Evaluating the Effectiveness of African School of Hypertension for Non-Physician Health Workers, a Qualitative Study: QuASH Hypertension Study.

Background: The implementation of task sharing and shifting (TSTS) policy as a way of addressing the shortage of physicians and reducing the burden of hypertension in Africa birthed the idea of the African School of Hypertension (ASH). The ASH is saddled with the responsibility of training non-physician health workers across Africa continent in the management of uncomplicated hypertension. Aim: To get feedback from some faculty members and students who participated in the first ASH programme. Methods: This was a cross-sectional exploratory qualitative study conducted among eight students and eight faculty members. Feedback from the program was obtained by conducting in-depth interviews centred on description of course content; expectations and knowledge acquired from ASH; level of interaction between students and faculty members; challenges faced during the ASH; level of implementation of acquired training; and suggestions to improve subsequent ASH programs. Results: The course content of the ASH was described as simple, appropriate and adequate while interaction between students and faculty members were highly cordial and engaging. New knowledge about hypertension management was acquired by the students with different levels of implementation post-graduation. Some identified challenges with the ASH program were poor internet connectivity during lectures, non-uniformity of TSTS policies and hypertension management guidelines across Africa, technical problems with hypertension management app and low participation from other African countries apart from Nigeria. Some recommendations to improve ASH program were development of a uniform hypertension management guideline for Africans, wider publicity of the ASH, interpretation of lectures into French and Portuguese languages and improvement of internet connectivity. Conclusion: The ASH programme has largely achieved its objectives with the very encouraging feedback received from both faculty members and the students. Steps should be taken to address the identified challenges and implement the suggested recommendations in subsequent ASH program to sustain this success.

Seroprevalence of Hepatitis B, C and coinfection among patients with chronic kidney disease in a Nigerian hospital.

Infectious diseases remain a major health challenge in developing countries, compounding the woes of growing noncommunicable diseases such as chronic kidney disease (CKD). Increased morbidity and mortality have been reported among CKD patients with hepatitis infection and may necessitate protocol for treatment, follow-up, and prevention of spread. We aimed to determine the prevalence of viral hepatitis B and C infections among CKD patients and the effects on their liver enzymes. In this retrospective study, 314 CKD patients screened for hepatitis C virus (HCV) and hepatitis B surface antigen (HBsAg) were reviewed. Participants were screened at the time of diagnosis of CKD or referral, using qualitative enzyme immunoassay rapid test kits before the initiation of treatment. Individuals who were reactive to human immunodeficiency virus were excluded, and data were analyzed using IBM SPSS Statistics version 21.0. Participants included 206 males (65.6%) and 108 females (34.4%), with a mean age of 50.5 ± 16.3 years. The seroprevalence of HBsAg, HCV, and coinfection was seen in 15.6% (49), 4.8% (15), and 0.92% of the patients, respectively. More than half (63.6%) of the seropositive patients were below 50 years of age. Alanine transaminase (ALT) activity was higher in HCV seropositive than negative (10.5 ± 10.5 vs. 21.2 ± 35.9) (P = 0.001), while aspartate transaminase (AST) and alkaline phosphatase (ALP) were similar. ALT, AST, and ALP were also similar between HBsAg-seropositive and HBsAg-negative patients. The prevalence of hepatitis B and C is high among our CKD patients. This suggests the need for improved screening and treatment of hepatitis infection in this group. Immunization may also be essential to prevent its spread among patients requiring hemodialysis.

Late referral and associated factors among chronic kidney disease outpatients in Southern Nigeria.

