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Item Resistivity index in the diagnosis and assessment of loss of renal function in diabetic nephropathy.(2021) Jinadu, Y.O.; Raji, Y.R.; Ajayi, S.O.; Salako, B.L.; Arije, A.; Kadiri, S.Objective: The aim of this study was to determine the haemodynamics of the intrarenal arteries from the relationship between resistivity index (RI) and kidney function, and to identify the predictors of high RI among patients with diabetic nephropathy (DN) and those with diabetes mellitus (DM) without DN. Methods: This was a cross-sectional survey of 133 participants, comprising 40 subjects with DM without DN, 53 with DM with DN and 40 healthy controls. Information obtained was demographics, lifestyle, medical and medication histories, while anthropometric and blood pressure measurements were taken. Albuminuria and estimated glomerular filtration rate were determined and RI was measured using a Doppler ultrasound scan. Results: The mean intrarenal artery RIs were higher among the patients with DM without DN (0.60 ± 0.04) and the group with DM with DN (0.61 ± 0.04) than in the controls (0.56 ± 0.04) (p = 0.02). Glycated haemoglobin (HbA1c) predicted high RI in the DM without DN group (OR 2.81; CI: 1.73–9.03) while hypertension (OR 3.60; CI: 1.06–12.22) predicted high RI in the DM with DN group. Conclusion: Elevated intrarenal artery RI was prevalent among patients with DM without DN and those with DM with DN, while elevated HbA1c level and hypertension predicted elevated RI in subjects with DM without DN and those with DM with DN.Item Impact of impaired kidney function on outcomes of Nigerians with COVID-9 infection: report of two cases from the University College Hospital, Ibadan(2021) Raji, Y.R.; Ajayi, S.O.; Abiola, B.I.; Augustine, T.; Adekanmbi, O.; Arije, A.Covid-19 infection predominantly affects the respiratory system; however, other systems and organs are also affected. The kidneys are among the organs commonly affected by SARS-CoV-2 and this has been reported to be a predictor of increased severity, need for intensive care (ICU), admission, and death. We presented two cases of COVID-19 that were associated with co-morbidities that include diabetes mellitus, systemic hypertension and impaired kidney function. The relationship of the multiple co-morbidities particularly the impaired kidney function with the outcomes of COVID-19 infection and the challenges of offering dialysis for patients with COVID-19 infection with kidney failure were discussed. The two cases presented also highlighted the state of preparedness for the management of COVID-19 and its various complications and co-morbidities, particularly kidney failure in a tertiary hospital in Nigeria at onset of the COVID-19 outbreak. WAJM 2021; 38(3): 292–296.Item Impact of impaired kidney function on outcomes of Nigerians with COVID-9 infection: report of two cases from the University College Hospital, Ibadan(2021) Raji, Y.R.; Ajayi, S.O.; Abiola, B.I.; Augustine, T.; Adekanmbi, O.; Arije, A.Covid-19 infection predominantly affects the respiratory system; however, other systems and organs are also affected. The kidneys are among the organs commonly affected by SARS-CoV-2 and this has been reported to be a predictor of increased severity, need for intensive care (ICU), admission, and death. We presented two cases of COVID-19 that were associated with co-morbidities that include diabetes mellitus, systemic hypertension and impaired kidney function. The relationship of the multiple co-morbidities particularly the impaired kidney function with the outcomes of COVID-19 infection and the challenges of offering dialysis for patients with COVID-19 infection with kidney failure were discussed. The two cases presented also highlighted the state of preparedness for the management of COVID-19 and its various complications and co-morbidities, particularly kidney failure in a tertiary hospital in Nigeria at onset of the COVID-19 outbreak. WAJM 2021; 38(3): 292–296.Item Exposure to agrochemicals and markers of kidney damage among farmers in rural communities in Southwestern Nigeria(2021) Ajayi, S.O.; Raji, Y.R.; Michael, O.S.; Adewole, D.; Akande, T.; Abiola, B.; Aminu, S.; Olugbenga-Bello, A.; Arije, A.Background: Chronic kidney disease of unknown origin (CKDu) is assuming an epidemic proportion, especially in farming communities worldwide. We explored the relationship between