Patterns of renal disease in Cape Town South Africa: a 10-year review of a single-centre renal biopsy database

Okpechi, Ikechi G.; Swanepoel, Charles R.; Duffield, Maureen; Mahala, Bonginkosi; Wearne, Nicola; Alagbe, S C; Barday, Zunaid; Arendse, Craig; Rayner, Brian

doi:10.1093/ndt/gfq655

Cited by 96 publications

(111 citation statements)

References 22 publications

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“…[6] The data also demonstrate a preponderance of females (58%). Although consistent with data from South Africa (SA), [17] this is in contrast to the distribution of AKI in the developed world which predominantly occurs in elderly male populations. [19][20][21] The data also suggest that AKI associated with intrinsic renal disease/glomerular injury presents predominantly as AKI3.…”

Section: Discussionsupporting

confidence: 88%

“…[13] In rural areas it is proposed that AKI is usually community-acquired affecting younger and previously healthy individuals in which AKI is associated with diarrhoeal disease, infectious diseases, animal venoms, septic abortions, dyes and natural medicines. [14] Although there are a handful of studies describing the association between glomerular disease and CKD in Africa, [15][16][17] in contrast very little data exist on the nature of AKI. Specifically, to our knowledge, no studies have characterised glomerular disease in AKI in this geographical context.…”

Section: Discussionmentioning

confidence: 99%

“…[24] This pattern of late presentation has also been seen in the context of CKD in SSA and is likely to reflect accessibility to healthcare services in the region. [17,25] It is also of note that in this study, we have only recruited from a cohort of patients with intrinsic renal disease and thus excluded patients with pre-renal AKI, which is also likely to contribute towards the predominance of Both baseline creatinine and baseline eGFR data are presented for 70 of the 100 patients for whom baseline renal function measurements were available. Recovery = sCr is no longer in keeping with the definition of AKI compared with baseline sCr values, or a return to within the normal range if baseline was not available.…”

Section: Discussionmentioning

confidence: 99%

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Glomerular disease and acute kidney injury in Sudan: Demographics, histological diagnosis and outcome

El-hassan¹,

Ghalib

Ibrahim³

et al. 2016

S Afr Med J

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Glomerular disease and acute kidney injury in Sudan: Demographics, histological diagnosis and outcome

El-hassan¹,

Ghalib

Ibrahim³

et al. 2016

S Afr Med J

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“…MCGN was found to be the cause in 14 cases (58.3% of biopsies and 29.7% of the entire group). Idiopathic MCGN is the most common biopsy finding in Cape Town [21] and in other areas of SA the second most common, [22] although it is declining in incidence in developed countries. [23] Known associations with MCGN did not explain the link between methamphetamine use and MCGN.…”

Section: Fig 1 Light Microscopic Features Of Kidney Changes Seen Inmentioning

confidence: 99%

Hypertension, end-stage renal disease and mesangiocapillary glomerulonephritis in methamphetamine users

Jones

Rayner

2015

S Afr Med J

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Background. Methamphetamine abuse has risen dramatically in South Africa. The chronic effects of abuse on the kidneys and blood pressure have not been documented. This study reviewed patients referred for evaluation of kidney disease and/or hypertension, who had been abusing methamphetamines. Methods. The records of patients referred to the renal unit between 2005 and 2013 who had been using methamphetamines were retrospectively reviewed. Patient demographics, biophysical parameters, blood pressure, renal function, renal ultrasound and biopsy findings, complications of chronic kidney disease and comorbidities were recorded. Results. Forty-seven patients were included in the study. Their mean age was 29 years. Hypertension was present in 42 (89.4%) of patients, with malignant hypertension in 21 (44.7%). Forty-five (95.7%) had chronic kidney disease (CKD), and 26 (55.3%) had end-stage renal disease. Renal biopsies were performed in 24 patients. Twelve (50.0%) of the biopsies showed hypertensive changes and 14 (58.3%) mesangiocapillary glomerulonephritis type 1, with deposition of IgM and C3 complement. Conclusion. Methamphetamine use is associated with severe hypertension, mesangiocapillary glomerulonephritis and CKD.

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“…Primary and secondary glomerular diseases also commonly occur in SSA, and for various reasons-such as late presentation of patients, inadequate tools to make a diagnosis, and inadequate treatment-premature ESRD may result (9). Recently, HIV-associated nephropathy was reported from our center in South Africa to have increased by 25.7% over a 10-year period (10). Diabetes mellitus is reported to affect 9.4 million people in Africa, with the reported prevalence of diabetic nephropathy being estimated at 6% -16% in SSA (11).…”

mentioning

confidence: 99%

Peritoneal Dialysis in Cape Town, South Africa

2012

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♦ Background: Chronic kidney disease is a major public health problem in sub-Saharan Africa (SSA), which encompasses 70% of the least-developed countries in the world. Most people in SSA have no access to any form of renal replacement therapy (RRT). Given its ease of performance and patient independence, peritoneal dialysis (PD) should be an ideal form of RRT in SSA, but several complex and interdependent factors make PD a difficult option in SSA. The present review describes the practice of PD in SSA, with emphasis on Cape Town, South Africa. ♦ Methods and Results: After a review of the recent PubMed literature on RRT in SSA and an appraisal of nephrology practice in South Africa, factors that make the provision of RRT (especially PD) a challenge in SSA include the low number of qualified health care workers, socio-demographic issues (poor housing, electricity, and water supplies), and the cost of PD fluids in the region. Although South Africa has the largest PD population in all of SSA, the growth of PD in South Africa is specifically impeded by the system of RRT rationing, which favors HD; the methods of funding for dialysis and for remuneration of doctors in private practice; and many other socio-economic factors. The peritonitis rate remains relatively high, and it is a significant contributor to morbidity in PD patients in Cape Town. ♦ Conclusions: In many parts of SSA, PD could be the main dialysis modality. However, African governments must start taking responsibility for their people by providing adequate funds for renal replacement programs. Attempts to produce PD fluids locally and to train and educate health care workers will greatly improve the use of PD as a RRT option in SSA. Perit Dial Int

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Patterns of renal disease in Cape Town South Africa: a 10-year review of a single-centre renal biopsy database

Abstract: Our data are an important contribution to the epidemiology of renal disease in Africa. We hope that this will form the basis for developing a renal biopsy registry in South Africa and across the continent.

Cited by 96 publications

References 22 publications

Glomerular disease and acute kidney injury in Sudan: Demographics, histological diagnosis and outcome

Glomerular disease and acute kidney injury in Sudan: Demographics, histological diagnosis and outcome

Hypertension, end-stage renal disease and mesangiocapillary glomerulonephritis in methamphetamine users

Peritoneal Dialysis in Cape Town, South Africa

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