ABSTRACT
BACKGROUND: The burden of chronic kidney disease (CKD) in Nigeria is quite alarming. The prevalence of CKD ranges from 11 - 23.5%. Hypertension and chronic glomerulonephritis (CGN) remain the two leading causes of CKD in Nigeria. The etiology of CKD in many of these patients remains unknown, as few biopsies are done. In order to demystify the various glomerular diseases that culminate in CGN, performing a kidney biopsy offers a ray of hope. Few studies on renal biopsies have emanated from Nigeria; this study, however, is unique as the histopathological analysis involves light, immunofluorescence, and electron microscopies. METHODS: This study involved two teaching hospitals in Lagos. Patients from these centers, who met the inclusion criteria, underwent real-time renal biopsy; after providing written informed consent. RESULTS: Among the 52 patients analyzed 26, (50%) were males. The mean age was 31.7 ± 12.8, with age range of 13 - 56 years. The most common indication for kidney biopsy was nephrotic syndrome, accounting for 73%. Focal segmental glomerulosclerosis (FSGS) was the most frequent histopathological diagnosis seen in 25 patients (48.1%). CONCLUSION: The findings from this study highlight the role that renal biopsy plays in making a concrete diagnosis in nephrology practice in a developing country like Nigeria. As almost 80% of the study population was made up of patients with FSGS and lupus nephritis, it remains to be determined by further studies among our patients, the role that Apolipoprotein L1 (APOL 1) gene mutation will play in the etiology of renal diseases in Nigeria.
Subject(s)
Renal Insufficiency, Chronic/pathology , Acute Kidney Injury/pathology , Adolescent , Adult , Biopsy/methods , Diagnosis, Differential , Female , Glomerulonephritis/pathology , Glomerulosclerosis, Focal Segmental/pathology , Humans , Kidney/pathology , Lupus Nephritis/pathology , Male , Microscopy, Electron , Microscopy, Fluorescence , Middle Aged , Nephrotic Syndrome/pathology , Nigeria , Prospective Studies , Proteinuria/urine , Young AdultABSTRACT
OBJECTIVE: To determine the prevalence of risk factors for cardiovascular disease (CVD) in first-degree relatives (FDRs) of patients with chronic kidney disease (CKD) in a sub-Saharan African population. METHODS: This was a cross-sectional survey of 460 subjects (230 FDRs of patients with CKD and 230 healthy controls). Anthropometrics and blood pressures were measured. Spot urine and fasting venous blood samples were obtained for biochemical analysis. RESULTS: The prevalence of hypertension, diabetes mellitus, obesity and dyslipidaemia were significantly higher in FDRs of patients with CKD compared with the controls: 56 (24.3%) vs 29 (12.6%), p = 0.01; 20 (8.7%) vs 6 (2.6%), p = 0.01; 40 (17.4%) vs 24 (10.4%), p = 0.03 and 171 (74.3%) vs 138 (60.0%), p = 0.01, respectively. Hypertension (OR, 1.65), dyslipidaemia (OR, 1.72) and albuminuria (OR, 1.61) were independently associated with being a FDR of patients with CKD. CONCLUSION: In this sub-Saharan African population, risk factors for CVD were more prevalent in the FDRs of patients with CKD than in healthy controls.
Subject(s)
Blood Pressure/physiology , Cardiovascular Diseases/epidemiology , Renal Insufficiency, Chronic/epidemiology , Adolescent , Adult , Africa South of the Sahara , Black People , Cardiovascular Diseases/complications , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Prevalence , Renal Insufficiency, Chronic/complications , Risk Factors , Young AdultABSTRACT
BACKGROUND: The appeal of the white coat to both the doctors and the public is waning. In most developing countries such as Nigeria doctors' view of the white coat is not known. OBJECTIVE: To determine the proportion of interns which supported wearing of white coat by doctors. METHODS: A 10-item questionnaire was distributed to medical interns undertaking mandatory pre-registration training in a tertiary hospital. Characteristics of interns who were supportive of doctors wearing the white coat were compared to those who did not support or were indifferent to it. RESULTS: Two hundred and thirty three interns returned completed questionnaires. About 54% (126) and 52% (107) of the participants were males and graduates of the College of Medicine, University of Lagos respectively. The majority of interns (167; 71.7%) supported the wearing of white coats by doctors when attending to patients; 22 (9.4%) were opposed to it while 44 (18.9%) were indifferent. Older interns, females and interns who had not rotated through Paediatrics were more likely to support the wearing of white coats by doctors. The commonest reason for wearing the white coat was for identification. CONCLUSION: The majority of medical interns supported the wearing of white coat by doctors. Prevention of infection is no longer the major reason for wearing the white coat. There is need to document the public's perception of the white coat.
