Amoako Yaw Ampem, Laryea Dennis Odai, Bedu-Addo George, Andoh Henry, Awuku Yaw Asante
Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Public Health Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Pan Afr Med J. 2014 Aug 4;18:274. doi: 10.11604/pamj.2014.18.274.4192. eCollection 2014.
Chronic kidney disease (CKD) has emerged as a public health challenge in countries around the world. The cost of management of CKD is enormous and unaffordable to most patients in the developing world. There is a dearth of data on characteristics of Ghanaian CKD patients at presentation.
This was a prospective cross sectional study of CKD patients during their first visit to the renal clinic of a tertiary hospital adult renal service. Following informed consent, a questionnaire was used to gather demographic, anthropometric and clinical details of patients. Laboratory data of patients were also collected and analysed.
The majority (64.5%) of 203 participants were male. Most were less than 60 years old and about one third were unemployed. Across all age groups stage 5 disease was the commonest presentation; however only 4.3% could afford to initiate haemodialysis. The mean number of dialysis sessions was 12.4 (range 6-18). Chronic glomerulonephritis (33%), hypertension (21.2%) and diabetes mellitus (22.2%) were found to be the leading causes of CKD. Common complications of CKD at presentation included anaemia (86.7%), pulmonary oedema (31%), high blood pressure (55%), and infection.
Early detection of CKD and institution of measures to slow disease progression are to be encouraged. There is the need to make renal replacement therapy increasingly accessible and affordable to patients.
慢性肾脏病(CKD)已成为世界各国面临的一项公共卫生挑战。CKD的管理成本巨大,对于发展中世界的大多数患者来说难以承受。目前缺乏关于加纳CKD患者初诊时特征的数据。
这是一项对三级医院成人肾脏科门诊首次就诊的CKD患者进行的前瞻性横断面研究。在获得知情同意后,使用问卷收集患者的人口统计学、人体测量学和临床详细信息。还收集并分析了患者的实验室数据。
203名参与者中大多数(64.5%)为男性。大多数患者年龄小于60岁,约三分之一失业。在所有年龄组中,5期疾病是最常见的表现;然而,只有4.3%的患者能够负担得起开始血液透析的费用。透析疗程的平均数为12.4(范围6 - 18)。慢性肾小球肾炎(33%)、高血压(21.2%)和糖尿病(22.2%)被发现是CKD的主要病因。CKD初诊时的常见并发症包括贫血(86.7%)、肺水肿(31%)、高血压(55%)和感染。
应鼓励早期发现CKD并采取措施减缓疾病进展。有必要使患者越来越容易获得且负担得起肾脏替代治疗。