scholarly journals Nutritional Status of Patients on Maintenance Hemodialysis at Muhimbili National Hospital in Dar es Salaam, Tanzania: A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Puneet Bramania ◽  
Paschal Ruggajo ◽  
Rimal Bramania ◽  
Muhiddin Mahmoud ◽  
Francis Furia
Keyword(s):  
Nutritional Status ◽  
Total Cholesterol ◽  
Hemodialysis Patients ◽  
Dar Es Salaam ◽  
Maintenance Hemodialysis ◽  
Diabetic Patients ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Increased Risk

Background. Patients on hemodialysis therapy are at high risk of malnutrition which is attributed to multiple factors. Protein-energy malnutrition in these patients confers poor clinical outcomes. This study investigated the nutritional status of patients on maintenance hemodialysis at Muhimbili National Hospital in Dar es Salaam, Tanzania. Methods. A cross-sectional descriptive study was done among 160 adult patients on maintenance hemodialysis therapy. Data concerning patients’ personal, medical, dietary, and hemodialysis-related information were collected. Patients’ anthropometric and laboratory tests (complete blood count, albumin, total cholesterol, creatinine, and urea) were measured. The quantitative Subjective Global Assessment (SGA) dialysis malnutrition score (DMS) was used to assess their nutritional status. Data analysis was done using the SPSS software version 20. Results. Among the 160 hemodialysis patients, 49 (30.6%) were female. Patients’ mean age was 52.2 ± 13.3 years. The median duration on hemodialysis was 18 (8.25–29.75) months. Malnutrition was present in 98 (61.2%) of the patients. Severe malnutrition was found in only 3 (1.9%) patients and 16.9% were underweight. The longer duration on hemodialysis, having diabetes mellitus, and being single were associated with increased risk for malnutrition in multivariate logistic regression. Malnourished patients had significantly lower dry weight, body mass index, mid-upper arm circumference, waist circumference, albumin, total cholesterol, and creatinine levels. Conclusion. Malnutrition is very common among hemodialysis patients at Muhimbili National Hospital, especially those on longer duration of hemodialysis, and diabetic patients. We recommend that hemodialysis patients should be regularly assessed for malnutrition and appropriately treated which if left unattended heralds worse outcomes.

scholarly journals Prevalence of Malnutrition Inflammation Complex Syndrome among Patients on Maintenance Haemodialysis at Muhimbili National Hospital in Tanzania: A Cross-Sectional Study

2020 ◽  
Author(s):  
Puneet Kishore Bramania ◽  
Paschal Ruggajo ◽  
Rimal Bramania ◽  
Muhiddin Mahmoud ◽  
Francis Fredrick Furia
Keyword(s):  
Total Cholesterol ◽  
Complete Blood Count ◽  
Early Recognition ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Reverse Epidemiology ◽  
Maintenance Haemodialysis

Abstract Background: Malnutrition, inflammation, and the combination thereof are predictors of poor outcomes in haemodialysis patients. Malnutrition Inflammation Complex Syndrome (MICS) is an accelerator of atherosclerosis and portends high mortality. Early recognition and treatment of MICS may help to improve the clinical outlook of such patients. This study investigated the prevalence of MICS and its associated factors among patients on maintenance haemodialysis at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. Methods: This was a prospective cross-sectional observational study done among 160 adult patients on maintenance haemodialysis at MNH in 2019. All participants provided written informed consent. Questionnaires were used to collect data and patients’ blood was tested for complete blood count (CBC), C-reactive protein (CRP), ferritin, transferrin, creatinine, urea, total cholesterol, and albumin. The Malnutrition Inflammation Score was used to assess MICS and its severity. Data analysis was done using the SPSS 20 software. Results: Of the 160 patients included in the study, 111 (69.4%) were male. The mean age (±SD) of patients and mean duration (±SD) on haemodialysis were 52.2(13.3) years and 22(18) months respectively. MICS was prevalent in 46.3% (mild in 24.4% and moderate to severe in 21.9%). Long-term haemodialysis (>4years) was an independent predictor of MICS [Adjusted Odds Ratio, AOR 5.04 (95% CI: 1.33–19.2), p<0.05]. Hypercholesterolaemia was a negative predictor of MICS [AOR 0.11 (95% CI: 0.01-0.97), p<0.05]. Patients with MICS had significantly lower mean body mass index, serum albumin, total cholesterol, transferrin, haemoglobin, and creatinine levels. The presence of MICS was higher in underweight patients and those who had inflammation. Haemodialysis adequacy did not correlate with MICS. Conclusion: Malnutrition Inflammation Complex Syndrome is relatively common among patients on haemodialysis in Dar es Salaam, Tanzania. Our study has shown a longer duration on haemodialysis to be associated with the occurrence of MICS; on the contrary, having hypercholesterolaemia seems to be protective against MICS consistent with the concept of reverse epidemiology. Patients on haemodialysis should be assessed regularly for malnutrition and inflammation and should receive appropriate and timely treatment to reduce the burden of associated morbidity, and mortality to these patients.