CKD markers and agrochemical exposure among rural farmers in South Western Nigeria. Methods: We studied selected farming communities in Southwestern Nigeria where the use of agrochemicals was widespread. A pre-tested questionnaire was administered to participants. Anthropometric data, information on use of agrochemicals; urine and blood samples were obtained. Informed consent was obtained from participants. The study was approved by the Institutional Ethics committee and complied with 1975 Helsinki declaration, as revised in 2000. Results: A total of 438 farmers made up of 202 males (46.1%) and 236 females (53.9%) were studied. The mean microalbuminuria was 30.2 ±11.7 mg/dl. Majority of the farmers had CKD stage 2 (42.0%) and CKD stage 3 (37.7%). The type of farming engaged in had a positive, but not significant, correlation with eGFR (r=0.012, p=0.832). There was positive correlation between type of farming and GFR category (r=0.24, p=0.000). Frequency of use of hexachlorocyclohexane had a positive and significant correlation with eGFR (r=0.111, p=0.045). Annual crop farming had a correlation with UACR (r=0.149, p=0.024). Conclusion: Annual crop farming had a positive correlation with UACR, eGFR and GFR category. The prolonged use of agrochemicals on an annual basis can cause kidney damage.Item Challenges and possible solutions to peritoneal dialysis use in Nigeria.(2020) Ajayi, S.; Raji, Y.; Bello, T.; Arije, A.Introduction: peritoneal dialysis is a form of renal replacement therapy that is both effective and relatively affordable. Peritoneal dialysis (PD) was first used in Nigeria as a treatment option for renal failure. Its use was first reported in Nigeria in 1969 and became more widespread in the 80s and 90s. Haemodialysis, which is capital intensive to set up and requires infrastructures and facilities such as electricity, intense water consumption and buildings, seems to have upstaged peritoneal dialysis both in demand and supply. Methods: this cross-sectional study is a convenient survey of nephrologists, renal technicians and nurses in Nigeria. We used a structured, self-administered questionnaire on a cross-section of members and associate members attending a national nephrology association meeting. Results: there were 68(54.4%) doctors, 43(27.2%) nurses, and 14(11.2%) renal technicians, all from medical institutions with renal treatment programs who participated in the study. The most common problems encountered with PD use are financial constraints (51.7%), inadequate fluid supply (50%), frequent line blockage (22.4%) and frequent infections (17.2%). Reasons attributed to the stoppage of PD in the centres included lack of PD fluids (50.8%), unavailability of PD catheters (22.8%), lack of expert personnel to train (15.8%). Conclusion: main challenges to peritoneal dialysis use in Nigeria include limited experience and training and availability and cost of consumables. Effort to overcome the factors militating against its use should be positively pursued so that peritoneal dialysis will be reintegrated into the mainstream of renal replacement therapy once moreItem May measurement month 2017: screening for hypertension in Nigeria, Sub-Saharan Africa.(2019) Ogah, O.S.; Arije, A.; Xia, X.; Beaney, T.; Adebiyi, A.A.; Sani, M.U.; Ojji, D.B.; Sogade, T.T.; Izezuo, S.; Chukwuonye, I,I.; Akinwusi, P.; Mbakwem, A.C.; Daniel, F.A.; Omotoso, A.B.; Poulter, N.R.Item Assessment of risk factors for kidney disease in an unselected population of nigerians: a report of the routine screening conducted during the national kidney disease awareness and sensitizing programme.(2006) Ulasi I.; Arogundade, F.A.; Aderibigbe, A.; Oviasu, E.; Akinsola, A.; Arije, A.; Ijoma, C.K.; Anteyi, E.A.; Ajayi, S.O.; Mamven, M.; Adeniyi A.B.; Mbah I.; Salako B.L.; Sanusi A.A.; Angbarzo I.; Kwaifa A.To be able to define some risk factors for renal disease in an unselected population of Nigerians the Nigerian Association of Nephrology conducted a screening exercise during the National Kidney Disease Awareness and Sensitization Programme whose theme was “Renal Disease in Nigeria: Taming the Lion” which was held at the capital city of Abuja on the 9th of February 2006. A total of unselected 129 respondents who consented were screened. One hundred and nine (56 male and 72 female respondents) were analyzed and the others [2] could not be analyzed because of incomplete data. The mean age