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1.
West Afr J Med ; 37(2): 107-112, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32150627

RESUMO

BACKGROUND: There are few reports on socioeconomic status (SES) of patients with chronic kidney disease (CKD) in Nigeria and indeed Africa, South of the Sahara. Identifying SES as an important factor for disability in people with CKD would provide a means for early identification of those at risk and, possible intervention. OBJECTIVE: To determine the SES of CKD patients attending renal clinic in the University of Nigeria Teaching Hospital. METHODS: Cross-sectional descriptive design was adopted using pretested questionnaire to elicit data on SES (age, place of residence, household asset ownership, source of drinking water; source of cooking energy; and type of toilet facility) from one hundred and forty-five (145) CKD patients attending renal clinic in the University of Nigeria Teaching Hospital. Principal component analysis was used to classify the SES into five quintiles. RESULTS: Majority of the respondents (patients) in stages 4 and 5 CKD, constituting 17.2% and 39.3% respectively were from the lower SES. There was significant correlation between SES and age of the patients; place of residence; hypertension history; ownership of some household assets; source of drinking water; source of cooking energy; and type of toilet facility. CONCLUSION: This study demonstrated that many of our patients were from the lower SES. It is recommended that both governmental and non-governmental agencies should help these patients with some form of health insurance to alleviate their healthcare cost burden.


Assuntos
Nefropatias/epidemiologia , Insuficiência Renal Crônica , Características de Residência , Classe Social , Estudos Transversais , Hospitais de Ensino , Humanos , Nefropatias/diagnóstico , Nefropatias/etiologia , Nigéria/epidemiologia , Pobreza/estatística & dados numéricos , Fatores Socioeconômicos
2.
West Afr J Med ; 37(4): 368-376, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32835398

RESUMO

The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplant consume up to 3% of the annual healthcare budget in high-income countries. However, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions - be they primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney, urinary tracts, as well as the exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycaemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, the management of co-morbidities such as uraemia and cardiovascular disease is a highly recommended preventive intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate this preventive approach. While national policies and strategies for non-communicable diseases might be in place in all or every country. Also, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness and importance of preventive measures among populations, professionals and policy makers.


Assuntos
Acessibilidade aos Serviços de Saúde , Insuficiência Renal Crônica , Progressão da Doença , Humanos , Diálise Renal , Fatores de Risco
3.
Ter Arkh ; 92(6): 4-14, 2020 Jul 09.
Artigo em Russo | MEDLINE | ID: mdl-33346487

RESUMO

The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can beimplemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.


Assuntos
Rim , Insuficiência Renal Crônica , Acessibilidade aos Serviços de Saúde , Humanos , Prevenção Primária , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/prevenção & controle , Prevenção Secundária
5.
Niger J Clin Pract ; 21(7): 932-938, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29984728

RESUMO

BACKGROUND: Chronic kidney disease (CKD) is a global public health problem with increasing incidence and mortality in Africa. Autonomic dysfunction (AD) has been implicated as a major contributor to the disease morbidity and mortality, but little is known about the predictors of this dysfunction in African populations. Understanding the predictors of this condition is necessary for early detection and management of CKDs. Objectives: This study was designed to determine the predictors of AD in CKD patients in Nigeria. MATERIALS AND METHODS: It was a cross-sectional study of CKD patients at University of Nigeria Teaching Hospital, Enugu, Nigeria. The CKD patients with AD were compared with those without AD and a normal control group. Autonomic function was assessed through noninvasive cardiovascular tests: measurement of resting tachycardia, orthostatic hypotension, heart rate response (HRR) to standing, HRR to Valsalva maneuvre, and HRR to respiration. Data on symptoms of CKD and AD were obtained using a validated questionnaire. RESULTS: The mean age of the CKD patients was 41.3 ± 1.5 (range: 21-69) years. Early hospital presentation is associated with significantly less risk of the development of AD (P < 0.001). Dizziness, nocturnal diarrhea, and impotence are the major markers/predictors of AD in CKD patients (P < 0.05). CONCLUSION: AD is common among predialysis CKD patients in Nigeria, and best predicted by the presence of postural dizziness, nocturnal diarrhea, and impotence in men. Physicians should, therefore, be on the lookout for these features for prompt and adequate management of cases.