Background: Chronic kidney disease (CKD) is a recognized noncommunicable disease that contributes to the global disease burden. Studies on late referral (LR) of CKD patients to the nephrologist have reported incidence rates of 22%-58% according to the definition of LR used. CKD patients who present late to the nephrologist tend to have poorer outcomes with increased morbidity and mortality. Aim: The aim of the study is to determine the prevalence of LR and associated factors among CKD outpatients. Materials and Methods: A cross-sectional observational study, in which CKD patients attending the renal outpatient clinic of two tertiary hospitals over a period of 6 months, were recruited. LR was defined as commencement of renal replacement therapy within 3 months after the first presentation to a nephrologist. Results: A total of 181 participants were recruited during the period of study; 114 were men. One hundred and twelve participants (61.8%) had stage 5 CKD, of which 97 had commenced maintenance hemodialysis. The prevalence of LR was 44.8% (81/181) (95% confidence interval: 37.4%-51.9%). Lack of funds was the most frequent reason given by participants who delayed after formal referral to a nephrologist. Being a known diabetic was associated with LR. Age, gender, level of education, occupation, being a known hypertensive, or known diabetic were not significant predictors of LR. Conclusion: Prevalence of LR is high. Education of medical practitioners, patients, and the general public on early symptoms and physical signs of kidney disease is required. Initiation of all-encompassing health insurance scheme is necessary to solve the problem of lack of funds for medical consultation and treatment.

RésuméContexte: La maladie rénale chronique (MRC) est une maladie non transmissible reconnue qui contribue au fardeau mondial de la maladie. Études sur référence tardive (LR) des patients atteints de néphropathie chronique chez le néphrologue ont signalé des taux d'incidence de 22% à 58% selon la définition de la LR utilisée. Les patients atteints d'IRC qui se présentent tardivement chez le néphrologue ont tendance à avoir de moins bons résultats avec une morbidité et une mortalité accrues. But: Le but de L'étude vise à déterminer la prévalence de la LR et des facteurs associés chez les patients ambulatoires atteints de néphropathie chronique. Matériels et méthodes: Une coupe transversale étude observationnelle, dans laquelle les patients atteints de néphropathie chronique fréquentant la clinique de néphrologie rénale de deux hôpitaux tertiaires sur une période de 6 mois, recruté. La LR était définie comme le début de la thérapie de remplacement rénal dans les 3 mois suivant la première présentation à un néphrologue. Résultats: Un total de 181 participants ont été recrutés pendant la période d'étude. 114 étaient des hommes. Cent douze participants (61,8%) ont eu stade 5 CKD, dont 97 avaient commencé une hémodialyse de maintenance. La prévalence de la LR était de 44,8% (81/181) (intervalle de confiance à 95%: 37,4% à 51,9%). Le manque de fonds est la raison la plus fréquemment invoquée par les participants qui ont tardé après avoir été officiellement dirigés vers un néphrologue. Étant un diabétique connu était associé à la LR. L'âge, le sexe, le niveau d'éducation, la profession, être un hypertendu connu ou un diabétique connu étaient prédicteurs non significatifs de la LR. Conclusion: La prévalence de la LR est élevée. Education des médecins, des patients et du grand public sur les premiers symptômes et les signes physiques de la maladie rénale est nécessaire. L'initiation d'un régime d'assurance maladie global est nécessaire pour résoudre le problème du manque de fonds pour la consultation et le traitement médicaux.

Cost implication of inpatient care of chronic kidney disease patients in a tertiary hospital in Southwest Nigeria.

The financial cost of inpatient care of chronic kidney disease (CKD) patients has not been well described in Nigeria; even though, the majority of these patients require inpatient care at the time of diagnosis due to late presentation. This study determined the cost implication of inpatient care among CKD patients in a Kidney Care Center in South-west Nigeria. This was an 18-month descriptive retrospective study. The financial records of the ward, laboratory, dialysis, pharmacy, and dietary services were obtained for each patient during their hospital stay and the sum of these costs was taken as the total direct cost of care. One hundred and twenty- three CKD patients with a male:female ratio of 2.3:1 and mean age of 50 ± 17 years were studied. One hundred and six (86.2%) patients had Stage 5 CKD, 105 (85.4%) had emergency hemodialysis (HD) at presentation and all patients paid out of pocket. The median number of HD sessions and days spent on admission was 4 and 14 days, respectively. The major contributors to the cost of care were total dialysis, ward, and pharmacy expenses with a median total cost of ₦70,000 (US $200), ₦28,000 ($80), and ₦22,230 ($66), respectively. The median total direct cost of inpatient care of CKD was ₦150,770 ($431). The cost of care was higher in those with Stage 5 CKD and diabetic nephropathy. The cost of inpatient care of CKD is beyond the reach of most Nigerians. There is a definite need for the government to include CKD care under the national insurance scheme.

