A nephrological program in Benin and Togo (West Africa)

Fogazzi, Giovanni B.; Attolou, Vénérand; Kadiri, S; Fenili, Domenico; Priuli, Fiorenzo

doi:10.1046/j.1523-1755.63.s83.12.x

Cited by 14 publications

(7 citation statements)

References 3 publications

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“…In Malaysia, recent data suggest the rate of ESRD may be slowing, 30 but it is unclear whether this trend will continue since estimates for prevalence of CKD remain high. 31 In Benin and Togo, 26 in partnership with the International Society of Nephrology, educational efforts for providers are ongoing through seminar courses, and a laboratory technician has been trained in urine microscopy; however, financial constraints have prohibited expansion and rigorous outcome assessments. In Mexico, the multidisciplinary CKD clinic organised by Garcia-Garcia et al 14 is now in its eighth year, caring for nearly 400 established patients with moderate to advanced CKD.…”

Section: Resultsmentioning

confidence: 99%

Chronic kidney disease care models in low- and middle-income countries: a systematic review

et al. 2018

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IntroductionThe number of persons with chronic kidney disease (CKD) living in low- and middle-income countries (LMIC) is increasing rapidly; yet systems built to care for them have received little attention. In order to inform the development of scalable CKD care models, we conducted a systematic review to characterise existing CKD care models in LMICs.MethodsWe searched PubMed, Embase and WHO Global Health Library databases for published reports of CKD care models from LMICs between January 2000 and 31 October 2017. We used a combination of database-specific medical subject headings and keywords for care models, CKD and LMICs as defined by the World Bank.ResultsOf 3367 retrieved articles, we reviewed the full text of 104 and identified 17 articles describing 16 programmes from 10 countries for inclusion. National efforts (n=4) focused on the prevention of end-stage renal disease through enhanced screening, public awareness campaigns and education for primary care providers. Of the 12 clinical care models, nine focused on persons with CKD and the remaining on persons at risk for CKD; a majority in the first category implemented a multidisciplinary clinic with allied health professionals or primary care providers (rather than nephrologists) in lead roles. Four clinical care models used a randomised control design allowing for assessment of programme effectiveness, but only one was assessed as having low risk for bias; all four showed significant attenuation of kidney function decline in the intervention arms.ConclusionsOverall, very few rigorous CKD care models have been reported from LMICs. While preliminary data indicate that national efforts or clinical CKD care models bolstering primary care are successful in slowing kidney function decline, limited data on regional causes of CKD to inform national campaigns, and on effectiveness and affordability of local programmes represent important challenges to scalability.

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Section: Resultsmentioning

confidence: 99%

Chronic kidney disease care models in low- and middle-income countries: a systematic review

et al. 2018

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“…The prevalent causes of end stage kidney disease in our environment are systemic hypertension and chronic glomerulonephritis and it affects mainly the young age group in contrast to industrialized countries where most of the patients are elderly [ 4 ]. In West Africa, the prevalence of chronic kidney disease is about 3.3% in Benin [ 5 ] and approximately 8–10% in Nigeria [ 6 , 7 ]. These estimates were obtained from hospital studies which might reflect only the tip of the iceberg.…”

Section: Introductionmentioning

confidence: 99%

The burden of renal admissions in a tertiary Hospital in Sierra Leone

et al. 2022

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Background The burden of both acute kidney injury and chronic kidney disease is on the rise globally. In sierra Leone, there has been no data on renal patients or admissions. This study intends to close this gap in knowledge and give preliminary data on the burden of renal disease in this country. Methods The study was a retrospective review of the case notes of patients admitted at Connaught Hospital, Freetown over a 2 year period. Data extraction was done using a well- structured proforma. Results A 2.7% renal admission burden was obtained; mean duration of hospital stay was 15.1 ± 14.7; mean age of patients was 47.2 ± 17.5 with a female preponderance. The common risk factors for chronic kidney disease were systemic hypertension (43%) and diabetes mellitus (24%). The common risk factors for acute kidney injury were sepsis (77%) and hypovolemia (15%). The in- hospital mortality rate was 47% and 73% were non-compliant with haemodialysis probably due to financial reasons. Conclusion There is a significant burden of kidney disease in our environment, affecting mainly our young and middle-aged population. A rational approach is to embark on kidney disease prevention programs.