Assuntos
Doenças do Sistema Nervoso Autônomo/epidemiologia , Hipotensão Ortostática/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Nigéria/epidemiologia , Manobra de Valsalva
9.
Niger J Clin Pract ; 18(2): 173-7, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25665987

RESUMO

BACKGROUND AND AIM: Estimation of the glomerular filtration rate (GFR) is important for the evaluation of patients with kidney disease. Some studies suggest that GFR estimated from serum cystatin C (Cys C) is more accurate than that from serum creatinine (SCr). For Cys C to be used for this purpose, normal values need to be determined for various populations. This study determined the serum Cys C levels and reference intervals (RIs) of a Nigerian population. MATERIALS AND METHODS: Three hundred and four healthy adult subjects were analysed. Serum Cys C and SCr were determined by particle enhanced turbidimetric immunoassay and modified Jaffe kinetic method respectively. Data were analysed using the Statistical Package for Social Sciences version 17.0 (SPSS for Windows Inc., Chicago, IL, USA). Estimation of RIs was done as per the International Federation of Clinical Chemistry guidelines. RESULTS: The RIs for Cys C were 0.65-1.12 mg/L (median 0.86) for males, 0.62-1.12 mg/L (median 0.85) for females and 0.64-1.12 mg/L (median 0.86) for all the subjects. The RIs for SCr were 73-110 µmol/L (median 89) for males, 65-102 µmol/L (median 82) for females and 66-106 µmol/L (median 86) for all the subjects. There was no significant gender difference in the RIs for serum Cys C, (P > 0.05). The SCr levels and RI were significantly lower in females than in males (P < 0.001). CONCLUSION: This study has determined the serum Cys C levels and RI of an indigenous healthy adult black population in Nigeria.


Assuntos
População Negra , Creatinina/sangue , Cistatina C/sangue , Taxa de Filtração Glomerular , Adulto , Idoso , Feminino , Humanos , Imunoensaio , Masculino , Pessoa de Meia-Idade , Nigéria , Valores de Referência , Adulto Jovem
10.
Niger J Med ; 22(4): 286-91, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24283085

RESUMO

Cardiovascular diseases (CVD) were previously considered a problem of the developed nations only. Emerging facts show that CVD and their risk factors are now prevalent in developing countries. We carried out a cross-sectional, population-based survey to determine the relation between place residence (rural or urban) and the burden of CVD risk factors in South East Nigeria. Hypercholesterolaemia, hypertension, abnormal blood glucose and obesity were assessed for, in middle-aged and elderly residents of two communities in Enugu, South East Nigeria. A total of 543 adults (308 at Ogwofia Owa and 235 at Emene) participated in the study. The mean and 95% CI for mean of the characteristics of subjects showed that they were in the middle-age group with apparently normal mean cardiovascular risk indices except for systolic and diastolic blood pressure indices which suggested pre-hypertension. The subjects residing in the rural area were older than those residing in the urban area but cardiovascular risk factors had higher mean values in urban residents except systolic blood pressure (SBP). The most prevalent cardiovascular risk factors in the study group were hypertension and obesity. Urban residence was found to influence the prevalence of risk factors, specifically obesity and diastolic hypertension.


