Prevalence Of Chronic Renal Failure Research Articles

The Relationship between Attitudes and Family Support and Compliance with Fluid Restrictions in Chronic Kidney Failure Patients on Hemodialysis

Chronic Kidney Failure is a non-communicable disease, where the process of the disease leading to a decline in function takes a long time and cannot return to normal. The prevalence of Chronic Renal Failure in the world and in Indonesia is estimated to increase by 8% every year. One of the most common problems faced by Chronic Kidney Failure patients undergoing hemodialysis is the increase in fluid volume between the two hemodialysis periods. Compliance with fluid restriction is a very important factor, where the factors that influence compliance include attitude and family support. The purpose of this study was to determine the relationship between attitude and family support with adherence to fluid restriction in patients with Chronic Kidney Failure with Hemodialysis at Jakarta Hajj Hospital with a quantitative method where the type of research used was descriptive analysis with a cross sectional design. Data collection was carried out using a questionnaire with chi-square test analysis. The number of samples used was 68 samples with purposive sampling. Statistical test results showed that there was a relationship between attitude and adherence to fluid restrictions (p=0.032) and there was a relationship between family support and adherence to fluid restrictions (p=0.033) in patients with chronic kidney failure in the hemodialysis room at Haji Hospital, Jakarta.

Hyperlipidemia in patients with chronic kidney disease on hemodialysis/conservative management

Background: The prevalence of chronic renal failure has increased, as has the need for renal replacement therapy, as both diabetes and hypertension have become more prevalent. Patients’ mortality rates from cardiac causes have increased despite effective monitoring and care. Dyslipidemia significantly contributes to the risk of arteriosclerotic cardiovascular disease, the main cause of death in people with chronic kidney disease (CKD). Aims and Objectives: The objectives of this study were to measurement of hyperlipidemia in patients with CKD on hemodialysis/conservative management. Materials and Methods: The investigation was conducted on 250 patients with CKD at all stages who were receiving hemodialysis and conservative of both sexes aged 20 years or more and sex-matched healthy control subjects. Lipid profiles of each subject were measured in specimens. Results: In our study, dyslipidemia was identified as having high levels of total cholesterol, triglycerides, and low-density lipoprotein and low levels of high-density lipoprotein. Conclusion: The significance of dyslipidemia as a standalone risk factor for coronary artery disease (CAD) in CKD patients was examined in this study. Hence, based on the evidence presented above, we conclude that close monitoring of the ideal cholesterol levels in CKD patients is necessary to reduce the risk of CAD-related death. In CKD patients, monitoring and treating dyslipidemia can reduce mortality.

Prevalence and determinants of chronic genitourinary conditions among older women in India

Introduction: Women have a higher life expectancy than men. However, this does not guarantees a healthy life as women are often disadvantaged section of society. Additionally, women develop a series of natural physiological changes during midlife accompanied with chronic conditions including genitourinary conditions. We aimed to estimate the prevalence and determine the correlates of chronic renal failure, incontinence and kidney stones among women aged ≥45 years in India. Methods: We employed data from the first wave of Longitudinal Ageing Study in India (LASI) wave-1, 2017-2018. A sample of 32,097 women aged ≥45 years were included. Descriptive statistics were used to report prevalence along with 95% confidence interval as a measure of uncertainty. Separate multivariable regression analysis was conducted to assess the association between various socio-demographic and behavioral correlates with the outcome i.e. chronic renal failure, incontinence and kidney stones. Results: The overall prevalence of chronic renal failure was 0.53% (95% CI: 0.45-0.62), incontinence was 2.9% (95% CI: 2.72-3.09) and 2.28% (95% CI: 2.11-2.45). The multivariable regression analysis showed participants aged ≥75 years had a higher odds [AOR: 1.81 (95% CI: 1.34-2.44)] of having incontinence. Kidney stone were significantly akin [AOR: 1.98 (95% CI: 1.53-2.55)] among participants having obesity.

