Introduction: Despite the rising prevalence of chronic kidney disease (CKD), access to adequate renal care is still not available to a very large part of the populace, essentially due to inadequate funds and this has further heightened the burden of the disease on patients and the general society. Measures are therefore needed to highlight this health challenge and proffer solutions. Methods: A comparative study in which consented 354 consented participants with CKD stage 3-5 gave history, were examined and had blood taken for serum biochemistry and hematocrit to access kidney function. Results: Two hundred and thirty six males and 118 females participated. The mean age of the participants was 52.11 ± 6.04 yrs. A greater percentage (44.6%) of participants had hypertension as cause of CKD and earned a monthly income less than the national minimum wage (47.7%). A greater proportion of participants had tertiary education (51.4%), were married (64.1%) and travelled less than 50 kilometers (67.5%) to access renal care. The health insured were more likely to be males (P=0.002), aged (P<0.001) have higher hematocrit (P=0.002), albumin (P=0.06), bicarbonate (P=0.04) and GFR (P=0.01).. The health insured had more frequent dialysis (P<0.001) and erythropoietin use (P<0.001. Forty percent of the health insured had renal transplant compared to 1.6% of the uninsured, P<0.001. The insured were more associated with IDHT as the uninsured were more associated with IDH. The health insured had a mean dialysis dose (Kt/V 1.34 ± 0.9) compared to 1.13 ± 0.5 for the uninsured, P<0.001. The dialysis dose was positively correlated with frequency of dialysis (P<0.001), and erythropoietin (P<0.001) but was negatively correlated with age (P=0.01) and serum creatinine (P=0.004). Predictors of dialysis dose were insurance status, frequency of dialysis, and erythropoietin, hematocrit, serum albumin and bicarbonate. Conclusion: Only 11.9% of the CKD cohorts had health insurance coverage and they were more likely to be males, aged, highly educated, with higher hematocrit, and albumin. The health insured had a mean dialysis dose of Kt/V 1.34±0.9 as against 1.13±0.5 for the uninsured. The uninsured had more metabolic acidosis, were younger and being the most active working population, their affectation only further worsens the burden associated with CKD. Key words: health insured, intradialysis hypotension, intradialysis hypertension, dialysis dose.
Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are used for managing painful conditions. They are available as cheap, over-the-counter drugs, and commonly abused. NSAIDs inhibit prostaglandins (PGs) actions on the kidneys and can cause kidney disease and hypertension, especially when used in excess doses, for prolonged period or in stressed states. Methods: The descriptive study was carried at the Orthopaedic and Family Medicine units of the Federal Medical Centre, Abeokuta. Two hundred respondents participated in the study. One hundred frequent users of NSAIDs (with daily use for ≥ 4 weeks) and age and sex-matched controls with no known risk for kidney disease and had consented were consecutively recruited. Data were entered from history, examination and investigations (urinalysis, serum electrolyte, kidney scan and biopsy). Cases with estimated glomerular filtration rate (eGFR) < 60 mls/min/1.73 m 2) and dip strip proteinuria ≥ 1+ had kidney biopsy. Statistical analysis was with SPSS 21 software. Student t-test and Chi-square tests were used to compare means and proportions respectively. Pearson's correlation test was used to determine the strength of association between independent risk factors and kidney dysfunction (KD). Results: Two hundred respondents participated in the study. Fifty one (51) females and Forty nine (49) males were recruited as cases and controls respectively. Thirteen (13) females had KD compared to 9 males, (P = 0.02). The mean age of cases with KD (63.04 yrs ± 4.21) was statistically higher than those without KD (P = 0.01). Majority of the cases were in the working population (30-59 yrs). Twenty two (22) frequent NSAIDs users had kidney dys-How to cite this paper: Uduagbamen PK,
Background: The kidney volume is a very reliable ultrasound measure, reflecting contributions from all kidney parts. It could be affected by gender, body size and disease conditions. Its use in renal function assessment is based on its correlation with the glomerular filtration rate (GFR). Objectives: To assess the determinants and clinical correlates of kidney volume in hypertension and in chronic kidney disease (CKD). Materials and Methods: The two-center study was carried out at the Federal Medical Centre, Abeokuta (June-December 2017) and Babcock University Teaching Hospital, Ilishan-Remo (August 2019-January 2020). The kidneys of sixty participants who had hypertension without kidney disease (HWKD) and 58 with CKD were scanned from the front and back and their blood samples were taken for electrolytes and hemoglobin concentration. Result: The participants with CKD were significantly older than those with hypertension, P < 0.001. The mean kidney volume of hypertensives, 132.4 ± 18.3, was significantly higher than those with CKD, 63.7 ± 5.9, P < 0.001. The glomerular filtration rate (GFR) and hemoglobin concentration were significantly higher in hypertensives than in CKD, P < 0.001, P < 0.001 respectively. The systolic blood pressure (SBP), creatinine and the albumin creatinine ratio (ACR) were significantly higher in CKD than in hypertension, P < 0.001, P < 0.001 and P < 0.001 respectively. Conclusion: The mean kidney volume was higher in hypertension and in males. The GFR and hemoglobin levels were significantly How to cite this paper: Uduagbamen PK,
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