C. Snead, C. Seneschall, Razeen Davids, T. Young, F. Caskey, E. Effa
Introduction: The burden of chronic kidney disease (CKD) is rising in sub-Saharan Africa. Access to kidney replacement therapy (KRT) remains limited and modelling suggests a significant hidden burden of kidney failure managed without KRT. Kidney failure is contributing to serious health-related suffering (SHS) at a global level. Despite this, access to palliative care remains extremely disparate. There is an urgent need for greater palliative care provision for patients with kidney failure in sub-Saharan Africa. To inform this, it is important to understand their current quality of life. This article outlines our review protocol, ensuring transparency of our planned methods and reporting.
{"title":"Quality of life of patients with kidney failure in sub-Saharan Africa: protocol for a systematic review of quantitative studies","authors":"C. Snead, C. Seneschall, Razeen Davids, T. Young, F. Caskey, E. Effa","doi":"10.21804/26-1-4847","DOIUrl":"https://doi.org/10.21804/26-1-4847","url":null,"abstract":"Introduction: The burden of chronic kidney disease (CKD) is rising in sub-Saharan Africa. Access to kidney replacement therapy (KRT) remains limited and modelling suggests a significant hidden burden of kidney failure managed without KRT. Kidney failure is contributing to serious health-related suffering (SHS) at a global level. Despite this, access to palliative care remains extremely disparate. There is an urgent need for greater palliative care provision for patients with kidney failure in sub-Saharan Africa. To inform this, it is important to understand their current quality of life. This article outlines our review protocol, ensuring transparency of our planned methods and reporting.","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68365479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Bjornstad, W. Muronya, Z. Smith, Manly Kamija, R. Evans, Amy K. Mottl, Y. Golightly, K. Gibson, A. Charles, Emily W. Gower
Background: Many low-resource settings have limited access to serum creatinine tests necessary for kidney disease identification. Among Malawian patients who are hospitalized after trauma, we evaluated the use of point-of-care saliva urea nitrogen (SUN) dipsticks to predict acute kidney injury (AKI). Methods: In a nested prospective cohort study, we enrolled hospitalized acute trauma patients aged ≥6 months to evaluate AKI (defined by KDIGO criteria) and the test characteristics of SUN to predict AKI.
{"title":"Saliva urea nitrogen dipsticks to predict acute kidney injury in Malawian trauma patients","authors":"E. Bjornstad, W. Muronya, Z. Smith, Manly Kamija, R. Evans, Amy K. Mottl, Y. Golightly, K. Gibson, A. Charles, Emily W. Gower","doi":"10.21804/26-1-5462","DOIUrl":"https://doi.org/10.21804/26-1-5462","url":null,"abstract":"Background: Many low-resource settings have limited access to serum creatinine tests necessary for kidney disease identification. Among Malawian patients who are hospitalized after trauma, we evaluated the use of point-of-care saliva urea nitrogen (SUN) dipsticks to predict acute kidney injury (AKI). Methods: In a nested prospective cohort study, we enrolled hospitalized acute trauma patients aged ≥6 months to evaluate AKI (defined by KDIGO criteria) and the test characteristics of SUN to predict AKI.","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68365699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Patients with kidney failure on maintenance haemodialysis therapy have a lower health-related quality of life (HRQOL) than matched controls without kidney failure. HRQOL is an important predictor of clinical outcomes among patients with kidney failure, yet there is a paucity of such data in Tanzania. We determined HRQOL among Tanzanian patients with kidney failure receiving maintenance haemodialysis therapy. Keywords: health-related quality of life, chronic kidney disease, kidney failure, Tanzania
{"title":"Health-related quality of life of patients undergoing haemodialysis therapy in Dar es Salaam, Tanzania","authors":"D. Msilanga, Priyank Punatar, P. Ruggajo","doi":"10.21804/26-1-5725","DOIUrl":"https://doi.org/10.21804/26-1-5725","url":null,"abstract":"Background: Patients with kidney failure on maintenance haemodialysis therapy have a lower health-related quality of life (HRQOL) than matched controls without kidney failure. HRQOL is an important predictor of clinical outcomes among patients with kidney failure, yet there is a paucity of such data in Tanzania. We determined HRQOL among Tanzanian patients with kidney failure receiving maintenance haemodialysis therapy. Keywords: health-related quality of life, chronic kidney disease, kidney failure, Tanzania","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68365756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Metastatic calcinosis cutis is an uncommon complication of end-stage kidney disease but has severe and disabling effects. Its development is attributed to disorders of calcium and phosphate metabolism associated with secondary hyperparathyroidism. The mainstay of treatment remains medical therapy; however, in refractory cases a parathyroidectomy is indicated. We describe the case of a 22-year-old female with refractory hyperparathyroidism treated with a subtotal parathyroidectomy resulting in complete resolution of metastatic calcinosis cutis of the hands. Clinicians should be aware that this complication can occur soon after the initiation of dialysis and that rapid complete resolution can be achieved with parathyroidectomy.