Study of hematological changes in patients with chronic renal failure undergoing hemodialysis (pre and post)

Background: Chronic renal failure (CRF), a debilitating condition responsible for high morbidity and mortality considered a financial burden to the government and society. Determining the prevalence of CRF in any country is important for planning the care of affected patients. Aim and Objectives: The study aimed at looking for the hematological changes before, and following hemodialysis (HD) in CRF patients. The objectives included comparing complete hemogram, coagulation profile, and blood biochemistry before and after HD; determining hematological complications post-HD; taking precautions to reduce morbidity and mortality from hematological point of view; and assessing changes in hematological profile of CRF patients undergoing HD. Materials and Methods: An institutional cross-sectional study was done on 62 patients of CRF undergoing HD. The hematological and biochemical parameters were studied along with urinary findings. Results: Males were more affected in the study. The hematological parameters which were elevated following dialysis were total leukocyte count, erythrocyte sedimentation rate, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin (MCH), bleeding and clotting time, prothrombin time, activated partial thromboplastin time, but MCH concentration and platelet count showed a fall. Postprandial blood sugar, calcium and erythropoietin showed elevated levels following hemodialysis., while decreased levels were found in fasting blood sugar, sodium, potassium, phosphate, urea, and creatinine. Urinary studies showed a increase in specific gravity and a decrease in 24 h urinary protein. Conclusion: CRF is becoming a dreadful condition in society, with dialysis playing an eminent role in treatment modality. Formulating precautions before and after dialysis based on various hematological and biochemical parameters can help to reduce morbidity and mortality.

Prévalence de la maladie rénale chronique en France, Esteban 2014–2016

BackgroundThe epidemiology of chronic kidney disease remains poorly described in France despite its burden. The objective of our study was to provide an estimate of the prevalence of chronic kidney disease stades 3–5 (without replacement therapy) in France. MethodThe data come from the Esteban study carried out in France between 2014 and 2016 on a representative sample of the French population. This study included 3,021 adults between 18 and 74 years old. Of these, 2422 adults (80.2%) had serum creatinine assay and were included in this analysis. Renal function was estimated by calculating glomerular filtration rate using the Chronic kidney disease epidemiology collaboration (CKD-Epi) and European Kidney function consortium (EKFC) equations. ResultsThe means glomerular filtration rate in our population were respectively 97.5 and 89.0 mL/min/1.73 m2 with the CKD-EPI and EKFC equations. The prevalence of chronic renal failure, defined by a glomerular filtration rate less than 60 mL/min/1.73 m2 was 1.5% with the CKD-EPI formula and 2.1% with the EKFC formula in adults aged 18 to 74 years. The prevalence was higher in women than in men and increased with age, reaching 6.5% and 9.9% in 65–74 years with the CKD-EPI and EKFC equations, respectively. After extrapolation to the French population, the number of adults with chronic kidney disease stades 3–5 without renal replacement therapy was around 1.6 million. ConclusionIn France, the prevalence of chronic kidney disease stades 3–5 without renal replacement therapy was between 1.5 and 2.1% of the adult population aged 18 to 74.

Self-Support Group for Chronic Renal Failure Patients and Caregivers on their Quality of Life: A Study Protocol

Background: Chronic renal failure (CRF) or Chronic kidney disease (CKD) is an irreversible progressive loss of kidney functions in which, kidney fails to sustain the metabolic waste, fluid and electrolyte balance in the body. The prevalence of chronic renal failure is 15% to 17 % in adult population in many developing countries.
 Objective: To find out the effectiveness of Self Support Group (SSG) for Chronic Renal Failure patients (CRF) and caregivers on their quality of life (QOL)
 Methodology: It is a single arm trial, interventional hospital based study. The patients of chronic renal failure of age group 18 to 50 years and caregivers age group above 18 years. Selection of patients and caregivers as per inclusion criteria, detail explanation about nature and purpose of the study, from the subject will be taken before data collection by the investigator after that the formation of groups for chronic renal failure patients and caregivers. Empowerments of the group with knowledge of chronic renal failure and its management, than evaluation quality of life (QOL) for patient and their caregivers with use of QOL scale. The assessments of quality of life for four times, it include day one to three months, six months and nine months respectively. The setting of the study is selected hospitals of Vidarbha Region.
 Expected Results:
 
 Formation of Self Support Group for CRF patients and their caregivers in Hospital Setting
 Improvement in knowledge regarding CRF of patients and their caregivers
 Improvement in QOL for both CRF patients and caregivers
 
 Conclusion: Conclusion will be drawn from the statistical analysis after completion of data collection.

