Abstract
IntroductionKidney transplant is the preferred renal replacement therapy for patients with end stage kidney disease. However management of patients with kidney transplant in resource poor countries is evolving and groaning under several mental, financial and infrastructural challenges. The objective of the study is to evaluate the management of patients with kidney transplant in a kidney care Centre in Nigeria.MethodsThis was a non-randomized prospective study. The study population were post-transplant patients presenting between 1st August 2010 and 31st December 2014.The biodata, pre and post-transplant details of these patients were documented. The data was analysed using SPSS Vs 17.ResultsA total of 47 patients were studied with M: F ratio of 4:1, the mean age was 45.4 ± 13.6 years. Chronic glomerulonephritis, hypertension, diabetes mellitus and HIV related kidney disease were the commonest cause of CKD. Financial constraint delayed transplant in 66% and non-availability of donor in 17.2%. About 90% of the transplants were in India and 81% either financed the transplant either directly or through a relation. There was no cadaveric transplant and about 70% of the donors were not related. Tacrolimus, mycophenolate and prednisolone were most frequently used immunosuppressive combination. The one and three years graft survival were 95.3% and 67.6% respectively while corresponding patients survival were 97.7% and 82.4% respectively. Septicaemia, acute rejection and urinary tract infection were most common complications.ConclusionManagement of patients with kidney transplant has good prospect despite the challenges.
Highlights
Kidney transplant is the preferred renal replacement therapy for patients with end stage kidney disease
The objective of this study is to evaluate the management of patients with kidney transplant in Nigeria using a kidney care centre in Nigeria as surrogate
All the patients were in end stage kidney disease (ESRD), all the patients except one were on maintenance haemodialysis before transplant
Summary
Kidney transplant is the preferred renal replacement therapy for patients with end stage kidney disease. Management of patients with kidney transplant in resource poor countries is evolving and groaning under several mental, financial and infrastructural challenges. The objective of the study is to evaluate the management of patients with kidney transplant in a kidney care Centre in Nigeria. Multiple immunologic and non-immunologic factors contribute to social, cultural and economic disparities in transplant outcomes, including biological, immune, genetic, metabolic, and pharmacological factors as well as associated comorbidities, time on dialysis, donor and organ characteristics, patient socio-economic status, medication adherence, access to care, and public health policies [3]. There is a need for a study that will include all the patients who had kidney transplant irrespective of the country of transplant It will highlight the challenges of managing patients with kidney transplant including the limitations that the care givers including nephrologist encounter with these patients. The objective of this study is to evaluate the management of patients with kidney transplant in Nigeria using a kidney care centre in Nigeria as surrogate
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