Conservative therapy is associated with worse clinical features and biochemical derangements than renal replacement therapy: a retrospective study in Kumasi, Ghana
Abstract Background The incidence of end stage kidney disease (ESKD) is increasing in Ghana as with the rest of the world. This study compared the sociodemographic, diagnostic characteristics (clinical, biochemical and imaging) and clinical outcomes of ESKD patients who chose either renal replacemen...
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-022-02951-z |
| _version_ | 1811334938122780672 |
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| author | Perditer Okyere Isaac Okyere Grace Essuman Joseph Attakora Dorcas Serwaa Irene Esi Donkoh Richard K.D. Ephraim |
| author_facet | Perditer Okyere Isaac Okyere Grace Essuman Joseph Attakora Dorcas Serwaa Irene Esi Donkoh Richard K.D. Ephraim |
| author_sort | Perditer Okyere |
| collection | DOAJ |
| description | Abstract Background The incidence of end stage kidney disease (ESKD) is increasing in Ghana as with the rest of the world. This study compared the sociodemographic, diagnostic characteristics (clinical, biochemical and imaging) and clinical outcomes of ESKD patients who chose either renal replacement therapy (RRT) or conservative therapy as well as the factors that influenced their choice. Methods We retrospectively reviewed the records of 382 ESKD patient from 2006 to 2018. The data was collected from the Nephrology Clinic at the Komfo Anokye Teaching Hospital (KATH). Sociodemographic, diagnostic (clinical, biochemical and imaging) and therapeutic data were obtained, organized and analyzed with Statistical Package for the Social Sciences (SPSS). Results Of the 382 patients, 321 had conservative therapy whiles 61 had renal replacement therapy. The mean age of participants was 47.71 ± 16.10 years. Bipedal swelling (16.8%), fatigue (10.4%) and facial swelling (9.2%) were the major clinical features. Chronic glomerulonephritis (31.4%), hypertension (30.3%) and diabetes mellitus nephropathy (28.2%) were the most frequent predisposing conditions. Nifedipine (82.0%), bisoprolol (32.8%), aspirin (19.7%), ranitidine (26.2%), metformin (13.1%) and lasix (78.7%) were commonly used by the RRT patients than their conservative therapy counterparts. Compared to their RRT counterparts, patients on conservative therapy were more on irbesartan/lisinopril (57.9%) and sodium hydro carbonate (NaHCO3) (52.0%). Diastolic blood pressure (DBP) (p = 0.047), uremic gastritis (p = 0.007), anaemia, uraemia, haematuria and hyperkalaemia (p < 0.001) were more common in conservative therapy patients than RRT patients with RRT patients showing better corticomedullary differentiation (38.1% vs. 27.7%, p < 0.001) and normal echotexture (15.0% vs. 11.6%, p = 0.005). Age, gender, occupation and duration of illness were significantly associated with the decision to opt for conservative therapy. Conclusion Patients on conservative therapy have worse clinical outcomes than their RRT counterparts. Early referrals to nephrologist as well as subsidized RRT should be targeted. |
| first_indexed | 2024-04-13T17:16:42Z |
| format | Article |
| id | doaj.art-9caf064e81d74f34a790ef2a5e84b6b3 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-04-13T17:16:42Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-9caf064e81d74f34a790ef2a5e84b6b32022-12-22T02:38:06ZengBMCBMC Nephrology1471-23692022-10-012311810.1186/s12882-022-02951-zConservative therapy is associated with worse clinical features and biochemical derangements than renal replacement therapy: a retrospective study in Kumasi, GhanaPerditer Okyere0Isaac Okyere1Grace Essuman2Joseph Attakora3Dorcas Serwaa4Irene Esi Donkoh5Richard K.D. Ephraim6Department of Medicine, School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and TechnologyDepartment of Surgery, School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and TechnologyDepartment of Medical Laboratory Science, School of Allied Health Sciences, University of Cape CoastDepartment of Medicine, School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and TechnologyDepartment of Obstetrics and Gynecology, College of Medicine, Institute of Life and Earth Sciences, Pan African