Prevalence, risk factors, and prescribing trends in chronic renal failure in the Indian population

Objective: To estimate the prevalence of Chronic renal failure (CRF) in the Indian subcontinent and to identify risk factors and treatment regimens for CRF. Methods: A prospective observational study was carried out for 7 months. A total of 200 patients with a level of creatinine >1.5 mg/dl were enrolled. CRF prevalence was measured using the hospital's inpatient department registry and medical records. The risk factors and prescribing were evaluated from the patient file report. Results: The prevalence rate of CRF was 13.7%. Male patients (59%) dominate the entire group of patients. Most patients (n = 52) were found between the age group of 71–80 years with a mean age of 62.67 ± 16.33 years. Drugs such as diuretics, and hypoglycemics were indicated to treat comorbidities. The average number of drugs per prescription were 7.43 ± 2.75 with high use of antimicrobial agents (88%). Out of 156 drugs prescribed, 76 were from essential as per essential Drug List 2017. Hypertension (P = 0.0072) and diabetes (P = 0.0084) were major concerns as risk factors followed by the drugs used for dyslipidemia, and recurrent infections. Conclusion: The prevalence rate was found to be 13.7% with significant association with risk factors such as hypertension, diabetes, and nonsteroidal anti-inflammatory drugs, dyslipidemia, chronic infections, smoking, and renal calculus for CRF. The pattern of prescribing was suitable and with few irrationalities.

Real-life data of major and minor bleeding events with direct oral anticoagulants in the one-year follow-up period: The NOAC-TURK study.

This study aimed to evaluate the safety of direct oral anticoagulants (DOACs) in patients with non-valvular atrial fibrillation (NVAF) during daily clinical practice. This was a prospective study conducted between January 01, 2016, and April 01, 2017, in patients aged ≥18 years with a diagnosis of NVAF. We performed the study in 9 clinical centers from different regions of Turkey, and the mean follow-up period was 12+2 months. We investigated major and minor bleeding events of DOAC. A total of 1807 patients with NVAF were enrolled. The mean age of the patients was 73.6±10.2 years, CHA2DS2-VASc score was 3.6±1.4, and HAS-BLED score was 2±1.2. The most frequently prescribed DOAC was dabigatran 110 mg bid in 409 (22.6%) patients. The patients on apixaban 2.5 mg bid were older (p<0.001). Patients on rivaroxaban 15 mg od also had a higher prevalence of chronic renal failure, 46 (16.7%) patients. A total of 205 (11.4%) bleeding events were observed; among these, 34 (1.9%) patients had major bleeding and 171 (9.4%) patients had minor bleeding. The major and minor bleeding events were 2/273 (0.7%) and 30/273 (10.9%) in patients receiving dabigatran 150 mg bid, 13/409 (3%) and 44/409 (10.7%) in patients receiving dabigatran 110 mg bid, 4/385 (1%) and 42/385 (10.9%) in patients receiving rivaroxaban 20 mg od, 8/276 (2.9%) and 27/276 (9.7%) in patients receiving rivaroxaban 15 mg od, 3/308 (0.9%) and 14/308 (4.5%) in patients receiving apixaban 5 mg bid, 4/156 (2.5%) and 14/156 (9%) in patients receiving apixaban 2.5 mg bid, respectively. The total bleeding events were 17 (5.6%) in patients receiving apixaban 5 mg, less than those receiving other DOACs. On multivariate analyses, rivaroxaban 20 mg od (p=0.002), ATRIA and HAS-BLED scores, and peripheral artery disease were independent indicators of bleeding. The most frequent location of major bleeding was the gastrointestinal system (GIS) [17 (0.9%) patients], and the most frequent location of minor bleeding was the gingiva [45 (2.5%) patients]. This study showed that similar results as the previous real-life study; however, we had some different results, such as the GIS tract bleeding was more frequent in patients receiving dabigatran 110 mg bid. The major and intracranial bleeding events were similar for different DOACs; and among DOACs, only rivaroxaban 20 mg od was associated with a high risk of bleeding.

