Okafor Umezurike Hughes
Renal unit, Department of Medicine, ESUT Teaching Hospital Parklane, Enugu, Nigeria.
Pan Afr Med J. 2016 Oct 25;25:112. doi: 10.11604/pamj.2016.25.112.7930. eCollection 2016.
Kidney 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.
This was a non-randomized prospective study. The study population were post-transplant patients presenting between 1 August 2010 and 31 December 2014.The biodata, pre and post-transplant details of these patients were documented. The data was analysed using SPSS Vs 17.
A 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.
Management of patients with kidney transplant has good prospect despite the challenges.
肾移植是终末期肾病患者首选的肾脏替代治疗方法。然而，资源匮乏国家肾移植患者的管理正在不断发展，并且在精神、经济和基础设施等多方面挑战下举步维艰。本研究的目的是评估尼日利亚一家肾脏护理中心肾移植患者的管理情况。
这是一项非随机前瞻性研究。研究对象为2010年8月1日至2014年12月31日期间的肾移植术后患者。记录了这些患者的生物数据、移植前后的详细情况。使用SPSS 17版对数据进行分析。
共研究了47例患者，男女比例为4:1，平均年龄为45.4±13.6岁。慢性肾小球肾炎、高血压、糖尿病和HIV相关肾病是慢性肾脏病最常见的病因。经济限制使66%的患者移植延迟，17.2%的患者供体不可用。约90%的移植在印度进行，81%的患者直接或通过亲属资助移植。没有尸体肾移植，约70%的供体与患者无血缘关系。他克莫司、霉酚酸酯和泼尼松龙是最常用的免疫抑制组合。1年和3年的移植物存活率分别为95.3%和67.6%，相应的患者存活率分别为97.7%和82.4%。败血症、急性排斥反应和尿路感染是最常见的并发症。
尽管存在挑战，但肾移植患者的管理前景良好。
