ABSTRACT
Background: Chronic kidney disease (CKD) has an increased risk of not only end-stage renal disease (ESRD); but majority of moderate CKD patients do die from cardiovascular disease (CVD) before reaching ESRD. The prognosis of these patients is very poor in most developing countries because of late presentation; inadequate diagnostic facilities; and inability to pay for treatment. Knowledge about CVD in CKD is crucial because of unpredictable progressive nature of the disease and increased risk of premature death from cardiovascular events. We sought to determine prevalence and pattern of electrocardiographic abnormalities in dialysis naive CKD patients. Materials and Methods: This is a 10-year prospective cross-sectional study carried out at the University of Ilorin Teaching Hospital; Ilorin. Patients were recruited from the nephrology clinic and renal wards and all who met diagnostic criteria for stages 4 and 5 CKD were included. All had their standard 12-lead electrocardiogram (ECG) recorded and various findings were critically studied and interpreted independently by two consultant physician including a cardiologist. Data analysis was done using SPSS version 16. Results: Overall; 86of the patients had at least one form of ECG abnormality; with hypertension (HTN) and anemia being the main contributory factors. These include left ventricular hypertrophy (LVH) (27.6); left atrial enlargement (LAE) (21.6); combination of LVH and LAE (17.2); and ventricular premature contractions (6). Etiology of CKD appears to have influence on ECG changes as prevalence of LVH and LAE were high among hypertensive renal disease; chronic glomerulonephritis (CGN); and diabetic nephropathy patients. Conclusion: LVH and LAE were very common ECG abnormalities in our dialysis naive CKD patients. HTN; CGN; anemia; late presentation; and male gender appear to be the main risk factors for the ECG abnormalities. There is need for gender-specific intervention strategies directed at early detection and treatment of HTN; anemia; and underlying kidney disease; especially in resource poor nations where the burden of CKD is assuming epidemic proportion
Subject(s)
Dialysis , Electrocardiography , Renal InsufficiencyABSTRACT
Background: Chronic renal failure (CRF) is a major cause of premature death and morbidity in Nigeria. Majority of patients with end stage renal disease (ESRD) are in the productive age bracket. Haemodialysis is the most commonly available mode of renal replacement therapy. The quality of life of the few that can afford the cost of haemodialysis is poor when compared to the transplanted patients. A survey is carried out to assess factors affecting attitudes towards kidney donation in Ilorin; Nigeria. Methods: A total of 600 self administered; semi-structured questionnaires were distributed amongst asymptomatic adults (aged 17years) with a response rate of 88. Data analysis was done using statistical package for social studies (SPSS) version 14. Results: There were 282 males (53.4) and 246 females (46.6) with age range of 17-65years and a mean of 34.76+14.9. Two hundred and ninety two (55) were willing to donate a kidney (165 males; 127 females). Majority of the willing donors (86) were between 30 and 50 years of age. Though educational level positively influenced the knowledge about the kidney failure; it did not influence willingness to donation of a kidney. There was religion related gender disparity in the willingness to donate a kidney as more male Christians and Muslims were willing to donation than their females. Conclusions: The main constraints to kidney donation were fear of surgical pains; belief in life after death and uncertainty of donor outcome. This calls for awareness programmes on the safety of kidney donation for transplantation