Effects of long non-coding RNA LINC00667 on renal tubular epithelial cell proliferation, apoptosis and renal fibrosis via the miR-19b-3p/LINC00667/CTGF signaling pathway in chronic renal failure

The global prevalence of chronic renal failure (CRF) has significantly elevated with various reports indicating there to be a 10% worldwide rate. The functions of long non-coding RNAs (lncRNAs) and their deeper association with CRF at present remain poorly understood. Hence, the aim of the present study was to investigate the altered expressions of lncRNA LINC00667 in CRF and its associated effects on renal tubular epithelial cell proliferation, apoptosis and renal fibrosis through the microRNA-19b-3p (miR-19b-3p)/LINC00667/connective tissue growth factor (CTGF) signaling pathway. Initially, verification of the targeting relationship between LINC00667, CTGF and miR-19b-3p was performed, after which evidence was obtained indicating that miR-19b-3p could negatively regulate LINC00667 and CTGF. The expressions of CTGF in both the CRF and normal renal tissues were determined by immunohistochemistry means, with LINC00667 and CTGF determined to be highly expressed, while poor expression levels of miR-19b-3p were detected among the CRF tissues. The expressions of LINC00667, miR-19b-3p, fibrosis- and epithelial-mesenchymal transition (EMT)-related genes were also examined. The successfully established CRF rat models were treated with varying mimics, inhibitors, and siRNA. ELISA was applied to determine the renal function-related factors. Besides, the renal cell proliferation, migration and apoptosis were detected. In response to LINC00667 silencing, the renal tubular epithelial cells displayed increased proliferation and migration accompanied by reduced apoptosis based on upregulated miR-19b-3p, along with inhibited renal fibrosis and EMT detected. Taken together, the key findings of our study demonstrated that decreased lncRNA LINC00667 could promote renal tubular epithelial cell proliferation and ameliorate renal fibrosis in CRF via the miR-19b-3p/LINC00667/CTGF signaling pathway.

Small renal cell carcinoma-active surveillance and ablation

The incidence of renal cell carcinoma has been rising for years. At the same time there is an increasing prevalence of chronic renal failure with subsequent higher morbidity and shorter life expectancy in those affected. In the last decades the gold standard has thus shiftedfrom radical to partial nephrectomy or tumor enucleation. Atreatment alternative can be advantageous for selected patients with high morbidity and an increased risk of complications in anesthesia or surgery. Active surveillance represents acontrolled delay in the initiation of treatment with a curative intention. Percutaneous radiofrequency ablation and laparoscopic cryoablation are currently the most commonly used treatment alternatives. Newer ablation procedures, such as high-intensity focused ultrasound, irreversible electroporation, microwave ablation, stereotactic ablative radiotherapy and high-dose brachytherapy have a high potential in some cases but are still considered experimental for the treatment.

Extensively drug-resistant Acinetobacter baumannii bacteraemia in a multidisciplinary intensive care unit during a 6-year period: Risk factors for fulminant sepsis.

This study aimed to determine potential host-, pathogen-, infection- and treatment-related risk factors that might predict a fulminant fatal course of bacteraemia caused by extensively drug-resistant Acinetobacter baumannii (XDR-Aba). Eighty-seven patients with monomicrobial growth of XDR-Aba in blood cultures within a 6-year period (2011-2016) were studied. Patients were divided into three groups according to ICU outcome: Group A (n=40) consisted of patients who survived; Group B (n=10) included patients with fulminant sepsis who died early (≤48h); and Group C (n=37) included patients who died later (>48h) after the onset of bacteraemia. Regarding patient co-morbidities, patients who died from fulminant XDR-Aba bacteraemia had a significantly higher prevalence of chronic renal failure compared with patients who survived (40.0% vs. 7.5%; P=0.029). Patients with fulminant sepsis showed more severe organ dysfunction based on SOFA score compared with survivors (10.83±2.93 vs. 6.65±3.6; P=0.013). The primary to secondary bacteraemia ratio and appropriate treatment were similar among the three outcome groups. Patients with fulminant bacteraemia displayed higher rates of colistin-, tigecycline- and pandrug-resistant strains, although not statistically significant. Patients suffering from a fulminant course of XDR-Aba bacteraemia showed significantly higher rates of chronic renal failure and multiple organ dysfunction. Resistance patterns of XDR-Aba isolates and receipt of appropriate treatment did not affect outcomes. Further studies including larger samples of patients along with investigation of specific virulence determinants of individual Aba strains are needed.

