Gender Disparity in Survival amongst End-Stage Renal Disease Patients on Haemodialysis.

BACKGROUND: Gender inequality in access and outcome of health care utilisation has been a major concern worldwide. We evaluated some demographic and clinical characteristics as well as compared the mortality rate between men and women with end-stage renal disease on haemodialysis (HD), to find out if gender has any influence on mortality. METHODS: This was a single centre retrospective study. All adult incident and prevalent haemodialysis patients with end-stage renal disease (ESRD) seen between July 2007 and June 2019 were enrolled in the study. Data collected included age, sex, hepatitis B and C viral status, vascular access at the commencement of haemodialysis, duration on haemodialysis, number of dialysis sessions ever conducted and outcome of haemodialysis. The outcome was stratified as alive, dead, or lost to follow up. The primary outcome measure was all-cause mortality. The IBM SPSS Statistical software version 23 was used to analyse the data. Kaplan Meier survival curve was used to compare all-cause mortality between men and women. RESULTS: This study included 995 HD patients of whom 704 (70.8%) were males. Mean age was 44.7 + 16.3 years. At the end of the study period, 878 (88.2%) patients died. The mortality rates for men and women did not significantly differ with a cumulative median survival of 17 and 16 days respectively (Log-rank = 0.85, p = 0.358). Hepatitis B seropositivity was significantly associated with increased mortality (Hazard Ratio (HR) = 1.2; 95% CI 1.025 - 1.526). CONCLUSIONS: Despite the perceived poor access to modern healthcare services by women in Northern Nigeria, there is no gender disparity in crude mortality in patients with end-stage renal disease on haemodialysis.

Clinical profile of patients with diabetes mellitus in gusau, Northwestern, Nigeria.

Background: There are variable reports of glycemic control and complications among patients living with diabetes mellitus (DM). Aim: The aim of this study was to determine the glycemic control and complications among patients with DM seen at the medical outpatient department of a tertiary health institution in Northwestern Nigeria. Methodology: This was a descriptive cross-sectional study of 236 patients attending DM Clinic at Federal Medical Centre Gusau. A questionnaire was administered that contains sociodemographic characteristics of the patients, duration of DM, adherence to management, and complications. Anthropometry, blood pressures, and fasting plasma glucose (FPG) were recorded. Data were analyzed using SPSS version 20.0. Results: Eighty-six (36%) males and 150 (64%) females patients with DM were evaluated. Their mean (standard deviation [SD]) age was 53.5 ± 12.3 years with mean (SD) duration of DM of 7.9 ± 6.2 years. The mean FPG was 8.85 ± 3.8 mmol/L (males 8.21 ± 3.6, females 9.49 ± 3.8). Forty-seven (20%), 75 (32%), 113 (48%) of the patients had good, fair, and poor glycemic control, respectively. The major complications observed were peripheral neuropathy (61%) and visual impairment (51%). Glycemic control was significantly better among males and those with good adherence to medications. There was a positive association between the longer duration of DM with complications. Conclusion: Only 20% of our patients achieved good glycemic control and many have complications. Majority of the patients adhered more with medications as compared to dietary management and exercise. There is a need for clinicians to educate patients more on the need for lifestyle modifications.

RésuméConcernant les origines de la situation: Il y a des variables rapports glycémie de contrôle et des complications parmi les patients qui vie avec le diabète mellitus(DM). BUT: Le but de cet étude était pour déterminer le contrôle et les complications glycémie parmi les patients avec le DM vue dans le service de consultation tertiaire dans l'établissement de santé au Nord-ouest du Nigéria. Méthodologie: C'était une description transversale d'étude de 236 patients qui ont assistait à l'événement clinique de la DM au centre médical fédérale à Gusau.Un questionnaire était gérer à contenu de socio démographe de trait de caractère des patients, durée de la DM, hypertension, et le FPG qui se lit "Fasting plasma glucose" en anglais ont été enregistré. Les données ont été analysé avec l'utilisation de la SPSS version 20.0. Résultat: Quatre-vingt huit(36%) mâles et 150(64%) femelles des patients avec la DM ont été évalué. Leurs âges (écart-type) [ET]) moyenne était 53.5±12.3 ans avec une moyenne (ET) et avec une durée de DM de 7.9±6.2 ans. La moyenne et pauvre contrôle du glycémie respectivement. Les complications majeur observé était les périphériques neuropathie(61%) et malvoyants(51%). Le contrôle glycémie était sensiblement mieux parmi les mâles et avec ceux de bonnes médications. Il y avait une association positive entre une longue durée de la DM avec complication. Conclusion: Seul 20% de nos patients ont obtenu un bon contrôle de glycémie et d'autre avec beaucoup de complications. La majorité des patients se sont adhérent plus avec la médication comparer à la gestion diététique et exercice. Il y a la nécessité des clinicien d'instruire ou éduquer les patients plus suis la mode de vie de modification.