of respondents was 27.03 (±10.75) years and majority (89.1 %), were in age group 15 to 44 years with no sex preference. Most of the respondents had normal BMI, the mean being 23.32 (±4.52)mg/m2. More females than males were found to be obese (16% versus 4%), the difference was not statistically significant (p=0.76). A relatively high percentage of respondents gave positive family history of hypertension (40%) as against 25% for diabetes mellitus. Only 5% of respondents gave positive history of renal disease. Use of nephrotoxic agents - medicated soap, native medication and herbal supplements/tea was found in 40%, 30% and 19% respectively. More than half of the studied population did not have routine medical check and about a third engaged in self medication. The prevalence of hypertension and proteinuria were 13.6% and 19% respectively. It is concluded from this study that the risk factors for development of chronic kidney disease (CKD) is high in the studied population and the level of awareness regarding need for routine medical check and appropriate attitude to health low. There is crying need for more intensive, aggressive and comprehensive education aimed at increasing the health seeking attitude of our population as well as establishment of preventive programmes against CKD in the country.Item Decreased dose requirement of antihypertensive agents with age.(2001) SalakoB.L.; Ajayi, S.O.; Kadiri, S.; Arije, A.Hypertension is very prevalent in the elderly and treatment has been shown to be beneficial. However, inappropriate doses of drugs may impair the quality of life in this group of patients. In an attempt to assess the role of advancing age on therapy and doses of antihypertensives, the authors studied the antihypertensive dose/response pattern as hypertensive subjects on regular treatment move from the young to the elderly age group. Forty-nine hypertensives who were still being followed up at the medical outpatient clinic. University College Hospital, Ibadan were recruited into the study. The patients were extensively inter viewed and information relating to age, sex, year, age of diagnosis, as well as blood pressure at diagnosis, 6 months and 5 years of therapy were noted. There were HI males and 39 females with mean ages of 66.5 ± 6.6 and 64.5 ± 4.5 years respectively. The mean ages at diagnosis for both male and female groups were 52 ± 9.3 and 50 ± 7.5 years respectively. At diagnosis, 22 (44.8%) patients were started on single (antihypertensive) drug therapy, 23 (46.9%) on two drags while 4 (8.3%) were on 3 drugs. By 5 years of fairly consistent therapy, there were 33 (67.3%) patients on single drug and 16 (32.7%) patients on 2 drugs. No patient was on 3 drugs regimen. The mean blood pressure at diagnosis of 174 ± 24/105 ± 9 mmHg dropped significantly and was maintained at 6 months of therapy at (139 ± 20 / 87 ± 13 mmHg) p < 0.001. After 5 years of therapy the mean was (139 ±24/81 ±8 mmHg) inspite of dose reduction in these patients (p < 0.001). The authors concluded that, in a hypertensive patient who is un regular treatment, consistent and gradual reduction of antihypertensive doses may be carried out with blood pressure remaining within acceptable limits as the patient grows old.Item Blood pressure changes in haemodialysis: the nigerian experience(1998) Salako, B.L.; Ajayi, S.O.; Kadiri, S.; Arije, A.; Osoba, O.A.The blood pressure changes in haemodialysis were assessed during 59 sessions in 21 patients. Blood pressure was measured with I he corresponding pulse before and subsequently hourly during dialysis, and the patients weights were measured before and after dialysis. The mean systolic blood pressure before dialysis was 170,22 + 29.64mmHg. This showed a statistically sig nificant decrease at l hour. being 167^31.79mmHg (P < 0.002 at 2 hours, being 164.83 + 40.26mmHgwith (P < 0.001). at 3 hours, being 166.84+ 36.94mm Hg (P< 0.001) intradialysis, and immediately after 4 hours of dialysis 166.28 ±35.70mmHg t P < 001). The mean diastolic blood pressure before dialysis of 109.90 + 20.SOmmHg also showed a significant decrease at 1 hour 106.07 + 22.84mmHg (P< 001) 2 hours 105.98+ 22.10mmHg (P < 0.001) and 3 hours intradialysis 107.81 + 25.39mmHg (P< 0.001). These findings suggest that blood pressure changes in haemodialysis are affected by drop in weight that invariably occurs in haemodialysis due to the accompanying process of ultrafiltration