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Biomedical subjects

A Arije

Publications and source records attributed to A Arije.

At least 19 recordsLinked to original sources
PubMed2006

Hepatitis B virus infection: implications in chronic kidney disease, dialysis and transplantation.

Hepatitis B virus (HBV) infection occurs worldwide but is most prevalent in Southeast Asia and sub-Saharan Africa with reported prevalence rates varying from 3 - 26 %. The higher prevalence of infection has been reported in patients with HBV and human immunodeficiency virus (HIV) co-infection. Hepatitis B virus not only affects the liver but has also been implicated in the pathogenesis of membranous, membranoproliferative and mesangial proliferative glomerulonephritides. Though controlling the spread of HBV infection in renal dialysis units has been one of the major triumphs in the management of end-stage renal disease, transmission of HBV can still occur through contamination of equipments and environmental surfaces and the use of multiple dose vials of drugs. Some reports have indicated that prior HBV infections have negative impact on graft and host survival following transplantation. Interferon can be used in the treatment of HBV-associated glomerulonephritides (HBV- GN) but is contraindicated in transplantation because of its immuno-modulatory effects. Despite the fact that patients with chronic kidney disease (CKD) have suboptimal response to HBV immunization, immunization is still beneficial to these patients. However, reports indicate that most patients with CKD were either not immunized or were given suboptimal doses. Control of HBV in the population by immunization can lead to a reduction in the prevalence of HBV- GN. In addition, immunization of patients with CKD will help in controlling HBV infection in dialysis settings and can lead to improved graft and host survival following transplantation.

Africa South of the Sahara↗
PubMed2002

Comparative effect of lisinopril and lacidipine on urinary albumin excretion in patients with type 11 diabetic nephropathy.

This study was carried out to assess whether with a similar degree of blood pressure reduction, Lisinopril compares favorably or otherwise with lacidipine in respect of effects on urinary albumin excretion and renal function as assessed by creatinine clearance, plasma creatinine, urea and electrolytes. Thirty hypertensive diabetic nephropathy patients with moderate hypertension were studied. After a 2-week washout period, they were allocated into two groups matched at baseline for age, sex, weight, blood pressure, and urinary albumin excretion rate as well as creatinine clearance. There were 8 males and 7 females in each group. One group received lisinopril (with furosemide if needed to control BP) and the other group received lacidipine. Staged increases in doses of antihypertensives were used until BP was controlled or maximum dose of 40 mg/day lisinopril or 8 mg/day lacidipine was reached. Furosemide was added to lisinopril if BP was not controlled at 40 mg/day. These medications were given for 12 weeks at the end of which measurements done at baseline were repeated. Comparison of baseline and end of study values of these parameters within the groups and between the two groups were made. Lisinopril group and lacidipine group achieved similar and highly significant reduction in blood pressure levels P < 0.001. There was reduction in urinary albumin excretion rate in both groups but this only reached statistical significance in the lisinopril group [480] [269] mg/day vs. 315 [202] mg/day P < 0.05] while for the lacidipine group it was not significant [491] [257] mg/day vs. 335 [182] mg/day P > 0.05]. However, comparison of albumin excretion rate between both groups at baseline and at end of the study did not show any significant difference, P > 0.1. With both drugs there is a tendency for creatinine clearance to increase and plasma creatinine to drop while plasma potassium tended to rise more with lisinopril than lacidipine but differences within and between both groups, did not reach statistical significance P > 0.05. In conclusion, blood pressure reduction was comparable in both drugs; both drugs reduced albuminuria but lisinopril appeared superior. Treatment with both drugs tended to increase creatinine clearance but both had no significant effects on blood sugar.

Albuminuria↗
PubMed2002

Rapidly progressive glomerulonephritis in adult Nigerians: a report of 4 cases.

The clinicopathological features of rapidly progressive glomerulonephritis (RPGN) were studied in 4 young adult Nigerians who presented with acute GN. There was a predilection for males with a male to female ratio of 3:1. Hypertension. nephrotic-range albuminuria, haematuria granular and cellular urinary casts, and a rapid progression to severe renal failure or death were the findings in all four patients. Renal biopsy revealed histological features compatible with findings in RPGN in all the patients, including the presence of crescents and epithelial cellular proliferation. The study shows that the early development of hypertension and deterioration of renal function in patients with features of acute glomerulonephritis should arouse suspicion of a rapidly progressive GN whose course could be altered by appropriate therapeutic measures, some of which are highlighted.

Acute Disease↗
PubMed2002

Short-term haemodialysis in pregnant patients with acute renal failure: a report of two cases.