LOW OXYGENATION STATUS INCREASES NAUSEA-VOMITING INCIDENCE IN HEMODIALYSIS PATIENTS

Background and Objective: Data from Indonesia Basic Health Research (2013) states that the chronic renal failure in Indonesia is increasing, especially in Yogyakarta with the prevalence of chronic renal failure of 0,3%. If the patients of chronic renal failure are in End Stage Renal Disease (ESRD), the kidney needs replacement therapy to help its function. This therapy is called Continuous Renal Replacement Therapy (CRRT) or Hemodialysis (HD). Hemodialysis therapy may influence to the imbalance of oxyhemoglobin in the blood. Patients undergoing hemodialysis may experience intradialytic nausea and vomiting. The objective of this study is to identify whether there is a relationship between pre-dialysis oxygenation status through oxygen saturation (SpO2) and respiratory rate (RR) examination and the intradialytic nausea-vomiting occurrence. Method: This research is a comparative research with analytical cross sectional design. This research was conducted in hemodialysis room in Public Hospital of Panembahan Senopati Bantul. The subject of the research was taken using total sampling, by paying attention to research ethics. The total research subjects are 183 respondents. The researchers measured the oxygen saturation and patients’ respiratory rate and examined the intradialytic nausea and vomiting complaints. Result: The analysis result of Fisher’s exact in this research shows p value of 0,000 both in bivariate analysis of oxygen saturation to the nausea and vomiting occurrence and in bivariate analysis of the respiratory rate to the nausea and vomiting occurrence. The multivariate analysis employing regression logistic shows that the OR of oxygen saturation is 73,57, this means that the measurement of the abnormal oxygen saturation has the chance of seventy three times more to the nausea and vomiting occurrence, if compared to the patients with normal oxygen saturation. Conclusion and Suggestion: Intradialytic nausea and vomiting is one of the causes of the imbalance of oxyhemoglobin. The readiness of pre-dialysis oxygenation status needs to be noticed so that the nausea and vomiting complaints can be anticipated earlier.

Diagnostic accuracy of salivary creatinine, urea, and potassium levels to assess dialysis need in renal failure patients.

The prevalence of chronic renal failure is increasing because of increase in chronic debilitating diseases and progressing age of population. These patients experience accumulation of metabolic byproducts and electrolyte imbalance, which has harmful effects on their health. Timely hemodialysis at regular intervals is a life-saving procedure for these patients. Salivary diagnostics is increasingly used as an alternative to the traditional methods. Thus, the aim of the present study was to determine the diagnostic efficacy of saliva in chronic renal failure patients. This case-control study included 82 individuals, of which 41 were chronic renal failure patients and 41 were age- and sex-matched controls. Blood and saliva were collected and centrifuged. Serum and supernatant saliva were used for biochemical analysis. Serum and salivary urea, creatinine, sodium, potassium, calcium, and phosphorus were evaluated and correlated in chronic renal failure patients using unpaired t-test, Pearson's correlation coefficient, diagnostic validity tests, and receiver operative curve. When compared to serum; salivary urea, creatinine, sodium, and potassium showed diagnostic accuracy of 93%, 91%, 73%, and 89%, respectively, based on the findings of study. It can be concluded that salivary investigation is a dependable, noninvasive, noninfectious, simple, and quick method for screening the mineral and metabolite values of high-risk patients and monitoring the renal failure patients.

