Risk Factors for Chronic Kidney Disease in Newly Diagnosed Hypertensive Subjects in Southeast Nigeria.

BACKGROUND: The aim of this study was to determine the prevalence and associated risk factors for chronic kidney disease (CKD) in newly diagnosed hypertensive patients. MATERIALS AND METHODS: This was a cross-sectional analytical study involving consenting newly diagnosed hypertensive patients who presented at GOPD of Federal Medical Centre, Umuahia, within 0-3 months of diagnosis; and non-hypertensive controls. A semi-structured interviewer- administered questionnaire was used to record the socio-demographic, anthropometric, clinical and bio-chemical characteristics of the respondents. Data were analyzed and compared between the hypertensive group and the non-hypertensive control group. RESULTS: Two hundred and sixty participants took part in the study. However, only 240 completed the study (120 hypertensive, and 120 control participants). After follow-up for 3 months, 42 (35.0%) hypertensive patients had CKD compared to 11 (9.2%) of the non-hypertensive control group. The prevalence of CKD in the hypertensive participants was significantly higher (2=23.27, p<0.001). Multivariate regression analysis of CKD with variables in the hypertensive study group showed an association between CKD and sex (p=0.020), serum triglycerides (p=0.030) as well as serum uric acid (p=0.030). In the control group there was significant association between CKD and sex (p=0.020), serum total cholesterol (p=0.030) as well as serum uric acid (p=0.030). CONCLUSION: The prevalence of CKD among newly diagnosed hypertensives in southeast Nigeria was high. In this group, CKD had an association with sex, serum uric acid and serum triglyceride.

Herbal vaginal pessary induced acute renal failure.

In Africa, the use of traditional herbal remedy is widespread. Acute renal failure (ARF) is one of the most serious complications. The use of herbal remedies (mostly orally) accounts for nearly 35% of all cases of acute renal failure in Africa. Development of renal failure following herbal vaginal pessary is rarely reported. In November 2003, a 35-year-old Nigerian female who is a petty trader and a primary school leaver with three children (all males) presented to us in the renal unit with oliguric ARF induced by herbal vaginal pessary. She had sought this alternative medicine in an attempt to have a female child as all her three children are males. Her condition was managed accordingly and required three sessions of hemodialysis. She started diuresing on the eighth day of admission. This case presentation highlights the potential tragedies of herbal preparation, of note, that herbal vaginal pessaries are as deleterious as the oral preparations, and that the dilemma of ignorance is still prevalent in our society.

Acute renal impairment following use of intravenous contrast agent: A case report and reminder for increased awareness of the problem.

OBJECTIVE: Contrast-induced nephropathy is one of the adverse reactions to the use of radiocontrast media. Its incidence can be reduced if preventive measures are instituted. This report presents a case of acute renal impairment following use of radiocontrast media. PATIENT, METHOD AND RESULTS: We report a case of an elderly hypertensive diabetic who developed acute renal impairment within 24 hours of undergoing an intravenous urography. He was not a known asthmatic and had no previous history of allergy. His renal function improved subsequently with hydration, diuretics and strict input/output monitoring. He was discharged after 23 days in hospital and renal function returned to pre-morbid state 3 months after discharge. CONCLUSION: The report is a reminder of the possibility of nephropathy associated with the use of intravascular contrast media. There is need for extra care to be taken to identify risk factors in patients that are to undergo intravascular contrast studies and adequate attention paid to these.