Hemodialysis: Management problems in developing countries, with Nigeria as a surrogate

Bamgboye, Ebun L.

doi:10.1046/j.1523-1755.63.s83.19.x

Cited by 77 publications

(68 citation statements)

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“…In our setting, chronic hemodialyzed patients were younger, likely including more individuals in their productive years, mainly unemployed and facing financial constraints for their care as previously reported in similar settings. This could affect their capacity for coping with ESRD management, including caring for complications such as anemia 1,10,16 .…”

Section: Discussionmentioning

confidence: 99%

Anemia in patients on chronic hemodialysis in Cameroon: prevalence, characteristics and management in low resources setting

Kaze¹,

Kengne²,

Mambap³

et al. 2015

Afr H. Sci.

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Background: Anemia is a common complication of chronic kidney disease. We investigated the prevalence, characteristics and management of anemia in patients on chronic hemodialysis and assessed the response to blood-transfusion based management in Cameroon. Methods: This was a cohort study of five months' duration (August-December 2008) conducted at the Yaoundé General Hospital's hemodialysis center, involving 95 patients (67 men, 70.5%) on chronic hemodialysis by a native arterio-venous fistula. A monthly evaluation included full blood counts, number of pints of red cell concentrates transfused, and vital status. Results: At baseline, 75 (79%) patients had anemia which was microcytic and hypochromic in 32 (43%). Anemia was corrected in 67 (70.5%) patients using blood transfusion only, while 28 (29.5%) patients were receiving erythropoietin (11 regularly, 39%). Only 77.2% of 342 pints (median 3.0, range 0-17 per patients) of red cell concentrates prescribed were effectively received during the follow-up at an unacceptably high cost to patients and families. Mean hemoglobin and mean corpuscular hemoglobin levels remained stable during follow-up, while mean corpuscular volume increased. Erythropoietin treatment was the main determinant of favorable trajectories of hematological markers. Conclusions: Patients on chronic hemodialysis have predominantly microcytic hypochromic anemia, with limited capacity for correction using blood transfusion.

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Section: Discussionmentioning

confidence: 99%

Anemia in patients on chronic hemodialysis in Cameroon: prevalence, characteristics and management in low resources setting

Kaze¹,

Kengne²,

Mambap³

et al. 2015

Afr H. Sci.

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“…Sixty five percent of the population lives in rural settings, a significant distance from cities where most of the organized health care delivery systems exist [5,8]. Data on ESRD from SSA are limited; however, data from the United States suggest that for every patient with ESRD there are more than 200 with overt CKD and almost 5000 with unknown renal disease (stage 1 and 2) [9].…”

Section: Discussionmentioning

confidence: 99%

An overview of renal replacement therapy and health care personnel deficiencies in sub-Saharan Africa

Pozo¹,

Leow²,

Groen³

et al. 2012

Transplant International

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Summary Chronic kidney disease (CKD) is a public health problem in sub‐Saharan Africa (SSA) but there is limited data to guide programs or plan interventions. To help set priorities and understand the needs for renal replacement therapy a baseline assessment is required. World Health Organization (WHO) databases and Medline were searched to determine the number of physicians, nephrologists, and dialysis centers and patients in SSA. Data on renal transplant (RTx) programs were collected from the WHO Global Observatory on Donation & Transplantation database for deceased‐donor and living‐donor RTx. Of the 47 countries in SSA only 15 had recent data with most rates of physicians per 10 000 population under 2.0. Nigeria and South Africa had the greatest absolute numbers of physicians and nephrologists but Mauritius had the greatest proportion to population. South Africa had the most dialysis patients. Kenya, Nigeria and South Africa were the only countries with RTx programs and reported rates per million population of 0.60, 0.23 and 5.12, respectively. Treatment for patients with CKD in SSA is limited by a lack of physicians, nephrologists, and dialysis centers. Few countries are performing RTx. Resources are needed to increase the health workforce and increase RTx programs in SSA.

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“…2 Detection of new cases of stage 5 CKD is increasing at a rate of 8% per year. 3 Hypertension and diabetes are the major forerunners of CKD. India is one of the leading nations in terms of prevalence of diabetes and hypertension.…”

Section: Introductionmentioning

confidence: 99%

Dyslipidemia in chronic kidney disease excluding diabetic and nephrotic aetiology

Velayudham

Sivasubramanian

2017

Int J Adv Med

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Background: Dyslipidemia is hypothesized as one of the risk factor of chronic kidney disease and plays an important role in the progression of renal failure. The present study was conducted to assess the association between ratio of TG/HDL-C and CKD and other abnormalities in the lipid profile in CKD patients.Methods: This case-control study was conducted in Government General Hospital from July 2013 to November 2013. 100 patients with CKD were included as study cases. 100 healthy patients from the same hospital, who came with different illness other than the study disease were included as controls. Fasting lipid profile was done – total cholesterol, triglycerides and high-density lipoproteins (HDL) were measured and low-density lipoproteins, & TG/HDL ratio were calculated. Comparison of lipid parameters among study and control groups was done. P value <0.05 was considered as statistically significant.Results: Majority of the study patients were under the age group of 40-50 years. Male dominance (86%) was seen in the study group. The association of HDL, LDL, TGL, TGL/HDL, TC parameters and stages of CKD was observed and found to be statistically significant (p value <0.0001 and <0.05). Comparison of lipid parameters among study and control groups were done and difference was found to be statistically significant (p value <0.0001).Conclusions: Dyslipidemia should be treated in early stages of CKD to prevent secondary complications.

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Hemodialysis: Management problems in developing countries, with Nigeria as a surrogate

Cited by 77 publications

References 1 publication

Anemia in patients on chronic hemodialysis in Cameroon: prevalence, characteristics and management in low resources setting

Anemia in patients on chronic hemodialysis in Cameroon: prevalence, characteristics and management in low resources setting

An overview of renal replacement therapy and health care personnel deficiencies in sub-Saharan Africa

Dyslipidemia in chronic kidney disease excluding diabetic and nephrotic aetiology

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