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Item Urinary transforming growth Factor-Beta 1 (uTGF-β1) and prevalent CKD risk in HIVpositive patients in West Africa(2019) Ekrikpo, U.E.; Okuku, C.N.; Ajayi, S.O.; Ayodele, O.E.; Bello, A.K.; Wonkam, A.; Dandara, C.; Kengne, A.P.; Okpechi, I.Introduction: This study investigated the association of urinary transforming growth factor-b1 (uTGF-b1) with prevalent chronic kidney disease (CKD) in the HIV-infected population. Methods: HIV-positive patients without CKD (HIVþCKD, n ¼ 194) and 114 with CKD (HIV CKD) who did not have hypertension, diabetes mellitus, or hepatitis B or C, had their urinary protein-creatinine ratio (uPCR), serum transforming growth factor (TGF)–b1, and uTGF-b1 measured. uTGF-b1-creatinine ratios (uTGF-b1Cr) were calculated. Spearman correlation was used to determine the association between uTGF-b1Cr and various attributes, and the Cuzick trend test was used to assess the presence of a linear trend in median uTGF-b1Cr levels across the stages of CKD. Multivariable robust linear regression models were used to assess independent association with variability in uTGF-b1Cr and estimated glomerular filtration rate (eGFR) levels. Results: The age of the participants was 38.3 0.3 years with 73.4% women. The median uTGF-b1Cr was higher among HIV CKD (4.85 ng/mmol [25th–75th percentile 1.96–12.35] vs. 2.95 [1.02–5.84]; P ¼ 0.001]). There was significant correlation between uTGF-b1Cr and age (P ¼ 0.02), eGFR (P ¼ 0.001), and uPCR (P < 0.001) in the HIV CKD group. Among the HIV CKD patients, there was gradual reduction in the median level of uTGF-b1Cr with CKD severity (P ¼ 0.04). HIV CKD patients had significantly higher levels of uTGF-b1Cr after controlling for potential confounders. Using eGFR as dependent variable, proteinuria explained the changes associated with uTGF-b1Cr levels. Conclusion: HIV CKD patients express higher levels of uTGF-b1 especially in the early stages of CKD apparently related to proteinuria levels.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.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.Item Prevalence of dyslipidemia in normoglycemic subjects with newly diagnosed high blood pressure in Abuja, Nigeria.(2009) Ojji, D.B.; Ajayi, S.O.; Manmak, H. M.; Atherthon J.The H3Africa Consortium (2014). Enabling the Genomic Revolution In Africa. American Association for the Advancement of Science: . 1346-1348pp. ISBN: 1612309842 (United States of America ) (Contribution : 20%) h. Background: High blood pressure and dyslipidemia additively increases the risk of cardiovascular disease. There is a high prevalence of high blood pressure in Nigeria, but there are little data regarding the prevalence of dyslipidemia in subjects with high blood pressure. OBJECTIVE: In this observational prospective study, we examined the prevalence of dyslipidemia in newly diagnosed normoglycemic subjects with high blood pressure. Methods: A total of 171 subjects presenting with high blood pressure for the first time in the cardiology and nephrology clinics at the University of Abuja Teaching Hospital were studied. Height, weight, and blood pressure were measured. Total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were determined in fasting plasma. The total cholesterol/HDL-C and non–HDL-C values were calculated. These measures were then classified according to the 2001 report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. RESULTS: Of the 171 subjects studied, 84 (49%) were male and 87 (51%) were female. Low HDL-C was present in 71 (45.8%), elevated LDL-C in 29 (17%), elevated total cholesterol in 19 (11.1%), and elevated triglyceride in 13 (7.6%), whereas eight (4.7%) of the study population had combined elevated total cholesterol and triglyceride. Female subjects had higher total cholesterol and lower HDL-C than male subjects, but these differences were not statistically significant. Obese subjects, compared to the nonobese, had significantly higher LDL-C and total cholesterol/HDL-C ratios in males and significantly higher triglyceride levels in females. Conclusions: Given the prevalence of dyslipidemia seen in this study, we suggest that fasting lipid measurements should be performed in all Nigerians with high blood pressure. These data suggest the need for health education and lifestyle modifications in hypertensive Nigerians to reduce both types of risk factors.