Loading...

Follow African Journal of Nephrology on Feedspot

Continue with Google
Continue with Facebook
or

Valid

Background: The prevalence of chronic kidney disease (CKD) is high in sub-Saharan Africa and affects the productive workforce. CKD has been associated with psychological problems such as anxiety and depression; however, there is little published information on the burden of psychological problems among the CKD population in African countries. Our study assessed psychological changes in two groups of patients, one group with end-stage renal disease receiving chronic haemodialysis, and a second with CKD not on dialysis.

Methods: A cross-sectional study involving patients on chronic haemodialysis and patients with CKD stages 3–5 (the “CKD” patients) was conducted at the Renal Unit of the Korle-Bu Teaching Hospital in Accra, Ghana. One hundred and sixty-eight participants (82 CKD and 86 haemodialysis patients) were recruited. Demographic, clinical and laboratory information was captured, the Revised Quick Cognitive Screening Test (RQCST) was used to assess cognitive function and the Brief Symptoms Inventory-18 (BSI-18) was used to screen for anxiety, somatization and depression.

Results: CKD patients were older than those on haemodialysis, with mean ages of 53.3 and 46.6 years, respectively. Two-thirds (113/167) were male. The median glomerular filtration rate (GFR) of the CKD patients was 21 mL/min/1.73 m2 (interquartile range 9–34). Most of the haemodialysis patients (78.6%) were receiving two sessions of haemodialysis per week and their mean kT/V was 1.16 ± 0.23. The RQCST global scores in the two groups of patients were similar, with almost 90% of haemodialysis patients and 85% of CKD patients obtaining scores above 50. Haemodialysis patients had better scores for immediate recall memory. The haemodialysis patients also had higher BSI-18 global scores than the CKD patients (mean of 0.83 vs 0.70, p = 0.033). Mean anxiety and somatization scores were also higher in the haemodialysis patients.

Conclusions: Haemodialysis patients demonstrated higher anxiety and somatization scores than the CKD patients. Clinical psychological support should therefore be included in the treatment of our patients, and especially for those on chronic haemodialysis.

Read Full Article
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 

Background: Chronic kidney disease (CKD) and stroke constitute worldwide public health problems with rising incidence, prevalence and poor outcomes. While the link between renal dysfunction and myocardial infarction is well established, the link with stroke has been less well investigated. In this study, the prevalence and prognostic implication of renal dysfunction in patients admitted with acute stroke was assessed.

Methods: This was a prospective observational study of 130 patients with first-ever stroke admitted within 7 days of stroke onset and followed up for 30 days. The study outcome measure was 30-day mortality. Stroke subtype was verified by a computerized tomography (CT) scan of the brain. Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine using the 4-variable Modification of Diet in Renal Disease (MDRD) equation. Renal dysfunction was defined as eGFR < 60 mL/min/1.73 m2 and significant proteinuria was defined as urinary protein excretion ≥ 0.5 g in 24 hours. The Cox proportional hazards regression model was used to determine the relationship between GFR, proteinuria and 30-day mortality.

Results: The majority of the patients studied (56%) were male and their mean age was 61.3 ± 13.9 years. Ischaemic stroke was the most common stroke subtype, accounting for 74% of all cases. Overall, 38% of patients had reduced eGFR < 60 mL/min/1.72 m2 while 35% had significant proteinuria. eGFR < 60 mL/min/1.73 m2 (hazard ratio, HR 3.59, 95% CI 1.03–13.26, p < 0.001) and proteinuria (HR 1.86, CI 1.00–8.14, p = 0.035) were independent predictors of mortality. Other independent predictors were age > 70 years, haemorrhagic stroke subtype, CNS score < 6.5 and random blood glucose > 7.8 mmol/L.

Conclusions:Renal dysfunction is common among adult Nigerian patients with acute stroke. Both reduced eGFR and proteinuria were independent predictors of 30-day mortality in these patients.

