Neglected and Emerging Infections of The Kidney.

Individuals, societies, and the environment are affected by neglected and emerging diseases. These diseases result in a variety of severe outcomes, including permanent disabilities, chronic diseases such as chronic kidney disease, and even mortality. Consequences include high health care expenditures, loss of means of support, social stigma, and social exclusion.

Chronic Kidney Disease Burden in Low-Resource Settings: Regional Perspectives.

The burden of chronic kidney disease (CKD) has increased exponentially worldwide but more so in low- and middle-income countries. Specific risk factors in these regions expose their populations to an increased risk of CKD, such as genetic risk with APOL1 among populations of West African heritage or farmers with CKD of unknown etiology that spans various countries across several continents to immigrant/indigenous populations in both low- and high-income countries. Low- and middle-income economies also have the double burden of communicable and noncommunicable diseases, both contributing to the high prevalence of CKD.

Posttransplant Care of Kidney Transplant Recipients and Their Donors in Nigeria.

Objectives: Kidney transplantation is not readily available in low-resource settings because of poor health structure, dearth of experts, and pervading poverty. Although many centers now offer kidney transplant, patients still travel outside Nigeria for this service for many reasons and many return home without a detailed medical report.

Materials And Methods: Medical records of individuals who underwent kidney transplant in Nigeria and elsewhere and who were presently receiving posttransplant care or had received such care from 2002 to 2018 at 4 Nigerian hospitals were retrospectively reviewed and analyzed.

Prevalence of autonomic dysfunction among pre-dialysis chronic kidney disease patients in a tertiary hospital, South East Nigeria.

Background: Autonomic dysfunction (AD) has been recognized as an important contributor to the poor outcome in chronic kidney disease (CKD) patients. Several studies have reported abnormalities in heart rate variability (HRV) among these patients.

Objectives: To determine the prevalence of Autonomic Dysfunction (AD) in pre-dialysis Chronic Kidney Disease (CKD) patients in a tertiary hospital in South East Nigeria.

Prevalence of CKD-MBD in pre-dialysis patients using biochemical markers in Enugu, South-East Nigeria.

Background: As kidney function declines, there is a progressive deterioration in mineral homeostasis with disruption of normal serum and tissue concentration of phosphorus and calcium, and changes in circulating levels of hormones-parathyroid hormone (PTH), calcitriol (1,25(OH)2 D), and Fibroblast growth factor-23 (FGF-23).

Objective: This study was aimed at determining the prevalence of markers of CKD-MBD in pre-dialysis patients.

Methods: We evaluated consecutively 168 subjects made up of 85 CKD patients and 83 healthy controls, who were attending the renal clinics and medical outpatient of University of Nigeria Teaching Hospital, Enugu.

Maximum accuracy obesity indices for screening metabolic syndrome in Nigeria: A consolidated analysis of four cross-sectional studies.

Background: In sub-Saharan Africa, there is no precise use of metabolic syndrome (MetS) definitions and risk factors screening indices in many clinical and public health services. Methods proposed and used in Western populations are adopted without validation within the local settings. The aim of the study is to assess obesity indices and cut-off values that maximise screening of MetS and risk factors in the Nigerian population.

Heart rate variability on antihypertensive drugs in black patients living in sub-Saharan Africa.

Background: Compared with Caucasians, African Americans have lower heart rate variability (HRV) in the high-frequency domain, but there are no studies in blacks born and living in Africa.

Methods: In the Newer versus Older Antihypertensive agents in African Hypertensive patients trial (NCT01030458), patients (30-69 years) with uncomplicated hypertension (140-179/90-109 mmHg) were randomized to single-pill combinations of bisoprolol/hydrochlorothiazide (R) or amlodipine/valsartan (E). 72 R and 84 E patients underwent 5-min ECG recordings at randomization and 8, 16 and 24 weeks.

High population frequencies of APOL1 risk variants are associated with increased prevalence of non-diabetic chronic kidney disease in the Igbo people from south-eastern Nigeria.

Background: Continental Africa is facing an epidemic of chronic kidney disease (CKD). APOL1 risk variants have been shown to be strongly associated with an increased risk for non-diabetic kidney disease including HIV nephropathy, primary non-monogenic focal and segmental glomerulosclerosis, and hypertension-attributed nephropathy among African ancestry populations in the USA. The world's highest frequencies of APOL1 risk alleles have been reported in West African nations, overlapping regions with a high incidence of CKD and hypertension.

Progress report on the first sub-Saharan Africa trial of newer versus older antihypertensive drugs in native black patients.

Background: The epidemic surge in hypertension in sub-Saharan Africa is not matched by clinical trials of antihypertensive agents in Black patients recruited in this area of the world. We mounted the Newer versus Older Antihypertensive agents in African Hypertensive patients (NOAAH) trial to compare, in native African patients, a single-pill combination of newer drugs, not involving a diuretic, with a combination of older drugs including a diuretic.

Methods: Patients aged 30 to 69 years with uncomplicated hypertension (140 to 179/90 to 109 mmHg) and ≤2 associated risk factors are eligible.

Rationale and design of the Newer Versus Older Antihypertensive Agents in African Hypertensive Patients (NOAAH) trial.

Background: Sub-Saharan Africa experiences an epidemic surge in hypertension. Studies in African Americans led to the recommendation to initiate antihypertensive treatment in Blacks with a diuretic or a low-dose fixed combination including a diuretic. We mounted the Newer versus Older Antihypertensive Agents in African Hypertensive Patients (NOAAH) trial to compare in native African patients a fixed combination of newer drugs, not involving a diuretic, with a combination of older drugs including a diuretic.

High prevalence and low awareness of hypertension in a market population in enugu, Nigeria.

Background. A community-based study put the prevalence of hypertension in Nigeria at 32.8%.

The enormity of chronic kidney disease in Nigeria: the situation in a teaching hospital in South-East Nigeria.

Background. The magnitude of the problem of chronic kidney disease (CKD) is enormous, and the prevalence keeps rising. To highlight the burden of CKD in developing countries, the authors looked at end-stage renal disease (ESRD) patients seen at the University of Nigeria Teaching Hospital (UNTH), Enugu, South-East Nigeria.

A community-based study of hypertension and cardio-metabolic syndrome in semi-urban and rural communities in Nigeria.

Background: The prevalence of cardio-metabolic syndrome (CMS) is increasing worldwide. In people of African descent, there is higher prevalence of hypertension and complications than other races. Bearing in mind these facts, we looked at the CMS in the general population and the population with hypertension.

Left ventricular hypertrophy in African Black patients with chronic renal failure at first evaluation.

Objective: Chronic kidney disease (CKD) is a major cause of cardiovascular morbidity and mortality all over the world. The combined effect of volume and pressure overload seen in patients with CKD is the primary cause of left ventricular hypertrophy (LVH). Though it accounts for a significant proportion of patients dying in hospitals in Nigeria, information on CKD in African Blacks is lacking.