{"title":"Metastatic calcinosis cutis in a dialysis patient","authors":"Nabeel A Bapoo, M. Chothia, P. Stead, Ismail Ally","doi":"10.21804/26-1-5281","DOIUrl":"https://doi.org/10.21804/26-1-5281","url":null,"abstract":"Metastatic calcinosis cutis is an uncommon complication of end-stage kidney disease but has severe and disabling effects. Its development is attributed to disorders of calcium and phosphate metabolism associated with secondary hyperparathyroidism. The mainstay of treatment remains medical therapy; however, in refractory cases a parathyroidectomy is indicated. We describe the case of a 22-year-old female with refractory hyperparathyroidism treated with a subtotal parathyroidectomy resulting in complete resolution of metastatic calcinosis cutis of the hands. Clinicians should be aware that this complication can occur soon after the initiation of dialysis and that rapid complete resolution can be achieved with parathyroidectomy.","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68366064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ranbir Maharaj, C. Dayal, Z. Cassimjee, Sheetal Chiba, A. Ajayi, M. Davies
Background Recipients of kidney replacement therapy are more susceptible to severe disease and mortality from SARS-CoV-2 infection. We evaluated disease kinetics and clinical outcomes across four COVID-19 outbreak waves in the haemodialysis unit of a tertiary-level hospital in South Africa.
{"title":"From Alpha to Omicron: anatomy of the SARS-CoV-2 pandemic in an outpatient haemodialysis unit in Johannesburg, South Africa","authors":"Ranbir Maharaj, C. Dayal, Z. Cassimjee, Sheetal Chiba, A. Ajayi, M. Davies","doi":"10.21804/26-1-5395","DOIUrl":"https://doi.org/10.21804/26-1-5395","url":null,"abstract":"Background Recipients of kidney replacement therapy are more susceptible to severe disease and mortality from SARS-CoV-2 infection. We evaluated disease kinetics and clinical outcomes across four COVID-19 outbreak waves in the haemodialysis unit of a tertiary-level hospital in South Africa.","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68365681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bianca Southon, J. Rusch, Helena Vreede, B. Davidson, Daniel Mweli, N. Wearne, Malini Chetty, E. Jones
Introduction: Aluminium is the most abundant metallic element in the earth’s crust and can be consumed through water, medications, and by using metallic cooking utensils. Aluminium levels become a concern when they are above biological exposure limits and can present with multiple clinical complications. When patients have chronic kidney disease and are on haemodialysis, impaired aluminium excretion can lead to its accumulation. Significantly elevated serum aluminium levels were noted in patients with chronic kidney disease (stage 5) on haemodialysis at Groote Schuur Hospital, Cape Town, South Africa. This coincided with one of the worst water crises ever experienced in this metropolitan area, with extreme water restrictions being imposed and alternative water sources being accessed.
