Medicine

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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.
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.
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

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