Assuntos
Hipertensão/epidemiologia , Obesidade/epidemiologia , Urbanização , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Fatores de Risco
11.
Niger J Med ; 22(4): 351-3, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24283099

RESUMO

BACKGROUND: Seizures are the commonest neurological condition presenting in Africa. The pattern of non- epileptic seizures in systemic diseases including chronic kidney disease is unknown in South East Nigeria. OBJECTIVES: This study examined the pattern of seizures in chronic kidney disease patients in Enugu, South East Nigeria. METHODS: This was a retrospective study of chronic kidney disease patients who presented to the University of Nigeria Teaching Hospital Enugu (UNTH) from January 2007 December 2008. Data from subjects who satisfied the inclusion criteria were reviewed and analysed using Statistical Package for the Social Sciences version 13.5. Ethical clearance was obtained from the UNTH Ethics Committee. RESULTS: There were 145 patients, 95 males and 50 females. Mean age was 35 years. Only 5 patients (3,4%) had seizures (mostly generalized tonic-clonic) associated with severe hypertension. None had hypocalcaemia. Three patients (60%) received dialysis with benefit while 2 patients (40%) died before dialysis could be done. CONCLUSION: Seizures are infrequent in chronic kidney disease patients in Enugu; are commoner in males and those with severe disease. Dialysis improved survival in those with seizures. Larger multicentre studies are needed to further elucidate the spectrum of Nigeria.


Assuntos
Epilepsia/complicações , Nefropatias/complicações , Adulto , Doença Crônica , Comorbidade , Epilepsia Tônico-Clônica/complicações , Feminino , Humanos , Masculino , Nigéria
12.
Niger J Clin Pract ; 16(4): 505-10, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23974748

RESUMO

BACKGROUND: Cancers are emerging public health problems in developing countries like Nigeria. The epidemiological shift and aging population make cancers a challenge. OBJECTIVE: We set out to describe the pattern of death due to cancer in our medical ward. The hospital is one of the premier hospitals covering the South East zone of Nigeria. MATERIALS AND METHODS: We retrospectively reviewed the case notes and death certificates of all who died of cancer in our adult medical wards for 16 years (January 1995 to December 2010). STATISTICAL ANALYSIS USED: Statistical Package for Social Sciences (SPSS Inc. Chicago, IL) version 17.0 was used. RESULTS: Twenty seven thousand, five hundred and fourteen patients were admitted into the medical wards. Six thousand, two hundred and fifty died. Out of the 6250 deaths, cancers accounted for 7.6%. Male to Female ratio was 2.4:1. The mean age at death was 43.7 ± 17.4 years. The mean age at death in both sexes was similar (42.9 ± 17.5 for men and 45.7 ± 17.0 years for women), P = 0.109. Primary liver cell carcinoma was the most common cause of death among men (40.8%), while cancer of hematopoietic organ was the most common in women (48.7%). The overall fatality rate was 1.7% (477/27 514) of medical admissions. Younger and middle age groups were most commonly affected in both sexes. CONCLUSION: Since the most productive age groups were affected, governments in developing countries should as a matter of urgency put in place adequate cancer preventive and curative services.


Assuntos
Mortalidade Hospitalar/tendências , Neoplasias/mortalidade , Adolescente , Adulto , Idoso , Causas de Morte , Feminino , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Estudos Retrospectivos , Fatores de Risco
13.
Ann Ib Postgrad Med ; 21(3): 46-56, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38706616

RESUMO

Background: The role of skin antisepsis after skin closure in abdominal surgery for sepsis is not well reported. This study assessed the effect of skin antisepsis following primary skin closure on surgical site infection (SSI) after contaminated and dirty abdominal surgery. Methods: This was a randomised controlled trial involving adult patients undergoing laparotomy for sepsis. Patients were randomised into a Control (C) group where the wound edge was cleaned once with 70% isopropyl alcohol before being covered with a dry sterile gauze dressing and a Povidone-iodine (PI) group in whom the wound edge was cleaned once with 70% isopropyl alcohol, then covered with a 10% povidone iodine-soaked gauze dressing. Both groups were compared for the presence of SSI. Statistical significance was set at a p value of < 0.05. Results: Thirty-seven patients (C group = 18; PI group = 19) were recruited. The median age was 36 years (Interquartile range, IQR = 72) with a male-to-female ratio of 2.7:1. The overall incidence of SSI was 48.6% (n = 18), comparable between the C group (n=10, 55.6%) and PI group (n = 8; 42.1%) (p = 0.413). In-hospital mortality rate was 10.8 % (n = 4), equally distributed between the groups (p = 1.000). The length of hospital stay was 8 days (IQR = 15) in the C group and 7 days in the PI group (IQR =9) (p = 0.169). Conclusion: In laparotomy for sepsis, skin antisepsis after primary skin closure had no effect on the incidence of surgical site infection.