scholarly journals Prevalence of malnutrition inflammation complex syndrome among patients on maintenance haemodialysis at Muhimbili National Hospital in Tanzania: a cross-sectional study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Puneet K. Bramania ◽  
Paschal Ruggajo ◽  
Rimal Bramania ◽  
Muhiddin Mahmoud ◽  
Francis F. Furia
Keyword(s):  
Total Cholesterol ◽  
Complete Blood Count ◽  
Early Recognition ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Reverse Epidemiology ◽  
Maintenance Haemodialysis

Abstract Background Malnutrition, inflammation, and the combination thereof are predictors of poor outcomes in haemodialysis patients. Malnutrition Inflammation Complex Syndrome (MICS) is an accelerator of atherosclerosis and portends high mortality. Early recognition and treatment of MICS may help to improve the clinical outlook of such patients. This study investigated the prevalence of MICS and its associated factors among patients on maintenance haemodialysis at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. Methods This was a prospective cross-sectional observational study done among 160 adult patients on maintenance haemodialysis at MNH in 2019. All participants provided written informed consent. Questionnaires were used to collect data and patients’ blood was tested for complete blood count (CBC), C-reactive protein (CRP), ferritin, transferrin, creatinine, urea, total cholesterol, and albumin. The Malnutrition Inflammation Score was used to assess MICS and its severity. Data analysis was done using the SPSS 20 software. Results Of the 160 patients included in the study, 111 (69.4%) were male. The mean age (±SD) of patients and mean duration (±SD) on haemodialysis were 52.2(13.3) years and 22(18) months respectively. MICS was prevalent in 46.3% (mild in 24.4% and moderate to severe in 21.9%). Long-term haemodialysis (> 4 years) was an independent predictor of MICS [Adjusted Odds Ratio, AOR 5.04 (95% CI: 1.33–19.2), p < 0.05]. Hypercholesterolaemia was a negative predictor of MICS [AOR 0.11 (95% CI: 0.01–0.97), p < 0.05]. Patients with MICS had significantly lower mean body mass index, serum albumin, total cholesterol, transferrin, haemoglobin, and creatinine levels. The presence of MICS was higher in underweight patients and those who had inflammation. Haemodialysis adequacy did not correlate with MICS. Conclusion Malnutrition Inflammation Complex Syndrome is relatively common among patients on haemodialysis in Dar es Salaam, Tanzania. Our study has shown a longer duration on haemodialysis to be associated with the occurrence of MICS; on the contrary, having hypercholesterolaemia seems to be protective against MICS consistent with the concept of reverse epidemiology. Patients on haemodialysis should be assessed regularly for malnutrition and inflammation and should receive appropriate and timely treatment to reduce the burden of associated morbidity, and mortality to these patients.

scholarly journals Prevalence of Malnutrition Inflammation Complex Syndrome among Patients on Maintenance Haemodialysis at Muhimbili National Hospital in Tanzania: A Cross-Sectional Study

2020 ◽  
Author(s):  
Puneet Kishore Bramania ◽  
Paschal Ruggajo ◽  
Rimal Bramania ◽  
Muhiddin Mahmoud ◽  
Francis Fredrick Furia
Keyword(s):  
Total Cholesterol ◽  
Complete Blood Count ◽  
Early Recognition ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Reverse Epidemiology ◽  
Maintenance Haemodialysis