University, University of IbadanDepartment of Medical Laboratory Science, School of Allied Health Sciences, University of Cape CoastDepartment of Medical Laboratory Science, School of Allied Health Sciences, University of Cape CoastAbstract Background The incidence of end stage kidney disease (ESKD) is increasing in Ghana as with the rest of the world. This study compared the sociodemographic, diagnostic characteristics (clinical, biochemical and imaging) and clinical outcomes of ESKD patients who chose either renal replacement therapy (RRT) or conservative therapy as well as the factors that influenced their choice. Methods We retrospectively reviewed the records of 382 ESKD patient from 2006 to 2018. The data was collected from the Nephrology Clinic at the Komfo Anokye Teaching Hospital (KATH). Sociodemographic, diagnostic (clinical, biochemical and imaging) and therapeutic data were obtained, organized and analyzed with Statistical Package for the Social Sciences (SPSS). Results Of the 382 patients, 321 had conservative therapy whiles 61 had renal replacement therapy. The mean age of participants was 47.71 ± 16.10 years. Bipedal swelling (16.8%), fatigue (10.4%) and facial swelling (9.2%) were the major clinical features. Chronic glomerulonephritis (31.4%), hypertension (30.3%) and diabetes mellitus nephropathy (28.2%) were the most frequent predisposing conditions. Nifedipine (82.0%), bisoprolol (32.8%), aspirin (19.7%), ranitidine (26.2%), metformin (13.1%) and lasix (78.7%) were commonly used by the RRT patients than their conservative therapy counterparts. Compared to their RRT counterparts, patients on conservative therapy were more on irbesartan/lisinopril (57.9%) and sodium hydro carbonate (NaHCO3) (52.0%). Diastolic blood pressure (DBP) (p = 0.047), uremic gastritis (p = 0.007), anaemia, uraemia, haematuria and hyperkalaemia (p < 0.001) were more common in conservative therapy patients than RRT patients with RRT patients showing better corticomedullary differentiation (38.1% vs. 27.7%, p < 0.001) and normal echotexture (15.0% vs. 11.6%, p = 0.005). Age, gender, occupation and duration of illness were significantly associated with the decision to opt for conservative therapy. Conclusion Patients on conservative therapy have worse clinical outcomes than their RRT counterparts. Early referrals to nephrologist as well as subsidized RRT should be targeted.https://doi.org/10.1186/s12882-022-02951-zConservative therapyRenal replacement therapyChronic kidney diseaseEnd stage kidney disease. |
| spellingShingle | Perditer Okyere Isaac Okyere Grace Essuman Joseph Attakora Dorcas Serwaa Irene Esi Donkoh Richard K.D. Ephraim Conservative therapy is associated with worse clinical features and biochemical derangements than renal replacement therapy: a retrospective study in Kumasi, Ghana BMC Nephrology Conservative therapy Renal replacement therapy Chronic kidney disease End stage kidney disease. |
| title | Conservative therapy is associated with worse clinical features and biochemical derangements than renal replacement therapy: a retrospective study in Kumasi, Ghana |
| title_full | Conservative therapy is associated with worse clinical features and biochemical derangements than renal replacement therapy: a retrospective study in Kumasi, Ghana |
| title_fullStr | Conservative therapy is associated with worse clinical features and biochemical derangements than renal replacement therapy: a retrospective study in Kumasi, Ghana |
| title_full_unstemmed | Conservative therapy is associated with worse clinical features and biochemical derangements than renal replacement therapy: a retrospective study in Kumasi, Ghana |
| title_short | Conservative therapy is associated with worse clinical features and biochemical derangements than renal replacement therapy: a retrospective study in Kumasi, Ghana |
| title_sort | conservative therapy is associated with worse clinical features and biochemical derangements than renal replacement therapy a retrospective study in kumasi ghana |
| topic | Conservative therapy Renal replacement therapy Chronic kidney disease End stage kidney disease. |
| url | https://doi.org/10.1186/s12882-022-02951-z |
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