14.
Afr Health Sci ; 22(1): 115-124, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36032423

RESUMO

Background: Surgical resection margins (RM), axillary nodal involvement and lymph node ratio (LNR) determine loco-regional control (LRC) in breast cancer management. Late presentation precludes breast conservation therefore surgical option is usually mastectomy and adjuvant chemoradiation minimize loco-regional recurrence (LRR). Objective: We investigated the prognostic role of lymph nodes positive for malignancy (pN), LNR and RM on LRR of breast cancer in a tertiary hospital in Ibadan, Nigeria. Methods: Longitudinal cohort study of 225 females with breast carcinoma managed and followed up for 5-years with end point of LRR or not. Chi-square test and logistic regression analysis were used to evaluate the interaction of resection margin and proportion of metastatic lymph nodes with LRR. The receiver-operator curve was plotted to determine the proportion of metastatic lymph nodes which predicted LRR. Results: Ninety-nine percent had modified radical mastectomy and 163 (72.4%) had negative resection margins. A mean of 11 axillary lymph nodes were harvested at surgery. The age, positive resection margin and number of harvested nodes with malignant cells are associated with LRR. The overall 5-year LRR rate was 16%. Conclusion: LRR is dependent on lymph node involvement as well as and tumor aggressiveness.


Assuntos
Neoplasias da Mama , Feminino , Humanos , Estudos Longitudinais , Linfonodos , Metástase Linfática , Margens de Excisão , Mastectomia , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Nigéria
15.
Braz J Med Biol Res ; 55: e12161, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35584454

RESUMO

The high burden of kidney disease, global disparities in kidney care, and the poor outcomes of kidney failure place a growing burden on affected individuals and their families, caregivers, and the community at large. Health literacy is the degree to which individuals and organizations have, or equitably enable individuals to have, the ability to find, understand, and use information and services to make informed health-related decisions and actions for themselves and others. Rather than viewing health literacy as a patient deficit, improving health literacy lies primarily with health care providers communicating and educating effectively in codesigned partnership with those with kidney disease. For kidney policy makers, health literacy is a prerequisite for organizations to transition to a culture that places the person at the center of health care. The growing capability of and access to technology provides new opportunities to enhance education and awareness of kidney disease for all stakeholders. Advances in telecommunication, including social media platforms, can be leveraged to enhance persons' and providers' education. The World Kidney Day declares 2022 as the year of "Kidney Health for All" to promote global teamwork in advancing strategies in bridging the gap in kidney health education and literacy. Kidney organizations should work toward shifting the patient-deficit health literacy narrative to that of being the responsibility of health care providers and health policy makers. By engaging in and supporting kidney health-centered policy making, community health planning, and health literacy approaches for all, the kidney communities strive to prevent kidney diseases and enable living well with kidney disease.