Rights versus Responsibilities of Health Care Workers in Nigeria: Changing the Narrative in the COVID-19 Era.

The outbreak of the coronavirus disease (COVID-19) in December 2019 and its spread to 216 countries within the first eight months has created a huge strain on health systems across the world. Health care workers (HCWs) at the fore-front of combating the pandemic are largely at risk of infection with the number of infected HCWs increasing daily in many countries. Prior to the outbreak of COVID-19, focus of laws and policies have largely been on the responsibilities of HCWs with little or no attention paid to their rights and protection. The increased rate of infection among health workers and the inadequate conditions under which HCWs have carried out their life- saving responsibilities during the pandemic has created the need to change the narrative by focusing on policy formulation and implementation to ensure that HCWs rights are protected. We endorse the widespread use of the WHO recommendations on Coronavirus Disease (COVID-19) Outbreak: Rights, Roles and Responsibilities of Health workers, including key considerations for occupational safety and health.

Burden, psychological well-being and quality of life of caregivers of end stage renal disease patients.

BACKGROUND: Caregivers of chronic kidney disease (CKD) patients play an important role in the management of the patients. Their psychological needs are often overlooked and unmet by the managing team. This study assessed the psychosocial well-being and quality of life (QoL) of caregivers of CKD patients in two hospitals in Southern Nigeria. METHODS: Burden of caregiving, QoL, depression, and anxiety were assessed using standardized instruments; modified Zarit questionnaire, modified SF-12 questionnaire and Hospital Anxiety and Depression Scale (HADS) respectively among caregivers of CKD patients on maintenance haemodialysis and controls. RESULTS: Fifty-seven caregivers of CKD patients and aged and sex-matched controls participated in the study. Anxiety was significantly higher in caregivers compared to control (31.6% vs 5.3%, p = 0.004). Also, depression was significantly higher in caregivers (31.6% vs 3.5%, p= <0.001). Twenty-eight (49.1%) of the caregivers had mild to moderate burden and 19 (33.3%) had a high burden. The mean Zarit burden score was higher in female caregivers compared to male caregivers (18.30±8.11 vs 14.83±6.70, p = 0.09). The mean depression score was higher in female caregivers compared to male caregivers (8.58±3.83 vs 6.75±3.80, p= 0.08). There was significant positive correlation between Zarit burden and hospital anxiety score (r = 0.539, p= < 0.001) and depression score (r = 0.472, p = 0.005). CONCLUSION: Depression, anxiety and burden were common among caregivers of CKD patients especially females compared to controls. Supportive interventions for these caregivers should be included in treatment guidelines in order to improve overall patients' outcome. FUNDING: Self-funded.

Skin changes and dermatological life quality index in chronic kidney disease patients in a tertiary hospital in Southern Nigeria.