Read Full Article
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 

Introduction: Diabetic nephropathy is a frequent and dreaded complication of diabetes mellitus. The purpose of this work was to study the role of serum cystatin C in the early detection of diabetic nephropathy among type 2 diabetic patients.

Methods: This was a cross-sectional study conducted in Cotonou over a period of six months. Blood samples were tested at the regional food safety testing analysis laboratory. Type 2 diabetic patients older than 15 years, who gave their informed consent, were included in the study. Patients with proven proteinuria, acute kidney injury, haematuria, a positive urine test for nitrite, or reduced glomerular filtration rate <60 mL/min/1.73 m2 were excluded from the study. All patients were subjected to serum cystatin C and microalbuminuria assays.

Results: Eighty-eight patients were included in the study. Their average age was 50.7 ± 9.6 years and the male to female ratio was 1.4:1. Twenty-four-hour microalbuminuria was positive in 53 (60%) cases whereas serum cystatin C tested positive in only 2 cases. Sensitivity and specificity tests applied to cystatin C showed very low sensitivity (4%) with a positive predictive value of 100% and high specificity (100%) with a negative predictive value of 41%.

Conclusions: When compared with 24-hour microalbuminuria, serum cystatin C assay was not sensitive enough to prove suitable for screening for diabetic nephropathy. Serum cystatin C would therefore not be useful for the early detection of nephropathy among type 2 diabetic patients.

Read Full Article
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 
African Journal of Nephrology by Deidra C Crews, Aminu K Bello, Gama.. - 3w ago

This World Kidney Day 2019 article is being published in Kidney International and reprinted concurrently in several journals. The articles cover identical concepts and wording, but vary in minor stylistic and spelling changes, detail, and length of manuscript in keeping with each journal’s style. Any of these versions may be used in citing this article.

Note that all authors contributed equally to the conception, preparation, and editing of the manuscript.

Read Full Article
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 

Background: Hypernatraemia is a common electrolyte problem in hospitalized patients and is associated with a high mortality rate. We aimed to determine the incidence, causes, management, and outcomes of hypernatraemia in adult hospitalized patients at a large South African tertiary hospital.

Methods: A retrospective study was conducted at Tygerberg Hospital in Cape Town, South Africa. Adult patients with hypernatraemia (at least one serum sodium concentration ≥150 mmol/L) during a 3-month period in 2014 were identified from our laboratory database for inclusion.

Results: There were 204 patients with hypernatraemia, an incidence of 1.5%. Of these patients, 101 (49.5%) were male, and the mean age was 53 years. There were 66 patients (32.4%) who had hypernatraemia on admission, and 138 who developed it during the course of their hospital stay. The overall in-hospital mortality was 38.7%, with higher rates for older patients and those with more severe degrees of hypernatraemia. Contributory causes which were most commonly present included dehydration/hypovolaemia (45%), followed by sepsis (39%). Net sodium gain, rather than water deficit, was identified as the main mechanism in most of the patients who developed hypernatraemia in the intensive care units. We found little evidence of any diagnostic work-up and also found that the details of fluid therapy and intake-output charting were poorly documented.

Conclusions: There is a very high mortality rate in our hospitalized patients with hypernatraemia.  The diagnostic work-up and therapy was often inadequate or poorly documented. The management of this important condition needs to be improved with the aid of standardized protocols.

 

Read Full Article
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 
African Journal of Nephrology by Mazhar H Amirali, Mogamat-yazied Ch.. - 3w ago
A case of drug-induced melanonychia due to cyclophosphamide is described in a patient with lupus nephritis. This resolved completely at 20 weeks after stopping the drug. Clinicians should be aware of the causes of melanonychia, and, if drug-induced melanonychia is suspected, the offending drug should be stopped whenever possible.
Read Full Article
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 

On behalf of the Editorial Board of the African Journal of Nephrology (AJN), I wish all readers, contributors and reviewers a happy and successful 2019. We have successfully completed our third year as an online Journal.  We sincerely thank everyone who contributed to this achievement.  With your support, we will achieve more milestones.