Haemodialysis in pregnancy is not common although, successful dialysis in pregnancy have been reported. It has also been found to improve survival of both mother and child especially, in patients with chronic renal failure, with pre-term labor being a common occurrence. Out of the 2,995 patients that were dialyzed at the University College Hospital, Ibadan in the last 10 years, only 2 of the patients were pregnant and both of them had acute renal failure. We present here the two cases, which represents our experience at the University College Hospital, Ibadan, Nigeria.

Acute Kidney Injury↗
PubMed2002

Prevalence of hepatitis B and C viruses in pre-dialysis patients with chronic renal failure.

CRF affects people in their prime of life; they are often the Nation's workforces thereby leading to severe economic and social problems. Many patients with CRF who need dialysis, present for the first time in end stage renal failure. The commonest causes of CRF in Nigeria and other tropical countries have been reported to be hypertensive nephrosclerosis and chronic glomerulonephritis. Various studies in and outside Nigeria have documented an increased seroprevalence of anti-HCV and HBsAg in chronic renal failure patients on maintenance haemodialysis. Any association established between these viruses and CRF would suggest that the prevention and/or treatment of these viruses may likely lead to a reduction in the prevalence of CRF. Thus, forty-five (45) consecutive subjects with CRF and (45) age- and sex-matched control subjects who satisfied the eligibility criteria for the study were enrolled. Marker of HBV (HBsAg) was assayed using HUMAN Enzyme linked Immunosorbent Assay (ELISA) Test. Marker of HCV (anti-HCV) was determined using the HUMAN ELISA Test. The mean age of the subjects was 37 +/- 14 years (range 17 to 62 years) while the mean age of the control subjects was 38 +/- 14 years (range of 18 to 66 years). There were no statistically significant differences in the prevalence of HBsAg and anti-HCV in the CRF patients and controls P=0.74 and P=1.0 respectively. Although, the sample was small anti-HCV seropositive CRF patients were significantly younger than anti-HCV seropositive controls P<0.027. In conclusion, this study has shown that there were no significant differences in the prevalences of HBsAg and anti-HCV in the CRF patients and controls. A larger scale study may be more desirable in defining the role of these viruses in patients with chronic renal failure.

Adolescent↗
PubMed2001

Effects of supplemental methionine and lysine on the nutritional value of housefly larvae meal (Musca domestica) fed to rats.

The performance and blood composition of rats fed housefly larvae meal supplemented with, or without, methionine and lysine, or fed at high concentration were investigated. Rats fed supplemental methionine alone achieved highest body weight gain (P < 0.05). Dietary supplementation of both methionine and lysine or high dietary concentration of larvae meal depressed (P < 0.05) rat feed intake. The blood composition of rats was superior (P < 0.05) on methionine-supplemented larvae meal. Additional amino acids from larvae elicited higher (P < 0.05) serum proteins, cholesterol and triglyceride; however, other blood biochemical profiles were lower (P < 0.05) than in the unsupplemented group. In conclusion, housefly larvae meal seemed deficient in methionine and it benefited the rat tremendously to supplement with this amino acid: however, additional lysine and high dietary inclusion of larvae meal as sole protein source appeared nutritionally inconsequential.

Animal Feed↗
PubMed2001

The influence of cuprophan and polysulfone membranes on dialyzer reusability and intradialytic complications.

The influence of cuprophan and polysulfone membranes on dialyzer reuse and intradialytic complications was examined in patients receiving chronic haemodialysis. Mean uses were 2.7 +/- 1.3 S.D. and 2.2 +/- 1.0 S.D. for cuprophan and polysulfone respectively (P < 0.001). 20.8% and 35.5% of cuprophan and polysulfone dialyzers respectively did not survive first use (X(2) = 17.4, P < 0.001), being unsuitable for further use. The most common number of uses obtainable was 3 for each type. 2.6% of cuprophan but none of the polysulfone dialyzers were usable over 5 times. Hypotension occurred in 12% and 29% of dialyses with cuprophan and polysulfone dialyzers (P < 0.001), and the difference persisted, but the frequency in each membrane group decreased, with reuse (P < 0.001). First use reactions occurred in 9.5% and 3.9% of dialyses with cuprophan and polysulfone respectively (P < 0.001), and the difference was not affected by reuse (P > 0.1), but the frequency decreased in each group (P < 0.001). Clotting of the dialyzer occurred in 2.2% and 1.9% of cases respectively (P > 0.5), diminished with reuse of cuprophan (P < 0.001), but not with polysulfone (P > 0.5). Cuprophan membrane was more reuseable and was associated with fewer episodes of hypotension, while polysulfone was associated with fewer episodes of first use reactions. Rational choice of membranes can be made during haemodialysis.