Prevalence of concealed and overt chronic renal failure in patients with COPD

AimTo assess the prevalence of chronic renal failure (concealed and overt) in patients with COPD. Patients and methodsThis study was conducted on 150 patients who were classified into three groups: Group I: 67 patients with COPD, Group II: 33 COPD patients with co morbidities (diabetes mellitus, hypertension and or ischemic heart disease). Group III: (control group): 50 patients with other diseases such as diabetes mellitus, ischemic heart disease and or hypertension. All patients were subjected to: (1) Full history taking. (2) Complete clinical examination. (3) Anthropometric measurements (weight, height and body mass index). (4) Arterial oxygen saturation. (5) Radiological examination (Plain chest X-ray posterior–anterior view and Pelvi-abdominal ultrasound). (6) ECG and Echocardiography. (7) Spirometry. (8) Laboratory investigations (complete blood picture, erythrocyte sedimentation rate, Liver function tests, serum creatinine, blood urea and uric acid and GFR, total cholesterol, sodium, potassium and chloride concentration). ResultsIn group I, there were 8 patients who had CRF (11.94%), 5 patients had overt CRF (7.46%) and 3 patients had concealed CRF (4.48%). In group II, there were 11 patients with CRF (33.33%), 6 patients had overt CRF (18.18%) and 5 patients had concealed CRF (15.15%). In group III, there were 9 patients having CRF (18%), 6 patients had overt CRF (12%) and 3patients had concealed CRF (6%). In COPD (group I and II) the overall prevalence of CRF was 19%. ConclusionCRF either concealed or overt may be associated with COPD patients and should be screened, not only by serum creatinine level but also by the estimated GFR to recognize the cases of concealed CRF who have low GFR despite normal serum creatinine level.

Is Renal Impairment an Anticipated COPD Comorbidity?

Many studies have investigated COPD-linked comorbidities and their influence on associated outcomes, but the extent to which COPD is related to chronic renal failure is undetermined. The objective of this work was to assess the prevalence of chronic renal failure (overt or concealed) in a cohort with COPD compared with that of a control group, and to investigate the relationships of the clinical and functional data with the subjects' renal conditions. The study was performed with 136 subjects with COPD and 104 control subjects. The subjects with COPD were divided into 2 groups according to a combined assessment. The COPD and control groups were compared in terms of clinical factors, renal function, estimated glomerular filtration rate, and spirometry data. The prevalence of the renal status types was examined in all groups, and the correlations of serum creatinine and estimated glomerular filtration rate with all of the clinical and spirometry data were examined. There were significant differences between both COPD groups and the controls regarding estimated glomerular filtration rate. Significantly worse renal function was observed in the COPD group, which also exhibited a greater percentage of subjects with concealed chronic renal failure. Additionally, there were significant differences in renal status among the 3 groups; the percentage of subjects with concealed chronic renal failure was significantly greater in group 2 than in both group 1 and the control group. Additionally, the percentages of subjects with concealed chronic renal failure were greater than those with overt chronic renal failure in the 3 groups. There were significant correlations of serum creatinine with COPD assessment test, exacerbations and hospitalizations, percent-of-predicted FVC, percent-of-predicted FEV1/FVC, percent-of-predicted maximum mid-expiratory flow, and percent-of-predicted peak expiratory flow. Moreover, there were significant correlations between estimated glomerular filtration rate and all of the clinical and spirometry data. Chronic renal failure should not be ignored or underestimated in patients with COPD because it frequently cannot be recognized based on serum creatinine because decreases in estimated glomerular filtration rate are more prevalent.

Chronic Kidney Disease in Children and Adolescents in Salvadoran Farming Communities: NefroSalva Pediatric Study (2009-2011)

ABSTRACT INTRODUCTION For two decades, various countries have experienced an epidemic of chronic kidney disease unexplainable by traditional causes. Typically a chronic tubulointerstitial nephritis, it predominantly affects young male agricultural workers and has been reported in several countries in Central America, as well as in Sri Lanka, India and Egypt. Recent studies in El Salvador have also reported the disease in male nonagricultural workers and in women, both those working in agriculture and not. Epidemiological information on whether this condition affects pediatric populations is virtually nonexistent. Globally, estimates of chronic kidney disease prevalence in pediatric populations range from 21 to 108 per million population. OBJECTIVE Determine the prevalence of urinary markers of renal damage and of chronic kidney disease in persons aged 300 mg/g) was detected only in girls in Las Brisas, 2.3%. Glomerular hyperfiltration (compared to international norms) was found in all age-sex groups in all three regions. Prevalence of chronic kidney disease was 3.9%—4.1% in girls and 3.6% in boys. The prevalence of chronic renal failure was 0.1%. CONCLUSIONS High prevalence of chronic kidney disease in children and adolescents calls attention to the need for primary prevention from very early ages. This finding in children in areas where chronic kidney disease of uncertain etiology is common in adults is consistent with a contribution of environmental toxins to the epidemic observed in these areas.

