Ibrahim Usman Muhammad, Jibo Abubakar Mohammed, Garba Rayyan Muhammad, Jalo Rabiu Ibrahim, Tsiga-Ahmed Fatimah Ismail, Musa Abubakar, Muazu Salisu, Lisanework Serawit, Buba Luka Fitto, Sidi Kamalu Shehu, Babatunde Ademola Lawrence, Abdulsalam Kabiru, Karkarna Mustapha Zakariyya
Department of Environmental Management, Bayero University Kano, Kano, Nigeria.
Department of Community Medicine, Aminu Kano Teaching Hospital; Department of Community Medicine, Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria.
Niger Postgrad Med J. 2023 Jul-Sep;30(3):200-209. doi: 10.4103/npmj.npmj_80_23.
Kidney diseases requiring haemodialysis are becoming an emerging public health problem. This study aimed to determine the burden, socio-demographic and other risk factors associated with haemodialysis in Northwest Nigeria.
The study was a retrospective multicentre review of secondary data from the dialysis centres of public hospitals in northwestern Nigeria. Risk factors for renal failure were examined in 1329 patients who were enrolled for haemodialysis between 2019 and 2022 in the four public dialysis centres in Kano and Jigawa state. Data were analysed using IBM SPSS Statistics for Windows, version 22.0, with statistical significance set at P ≤ 0.05.
The minimum age of the patients was 2 years and the maximum was 100 years with a median of 48 (interquartile range = 31, 60) years. Chronic kidney disease (CKD) was found amongst more than two-thirds 998 (75.1%) of the patients. Up to 51 (3.8%), 62 (4.7%) and 10 (0.8%) were seropositive for HIV, hepatitis B and hepatitis C, respectively. Acute kidney injury (AKI) was significantly higher (67.9%, P < 0.001) amongst patients with post-partum haemorrhage (PPH), and were 24 times more likely to develop AKI when compared with those with no PPH (adjusted odds ratio [aOR] =24, 95% confidence interval [CI] = [13.5-44.5]). CKD was significantly higher amongst patients with hypertension (HTN) (84.9%, P < 0.001), and were 3.2 times more likely to develop CKD compared with non-hypertensives (aOR = 3.2, 95% CI = [2.4-4.1]). Acute on CKD (AOCCKD) was significantly higher amongst patients with chronic glomerulonephritis (CGN) (28.1%, P < 0.001), and were three times more likely to develop AOCCKD than those without CGN (aOR = 3, 95% CI = [2.1-4.2]).
PPH was the major reason for AKI related haemodialysis while diabetes and HTN were the major causes of CKD-requiring haemodialysis. CGN was more amongst patients who had dialysis due to acute exacerbation of CKD. The government and relevant stakeholders should ensure a favourable policy for the screening and management of patients.
需要血液透析的肾脏疾病正成为一个新出现的公共卫生问题。本研究旨在确定尼日利亚西北部与血液透析相关的负担、社会人口统计学及其他风险因素。
本研究是对尼日利亚西北部公立医院透析中心的二手数据进行的回顾性多中心分析。对2019年至2022年期间在卡诺州和吉加瓦州的四个公共透析中心登记进行血液透析的1329例患者的肾衰竭风险因素进行了检查。使用IBM SPSS Statistics for Windows 22.0版对数据进行分析，设定统计学显著性为P≤0.05。
患者的最小年龄为2岁，最大年龄为100岁，中位数为48岁（四分位间距=31，60岁）。超过三分之二的998例（75.1%）患者患有慢性肾脏病（CKD）。分别有51例（3.8%）、62例（4.7%）和10例（0.8%）的HIV、乙型肝炎和丙型肝炎血清学检测呈阳性。产后出血（PPH）患者中急性肾损伤（AKI）显著更高（67.9%，P<0.001），与无PPH的患者相比，发生AKI的可能性高24倍（调整优势比[aOR]=24，95%置信区间[CI]=[13.5-44.5]）。高血压（HTN）患者中CKD显著更高（84.9%，P<0.001），与非高血压患者相比，发生CKD的可能性高3.2倍（aOR=3.2，95%CI=[2.4-4.1]）。慢性肾小球肾炎（CGN）患者中慢性肾脏病急性加重（AOCCKD）显著更高（28.1%，P<0.001），与无CGN的患者相比，发生AOCCKD的可能性高3倍（aOR=3，95%CI=[2.1-4.2]）。
PPH是与AKI相关血液透析的主要原因，而糖尿病和HTN是需要血液透析的CKD的主要原因。因CKD急性加重而进行透析的患者中CGN更多。政府和相关利益攸关方应确保制定有利于患者筛查和管理的政策。