{"title":"Investigating toxic aluminium levels in haemodialysis patients after “Day Zero” drought in Cape Town, South Africa","authors":"Bianca Southon, J. Rusch, Helena Vreede, B. Davidson, Daniel Mweli, N. Wearne, Malini Chetty, E. Jones","doi":"10.21804/26-1-5423","DOIUrl":"https://doi.org/10.21804/26-1-5423","url":null,"abstract":"Introduction: Aluminium is the most abundant metallic element in the earth’s crust and can be consumed through water, medications, and by using metallic cooking utensils. Aluminium levels become a concern when they are above biological exposure limits and can present with multiple clinical complications. When patients have chronic kidney disease and are on haemodialysis, impaired aluminium excretion can lead to its accumulation. Significantly elevated serum aluminium levels were noted in patients with chronic kidney disease (stage 5) on haemodialysis at Groote Schuur Hospital, Cape Town, South Africa. This coincided with one of the worst water crises ever experienced in this metropolitan area, with extreme water restrictions being imposed and alternative water sources being accessed.","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68365687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Tannor, E. Ofori, K. Hutton-Mensah, M. Akutek, F. A. Afriyie, O. Nyarko, Y. Hardy, S. Kontoh, P. Opare-Addo, D. Amenuke
Introduction: Acute kidney injury (AKI) occurs in patients with coronavirus disease 2019 (COVID-19) and is associated with high mortality, but this has not yet been described in Ghana. We therefore record here the proportion of COVID-19 patients with AKI, and determined the corresponding mortality, in a tertiary-level hospital in Ghana.
{"title":"Acute kidney injury and in-hospital mortality among patients with COVID-19 in Ghana – a single centre study","authors":"E. Tannor, E. Ofori, K. Hutton-Mensah, M. Akutek, F. A. Afriyie, O. Nyarko, Y. Hardy, S. Kontoh, P. Opare-Addo, D. Amenuke","doi":"10.21804/26-1-4908","DOIUrl":"https://doi.org/10.21804/26-1-4908","url":null,"abstract":"Introduction: Acute kidney injury (AKI) occurs in patients with coronavirus disease 2019 (COVID-19) and is associated with high mortality, but this has not yet been described in Ghana. We therefore record here the proportion of COVID-19 patients with AKI, and determined the corresponding mortality, in a tertiary-level hospital in Ghana.","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68365593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Faye, Ismail Raqui, M. Faye, B. Ba, A. Lemrabott, S. Seck, A. Niang, E. Ka
Introduction: It is recommended that patients should start chronic haemodialysis using an arteriovenous fistula (AVF). We aimed to determine the proportion of Senegalese patients who used an AVF at the start of haemodialysis and examined the factors associated with its use. Methods: We conducted a cross-sectional study from 1 June 2021 to 2 October 2021 among patients on chronic haemodialysis in 10 centres in the Dakar and Thiès regions. Clinical and laboratory data were collected from medical records and also via patient interviews. Results: The patients (n = 543) had a median age of 50 years [interquartile range (IQR) 40–62 years] and 50.6% were male. The socio-economic level was low in two-thirds of cases. The median duration of haemodialysis was 40 (IQR 17–76) months. Hypertension was noted in 92% and diabetes in 13%. Hypertensive kidney disease was the cause of kidney failure in 33%. Only 47 patients (9%) had started dialysis using an arteriovenous fistula. Factors associated with its use at haemodialysis initiation were socio-economic level (OR 0.48; 95% confidence interval (CI) 0.25–0.94 for low socio-economic level) and duration of pre-dialysis follow-up by a nephrologist for >4 months (OR 7.82; 95% CI 3.05–26.50). In 65% of prevalent patients, the vascular access used was an AVF, a tunnelled central venous catheter in 28%, an arteriovenous graft in 2% and a temporary central venous catheter in 4.4%. Conclusions: The proportion of Senegalese patients with an AVF at the start of haemodialysis was low. AVF use was associated with socio-economic level and pre-dialysis follow-up by a nephrologist for >4 months. Keywords: arteriovenous fistula, arteriovenous graft, haemodialysis catheter, Senegal