Epidemiological Profile of Chronic Kidney Disease at the General Hospital of National Reference of N’Djamena (Chad)

Introduction: Chronic renal failure is a disease that affects many patients worldwide and increasingly in Africa. At the end of 2003, about 1.1 million people were suffering from End-Stage Renal Disease (ESRD) and were treated with periodic dialysis [12]. In Africa, CKF represents 2% to 10% of hospital admissions and is responsible for 4% to 22% of deaths [14]. So, this study is conducted for the first time in Chad, with the aims to determine the prevalence of CKD. Methods: This was a retrospective, descriptive and analytical study over a period of 12 months from April 29, 2011 to April 28, 2012. All patients with chronic renal failure regardless of etiology and stage of chronic kidney disease were included in the study. Chronic renal failure was defined as a glomerular filtration rate below 60 ml/min/1.73m (MDRD) for more than 3 months. This study was conducted in several departments of the National General Reference Hospital (NGRH) of N’Djamena. Result: Among 2039 inpatients, 195 patients had chronic renal failure, as a frequency of 9.6%. The average age of our patients was 51 ± 16.8 years, ranging from 11 to 85 years. Male predominance was noted to be 59% of men against 41% of women. We noted that high blood pressure accounted for 66.2% (N = 129) of cases, diabetes in 48.2% (N = 94), alcoholism in 28.7% (N = 56), smoking in 14.9% (N = 29) and the association alcoholism-smoking in 19.5% (N = 38). Hypertension was the leading cause of chronic renal failure (66.2%). All patients had a serum creatinine and creatinine clearance was assessed. Among them, we noted 57 patients (29%) with end-stage renal failure. The average calcium and phosphate serum were 1.8 mmol/l and 1.6 mmol/l, respectively. We noted that 120 patients as 61.5%, currently took herbal medicine. 48 out of 57 of our patients with ESRD as 24.6% of patients in the study had received replacement therapy (hemodialysis) with 12.5% of deaths. Conclusion: Chad, who compiled the first study with 195 patients at the General Hospital of N’Djamena National Reference over a period of one year has objectified a prevalence of chronic renal failure of 9.6%.

Chronic Kidney Disease in Children and Adolescents in Salvadoran Farming Communities: NefroSalva Pediatric Study (2009-2011).

ABSTRACT INTRODUCTION For two decades, various countries have experienced an epidemic of chronic kidney disease unexplainable by traditional causes. Typically a chronic tubulointerstitial nephritis, it predominantly affects young male agricultural workers and has been reported in several countries in Central America, as well as in Sri Lanka, India and Egypt. Recent studies in El Salvador have also reported the disease in male nonagricultural workers and in women, both those working in agriculture and not. Epidemiological information on whether this condition affects pediatric populations is virtually nonexistent. Globally, estimates of chronic kidney disease prevalence in pediatric populations range from 21 to 108 per million population. OBJECTIVE Determine the prevalence of urinary markers of renal damage and of chronic kidney disease in persons aged 300 mg/g) was detected only in girls in Las Brisas, 2.3%. Glomerular hyperfiltration (compared to international norms) was found in all age-sex groups in all three regions. Prevalence of chronic kidney disease was 3.9%—4.1% in girls and 3.6% in boys. The prevalence of chronic renal failure was 0.1%. CONCLUSIONS High prevalence of chronic kidney disease in children and adolescents calls attention to the need for primary prevention from very early ages. This finding in children in areas where chronic kidney disease of uncertain etiology is common in adults is consistent with a contribution of environmental toxins to the epidemic observed in these areas.

