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尼日利亚常染色体显性多囊肾病的临床表现及转归

Clinical presentation and outcome of autosomal dominant polycystic kidney disease in Nigeria.

作者信息

Arogundade Fatiu A, Akinbodewa Akinwumi A, Sanusi Abefe A, Okunola Oluyomi, Hassan Muzamil O, Akinsola Adewale

机构信息

Renal Unit, department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria.

Kidney Care Centre, department of Medicine, University of Medical Sciences Teaching Hospital, Ondo city, Nigeria.

出版信息

Afr Health Sci. 2018 Sep;18(3):671-680. doi: 10.4314/ahs.v18i3.25.

Abstract

INTRODUCTION

Autosomal Dominant Polycystic Kidney Disease (ADPKD) is presumably rare in Africa. Knowledge about the disease in Nigeria is limited as demonstrated by scanty articles on the subject.

OBJECTIVES

To determine the pattern of clinical presentation and outcome of ADPKD among ADPKD patients.

METHOD

ADPKD subjects were prospectively studied between January 1996 and December 2010. Their demographics, clinical and investigation parameters were documented. Dependency on dialysis, renal transplant and death were the final outcomes.

RESULTS

Forty one patients (M:F=1.3:1) with mean age of 48.6±4.6 years were studied. ADPKD was diagnosed at 2.73 cases per annum. Family history of ADPKD and hypertension were present in 56.1% and 82.9% respectively. Their mean systolic and diastolic blood pressures were 166.9 ±23.6 and 104 ±21.2 respectively.Nocturia (78.0%) and loin pain (68.3%) were the most common presenting symptoms. Liver cysts (31.7%) and aortic regurgitation (22.0%) were the predominant extra-renal manifestations.Twenty three (56.1%) received haemodialysis; no renal transplantation. Death rate was 51.2%. Presence of uraemia and intra-cerebral aneurysm contributed significantly to mortality.

CONCLUSION

ADPKD may not be so rare in Nigeria. Awareness campaign to change attitude of family members to screening and further studies using newer criteria for diagnosis of ADPKD should be conducted.

摘要

引言

常染色体显性遗传性多囊肾病(ADPKD)在非洲可能较为罕见。关于尼日利亚该疾病的知识有限,相关文章数量稀少即证明了这一点。

目的

确定ADPKD患者的临床表现模式及预后。

方法

对1996年1月至2010年12月期间的ADPKD患者进行前瞻性研究。记录他们的人口统计学、临床和检查参数。最终结局为对透析的依赖、肾移植和死亡情况。

结果

研究了41例患者(男:女 = 1.3:1),平均年龄为48.6±4.6岁。每年诊断出2.73例ADPKD。分别有56.1%和82.9%的患者有ADPKD家族史和高血压家族史。他们的平均收缩压和舒张压分别为166.9±23.6和104±21.2。夜尿(78.0%)和腰痛(68.3%)是最常见的首发症状。肝囊肿(31.7%)和主动脉反流(22.0%)是主要的肾外表现。23例(56.1%)接受了血液透析;无人接受肾移植。死亡率为51.2%。尿毒症和脑内动脉瘤的存在显著增加了死亡率。

结论

ADPKD在尼日利亚可能并非如此罕见。应开展宣传活动以改变家庭成员对筛查的态度,并采用更新的ADPKD诊断标准进行进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/086e/6307032/1090e445e1c2/AFHS1803-0671Fig1.jpg

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