BACKGROUND: Cutaneous changes commonly occur in chronic kidney disease (CKD), however, there is limited information on its effect on quality of life of these patients. This study determined the prevalence and pattern of skin changes in CKD patients and their effects on the dermatology life quality index (DLQI) of the patients. MATERIALS AND METHODS: This was a descriptive cross-sectional study that involved stages 3-5 CKD patients who were examined for skin changes. The effects of the observed skin changes on DLQI were assessed using the standardized DLQI questionnaire. RESULTS: One hundred and five CKD patients participated in the study consisting of 56 males and 49 females with a mean age of 51.93 ± 15.23 years. The prevalence of cutaneous changes was 94.3%. Common skin manifestations were pallor 99 (94.3%), hyperpigmentation 58 (55.2%), fluffy hair 55 (52.4%), Lindsay nails 48 (45.7%), and pruritus 44 (41.9%). The effect of dermatoses on DLQI was mild in 34 (32.4%), moderate in 13 (12.4%), and severe in 4 (3.8%).There was no significant association between dermatoses and CKD stage. There was significant positive correlation between DLQI scores and number of skin dermatoses (r = 0.522, P = <0.001), duration on maintenance hemodialysis (r = 322, P = 0.017). There was significant negative correlation between DQOL scores and packed cell volume (r = -0.232, P = 0.022). On multiple regression analysis, number of dermatoses was the only significant predictor of DLQI (P = <0.001). CONCLUSION: Skin changes occur commonly in CKD patients and significantly affected their DLQI. This study highlights the significant burden that skin changes add to CKD.

Burden, psychological well-being and quality of life of caregivers of end stage renal disease patients

BACKGROUND: Caregivers of chronic kidney disease (CKD) patients play an important role in the management of the patients. Their psychological needs are often overlooked and unmet by the managing team. This study assessed the psychosocial well-being and quality of life (QoL) of caregivers of CKD patients in two hospitals in Southern Nigeria. METHODS: Burden of caregiving, QoL, depression, and anxiety were assessed using standardized instruments; modified Zarit questionnaire, modified SF-12 questionnaire and Hospital Anxiety and Depression Scale (HADS) respectively among caregivers of CKD patients on maintenance haemodialysis and controls. RESULTS: Fifty-seven caregivers of CKD patients and aged and sex-matched controls participated in the study. Anxiety was significantly higher in caregivers compared to control (31.6% vs 5.3%, p = 0.004). Also, depression was significantly higher in caregivers (31.6% vs 3.5%, p= <0.001). Twenty-eight (49.1%) of the caregivers had mild to moderate burden and 19 (33.3%) had a high burden. The mean Zarit burden score was higher in female caregivers compared to male caregivers (18.30±8.11 vs 14.83±6.70, p = 0.09). The mean depression score was higher in female caregivers compared to male caregivers (8.58±3.83 vs 6.75±3.80, p= 0.08). There was significant positive correlation between Zarit burden and hospital anxiety score (r = 0.539, p= < 0.001) and depression score (r = 0.472, p = 0.005). CONCLUSION: Depression, anxiety and burden were common among caregivers of CKD patients especially females compared to controls. Supportive interventions for these caregivers should be included in treatment guidelines in order to improve overall patients' outcome

Changes in antioxidant status associated with haemodialysis in chronic kidney disease.

Oxidative stress has been implicated in the pathogenesis, progression of chronic kidney disease (CKD) and development of cardiovascular complications. Hemodialysis (HD) has also been described to contribute significantly to oxidative stress in CKD patients, though reports are conflicting. OBJECTIVE: We evaluated the effects of one session of HD on the antioxidant capacity and lipid peroxidation in CKD patients. METHOD: Thirty-six CKD patients requiring HD were recruited into this study. Participants were naïve to HD and each completed a session of three hours using polysulfone membrane dialyzers. Blood samples were collected before and after dialysis. Total antioxidant capacity (TAC) was measured by ferric reducing antioxidant power (FRAP) while malondialdehyde (MDA) was measured using thiobarbituric acid-reactive substance (TBARS). Comparison was made between pre-HD and post-HD values of TAC and MDA respectively, p value of <0.05 was taken as significant. RESULT: Mean age and estimated glomerular filtration rate of subjects were 45 ±15 years and 6.3± 4.7mls/1.73m2 respectively. There was significant decrease in the mean TAC from 1232.2 ± 495.6 µmol Trolox equiv/ to 832.4 ± 325.7 µmol Trolox equiv/L post-dialysis (p< 0.001) while MDA values were similar before and after HD (11.8 ± 1.8 vs 11.8 ± 2.331)µmol/L (p> 0.05). There was no significant association between changes in antioxidant status following HD with blood flow rate, ultrafiltration volume nor dialyzer per size. CONCLUSION: A session of HD in patients with CKD is associated with significant reduction of the total antioxidants capacity; and no effect on MDA levels. FUNDING: No external funding received.

