scholarly works

Permanent URI for this collectionhttps://repository.ui.edu.ng/handle/123456789/518

Browse

Author: search.filters.author.Salako, B.L.Subject: search.filters.subject.Nigeria

Search Results

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Outcomes of tunneled internal jugular venous catheters for chronic haemodialysis at the University College Hospital, Ibadan, Nigeria.
    (2018) Raji, Y.R.; Ajayi, S.O.; Aminu O.; Abiola, B.; Efuntoye, O.; Salako, B.L.
    Introduction: vascular access is an important aspect of haemodialysis treatments and determinant of patient outcomes. Arteriovenous (AV) fistula has been described as the preferred haemodialysis vascular access for patients on chronic dialysis. There continues to be a challenge with the creation of AV fistula, due to shortage of vascular surgeons skilled in the AV fistula creation particularly in source limited setting. We described the outcomes of the tunneled internal jugular venous catheters amongst our patients at the University College Hospital (UCH) Ibadan. Methods: a retrospective study of patients on maintenance haemodialysis at the UCH, Ibadan, we reviewed the records of all patients on chronic dialysis over a period of 5 years. Information obtained include demographics, types and aetiology of renal failure, types of vascular access, observed complications and outcomes. Results: a total number of 147 catheters were inserted during the period under review, 94 were males while 53 were females. The age range was 18-85 years while the mean age was 46.3 ± 17.2 years. The range and mean duration for Tunneled Dialysis Catheter (TDC) carriage were (30 - 1,440) and 220±185 days respectively. The observed immediate complications of TDCs were failed first attempt 7(4.7%), reactionary haemorrhage 5(3.4%), arrhythmia 3(2.0%), haemothorax 2(1.4%) while death during catheter placement was recorded in 2(1.4%) cases. Catheter related infection was the commonest long-term complications and occurred in 15 cases (10.1%), while being diabetic increased the risk of developing catheter related complications. One tenth of our patients with End Stage Renal Disease on TDC had kidney transplantation while catheter related mortality was 16.3%. Conclusion: internal jugular tunneled dialysis catheters despite its shortcomings, has been a safe procedure with good outcomes among our patients on maintenance haemodialysis.
  • Thumbnail Image
    Item
    Outcomes of tunneled internal jugular venous catheters for chronic haemodialysis at the University College Hospital, Ibadan, Nigeria
    (2018) Raji, Y.R.; Ajayi, S.O.; Aminu O.; Abiola, B.; Efuntoye, O.; Salako, B.L.
    Introduction: vascular access is an important aspect of haemodialysis treatments and determinant of patient outcomes. Arteriovenous (AV) fistula has been described as the preferred haemodialysis vascular access for patients on chronic dialysis. There continues to be a challenge with the creation of AV fistula, due to shortage of vascular surgeons skilled in the AV fistula creation particularly in source limited setting. We described the outcomes of the tunneled internal jugular venous catheters amongst our patients at the University College Hospital (UCH) Ibadan. Methods: a retrospective study of patients on maintenance haemodialysis at the UCH, Ibadan, we reviewed the records of all patients on chronic dialysis over a period of 5 years. Information obtained include demographics, types and aetiology of renal failure, types of vascular access, observed complications and outcomes. Results: a total number of 147 catheters were inserted during the period under review, 94 were males while 53 were females. The age range was 18-85 years while the mean age was 46.3 ± 17.2 years. The range and mean duration for Tunneled Dialysis Catheter (TDC) carriage were (30 - 1,440) and 220±185 days respectively. The observed immediate complications of TDCs were failed first attempt 7(4.7%), reactionary haemorrhage 5(3.4%), arrhythmia 3(2.0%), haemothorax 2(1.4%) while death during catheter placement was recorded in 2(1.4%) cases. Catheter related infection was the commonest long-term complications and occurred in 15 cases (10.1%), while being diabetic increased the risk of developing catheter related complications. One tenth of our patients with End Stage Renal Disease on TDC had kidney transplantation while catheter related mortality was 16.3%. Conclusion: internal jugular tunneled dialysis catheters despite its shortcomings, has been a safe procedure with good outcomes among our patients on maintenance haemodialysis.
  • Thumbnail Image
    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 IDA
  • Thumbnail Image
    Item
    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.