Assuntos
Letramento em Saúde , Insuficiência Renal , Cuidadores , Educação em Saúde , Humanos , Rim
16.
Niger J Med ; 20(3): 383-6, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21970224

RESUMO

We present a 72-year-old man and a known hypertensive with poor drug compliance seen here on 22-03-06, with a 4-year history of progressive dyspnoea, associated with cough and a wheeze. On examination he was chronically ill looking with altered state of consciousness, pale, centrally cyanosed, febrile (T-38 degrees C), in respiratory distress (RR-33 pm). Significant chest radiological findings include marked aortic unfolding and cardiomegaly, with biventricular involvement. Numerous nodular opacities in both lung fields especially the Right side with right apical opacification/thickening. Treatment as appropriate was instituted but unfortunately the patient succumbed after thirty days on admission and an autopsy carried out revealed multiple pulmonary infarcts with pulmonary thrombo-embolism.


Assuntos
Dispneia/etiologia , Hipertensão Pulmonar/patologia , Infarto Pulmonar/patologia , Tromboembolia/patologia , Idoso , Doença Crônica , Progressão da Doença , Evolução Fatal , Humanos , Hipertensão Pulmonar/complicações , Masculino , Infarto Pulmonar/complicações , Tromboembolia/complicações
17.
Niger J Med ; 20(2): 285-8, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21970246

RESUMO

We present a 72-year-old man and a known hypertensive with poor drug compliance seen here on 22-03-06,with a 4-year history of progressive dyspnoea, associated with cough and a wheeze. On examination he was chronically ill looking with altered state of consciousness, pale, centrally cyanosed, febrile (T-38 degrees C), in respiratory distress (RR-33pm). Significant chest radiological findings include marked aortic unfolding and cardiomegaly, with biventricular involvement. Numerous nodular opacities in both lung fields especially the Right side with right apical opacification/thickening. Treatment as appropriate was instituted but unfortunately the patient succumbed after thirty days on admission and an autopsy carried out revealed multiple pulmonary infarcts with pulmonary thrombo-embolism.


Assuntos
Hipertensão Pulmonar/complicações , Hipertensão/complicações , Infarto Pulmonar/complicações , Idoso , Autopsia , Doença Crônica , Dispneia/complicações , Dispneia/patologia , Evolução Fatal , Humanos , Masculino , Infarto Pulmonar/patologia
18.
Ann Ib Postgrad Med ; 19(2): 124-130, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36177322

RESUMO

Background: Although studies are rife on preoperative skin antisepsis, little is known about what surgeons in Nigeria practice. Objective: To describe the pattern of practice of skin antisepsis prior to skin incision among surgeons in select tertiary hospitals in Nigeria. Methods: This was a questionnaire-based descriptive cross-sectional survey involving surgeons and surgeons in training in the departments of surgery, obstetrics and gynaecology (O&G), otorhinolaryngology (ENT), and oral & maxillofacial surgery (OMS) of 26 select tertiary hospitals from all six geopolitical zones in Nigeria. Data was analysed using version 23 of the SPSS for Windows. Results: A total of 200 surgeons participated in the study with a male-to-female ratio of 9:1. The mean age was 37.2 ± 5.2 years. Senior registrars constituted 60.5% (n=121), followed by registrars (24%; n= 48) and consultants (15.5%; n= 31). The respondents performed a mean volume of 4 surgeries per week. Their most common practice is to perform skin preparation with 3 antiseptic agents with skin scrubbing lasting for 3-4 minutes. Skin scrubbing was performed for longer duration amongst consultants compared with senior registrars and registrars. Of all the surgical wounds encountered in their practice, 57%were clean. The common complications associated with the use of these antiseptic agents include allergic dermatitis and blisters. Conclusion: The practice of pre-incision skin antisepsis varies widely among Nigerian surgeons. The majority use 3 antiseptic agents for skin antisepsis although most of the procedures performed were clean surgeries. We recommend further studies to standardize our practice locally.