I wish to take this opportunity to remind all our readers and contributors that AJN is the official journal of the African Association of Nephrology (AFRAN).

During 2019, AFRAN, in partnership with the Kenya Renal Association, will convene its biennial congress in Mombasa, Kenya, from 25–29 September. Let us give Professor Were, AFRAN President-Elect, and the Kenya Renal Association all the support they need.  Through our participation, we will ensure that the AFRAN congress is a great success.

This year, the nephrology calendar is fully loaded. Besides various local and regional congresses, including the AFRAN Congress, at the global level the World Congress of Nephrology will be held in Melbourne, Australia, from 12–15 April 2019. World Kidney Day is also fast approaching. It will be celebrated as usual, on the second Thursday of March, 14 March 2019. The theme this year is “Kidney Health for Everyone Everywhere”.

In Volume 21 in 2018, AJN published excellent original articles from various regions of Africa, including East, West and Southern Africa. The proceedings of the 2018 South African Renal Congress are also part of AJN Volume 21. Of note, also in Volume 21, the publication of the 2016 South Africa Renal Registry Annual Report gives a picture of renal replacement therapy in an African country.

In 2019, in Volume 22, AJN expects to continue to publish excellent original articles as well as review articles to display research outputs from our contributors. We invite researchers to continue to submit their best work, and nephrology societies to submit the proceedings of their local and regional congresses.

Once again, Happy 2019 and we look forward to seeing you in Melbourne in April and Mombasa in September!

KARIBUNI SANA AFRAN Congress in Kenya!

Alain G Assounga
Editor-in-Chief

Read Full Article
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 
The editors of AJN wish to thank the colleagues who generously gave of their time and expertise to review manuscripts for us during 2018. We greatly appreciate their contribution to the quality of the work that we publish.
Read Full Article
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 

Introduction: Diabetic nephropathy is a frequent and dreaded complication of diabetes mellitus. The purpose of this work was to study the role of serum cystatin C in the early detection of diabetic nephropathy among type 2 diabetic patients.

Methods: This was a cross-sectional study conducted in Cotonou over a period of six months. Blood samples were tested at the regional food safety testing analysis laboratory. Type 2 diabetic patients older than 15 years, who gave their informed consent, were included in the study. Patients with proven proteinuria, acute kidney injury, haematuria, a positive urine test for nitrite, or reduced glomerular filtration rate <60 mL/min/1.73 m2 were excluded from the study. All patients were subjected to serum cystatin C and microalbuminuria assays.

Results: Eighty-eight patients were included in the study. Their average age was 50.7 ± 9.6 years and the male to female ratio was 1.4:1. Twenty-four-hour microalbuminuria was positive in 53 (60%) cases whereas serum cystatin C tested positive in only 2 cases. Sensitivity and specificity tests applied to cystatin C showed very low sensitivity (4%) with a positive predictive value of 100% and high specificity (100%) with a negative predictive value of 41%.

Conclusions: When compared with 24-hour microalbuminuria, serum cystatin C assay was not sensitive enough to prove suitable for screening for diabetic nephropathy. Serum cystatin C would therefore not be useful for the early detection of nephropathy among type 2 diabetic patients.

Read Full Article
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 
African Journal of Nephrology by Deidra C Crews, Aminu K Bello, Gama.. - 3M ago

This World Kidney Day 2019 article is being published in Kidney International and reprinted concurrently in several journals. The articles cover identical concepts and wording, but vary in minor stylistic and spelling changes, detail, and length of manuscript in keeping with each journal’s style. Any of these versions may be used in citing this article.

Note that all authors contributed equally to the conception, preparation, and editing of the manuscript.

Read Full Article

Read for later

Articles marked as Favorite are saved for later viewing.
close
  • Show original
  • .
  • Share
  • .
  • Favorite
  • .
  • Email
  • .
  • Add Tags 

Separate tags by commas
To access this feature, please upgrade your account.
Start your free month
Free Preview