7 research outputs found
Demographics, cost, and sustainability of haemodialysis among end-stage kidney disease patients in Southern Nigeria: A single-center study
No full textContext: Access to chronic hemodialysis for patients with end‑stage kidney disease has improved over the years. However, it is unclear if thisbhas resulted in lower cost and improved dialysis vintage. Aim: We aimed to assess the demographics, cost implication, and sustainability of maintenance hemodialysis in our cohort of end‑stage kidney disease (ESKD) patients. Methods: Retrospective descriptive study of ESKD patients on maintenance HD from 2014 to 2018 using hemodialysis records. Time‑to‑HD discontinuation and reasons for discontinuation were recorded. Using Kaplan–Meier graphs, the time‑to‑dialysis discontinuation experience of the cohort was shown. Log‑rank test was used to compare the experience between both genders. Univariable and multivariable Cox proportional hazard models were built to identify independent associations with time‑to‑dialysis discontinuation. Results: Over the 5‑year period, 702 individuals initiated HD, males were older than females, the complete cohort contributed 65,714 person‑days to the study and the median time‑to‑HD discontinuation was 10 days (interquartile range, 2–42). Females had a shorter time to HD discontinuation (8 days [1–32 days]) compared to males (11 days [2–48 days]). Only 28.5%, 15.3% and 8.3% of the patients had HD beyond 30, 90, and 180 days, respectively. About 128 (18.2%) had thrice‑weekly HD. Most sustained the treatment for the 1st week. Majority (98.4%) of the patients were presumed dead, while 4 (0.65%) were still alive and 6 (0.98%) had renal transplantation. All patients who discontinued dialysis did so for financial reasons. Multivariable Cox proportional hazards model showed that individuals who could afford dialysis more than once a week had reduced hazard of dialysis discontinuation. Conclusion: Most patients cannot sustain HD beyond a few weeks for financial reasons. Several cost containment strategies need to be deployed to bring down the cost of care
Comparative Analysis Of Atherogenic Index Of Plasma And Its Relationship With Cardiovascular Risk Among Patients With Diabetes Mellitus And Concurrent Diabetes Mellitus With Hypertension Attending Endocrinology Clinic In A Tertiary Hospital South-South Ni
No full textAbstract: Insulin resistance, found in type 2 diabetes mellitus is often associated with increased triglyceride (TG) and decreased HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-
Crosstalk of Hyperglycaemia and Cellular Mechanisms in the Pathogenesis of Diabetic Kidney Disease
No full text
Priority setting for systematic review of health care interventions in Nigeria
No full textObjectives In an era of evidence based medicine and systematic review, this study seeks to identify priority systematic review topics that address common health problems in Nigeria.Methods Firstly, a primary list of health problems was compiled from the National Health Management Information Systems and information from key informants (health professionals, researchers and NGOs) drawn from the six geo-political zones in Nigeria. Key steps included compilation and ranking of a comprehensive list of health problems into 4 categories: adult communicable, non-communicable, maternal and child health; searching the Cochrane Library and electronic databases for systematic reviews on identified priority problems, analysis of search outputs to identify gaps; listing and ranking of new priority systematic review topics using pre-determined criteria.Results Eighteen questions made the final list of priorities systematic reviews and 9 of them were related to malaria. There were 7 additional issues that the panelists identified as crucial cross-cutting issues that need to be addressed in systematic reviews.Conclusion Identification and prioritization of systematic reviews relevant to health care in Nigeria will improve the opportunity to deliver evidence-based and equitable health care to the people. These topics are likely to be also important for health care decision in other resource-poor settings.Priority setting Evidence based medicine Systematic review Healthcare practice Nigeria
Crosstalk of Hyperglycaemia and Cellular Mechanisms in the Pathogenesis of Diabetic Kidney Disease
No full textUnderstanding the network of cellular mechanisms that underlie the pathogenesis of diabetic kidney disease and how they affect renal tissu
