectively while regression analysis was used to determine predictors of blood pressure changes.Results: The mean age of participants was 49.9 + 4.6. More participants (38.8%) had hypertension associated CKD, than chronic glomerulonephritis, (37.9%). Majority (60.7%) had internal jugular catheter. Intradialysis hypertension was commoner than intradialysis hypotension (24.4% versus 19.4%). Intradialysis hypotension was commoner in females, diabetics and with less frequent dialysis while intradialysis hypertension was commoner in males, frequent erythropoietin use. The mean dialysis dose (Kt/V) was 1.02 + 0.4, with 0.68 + 0.1for intradialysis hypotension and 0.84 + 0.2 for intradialysis hypertension.Conclusion: Risk factors for intradialysis hypertension were males, frequent erythropoietin use while for intradialysis hypotension, were female gender and less frequent dialysis. Effective intra and inter-dialytic blood pressure control with adequate pre dialysis work up should be carried out to lessen the degree, burden and outcome of these variations.

Background: Proteinuria is a risk factor for the occurrence and progression of chronic kidney disease hence its use in screening, diagnosis and  monitoring purposes. The use of untimed sample has become more common due to shortcomings associated with 24 hour urine collection.Aim: To use urinary measures in comparing the kidney function of a healthy population with an apparently healthy population with frequent use of non-steroidal anti-inflammatory drugs (NSAIDs).Methods: Two hundred participants submitted paired urine samples. Blood was collected for estimation of creatinine based glomerular filtration rate (GFR). Student t-test and Chi-square tests were used to compare means and proportions respectively.Result: The prevalence of kidney dysfunction among NSAIDs users using eGFR, albumin creatinine ratio (ACR), protein creatinine ratio (PCR) and 24 hour urine protein (24HUP) were 22%, 18%, 16% and 11% while in the controls were 6%, 6%, 5% and 0% respectively. The albumin creatinine ratio (ACR) was most strongly correlated with GFR in NSAIDs users.Conclusion: The prevalence of kidney dysfunction using eGFR, ACR, PCR and 24HUP in NSAIDs users were all higher than in the healthy controls. The correlation between GFR and ACR was strongest of all urinary measures hence the ACR was a more reliable measure of kidney function  assessment in health and in frequent NSAIDs use. Keywords: non-steroidal anti-inflammatory drugs, albumin creatinine ratio, protein creatinine ratio, 24-hour urine protein, glomerular filtration rate.   French title: L'utilité des mesures urinaires dans l'évaluation de la fonction rénale chez les Nigérians en matière de santé et avec l'utilisation fréquente d'anti-inflammatoires non stéroïdiens Contexte général de l'étude : La protéinurie est un facteur de risque d'apparition et de progression de l'insuffisance rénale chronique, d'où leur utilisation à des fins de dépistage, de diagnostic et de surveillance. L'échantillon non chronométré est devenu plus courant en raison de lacunes associées à la collecte d'urine sur 24 heures. Des études ont montré une bonne corrélation entre les mesures urinaires dans la maladie et dans la santé.Objectif de l'étude : Déterminer l'utilité des mesures urinaires dans l'évaluation de la fonction rénale chez les utilisateurs d'AINS et en santé.Méthodes de l'étude : Deux cents participants ont soumis des échantillons d'urine appariés et du sang a été collecté pour l'estimation du DFG basée sur la créatinine. Les variables continues en tant que moyenne avec écart-type ont été comparées à l'aide du Test d'Étudiant (Student). Les variables catégorielles sous forme de proportions avec des pourcentages ont été comparées à l'aide du test du chi carré. La corrélation a été  effectuée par analyse de régression linéaire en utilisant la corrélation de Spearman.Résultat de l'étude : L'âge moyen des utilisateurs d'AINS, des contrôles et des utilisateurs d'AINS souffrant de dysfonction rénale (KD) était respectivement de 46,5 + 14,5, 46,0 + 14,5 et 63,11 ± 18,62. La prévalence de KD parmi les utilisateurs d'AINS utilisant eGFR, ACR, PCR et 24HUP était de 22%, 18%, 16% et 11%, tandis que chez les témoins étaient de 6%, 6%, 5% et 0% respectivement. L'ACR était fortement corrélé avec le DFG chezles utilisateurs d'AINS.Conclusion : La prévalence de KD utilisant eGFR et ACR chez les utilisateurs d'AINS était de 22%, 18%, 16% et 30% et parmi les témoins sains étaient de 6%, 6%, 5% et 0% respectivement. La corrélation entre le DFG et les mesures urinaires était la plus forte avec l'ACR. L'ACR localisé dans l'urine semble être une mesure plus fiable de l'évaluation de la fonction rénale en santé et en maladie. Mots-clés: Anti-inflammatoires non stéroïdiens, ratio albumine-créatinine, ratio protéine-créatinine, protéines urinaires sur 24 heures, taux de  filtration glomérulaire

Introduction: Non-steroidal anti-inflammatory drugs (NSAIDs) use is very common. NSAIDs use could be associated with elevated eosinophil count which could be a class effect or patient-related. Inflammation could be the link between NSAIDs use and eosinophilia. Aims: To compare the pattern of eosinophil count in the peripheral blood of frequent users of NSAIDs and healthy controls. Methodology: Two hundred (one hundred frequent users of NSAIDs and 100 healthy controls) participants who had no known risk factor for kidney disease and had given informed consent were recruited. Blood was taken to determine the white cell count and differentials, serum electrolyte and creatinine, and random blood sugar. Results: The mean age of NSAIDs users was not significantly different from controls, P = 0.3. The mean eosinophil count was higher in males than females. The incidence of eosinophilia in NSAIDs users was 4%. The mean Eosinophil count of NSAIDs users was insignificantly higher than controls, 164.3 ± 51 6 vs 135.

