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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 Assessment of iron deficiency anaemia and its risk factors among adults with chronic kidney disease in a tertiary hospital in Nigeria(2021) Raji, Y.R.; Ajayi, S.O.; Gbadegesin, B.A.; Bello, T.O.; Salako, B.L.A substantial proportion of patients with chronic kidney disease (CKD) develop iron deficiency anaemia (IDA). Despite the association of IDA with adverse cardiovascular outcomes, it remains underdiagnosed and poorly managed. Up to 70% of patients with CKD are anaemic at the time of initiating dialysis, while the predictors of IDA in these patients in our setting are unknown. This study aimed to determine the prevalence and risk factors for IDA in patients with CKD. Materials and Methods: This is a case–control study of 157 patients with CKD and 157 age and gender matched subjects without CKD. Information obtained from the participants were socio demographic details, aetiology of CKD, medication history and features of IDA. All participants had serum ferritin, total iron binding capacity (TIBC), transferrin saturation (TSAT), highly sensitive C reactive protein, serum creatinine and complete blood count determined. Results: The median estimated glomerular rate (22.7 [3.4–59.5] vs. 110.2 [60.3–152.8] ml/min/1.73 m2 , P < 0.01), the mean haemoglobin concentration (9.3 ± 2.6 vs. 11.4 ± 1.7 g/dl, P < 0.01), and TSAT (27.9% ± 6.4% vs. 34.8% ± 8.1%, P < 0.04) were significantly lower in patients with CKD. The mean age, serum ferritin and TIBC were similar in both groups. The prevalence of absolute (24.8% vs. 13.4%, P < 0.01) and relative (17.8% vs. 7.6%, P < 0.01) iron deficiencies were higher among individuals with CKD compared to the controls. Female gender (odd ratio [OR]:1.50, 95% confidence interval [CI]:1.0267–4.1163, P < 0.04) and severity of CKD (OR: 3.43, 95% CI: 1.5568–7.8324, P < 0.02) were independently associated with IDA. Conclusion: IDA is common among individuals with CKD while female gender and severity of CKD were factors that independently predicted IDAItem Challenges facing the growth of kidney transplantation in nigeria: perceptions and knowledge of the nephrologists and other health-care providers(2021) Raji, Y.R.; Ajayi, S.O.; Gbadegesin, B.A.; Bello, T.O.; Salako, B.L.Objective: The objective of this study was to determine the perception and knowledge of health-care providers to the challenges of sustaining the growth of kidney transplantation programs in Nigeria. Materials and Methods: We conducted a survey of 166 health-care providers. A pretested questionnaire was administered on all participants. Information obtained were demographics, characteristics of end-stage renal disease (ESRD) patients, and prospective kidney donors encountered and perception of the barriers to the growth of kidney transplantation program. Results: The respondents returned 134 questionnaires out of 166 (response rate: 80.7%) and only 121 with complete responses were included in the analysis. The mean age was 42.5 ± 0.8 years and 47.9% were females. A quarter of the health-care providers encountered ESRD patients who were more likely to refuse kidney transplantation and 34.1% reported that most of the prospective kidney donors were unwilling to donate. Most of the health care professionals (71.1%) preferred centers outside Nigeria for their patient’s kidney transplantation, while three leading barriers to the growth of kidney transplantation program reported were lack of patients’ trust (58.8%), failure of inter-program collaborations (55.0%), and absent of governmental supports (48.1%). Conclusions: The health-care professionals reported that more than a third of ESRD patients were not likely to accept kidney transplantation and an equal proportion of prospective donors will not agree to kidney donation. Majority of the health care professionals preferred centers outside Nigeria for patients’ kidney transplantation.