Knowledge of acute kidney injury among nurses in two government hospitals in Ondo City, Southwest Nigeria.

Adequate knowledge of acute kidney injury (AKI) among all health-care providers is essential for early diagnosis and management to reduce the associated burden. This study determined the knowledge of AKI among nurses in two government hospitals in Ondo City, Southwest Nigeria. This cross-sectional descriptive study was carried out in two government hospitals in Ondo City using a self-administered pretested questionnaire that assessed knowledge of AKI and associated factors. A total of 156 respondents participated in the study. Majority were between 20 and 40 years of age and were females. Ninety-nine (63.5%) had ≤10 years of nursing experience. A total of 106 (67.5%) respondents had received formal lectures on AKI in the past. Only 12 (7.7%) respondents had good knowledge of AKI, 98 (62.8%) had fair knowledge, and the remaining 46 (29.5%) had poor knowledge of AKI. There was a significant association between the knowledge of AKI and having received previous AKI lectures (P = 0.03), but knowledge was not associated with the years of nursing experience (P = 0.37). There was a significant association between having received previous AKI lecture and knowledge of AKI. We, therefore, recommend regular in-service training on AKI for practicing nurses.

Knowledge of Kidney Donation Among Care Givers in Two Tertiary Hospitals in Southwest Nigeria.

One of the major challenges of kidney transplantation is shortage of kidney donors. Care givers (CGs) are potential kidney donors, but the majority of them are unwilling to donate due to inadequate knowledge on kidney donation. This study evaluated the knowledge of kidney donation and its determinants among CGs in two tertiary hospitals in Southwest Nigeria. This was a cross-sectional study that was carried out in the Kidney Care Centre (KCC), Ondo and Babcock University Teaching Hospital (BUTH), Ilishan-Remo using a self-administered pretested questionnaire that assessed knowledge of kidney donation and its determinants. Pvalue of <0.05 was taken as significant. A total of 244 respondents participated in the study. The majority were below 40 years, married, and female. The proportion of respondents with adequate knowledge of kidney donation was 63.4%. More respondents from BUTH compared to KCC had adequate knowledge of kidney donation (80% vs. 46.7%, P ≤ 0.001). Similarly, the mean knowledge score was higher in respondents from BUTH (P ≤ 0.001). Factors that determined knowledge of kidney donation were female gender (AOR: 3.43, 95% CI: 1.25-9.40, P = 0.02) and social class (AOR: 1.22, 95% CI: 0.50-2.95, P ≤ 0.001). There was positive correlation between knowledge of kidney donation among the respondents from both hospitals and their willingness to donate kidneys (r = 0.439, P ≤ 0.001). Knowledge of kidney donation was better among BUTH's respondents. Gender and social class were predictors of knowledge of kidney donation. Improving knowledge of kidney donation may improve willingness to donate among the public.

Serum C-reactive protein levels in pre-dialysis chronic kidney disease patientsin southern Nigeria.