19.
West Afr J Med ; 29(4): 225-9, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20931508

RESUMO

BACKGROUND: Diastolic dysfunction is common in chronic kidney disease (CKD) accounting for 40%-66% of cardiovascular complications. OBJECTIVE: To determine the prevalence of and factors associated with left ventricular diastolic dysfunction (LVDD) in adult Nigerians with CKD at presentation and to compare findings with those of hypertensive patients with normal renal function. METHODS: Eighty-six consecutive patients with CKD were studied, comprising 43 hypertensives and 43 age- and sex-matched healthy subjects as controls. Clinical, laboratory, and echocardiographic variables were measured. RESULTS: Left ventricular diastolic dysfunction was present in 62.8% of CKD patients, 79.1% of hypertensive patients and 25.6% of normal controls (p<0.001). There was a positive correlation between left ventricular diastolic function (LVDF) and systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), severity of SBP, severity of DBP in CKD patients but not in hypertensive patients. There was a negative correlation between LVDF and age in CKD patients and hypertensive patients. Linear multiple regression analysis showed age as the only predictor of LVDD. CONCLUSION: There is a high prevalence of diastolic dysfunction in CKD patients at first presentation to a nephrologist in Nigeria.


Assuntos
Falência Renal Crônica/epidemiologia , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/epidemiologia , Adulto , Fatores Etários , Determinação da Pressão Arterial , Estudos de Casos e Controles , Ecocardiografia , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico por imagem , Hipertensão/fisiopatologia , Falência Renal Crônica/complicações , Falência Renal Crônica/fisiopatologia , Nigéria/epidemiologia , Prevalência , Análise de Regressão , Fatores de Risco , Disfunção Ventricular Esquerda/etiologia , Disfunção Ventricular Esquerda/fisiopatologia
20.
Niger Postgrad Med J ; 17(4): 301-7, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21809609

RESUMO

AIMS AND OBJECTIVES: This study evaluates left ventricularsystolic function (LVSF) and factors affecting it in CKD patients at first presentation, using two dimensional echocardiography. PATIENTS AND METHODS: One hundred consecutive patients with CKD who were presenting to the medical outpatient and renal clinics of university of Nigeria teaching hospital, Enugu for the first time, who satisfied the study criteria were screened. Eighty six patients completed the study. Forty-eight sex matched hypertensive patients with normal renal function and forty-six age and sex matched subjects (with normal blood pressure and renal function) were selected as controls. Clinical and laboratory parameters and echocardiographic indices were measured. RESULTS: Left ventricular systolic dysfunction (LVSD) was present in 13 (15.1%) of CKD patients and 4 (8.3%) of hypertensive patients (p < 0.001). The mean fractional shortening in CKD patients (35.1 +/- 10.4%) was significantly lower than the hypertensive patients (40.1 +/- 9.8), p = 0.008. Positive correlation was found between fractional shortening (FS) and estimated glomerular filtration rate, haemoglobin level, CKD stage, diastolic blood pressure, serum albumin and systolic blood pressure.(r = 0.281, P < 0.001; r = 0.277, p < 0.001; r = 0.270, p = < 0.001; r = 0.237; P = 0.001; r = 0.230, p = 0.002; and r = 0.199, p = 0.007) respectively. Left ventricular mass index and mean arterial blood pressure, correlated negatively with LV systolic function (r = -0.315, P < 0.001; and r = -0.223, P Stepwise multiple regression analysis showed that of all the factors that correlated with LVSF. CONCLUSION: This study has shown that LVSF is impaired in a significant number of our CKD patients at presentation.


Assuntos
Hipertensão/fisiopatologia , Falência Renal Crônica/fisiopatologia , Disfunção Ventricular Esquerda/etiologia , Função Ventricular Esquerda/fisiologia , Adulto , População Negra , Pressão Sanguínea/fisiologia , Estudos de Casos e Controles , Diálise , Ecocardiografia , Feminino , Taxa de Filtração Glomerular , Hospitais de Ensino , Humanos , Hipertensão/etnologia , Falência Renal Crônica/complicações , Falência Renal Crônica/etnologia , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Sístole , Disfunção Ventricular Esquerda/etnologia , Adulto Jovem
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