{"title":"Vascular access in Senegalese patients starting chronic haemodialysis","authors":"M. Faye, Ismail Raqui, M. Faye, B. Ba, A. Lemrabott, S. Seck, A. Niang, E. Ka","doi":"10.21804/26-1-5381","DOIUrl":"https://doi.org/10.21804/26-1-5381","url":null,"abstract":"Introduction: It is recommended that patients should start chronic haemodialysis using an arteriovenous fistula (AVF). We aimed to determine the proportion of Senegalese patients who used an AVF at the start of haemodialysis and examined the factors associated with its use. Methods: We conducted a cross-sectional study from 1 June 2021 to 2 October 2021 among patients on chronic haemodialysis in 10 centres in the Dakar and Thiès regions. Clinical and laboratory data were collected from medical records and also via patient interviews. Results: The patients (n = 543) had a median age of 50 years [interquartile range (IQR) 40–62 years] and 50.6% were male. The socio-economic level was low in two-thirds of cases. The median duration of haemodialysis was 40 (IQR 17–76) months. Hypertension was noted in 92% and diabetes in 13%. Hypertensive kidney disease was the cause of kidney failure in 33%. Only 47 patients (9%) had started dialysis using an arteriovenous fistula. Factors associated with its use at haemodialysis initiation were socio-economic level (OR 0.48; 95% confidence interval (CI) 0.25–0.94 for low socio-economic level) and duration of pre-dialysis follow-up by a nephrologist for >4 months (OR 7.82; 95% CI 3.05–26.50). In 65% of prevalent patients, the vascular access used was an AVF, a tunnelled central venous catheter in 28%, an arteriovenous graft in 2% and a temporary central venous catheter in 4.4%. Conclusions: The proportion of Senegalese patients with an AVF at the start of haemodialysis was low. AVF use was associated with socio-economic level and pre-dialysis follow-up by a nephrologist for >4 months. Keywords: arteriovenous fistula, arteriovenous graft, haemodialysis catheter, Senegal","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68365646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article briefly reviews the mineral and bone disorder (MBD) found in patients with chronic kidney disease (CKD) and should provide a useful summary for trainees in nephrology and internal medicine. The storage of minerals is one of the principal roles of our bones, which are alive and are constantly being remodelled under the influence of vitamin D and parathyroid hormone (PTH), aided and abetted by calcium and phosphates. This occurs in a controlled fashion in healthy individuals. In patients with CKD, this control is lost and either an exaggerated, ineffectual remodelling takes place, resulting in the removal (in the case of high-turnover bone disease) or inadequate (in low-turnover bone disease) deposition of minerals. Vascular (and other soft tissue) calcification accompanies MBD, with phosphate and calcium playing major roles in the pathogenesis of the condition.
{"title":"Disordered minerals and disease of soft tissue and bones in chronic kidney disease","authors":"C. Swanepoel","doi":"10.21804/26-1-5668","DOIUrl":"https://doi.org/10.21804/26-1-5668","url":null,"abstract":"This article briefly reviews the mineral and bone disorder (MBD) found in patients with chronic kidney disease (CKD) and should provide a useful summary for trainees in nephrology and internal medicine. The storage of minerals is one of the principal roles of our bones, which are alive and are constantly being remodelled under the influence of vitamin D and parathyroid hormone (PTH), aided and abetted by calcium and phosphates. This occurs in a controlled fashion in healthy individuals. In patients with CKD, this control is lost and either an exaggerated, ineffectual remodelling takes place, resulting in the removal (in the case of high-turnover bone disease) or inadequate (in low-turnover bone disease) deposition of minerals. Vascular (and other soft tissue) calcification accompanies MBD, with phosphate and calcium playing major roles in the pathogenesis of the condition.","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68365709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed Mushtak Esmail, W. Bates, M. Amirali, T. Jardine, M. R. Davids
Introduction: Little data is available on biopsy-proven kidney disease in African countries. In this study, we have described the patterns of biopsy-proven kidney disease amongst South African adults encountered over a 23-year period and report whether these have changed over time.
{"title":"Patterns of biopsy-proven kidney disease amongst South African adults from 1995 to 2017","authors":"Ahmed Mushtak Esmail, W. Bates, M. Amirali, T. Jardine, M. R. Davids","doi":"10.21804/26-1-5376","DOIUrl":"https://doi.org/10.21804/26-1-5376","url":null,"abstract":"Introduction: Little data is available on biopsy-proven kidney disease in African countries. In this study, we have described the patterns of biopsy-proven kidney disease amongst South African adults encountered over a 23-year period and report whether these have changed over time.","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68365628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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