Abstract Background: Malnutrition, inflammation, and combination thereof are predictors of poor outcomes in haemodialysis patients. Malnutrition Inflammation Complex Syndrome (MICS) is an accelerator of atherosclerosis and portends high mortality. Early recognition and treatment of MICS may help to improve the clinical outlook of such patients. This study investigated the prevalence of MICS and its associated factors among patients on maintenance haemodialysis at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. Methods: This was a prospective cross-sectional observational study done among 160 adult patients on maintenance haemodialysis at MNH in 2019. All participants provided written informed consent. Questionnaires were used to collect data and patients’ blood was tested for complete blood count (CBC), C-reactive protein (CRP), ferritin, transferrin, creatinine, urea, total cholesterol, and albumin. The Malnutrition Inflammation Score was used to assess MICS and its severity. Data analysis was done using the SPSS 20 software.Results: Of the 160 patients included in the study, 111 (69.4%) were male. The mean age (±SD) of patients and mean duration (±SD) on haemodialysis were 52.2(13.3) years and 22(18) months respectively. MICS was prevalent in 46.3% (mild in 24.4% and moderate to severe in 21.9%). Long-term haemodialysis (>4years) was an independent predictor of MICS [Adjusted Odds Ratio, AOR 5.04 (95% CI: 1.33–19.2), p<0.05]. Hypercholesterolaemia was a negative predictor of MICS [AOR 0.11 (95% CI: 0.01-0.97), p<0.05]. Patients with MICS had significantly lower mean body mass index, albumin, total cholesterol, transferrin, haemoglobin and serum creatinine levels. The presence of MICS was higher in underweight patients and those who had inflammation. Haemodialysis adequacy did not correlate with MICS.Conclusion: Malnutrition Inflammation Complex Syndrome is relatively common among patients on haemodialysis in Dar es Salaam, Tanzania. Our study has shown a longer duration on haemodialysis to be associated with the occurrence of MICS; on the contrary, having hypercholesterolaemia seems to be protective against MICS consistent with the concept of reverse epidemiology. Patients on haemodialysis should be assessed regularly and accordingly treated for malnutrition and inflammation which if left unattended, compounds morbidity, and mortality among these patients.

Assessment of nutritional status of hemodialysis patients by subjective global assessment score: a single centre study from Karachi, Pakistan

2022 ◽  
Vol 71 (12) ◽  
pp. 2761-2765
Author(s):  
Lubna Ghazi ◽  
Murtaza Dhrolia ◽  
Aamna Hamid ◽  
Ruqaya Qureshi ◽  
Kiran Nasir ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Global Assessment ◽  
Practical Method ◽  
Hemodialysis Patients ◽  
Normal Weight ◽  
Maintenance Hemodialysis ◽  
P Value ◽  
Binary Logistic Regression Analysis ◽  
Subjective Global Assessment ◽  
Cross Sectional

Objective: Despite being an important predictor of morbidity and mortality, routine screening for malnutrition in dialysis patients is not a common practice in Pakistan. Modified Subjective Global Assessment (SGA) is a convenient, inexpensive and practical method to assess nutritional status particularly in resource limited setup. Methods: This cross sectional study was conducted in The Kidney Center Post Graduate Training institute (TKC-PGTI). Patients on maintenance hemodialysis (MHD) were included through non-probability consecutive sampling. A one-time SGA score was calculated based on the history and physical examinations using modified SGA or Dialysis Malnutrition Score (DMS). Chi square test was applied to find association between variables, while to observe the amount of effect of factors on SGA score; binary logistic regression analysis was run. P value of ? 0.05 considered significant. Results: Mild-Moderately malnourished patients were the most frequent in our study 96(64%).None of patient had severe malnourishment. Females were 2.6 times more prone for malnourishment (p value=0.009). More than 5- years on hemodialysis also increased the risk of malnourishment by 12.5 times (p value <0.001). Overweight patients had 85 % less chance of being malnourished as compare to patients with normal weight (p value=0.004). Conclusion: Malnutrition is quite common in hemodialysis patients, which necessitates its regular assessment and monitoring. There is a need to assess the reasons of more malnourishment in female as compared to male. Similarly, the longer duration (> 5 years) on hemodialysis also need attention for prevention and cure of malnourishment.  Continuous...

scholarly journals The pattern of central corneal thickness in patients attending a Tertiary Hospital in Dar-Es-Salaam

2021 ◽  
Vol 9 (2) ◽  
pp. 127-133
Author(s):  
Annamary Stanislaus ◽  
Ntsilane Susan Mosenene ◽  
Celina Mhina ◽  
John Stanslaus Kisimbi ◽  
Frederick Robert Burgess ◽  
...  
Keyword(s):  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Dar Es Salaam ◽  
Applanation Tonometry ◽  
P Value ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Mean

Background: Central Corneal Thickness (CCT) is an indicator of corneal health status as well as being an essential tool in assessment and management of corneal diseases. It is an important factor in the diagnosis and management of glaucoma as it affects the measurement of intraocular pressure. However, the pattern of central corneal thickness in our population is not known. Our study aimed to describe the CCT measurements and their variation with age and sex among patients attending the eye clinic at Muhimbili National Hospital (MNH), in Dar es Salaam, Tanzania. Methodology: A hospital-based descriptive, cross-sectional study used convenient sampling to recruit adult patients aged 18 years and above, presenting to the MNH between August 2016 and January 2017.Visual acuity assessment, Goldman applanation tonometry and CCT assessment using an ultrasound pachymeter were performed. Patients with previous intraocular surgery were excluded. Results: A total of 398 patients (208 males and 190 females) were recruited. The mean CCT was 526.64±38.30 µm; being 523.99±38.20 µm for males and 529.7±38.3 µm for females. 226 (56.85%) had CCT of less than 520 µm.There was no statistically significant difference in CCT between gender. The proportion of patients with thinner CCT increased with increasing age from 25.8% in those < 30 years to 75% in those aged 71years and above. The mean CCT decreased with increasing age with P-value<0.001. Conclusion: The average CCT in patients attending Muhimbili National Hospital is 526.64 µm (SD 38.30) which is generally thin, inversely proportion to age and similar that of other Africans and African-Americans. This finding has implications for the management of glaucoma in this population.