Gender differences have been known to exist both in physiologic and pathological states including kidney disease. There is a need to be well acquitted with these differences to enhance preventive and curative strategies for kidney diseases. One hundred and forty-four participants with chronic kidney disease, stage 3 to non-dialytic 5 had urine, blood, and radiological investigations to assess albuminuria, kidney function, and sizes. The findings were compared on a gender basis. Eighty-two males and 62 females participated. The mean age of the males and females were 47.9 ± 16.8 years and 50.5 ± 14.73 years respectively. A greater proportion of participants 65 years and older were females. Chronic interstitial nephritis was more common in females while chronic glomerulonephritis was more common in males. Hyponatremia, metabolic acidosis, and hyperphosphatemia were more common in females. Men used vitamin D analogs and erythropoietin more than women while women used sodium bicarbonate and phosphate binders more than men. Aging (OR-3.28, CI-2.69-387), hyponatremia (OR-4.74, CI-2.10-6.33), hypoalbuminemia ((OR-4.56, CI-3.45-7.49)), and metabolic acidosis (OR-4.14, CI-1.46-4.92) were independently associated with the female gender. Gender differences exist in the risk profile, epidemiology, laboratory findings, and response to treatment of CKD sufferers. Women had more hyponatremia and hyperphosphatemia while men had higher albumin and kidney sizes. Gender partitioned median range cut-offs of some variables would be needed for effective prevention, treatment, and follow-up of CKD sufferers.

Introduction: Despite improvements in hemodialysis delivery, acid base imbalance is still common in the dialysis population and it is associated with intradialysis blood pressure changes, dialysis termination, inadequacy and poor treatment outcome. We studied acid base imbalance in maintenance hemodialysis, its determinants and relationship with intradialysis blood pressure changes. Materials & Methods: A prospective study carried out at Babcock University Teaching Hospital, Ilishan-Remo between May 2019 and April 2021 that involved 298 participants who had 1642 hemodialysis sessions. Results: The mean age was 51.44 + 7.31 years, with the females been older than males, P=0.04. The mean predialysis and post dialysis serum bicarbonate were 18.41 ± 3.63 mmol/l and 20.61 ± 6.26 mmol/l (P<0.001). The prevalence of pre and post dialysis metabolic acidosis were 79.0% and 38.3% (P<0.001) and of intradialysis hypotension and hypertension were 19.1% and 25.0% (P=0.02). The risk of intradialysis hypotension was negatively correlated with predialysis bicarbonate while intradialysis hypertension was positively correlated with predialysis bicarbonate. The mean dialysis dose was higher in males (P=0.03). Metabolic acidosis was commoner in elderly and females, and was associated with intradialysis hypotension, dialysis termination and inadequacy. Aging and infrequent dialysis, predicted metabolic acidosis. Conclusion: Metabolic acidosis is common in maintenance hemodialysis, particularly in females, aged and infrequent dialysis, and leads to intradialysis hypotension, dialysis termination, inadequacy and poor treatment outcome. Keywords: Metabolic acidosis, Maintenance hemodialysis, Dialysis dose, Intradialysis hypotension, Intradialysis hypertension, Predialysis bicarbonate, Poor treatment outcome.

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are very common “over-the-counter” commonly abused drugs used in treating fever, pain and inflammatory conditions. They inhibit prostaglandins and can cause kidney disease and hypertension, particularly in stressed states like dehydration and exercises. Objectives: To access prescription pattern and effects of common NSAIDs on the kidneys. Methods: One hundred frequent NSAIDs users (daily use > 4 weeks) and 100 healthy controls, who had no known risk factor for kidney disease and gave consent were recruited. Blood samples for serum electrolytes, urea and creatinine, haemoglobin concentration and urine samples for dip strip, and 24 hour protein were collected and analysed. Results: The mean age of the controls, all NSAIDs users, NSAIDs users without kidney dysfunction (KD) and NSAIDs users with KD were 46.04 + 14.21 years, 46.5 + 14.2 years, 41.84 years + 14.52 yrs and 63.04 + 4.21 years respectively, P=0.03. The mean estimated glomerular filtration rate (eGFR) was significantly lower in frequent NSAIDs users than controls, P<0.001. Ibuprofen was the most nephrotoxic and, nephrotoxicity was positively related to combination therapy (P<0.001) and duration of use (P=0.03). Herbal medicines significantly increased the risk of KD, P=0.01. Predictors of KD were advancing age, longer duration of NSAIDs use, Ibuprofen use and combined NSAIDs. Conclusion: Frequent NSAIDs use, common in Orthopaedic units, could be complicated by kidney dysfunction. Ibuprofen, followed by ketoprofen, was the most nephrotoxic. Observed risk factors for NSAIDs induced nephrotoxicity included advancing age, herbal remedies, Ibuprofen and combination therapy.

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