Insuffisance rénale chronique au cours de la drépanocytose : une analyse rétrospective de 100 patients adultes drépanocytaires majeurs d’Afrique noire

The prevalence of chronic renal failure (CRF) in sickle cell disease (SCD) patients could vary from one country to another depending on the modalities of management. The aim of the present study was to appreciate the epidemiology of CRF in SCD patients from black Africa in order to search for promoting factors. One hundred SCD adult patients have been considered for the study. The glomerular filtration rate (GFR) has been estimated according to the CKD-EPI formula. Three groups of patients have been identified according to the value of their GFR. The mean age of the patients was 30.84±8.26 years. Male gender has represented 51% of the study population. The mean GFR value was 175.4±86.2 mL/min/1.73 m2. The prevalence of CRF was 11%. About 3% of them had severe CRF. Subjects with normal GFR were 20%. Subjects with glomerular hyperfiltration (HF) were 69%. By univariate analysis, when subjects with HF were compared with those presenting normal GFR, the following factors have appeared to be significantly associated: female gender (female 60.9% versus male 39.1%; P<0.01), weight <60 kg (weight <60 kg; 53.67±9.45 kg versus weight >60 kg; 59.9±9.41 kg; P<0.008), age <30 years (younger age 29.36±7.9 years versus older age 35.14±8.02 years; P<0.001), lower hemoglobin value (9.38±2,3 g/dL versus 10.33±2.61 g/dL; P<0.04). By logistic regression analysis, age <30 years (age >30 years; OR=0.12 [CI95% 0.03–04]; P<0.001), female gender (male gender; OR=0.17 [0.04–0.64]; P<0.01), weight <60 kg (weight >60 kg; OR=0.19 [CI95% 0.05–0.72]; P<0.01) were associated with HF. By univariate analysis, when subjects with CRF were compared with those presenting normal GFR, a lower hemoglobin value was significantly associated with CRF (7.92±2.7 g/dL versus 10.43±2.5 g/dL; P<0.009). There was a trend for subjects not being under maintenance therapy to more experience CRF (36.4% versus 70%; P<0.07). By logistic regression analysis, only a low hemoglobin value was associated to CRF (higher hemoglobin level; OR=0.55 [0.20–6.3]; P<0.01). In total, CRF and HF are frequent complications in SCD adult patients from black Africa.

Epidemiological characteristics of chronic kidney disease of non-traditional causes in women of agricultural communities of El Salvador.

In El Salvador end-stage renal disease (ESRD) was the first cause of hospital mortality overall, the first cause of hospital deaths in men, and the fifth cause of hospital mortality in women in 2013. In agricultural communities, chronic kidney disease (CKD) occurs predominantly in male agricultural workers, but it also affects women to a lesser degree, even those who are not involved in agricultural work. Internationally, most epidemiological CKD studies emphasize men and no epidemiological studies focused exclusively on women. To describe the epidemiological characteristics of CKD in females in agricultural communities of El Salvador. A cross-sectional epidemiological study was carried out in 2009 - 2011 based on active screening for CKD and risk factors in women aged ≥ 18 years in 3 disadvantaged populations of El Salvador: Bajo Lempa (Usulután Department), Guayapa Abajo (Ahuachapán Department), and Las Brisas (San Miguel Department). Epidemiological and clinical data were gathered through personal history, as well as urinalysis for renal damage markers, determinations of serum creatinine and glucose, and estimation of glomerular filtration rates. CKD cases were confirmed at 3 months. Prevalence of CKD was 13.9% in 1,412 women from 1,306 families studied. Chronic kidney disease of nontraditional causes (CKDu), not attributed to diabetes mellitus, hypertension, or proteinuric primary glomerulopathy (proteinuria > 1 g/L) was 6.6%. Prevalence of chronic renal failure was 6.8%. Prevalence of renal damage markers was 9.8% (microalbuminuria (30 - 300 mg/L) 5.7%; macroalbuminuria (> 300 mg/L) 2%; and hematuria, 2.1%. Prevalence of chronic kidney disease risk factors was: diabetes mellitus, 9.3%; hypertension, 23%; family history of CKD, 16%; family history of diabetes mellitus (DM), 18.7%; family history of hypertension (HT), 31.9%; obesity, 21%; central obesity, 30.7%; NSAID use, 84.3%; agricultural occupation, 15.2%; and contact with agrochemicals, 33.1%. CKD in women of Salvadoran agricultural communities is associated with disadvantaged populations, traditional (DM, HT, obesity) and non-traditional causes (environmental and occupational exposure to toxic agents and inadequate working conditions). Our results reinforce the hypotheses emerging from other studies, suggesting a multifactorial etiopathology including environmental and occupational nephrotoxic exposure.