Pediatrics
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Item Cardiovascular risk factor burden and association with CKD in Ghana and Nigeria(Elsevier Inc., 2023)Introduction: Cardiovascular disease is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD); however, the burden of cardiovascular risk factors in patients with CKD in Africa is not well characterized. We determined the prevalence of selected cardiovascular risk factors, and association with CKD in the Human Heredity for Health in Africa Kidney Disease Research Network study. Methods: We recruited patients with and without CKD in Ghana and Nigeria. CKD was defined as estimated glomerular filtration rate of <60 ml/min per 1.73 m2 and/or albuminuria as albumin-to-creatinine ratio <3.0 mg/mmol (<30 mg/g) for $3 months. We assessed self-reported (physician-diagnosis and/or use of medication) hypertension, diabetes, and elevated cholesterol; and self-reported smoking as cardiovascular risk factors. Association between the risk factors and CKD was determined by multivariate logistic regression. Results: We enrolled 8396 participants (cases with CKD, 3956), with 56% females. The mean age (45.5 _ 15.1 years) did not differ between patients and control group. The prevalence of hypertension (59%), diabetes (20%), and elevated cholesterol (9.9%), was higher in CKD patients than in the control participants (P < 0.001). Prevalence of risk factors was higher in Ghana than in Nigeria. Hypertension (adjusted odds ratio [aOR] ¼ 1.69 [1.43–2.01, P < 0.001]), elevated cholesterol (aOR ¼ 2.0 [1.39–2.86, P < 0.001]), age >50 years, and body mass index (BMI) <18.5 kg/m2 were independently associated with CKD. The association of diabetes and smoking with CKD was modified by other risk factors. Conclusion: Cardiovascular risk factors are prevalent in middle-aged adult patients with CKD in Ghana and Nigeria, with higher proportions in Ghana than in Nigeria. Hypertension, elevated cholesterol, and underweight were independently associated with CKD.Item Childhood nephrotic syndrome in Africa: Epidemiology, treatment trends, and outcomes(Elsevier Inc., 2022) Ademola, A. D.; Asinobi, A. O.; Alao, M. A.; Olowu, W. A.Nephrotic syndrome is a common childhood glomerular disease that is associated with massive proteinuria and edema. Children with nephrotic syndrome are at risk of chronic kidney disease, disease-related complications, and treatment-related complications. Patients with frequently relapsing disease or steroid toxicity may require newer immunosuppressive medications. However, access to these medications is limited in many African countries owing to prohibitive cost, the need for frequent therapeutic drug monitoring, and a lack of appropriate facilities. This narrative review examines the epidemiology of childhood nephrotic syndrome in Africa, including trends in treatment and patient outcomes. In most of North Africa, as well as among White and Indian populations in South Africa, the epidemiology and treatment of childhood nephrotic syndrome closely resembles that of European and North American populations. Historically, secondary causes of nephrotic syndrome (eg, quartan malaria nephropathy and hepatitis B−associated nephropathy) were predominant among Blacks in Africa. Over time, the proportion of secondary cases has decreased, along with rates of steroid resistance. However, focal segmental glomerulosclerosis increasingly has been reported among patients with steroid resistance. There is a need for consensus guidelines for the management of childhood nephrotic syndrome in Africa. Furthermore, establishing an African nephrotic syndrome registry could facilitate monitoring of disease and treatment trends, and provide opportunities for advocacy and research to improve patient outcomes.Item Management of idiopathic childhood nephrotic syndrome in sub-Saharan Africa: Ibadan consensus statement(International Society of Nephrology, 2020) Esezobor, C.; Ademola, A. D.; Adetunji, A. E.; Anigilaje, E. A.; Batte, A.; Jiya-Bello, F. N.; Furia, F. F.; Muoneke, U.; McCulloch, M.; Nourse, P.; Obiagwu, P.; Odetunde, O.; Okyere, P.; Solarin, A.; Tannor, E. K.; Noone, D.; Gbadegesin, R.; Parekh, R. S.Item Genomic approaches to the burden of kidney disease in Sub-Saharan Africa: the Human Heredity and Health in Africa (H3Africa) kidney disease research network(International Society of Nephrology., 2016) Osafo, C.; Raji, Y. R.; Olanrewaju, T.; Mamven, M.; Arogundade, F.; Ajayi, S.; Ulasi, I.; Salako, B.; Plange-Rhule, J.; Mengistu, Y.; Mc’Ligeyo, S. O.; Moturi, G.; Winkler, C. A.; Moxey-Mims, M. M.; Rasooly, R. S.; Kimmel, P.; Adu, D.; Ojo, A.; Parekh, R. S.; Ademola, A. D.