BACKGROUND: Cardiovascular disease is the major cause of hospitalization and mortality in chronic kidney disease (CKD). C-reactive protein (CRP) is a marker of cardiovascular disease and predictor of mortality in CKD patients. CKD patients with elevated CRP should be identified early with institution of measures to treat cardiovascular risk factors in order to reduce attendant mortality. AIMS: Determination of serum CRP levels in CKD patients and associated factors. METHODS: This was a case-control study involving 80 consecutive CKD patients and 40 control subjects without CKD. Data obtained from participants included demographics, body mass index (BMI), and aetiology of CKD. Serum CRP levels, albumin, creatinine and lipid profile were determined. Cases and controls were compared. P values <0.05 were taken as significant. RESULTS: The mean age of the CKD subjects was 49.09±16.85 years. The median CRP value was significantly higher in the CKD group compared to controls (p=<0.001). Low, average and high cardiovascular event risk according to CRP values were present in 51(63.8%), 13(16.2%) and 16(20%) of the CKD patients respectively. Cardiovascular event risk was significantly higher in CKD subjects (p=<0.001). Serum creatinine, BMI, triglyceride and atherogenic index of plasma correlated positively with CRP. Estimated glomerular filtration rate (eGFR), high density lipoprotein-cholesterol and albumin correlated negatively with CRP. Elevated serum CRP was significantly predicted by low eGFR and high BMI on multivariate analysis. CONCLUSION: Chronic kidney disease patients have increased cardiovascular event risk. Interventions aimed at reducing weight and treating dyslipidaemia should be instituted early in order to reduce this risk.

Lipid profile in pre-dialysis chronic kidney disease patients in southern Nigeria.

BACKGROUND: Dyslipidaemia is one of the cardiovascular risk factors responsible for cardiovascular disease and rapid progression of chronic kidney disease (CKD) to end stage renal disease. Early detection and management of dyslipidaemia will reduce cardiovascular burden and retard progression of CKD. AIMS: To determine the prevalence and pattern of dyslipidaemia in pre-dialysis CKD patients in a tertiary hospital in southern Nigeria. METHODS: This was a case-control study that involved 105 consecutive pre-dialysis CKD patients recruited over two years and 105 age and sex matched control subjects. Data obtained from participants included demographics, body mass index, and aetiology of CKD. Blood sampling was done for the determination of creatinine and fasting serum lipids. P values < 0.05 were taken as significant. RESULTS: The mean age of the CKD and control subjects were 46.98±16.81 and 47.57±15.97 years respectively with a male:female ratio of 1.7:1. The median atherogenic index of plasma (AIP), low density lipoprotein-cholesterol and triglyceride (TG) were significantly higher in the CKD patients while mean high density lipoprotein-cholesterol (HDL-C) was significantly lower in the CKD patients (p=<0.001). The overall prevalence of dyslipidaemia in the CKD patients was 60% which was significantly higher than 39% in the control (p=0.002). The prevalence of high AIP, elevated TG and reduced HDL-C increased with worsening renal function. Dyslipidaemia was commoner in female CKD patients (p=0.02) and those who were ≥ 45years (p=0.94). CONCLUSION: Dyslipidaemia is common in pre-dialysis CKD especially in female and older patients. Some lipid abnormalities increased with worsening kidney function.

Chronic kidney disease in Nigeria: Late presentation is still the norm.

BACKGROUND: Chronic kidney disease (CKD) has become a public health problem in Nigeria. Efforts are being geared toward early diagnosis and prevention of CKD. This study involved the evaluation of the referral pattern and mode of presentation of CKD patients at first contact in a tertiary health institution. PATIENTS AND METHODS: Patients' records over an 18 month period were retrieved and the following information extracted: Sociodemographic data, referral hospital, mode of presentation, etiology of CKD, packed cell volume, blood pressure, and estimated glomerular filtration rate (GFR) at first presentation. RESULTS: There were 202 CKD patients with a male: female ratio of 1.7:1 and a mean age of 48.15 ± 16.69 years. The median estimated GFR of the patients at presentation was 3.17 ml/min/1.73 m(2). The common etiologies of CKD were chronic glomerulonephritis, hypertension, diabetes mellitus, obstructive nephropathy in 69 (34.2%), 47 (23.3%), 38 (18.8%), and 21 (10.4%) respectively. Among these patients, 111 (55%) and 98 (48.6%) had moderate to severe hypertension and anemia, respectively, 173 (85.6%) presented in CKD Stage 5, 101 (50%) required urgent hemodialysis whereas 123 (60.9%) required in-hospital admission. Only (18) 9% of these CKD patients presented by self-referral while (103) 51% were referred from secondary and private health facilities. CONCLUSION: Most Nigerian CKD patients still present very late to nephrologists implying that the present preventive strategies have not yielded desired results. Early diagnosis and referral of CKD patients could be better achieved through regular education of the public and retraining of health workers especially those in primary and secondary health institutions.