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“…In the countries of Sub-Saharan Africa, facilities for the treatment of CKD are scanty, and chronic dialysis is available in less than half of them. In those countries that do offer transplantation and dialysis, only a small proportion of the population can afford the treatment [ 8,9 ]. Hence, in developing countries, just as in developed countries, detection of kidney disease and prevention of its progression are of paramount importance.…”

Section: Introductionmentioning

confidence: 99%

Assessment of GFR by four methods in adults in Ashanti, Ghana: the need for an eGFR equation for lean African populations

Eastwood

Kerry

Plange‐Rhule

et al. 2010

Nephrology Dialysis Transplantation

122

121

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Background. Equations for estimating glomerular filtration rate (GFR) have not been validated in Sub-Saharan African populations, and data on GFR are few.Methods. GFR by creatinine clearance (Ccr) using 24-hour urine collections and estimated GFR (eGFR) using the four-variable Modification of Diet in Renal Disease (MDRD-4)[creatinine calibrated to isotope dilution mass spectrometry (IDMS) standard], Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Cockcroft–Gault equations were obtained in Ghanaians aged 40–75. The population comprised 1013 inhabitants in 12 villages; 944 provided a serum creatinine and two 24-hour urines. The mean weight was 54.4 kg; mean body mass index was 21.1 kg/m2.Results. Mean GFR by Ccr was 84.1 ml/min/1.73 m2; 86.8% of participants had a GFR of ≥60 ml/min/1.73 m2. Mean MDRD-4 eGFR was 102.3 ml/min/1.73 m2 (difference vs. Ccr, 18.2: 95% CI: 16.8–19.5); when the factor for black race was omitted, the value (mean 84.6 ml/min/1.73 m2) was close to Ccr. Mean CKD-EPI eGFR was 103.1 ml/min/1.73 m2, and 89.4 ml/min/1.73 m2 when the factor for race was omitted. The Cockcroft–Gault equation underestimated GFR compared with Ccr by 9.4 ml/min/1.73 m2 (CI: 8.3–10.6); particularly in older age groups. GFR by Ccr, and eGFR by MDRD-4, CKD-EPI and Cockcroft–Gault showed falls with age: MDRD-4 5.5, Ccr 7.7, CKD-EPI 8.8 and Cockcroft–Gault 11.0 ml/min/1.73 m2/10 years. The percentage of individuals identified with CKD stages 3–5 depended on the method used: MDRD-4 1.6% (7.2 % without factor for black race; CKD-EPI 1.7% (4.7% without factor for black race), Ccr 13.2% and Cockcroft–Gault 21.0%.Conclusions. Mean eGFR by both MDRD-4 and CKD-EPI was considerably higher than GFR by Ccr and Cockcroft–Gault, a difference that may be attributable to leanness. MDRD-4 appeared to underestimate the fall in GFR with age compared with the three other measurements; the fall with CKD-EPI without the adjustment for race was the closest to that of Ccr. An equation tailored specifically to the needs of the lean populations of Africa is urgently needed. For the present, the CKD-EPI equation without the adjustment for black race appears to be the most useful.

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A nephrological program in Benin and Togo (West Africa)

Abstract: Severe renal diseases are found frequently in patients of Benin and Togo. However, due to the lack of money and basic diagnostic and therapeutic facilities, these patients cannot be properly managed.

Cited by 14 publications

References 3 publications

Chronic kidney disease care models in low- and middle-income countries: a systematic review

Chronic kidney disease care models in low- and middle-income countries: a systematic review

The burden of renal admissions in a tertiary Hospital in Sierra Leone

Assessment of GFR by four methods in adults in Ashanti, Ghana: the need for an eGFR equation for lean African populations

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