Biocompatible Materials↗
PubMed1995

The problems of peritoneal dialysis in the management of chronic uraemia in Nigeria.

The problems encountered in the use of peritoneal dialysis (PD) in the initial management of patients with chronic renal failure in Nigeria were highlighted, studying 23 patients (13 males and 10 females) aged between 15 and 68 years (mean age 36.4 years). Peritonitis was the most common complication, occurring in 16 (70%) of patients; effluent drainage obstruction in 11 patients (48%); haemorrhagic effluent in 10 patients (44%); fluid leak from catheter site infection in 7 patients (30%); accidental disconnection of line/catheter joint in 5 patients (22%); and catheter site infection in 2 patients (9%). A positive effluent culture was found in only 4 out of 18 cultured samples, with Klebsiella and Staphylococcus aureus being the organisms isolated. Dialysis was terminated in patients for the following reasons: financial constraints (8 patients), unresolving peritonitis (7 patients), drainage problems (3 patients), and clinical improvement (5 patients). The study concludes that PD in the management of chronic uraemia in developing countries, while producing clinical benefits in the majority of patients, is still not generally acceptable as a long-term treatment modality in view of the number of problems.

Adolescent↗
PubMed1995

Hemodialysis in Ibadan: a preliminary report on the first 100 dialysis.

The experience with the first 100 hemodialysis sessions at the Owena Dialysis Centre of the University College Hospital, Ibadan (UCH) is hereby presented. A total of 9 patients were dialysed during a 7-month period. The femoral vein was the most often utilised vascular access route (53 episodes in 5 patients) while a forearm fistula was functional in only one patient. The dialyzer and blood lines were reused for each patient for a maximum of 5 times. Technical problems encountered were: power failure (12 episodes), ruptured dialyzer (3), water-pipe leakage (4) machine breakdown (2) and heparin pump failure (2). Clinical problems were: failure of fistula access (2), thrombosed femoral veins (2), clotted cannula (3), low arterial pressure (20); nausea and vomiting (2), pruritus (46), muscle cramps (5), Sepsis (8) and hypotension (2). Six patients discontinued treatment after less than 10 dialyses due to financial constraints. The high cost of hemodialysis remains the major setback to its use in the treatment of end-stage renal disease in developing countries; there is the need for acceptable improvisation to reduce the overhead cost so as to make it available to most patients requiring dialysis.

Adolescent↗
PubMed1994

Glomerular function in sickle cell disease patients during crisis.

An 8 month prospective study was carried out in 20 adult sickle cell disease (SCD) patients 16 sickle cell anaemia (Hbss) and 4 sickle cell Hbc disease (Hbsc); who had vaso-occlusive crises within the study period to determine the extent of the effect of sickle cell crisis on glomerular function in SCD patients during crisis. The male: female ratio was 1:57 and their mean age was 21.1 +/- 7.9 years. Creatinine clearance (CCr), as an index of glomerular function, was determined at the pre-crisis, crisis, 2 and 4 weeks post-crisis and at the end of the study period. The mean values of their CCr dropped from 113.37 +/- 33.80mls/min at pre-crisis stage to 96.39 +/- 30.13mls/min during crisis (p < 0.001) indicating glomerular dysfunction. It improved significantly to 107.75 +/- 30.20mls/min at 4 weeks post-crisis (p < 0.001). There was no significant differences in the mean values of CCr at the end of the study (116.20 +/- 31.43mls/min) compared to the pre-crisis stage (p > 0.05). It is concluded that glomerular dysfunction in SCD patients during crisis is potentially reversible.

Acute Disease↗
PubMed1993

Plasma lipids and lipoprotein-cholesterol distribution in nephrotic syndrome patients during short term high dose steroid treatment.

Plasma lipids and lipoprotein-cholesterol profiles were studies in 11 consecutive patients (eight females and three males) with the nephrotic syndrome (NS) during a short term treatment with high dose prednisolone. A significant fall from the high mean pre-treatment levels of total cholesterol and LDL-cholesterol was demonstrated at four, eight and 12 weeks of treatment (p < 0.005) while the fall in the mean triglyceride level only became significant at eight weeks (p < 0.01). The mean HDL-cholesterol level did not change significantly throughout, although there was a significant rise in the mean HDL-cholesterol total cholesterol ratio at four weeks (p = 0.01) and at both eight and 12 weeks (p < 0.005). The study has demonstrated a significant improvement in the lipids and lipoprotein-cholesterol profile of patients with the nephrotic syndrome during a shortterm high dose steroid treatment.