scholarly journals Metabolic Bone Disease in Chronic Kidney Disease Patients (CKD-MBD) and its Associated Factors at Muhimbili National Hospital in Dar es salaam, Tanzania: A Cross-Sectional Study

2020 ◽  
Author(s):  
Felix Faustin Mungulluh ◽  
Paschal Ruggajo ◽  
Francis Fredrick Furia
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Metabolic Bone

Abstract Background: Metabolic bone disease in chronic kidney disease patients is associated with high morbidity and mortality, and it has been reported to start early in the course of the disease and worsen as the kidney damage progresses. However, the prevalence and factors associated with metabolic bone disease in chronic kidney disease patients in our setting has not been established, so we aimed to determine the prevalence and factors associated with metabolic bone disease among patients with chronic kidney disease at a tertiary Muhimbili National Hospital in Dar es salaam, Tanzania so as to help physicians recognize the patients at risk, diagnose the problem and prevent complications sooner.Methods: This was a hospital based cross-sectional study involving adult patients with chronic kidney disease attending renal unit Muhimbili National Hospital, a tertiary referral center in Dar es Salaam, Tanzania. Systematic sampling technique was employed to get study participants after being given informed consent. In this study, CKD-MBD was defined basing on the abnormality of serum calcium, phosphate or parathyroid hormone level. Data analysis was done using the SPSS version 23.0 software. Results: A total of 300 participants with chronic kidney disease stage 3 and above were included in this study. Majority were male, 198 (66.0%), with a mean age of 53 years. The prevalence of metabolic bone disease was found to be 75.0%. The most common form of metabolic bone disease was hyperparathyroidism 196 (87.1%), followed by hypocalcemia 174 (77.3%) and hyperphosphatemia 82 (36.4%), which was the least common. Factors which were found to be significantly associated with CKD-MBD were the use of calcium supplements, use of phosphate binders, being on dialysis, a calcium rich diet and a low phosphate diet.Conclusion: Metabolic bone diseases are common in patients with CKD at Muhimbili National Hospital. Patients with CKD should undergo serial assessment of phosphate, calcium and parathyroid hormone level, considered together, so as to diagnose metabolic bone disease early and treat those patients who will be found to have persistently or prolonged abnormalities in these bone mineral biomarkers.

scholarly journals ERECTILE DYSFUNCTION

2016 ◽  
Vol 23 (03) ◽  
pp. 268-273
Author(s):  
Ansari Muhammad Rafique ◽  
Pooran Mal ◽  
Jairamani Bhagwan Das ◽  
Shafique-Ur-Rehman Memon ◽  
Syed M Tahir ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Erectile Dysfunction ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Male Patients

Objectives: Erectile dysfunction (ED) is a very common and distressing healthproblem in chronic maintenance hemodialysis patients. There is no such data available fromSind province of Pakistan on this issue; we want to highlight the factors and prevalence oferectile dysfunction among hemodialysis patients in this part of our country. Study Design:This hospital based observational, cross-sectional study Setting: It was conducted at 04hemodialysis centers of Hyderabad city Perod: In 2014 Methods: The Study was conductedby using International Index of Erectile Dysfunction (IIEF-5) for determination of prevalence& severity of ED among these patients. Comparative analysis for frequency of ED was alsodone between urban & rural patients. Adapted Urdu version of IIEF-5 was used for those whocannot understand English pro forma. Results: There were total 62 male patients; all of themwere on maintenance hemodialysis for more than 6 months. Their ages were between 20 to59 years with mean 36±11. In this series of patients 80% (n=50) were < 50 years of age whilethe diabetic patients were 58% (n=36). The overall prevalence of ED observed in patients was88.7% (n=55) in our study. Severe ED was seen in 30 (48.4%) patients. The prevalence &severity of ED was significantly higher in diabetes mellitus and over 50 years of age. There washigher incidence of ED 94% observed in patients who are living in rural areas as compared tourban areas patients 82%. Conclusions: It has been concluded in this study that majority ofmale hemodialysis patients were suffering from ED problem. Diabetes mellitus and & > 50 yearsof age has the highest prevalence of ED. Erectile dysfunction is very common and distressinghealth related issue among hemodialysis patients and this should be addressed with routine

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