DSpace Collection: These are articles published in journals by academic staff

Under dialysis: Determinants and clinical correlates - Findings from a two-centre retrospective study in Nigeria

Sun, 01 Jan 2023 00:00:00 GMT

Title: Under dialysis: Determinants and clinical correlates - Findings from a two-centre retrospective study in Nigeria Authors: Uduagbamen, P. K.; Soyinka, F. O.; Binuyo, T. O.; Boco, N. O. Abstract: Background: To deliver an adequate dialysis dose, it is necessary that the dialysis frequency, erythropoietin use, blood pressure control among others, be optimized. This is in addition to treating comorbidities and minimizing complications. Adequate dialysis improves the quality of life (QOL) and reduces the morbidity and mortality rates. Aim: To assess the determinant and correlates of under-dialysis in these two centres. Materials and Methods: We analyzed 5065 prevalent dialysis treatments given to 623 participants with end stage renal disease from two centres in Nigeria. Participants’ biodata, serum biochemistry, and hematocrit of cohorts with once , twice , and thrice weekly sessions were analyzed. Results: Males had more dialysis treatments than women. Two hundred and twenty seven (36.4%) cohorts had weekly sessions, 296 (47.5%) had twice weekly sessions, and 100 (16.1%) had thrice weekly sessions. The mean age of all participants was 50.5 ± 7.9 years, and was higher in women than men, P= 0.02. The percentage of the elderly in the maintenance dialysis population was 13.8%. Only 19.4% of the participants meet the Kidney Disease Outcomes Quality Initiative recommendation of thrice weekly erythropoietin, just as only 11.9% had health insurance. The dialysis dose was higher in males (P = 0.07), with health insurance (P < 0.001), frequent dialysis (P < 0.001), frequent erythropoietin (P < 0.001), higher hematocrit (P = 0.03), and bicarbonate (P = 0.001), but was lower in intradialytic hypotension compared to intradialytic hypertension, P = 0.004 versus P = 0.005. Dialysis termination and intradialytic death were negatively correlated with dialysis frequency. Health insurance, frequency of dialysis, and erythropoietin predicted the dialysis dose. Conclusion: Under dialysis and suboptimal erythropoietin use were prevalent in the dialysis population and it restricted the prescribed dose which eventually gave lower dialysis doses, higher dialysis complications, and poor QOL.

Gender differences in chronic kidney disease: Findings from a two-center study in Nigeria

Sat, 01 Jan 2022 00:00:00 GMT

Title: Gender differences in chronic kidney disease: Findings from a two-center study in Nigeria Authors: Uduagbamen, P. K.; AdebolaYusuf, A. O.; Ahmed, S. I.; Thompson, M. U.; Alalade, B. A.; Ogunmola, M. I.; Falana, T. E.; Omokore, O. A.; Emmanuel, C. C. Abstract: Gender differences have been known to exist both in physiologic and pathological states including kidney disease. There is a need to be well acquitted with these differences to enhance preventive and curative strategies for kidney diseases. One hundred and forty-four participants with chronic kidney disease, stage 3 to non-dialytic 5 had urine, blood, and radiological investigations to assess albuminuria, kidney function, and sizes. The findings were compared on a gender basis. Eighty-two males and 62 females participated. The mean age of the males and females were 47.9 ± 16.8 years and 50.5 ± 14.73 years respectively. A greater proportion of participants 65 years and older were females. Chronic interstitial nephritis was more common in females while chronic glomerulonephritis was more common in males. Hyponatremia, metabolic acidosis, and hyperphosphatemia were more common in females. Men used vitamin D analogs and erythropoietin more than women while women used sodium bicarbonate and phosphate binders more than men. Aging (OR-3.28, CI-2.69-387), hyponatremia (OR-4.74, CI2.10-6.33), hypoalbuminemia ((OR-4.56, CI-3.45-7.49)), and metabolic acidosis (OR-4.14, CI-1.46-4.92) were independently associated with the female gender. Gender differences exist in the risk profile, epidemiology, laboratory findings, and response to treatment of CKD sufferers. Women had more hyponatremia and hyperphosphatemia while men had higher albumin and kidney sizes. Gender partitioned median range cut-offs of some variables would be needed for effective prevention, treatment, and follow-up of CKD sufferers.

Complement factor H levels in steady state sickle cell anaemia

Mon, 01 Jan 2018 00:00:00 GMT

Title: Complement factor H levels in steady state sickle cell anaemia Authors: Olutogun, T. A.; Olufemi-Aworinde, K. J.; Fasola, F. A.; Ano-Edward, G. H.; Aworinde, O. O.; Ajiboye, A. O. Abstract: Objective: The red cell membrane of sickle cell anaemia is vulnerable to attack from the alternative complement pathway. The activation of the alternative complement pathway is initiated by externalization of phosphatidylserine on red cell membrane. Serum and cell bound regulators normally prevent amplification of the cascade. However, red blood cells in sickle cell anaemia appear to be exposed and the cell lysing membrane attack complex is ubiquitous on irreversible sickle red blood cells. It is possible that there are deficiencies (either functional or quantitative) of complement regulators. In this study the quantitative defects of the most abundant serum phase regulator, complement factor H in sickle cell anaemia was investigated. Methods: We compared the plasma levels of complement factor H (a serum phase regulator of the alternative pathway) in 61 steady state Hb SS with 60 healthy Hb AA using an enzyme linked immunosorbent assay to analyze complement factor H level in the plasma. The full blood count parameters were estimated using flow cytometry. Results: There was no significant difference in the serum complement factor H levels between the steady state Hb SS and healthy Hb AA. Significant inverse relationships existed between complement factor H, total white cell count, granulocyte cell count and platelet count as well as significant direct relationships between complement factor H, haematocrit, and the haemoglobin concentration. Conclusion: Complement factor H in patients with sickle cell anaemia who are in steady state is not significantly lower than in controls.

Cavernous hemangioma of the uterine cervix: A case report

Wed, 01 Jan 2020 00:00:00 GMT

Title: Cavernous hemangioma of the uterine cervix: A case report Authors: Ogunlaja, O. A.; Ano-Edward, G.; Ogunlaja, I. P.; Lasisi, M. Abstract: Cavernous hemangioma of the uterine cervix is a rare clinical condition which has the potential of being life threatening. This rare clinical condition can manifest with patients presenting with abnormal uterine bleeding, menorrhagia with eventual anaemia. The case report here is that of a 27 year old Para o+o lady who was admitted to the Accident and Emergency Unit of our hospital with a day history of a huge mass protruding per vagina and a history of significant bleeding per vagina. Packed cell volume was 16% on admission and she had 4 units of blood transfused. She subsequently had examination under anaesthesia and excision of the prolapsed mass done via the vaginal route. Histology of the excised mass was in keeping with cavernous hemangioma of the uterus. Her Postoperative clinical state was satisfactory.