Adolescent↗
PubMed1992

Microalbuminuria in non-insulin-dependent (type 2) Nigerian diabetics: relation to glycaemic control, blood pressure and retinopathy.

Twenty-four hour urinary albumin concentrations were measured in 113 (mean age 51.1 years) non-insulin-dependent (NIDDM) Nigerian diabetics (50 males, 63 females). A high prevalence of microalbuminuria (> or = 30 mg/24 hour) was observed in male (54%) as well as female diabetics (59%). Microalbuminuria was also observed in a high proportion of diabetics (52%) with a short duration (< 5 years) of disease. Elevated blood pressure and retinopathy were present in 41% and 16% of patients respectively. Among the 49 patients with normoalbuminuria (< 30 mg/24 hour), six (12%) had retinopathy compared with 12 (18%) in the microalbuminuria group. Diastolic blood pressure levels were significantly higher (P < 0.01) in male diabetics with retinopathy but this was not associated with higher albuminuria. Urinary albumin concentrations were not influenced by elevated blood pressure. There were no significant differences in age, duration of diabetes, blood pressure or serum creatinine between diabetics with and without microalbuminuria. These results suggest that though there is a high prevalence of microalbuminuria amongst NIDDM Nigerian diabetics it may not predict retinopathy and occurs independently of either glycaemic control or elevated blood pressure levels.

Adult↗
PubMed1990

Dyslipoproteinaemia in Nigerians with the nephrotic syndrome (an increased risk for ischaemic heart disease?).

Plasma lipids and lipoproteins were measured in 24 Nigerians with the nephrotic syndrome and 29 healthy subjects. None of the patients had been commenced on treatment. Plasma total cholesterol, low density lipoprotein (LDL) cholesterol group (P less than 0.005). By contrast, the HDL-cholesterol to total cholesterol ratio as well as the HDL-cholesterol concentrations were found to be significantly lowered in the nephrotics than the controls (P less than 0.005). A strong correlation was observed between plasma total cholesterol and LDL cholesterol values but not between the other biochemical parameters (r = 0.98.P less than 0.01). These results, though not definitive, suggest that Nigerians with the nephrotic syndrome may represent a risk group for the development of ischaemic heart disease. Long term prospective studies in such patients are desirable to define the effect of these lipid and lipoprotein abnormalities.

Adolescent↗
PubMed1989

Diabetic retinopathy in Nigerians: relation to duration of diabetes, type of treatment and degree of control.

The results of a prospective study of the prevalence of diabetic retinopathy among Nigerian diabetics attending a Nigerian Teaching Hospital over a one and a half-year period are presented. Diabetics with mature cataracts whose fundi could not be visualised were excluded from the study. 15.1% of the 377 diabetic patients included in the study group had changes consistent with diabetic retinopathy. The prevalence was found to increase with increasing duration of disease, being 12.7%, 16.8% and 20.0% in patients with duration less than 5 years, between 5 and 10 years and greater than 10 years respectively. A considerably higher prevalence was also found in the insulin treated diabetics compared to the non insulin treated group (P less than 0.05). The degree of glycaemic control appeared to be poorer in the diabetics with retinopathy compared to those without, even though the differences between the mean fasting plasma glucose concentrations between the two groups did not reach statistical significance. Proteinuria was found to be significantly commoner in diabetics with retinopathy (P less than 0.025). It was concluded that diabetic retinopathy is on the increase among Nigerians and that efforts should be directed at evolving preventive measures and early identification of high risk patients.

Adolescent↗
PubMed1988

Renal function in adult Nigerian diabetics.

Renal function was studied in 31 stable adult diabetic patients and 17 healthy non-diabetic adults of similar age groups and sex distribution. 14 patients (45%) were insulin dependent and 9 (27%) were hypertensive. Glomerular function was studied by creatinine clearance and 24 hour urinary protein excretion, tubular function early morning urine concentration, urine pH and urinary excretion of sodium, potassium and uric acid. 24 hour urine protein excretion was significantly higher (p less than 0.05) in the diabetics than the controls, mean values 345 +/- 94.5 mg and 109 +/- 10 mg, respectively. 42% of the patients had values well above 200 mg per day in contrast to 16% with clinical proteinuria by albustix testing. 24 hour protein excretion was higher in insulin dependent diabetic than in non-insulin diabetic patients. Mean values of creatinine clearance were similar in diabetics and controls. Increased uric acid excretion was observed in the diabetic patients. This study emphasizes the superiority of 24 hours urinary protein estimation in the detection of early nephropathy in diabetic patients. Further studies to elucidate the mechanisms and implication of the hyperuricosuria need to be carried out.

Adult↗