Prevalence and factors associated with the severity of anaemia among patients on chronic haemodialysis in Lagos, Nigeria

Anaemia is a global public health problem with high mortality and morbidity. It is also a common consequence of chronic kidney disease (CKD). There is a paucity of data on the actual burden of anaemia among patients on chronic haemodialysis (CHD) in Lagos, Nigeria. Objectives: To determine the prevalence and factors associated with the severity of anaemia among Nigerian patients undergoing chronic haemodialysis. Methods: This was a retrospective analysis of adult patients with end-stage renal disease (ESRD) on maintenance haemodialysis at the Lagos State University Teaching Hospital, Ikeja, Lagos. The data extracted from the clinical case files included the bio-demographic and clinical parameters, including the treatment modalities. Results: A total of 92 patients comprising 69 (75%) males and 23 (25.0%) females with the overall mean age of 48.2±14.0 years were included. Hypertension was the commonest aetiology of CKD and the average duration of haemodialysis was 16.6 months. The commonest access route for haemodialysis was a central line while 96.7% and 81.5% received erythropoietin and intravenous iron sucrose respectively. Seventy-three (79.3%) patients have had intra-dialysis blood transfusions in the past. Mild, moderate, and severe anaemia were recorded in 17%, 67%, and 16% respectively. The use of erythropoietin, iron sucrose, and increased frequency of blood transfusions correlated with the severity of anaemia. Conclusion: Anaemia is highly prevalent among patients with CKD on chronic haemodialysis. Increased frequency of blood transfusions, inadequate utilization of erythropoietin, and iron sucrose administration are associated with anaemia severity.

Clinical Characteristics of Human Immunodeficiency Virus (HIV) Seropositive Nigerian Patients Undergoing Dialysis

Renal failure is a common finding in human immunodeficiency virus infected patients; and it contributes significantly to their morbidity and mortality. Most dialysis centres in Nigeria currently do not accept HIV positive patients for dialysis therapy for many reasons. The prevailing high level of stigmatization of HIV positive patients and the lack of job security for infected staff are two major reasons for the non-acceptance of HIV infected patients for dialysis by these centres. Following a pathetic encounter with an HIV positive patient who required dialysis and the success of his treatment; our centre currently perform dialysis for HIV positive patients on routine basis. In this article; we present our clinical observations on the characteristics of HIV patients dialyzed in our unit between 1st January 2004 and 31st December 2004. A total of 142 patients dialyzed in our centre during this period. 24 (16.9) were HIV positive. Acute renal failure was significantly more common in the HIV positive patients. [14(31.8) of 44 patients who presented with acute renal failure. X2 = 8.95; p 0.05]. Aetiologically; septicaemia was the most common cause of acute renal failure [7(50) of 14 patients]. HIV associated nephropathy accounted for 8(80) out of 10 HIV positive patients dialyzed with chronic renal failure. Outcome of therapy was not significantly different when compared with the HIV negative patients. We conclude that renal function impairment is common in patients with HIV infection. Treatment outcomes are essentially similar to HIV seronegative patients. The main determining factor being the ability of the patient to finance dialysis therapy

Clinical characteristics of human Immunodefiency Virus (HIV) seropositive Nigerian patients undergoing dialysis

Renal failure is a common finding in human immunodeficiency virus infected patients; and it contributes significantly to their morbidity and mortality. Most dialysis centres in Nigeria currently do not accept HIV positive patients for dialysis therapy for many reasons. The prevailing high level of stigmatization of HIV positive patients and the lack of job security for infected staff are two major reasons for the non-acceptance of HIV infected patients for dialysis by these centres. Following a pathetic encounter with an HIV positive patient who required dialysis and the success of his treatment; our centre currently perform dialysis for HIV positive patients on routine basis. In this article; we present our clinical observations on the characteristics of HIV patients dialyzed in our unit between 1st January 2004 and 31st December 2004. A total of 142 patients dialyzed in our centre during this period. 24 (16.9) were HIV positive. Acute renal failure was significantly more common in the HIV positive patients. [14(31.8) of 44 patients who presented with acute renal failure. X2 = 8.95; p 0.05]. Aetiologically; septicaemia was the most common cause of acute renal failure [7(50) of 14 patients]. HIV associated nephropathy accounted for 8(80) out of 10 HIV positive patients dialyzed with chronic renal failure. Outcome of therapy was not significantly different when compared with the HIV negative patients. We conclude that renal function impairment is common in patients with HIV infection. Treatment outcomes are essentially similar to HIV seronegative patients. The main determining factor being the ability of the patient to finance dialysis therapy