Heavy metal exposure and renal impairment: A systematic review of observational studies

Background: Environmental exposure to toxins has been strongly implicated in its multi-faceted etiology of chronic kidney disease, a serious public health problem affecting individuals, families, and communities. There is a need to synthesize available studies on the effect of heavy metal exposure on renal function, considering the rising global burden of kidney disease. The objective of this study is to determine the association between exposure to heavy metals and renal disease. Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) were used to conduct the review. A comprehensive independent search, title, abstract, and full-text screening of available literature on Google Scholar, PubMed, and OAREScience was done between March 2021 and May 2021. The criteria for study inclusion were full-text articles published in English language in the last 20 years (2001-2020), and observational primary human studies reporting the association between heavy metal exposure and renal disease. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of the included studies. Results: A total of 552 studies were identified following the search from the different databases. A total of 13 studies were finally included in the review. Heavy metals implicated in the studies include cadmium, lead, mercury, and arsenic, with ten studies showing environmental exposure as the primary source. Ten (10) studies showed an association between heavy metal exposure and renal impairment (p<0.05) while only 3 studies reported no association. Conclusion: Environmental monitoring is needed to stem the tide of heavy metal exposure in view of the growing burden of chronic kidney disease.

Serum lipids profile of untreated hypertensive patients in Port Harcourt, Nigeria

Background: Hypertension is the commonest non-communicable disease with variable prevalence rates in different parts of the world. Dyslipidaemia is associated with and predisposes to hypertension and hence increases the risk of cardiovascular disease. Aim: To determine the lipid profile in newly diagnosed hypertensive patients and compare them with age, sex and body mass index (BMI) of matched healthy non-hypertensive controls. Methods: A prospective descriptive study of newly diagnosed and treatment naive hypertensive patients. Healthy non-hypertensive adult Nigerians, who gave informed consent, consisting mainly of hospital staff and relatives of patients, matched for sex, age and BMI were recruited as controls. Results: A total of 89 patients, 42 females and 47 males and 87 healthy adults matched for age, sex, and body size were recruited as controls. Mean age of hypertensive subjects was 42.6±9.3 years and mean age for the control subjects was 41.5±4.5 years. The mean systolic blood pressure in the hypertensive subjects was 177.6±20.1 mmHg and mean diastolic blood pressure was 110.9 ±9.9 mmHg. The mean BMI in the hypertensive patients was 28.7±4.2 kg/m2, while the controls had mean BMI of 28.2±4.0 kg/m2 (P=0.5178). The mean total cholesterol (TCH) was 5.3±1.1 mmol/l in the study subjects and 4.7±0.95 mmol/l in the controls (P =0.0002). The mean low density lipoprotein cholesterol 250 in the study subjects was 4.3±1.1 mmol/l and 3.6±0.9 mmol/l in the control group (P=0.000054), while the mean triglyceride in the subjects was 1.3±0.3 mmol/l and 1.0±0.3 mmol/l in the controls (P=0.0000). Conclusion: Newly diagnosed hypertensives have significantly higher serum cholesterol levels than non-hypertensives of comparable age, sex and body size

A Three-Year Review of the Pattern of HIV Infection among Pregnant Women Attending Braithwaite Memorial Specialist Hospital; Port Harcourt; Nigeria

Background: The HIV prevalence rate in Rivers State was low at onset; but increased progressively; often exceeding the National average since 2001. However; there has been a reported decline in the prevalence in Nigeria and elsewhere with wide local and zonal differences. Aim: To assess the HIV sero-prevalence among pregnant women attending the antenatal clinic (ANC) at the Braithwaite Memorial Specialist Hospital Port Harcourt; Rivers State. Methods: Hospital records of all pregnant women who registered and attended the antenatal clinic from 2nd January 2005 to 31st December 2007 and were screened for HIV infection at the Haematology laboratory were retrieved and analysed using Epi-Info version 6.04d. Results: A total of 9;869 ANC attendees were screened for HIV infection at the Hospital. The prevalence rates were 4.8in 2005; 5.4in 2006 and 5.3in 2007. The pattern of infection showed that the highest prevalence rate of 5.6was found among the youngest age group (15- 24 years); clients with only primary education (8.5); and skilled workers (7.3) (p= 0.000). Conclusion: HIV infection is still in its epidemic phase in Rivers State unlike in other areas in the country where declines have set in. Caution is therefore required in extending the emerging declines in prevalence rates elsewhere to Rivers State; so that the existing political will and commitment in control efforts in the State are not weakened; if the State wishes to experience a sustained decline in prevalence rate in the foreseeable future