Hyperuricemia in predialysis chronic kidney disease patients in Southern Nigeria

Background: Cardiovascular disease (CVD) is the leading cause of hospitalization and death in chronic kidney disease(CKD) patients. Hyperuricemia has emerged as one of the nontraditional cardiovascular risk factors. Studies have shown that hyperuricemia plays a major role in the development of CVD and rapid progression of CKD to end-stage renal disease. Objective: The aim was to determine the prevalence and pattern of hyperuricemia in predialysis CKD patients attending a teaching hospital in Southern Nigeria. Methodology: One hundred and twenty consecutive predialysis CKD patients and 40 control subjects with normal renal function were recruited over 2 years. Data obtained from participants included demographics, body mass index, blood pressure reading, and etiology of CKD. Blood sampling was done for the determination of serum uric acid, creatinine, and fasting serum lipids. P < 0.05 were taken as significant. Results: The mean age of the CKD subjects was 48.8 ± 16.6 years with a male:female ratio of 1.7:1. The prevalence of hyperuricemia in the CKD subjects was 47.5% and this was significantly higher than 15% observed in the control group (P ≤ 0.001). The prevalence of hyperuricemia was highest in CKD stage 3b. Hyperuricemia was more prevalent in younger predialysis CKD subjects and those with hypertensive nephropathy. There was no significant association between hyperuricemia, obesity, gender and dyslipidemia in this study. Conclusion: Hyperuricemia is highly prevalent in young predialysis CKD patients even in the early stages. Measures to reduce hyperuricemia should be put in place especially lifestyle and dietary modification

Assessment of some cardiovascular risk factors in predialysis chronic kidney disease patients in Southern Nigeria.

BACKGROUND: Cardiovascular risk factors are responsible for cardiovascular disease and rapid progression of chronic kidney disease (CKD) to end-stage renal disease. Prompt evaluation, modification, and treatment of these factors in predialysis patients will reduce morbidity and mortality. This study assessed some cardiovascular risk factors in predialysis CKD patients in a tertiary hospital in Southern Nigeria. PATIENTS AND METHODS: This was a case-control study that involved 76 consecutive predialysis CKD patients and 38 age-and sex-matched controls without CKD over 1 year period. Both groups were assessed for cardiovascular risk factors, and comparisons were made. A P value of <0.05 was taken as significant. RESULTS: The mean ages of the CKD versus control group were 48.00 ± 15.28 versus 45.34 ± 15.35 years. The male:female ratio was 1.7:1 for both groups. The common etiologies of CKD in this study were hypertension 30 (39.5%), diabetes mellitus 23 (30.3%), and chronic glomerulonephritis 19 (25%). There were 38 (50%) in CKD stage 3, 31 (40.8%) in CKD stage 4, and 7 (9.2%) in CKD stage 5. The common cardiovascular risk factors found in the CKD versus control were hypertension (96.1% vs. 42.1%), anemia (96.1% vs. 23.7%), left ventricular hypertrophy (77.6% vs. 23.7%), dyslipidemia (67.1% vs. 39.5%), hypocalcemia (60.1% vs. 18.5%), hyperphosphatemia (63.2% vs. 0%), and hyperuricemia (57.9% vs. 15.8%). These risk factors were significantly higher in CKD group. Hyperphosphatemia and hypoalbuminemia significantly increased across CKD stages 3-5. Anemia was significantly more common in males whereas dyslipidemia was more common in female CKD patients. CONCLUSION: Cardiovascular risk factors were highly prevalent in predialysis CKD subjects even in early stages. Hypoalbuminemia and hyperphosphatemia significantly increased across the CKD stages 3-5 whereas anemia and dyslipidemia showed significant gender differences. Cardiovascular risk factors should be treated early in predialysis CKD patients.