Terminal chronic kidney disease in Gambia. A one-year study
Enfermedad renal crónica terminal en Gambia. Estudio de un año
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A one-year study" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "144" "paginaFinal" => "146" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Mauro Cuba de la Cruz, Osmani Rojas Téllez, Odalys Pérez Caloto" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Mauro" "apellidos" => "Cuba de la Cruz" "email" => array:1 [ 0 => "mcuba@hcqho.hlg.sld.cu" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:3 [ "nombre" => "Osmani" "apellidos" => "Rojas Téllez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] 2 => array:3 [ "nombre" => "Odalys" "apellidos" => "Pérez Caloto" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "affc" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Trasplante, Hospital Clínico Quirúrgico Lucía Íñiguez Landín, Holguín, Cuba, " "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:3 [ "entidad" => "Cuidados Intensivos, Hospital Docente Ernesto Guevara, Las Tunas, Cuba, " "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] 2 => array:3 [ "entidad" => " Dirección Municipal de Salud, Colón, Matanzas, Cuba, " "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "affc" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Enfermedad renal crónica terminal en Gambia. Estudio de un año" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Tab. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "11469_16025_42299_en_t111469.jpg" "Alto" => 943 "Ancho" => 1424 "Tamanyo" => 167446 ] ] "descripcion" => array:1 [ "en" => "Patients' characteristics" ] ] ] "textoCompleto" => "<p class="elsevierStylePara">Terminal chronic kidney disease (TCKD) is an important issue for public health, given its high incidence, prevalence, morbidity and mortality and socioeconomic cost.<span class="elsevierStyleSup">1</span></p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">No reliable statistics exist in Africa concerning the incidence of TCKD and the South African Dialysis and Transplant Registry only includes patients who are eligible for transplant. Therefore, the availability of dialysis and transplants is extremely variable with a treatment rate that fluctuates in the north between 30 and 186.5 per million population, depending on the programmes in the other countries, the availability of funds and donors.<span class="elsevierStyleSup">2</span></p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">In October 2006 in Gambia, haemodialysis was started on patients with TCKD through donations received from other countries, as well as through the human resources aid offered by Cuba, which was a step forward in health services. The possibility of receiving this therapeutic treatment was provided to some patients who would have previously had to be transferred to Senegal.</p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">This study shows, for the first time, statistical data of the new cases diagnosed with TCKD in Gambia with Cuban medical cooperation. A cross-sectional descriptive study was carried out on 69 TCKD patients who required renal replacement therapy in the Royal Victoria Hospital (Banjul) in 2009. The patients’ characteristics are presented in Table 1.</p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">The authors consider that the incidence of this disease in Gambia is much higher, since this study only deals with the patients diagnosed in the Royal Victoria Hospital of the capital city, which only provides service to a part of the population, leaving many other TCKD patients in the rest of the country with or without confirmed diagnosis who were not included in the research statistics but who would undoubtedly increase considerably the real number of incidents with TCKD in the country.</p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">Nevertheless, it is a situation that is particular to Gambia, since the haemodialysis services are free with access for everybody, independently of their economic means. However, it only has five artificial kidneys, which does not satisfy demand and explains why only 31.8% of patients received renal replacement treatment. This limitation in material resources means that it is necessary to select people for haemodialysis, with those who have low life expectancy, the elderly, those who cannot travel to the hospital at least twice a week to receive treatment and those who are hepatitis B-positive or HIV positive being excluded.</p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">The average age was relatively low if we take into account the fact that there is currently a global trend towards the increase in the age of patients on dialysis, but we consider that this is due to the low life expectancy of the Gambian population, which is 56 years.</p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">It was interesting that no case of diabetes mellitus was found among the patients since it is the main cause of TCKD worldwide.<span class="elsevierStyleSup">3-5</span> This could be explained by the low average age of the patients, since diabetes mellitus type 2, otherwise very frequent in this country, leads to TCKD after a long time with diabetes. We consider that there must be a high prevalence of chronic kidney disease of diabetic aetiology, which has not been properly diagnosed due to the precariousness of the health system.</p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">The situation described in this study is typical of poor countries, which cannot maintain a dialysis and transplant programme, and is very frequent in Sub-Saharan Africa, where Gambia is located.</p><p class="elsevierStylePara"> </p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conflicts of interest</span></p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">The authors declare that they have no conflicts of interest related to the contents of this article.</p><p class="elsevierStylePara"><a href="grande/11469_16025_42299_en_t111469.jpg" class="elsevierStyleCrossRefs"><img src="11469_16025_42299_en_t111469.jpg" alt="Patients' characteristics"></img></a></p><p class="elsevierStylePara">Table 1. Patients' characteristics</p>" "pdfFichero" => "P1-E547-S3875-A11469-EN.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig1" "etiqueta" => "Tab. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "11469_16025_42299_en_t111469.jpg" "Alto" => 943 "Ancho" => 1424 "Tamanyo" => 167446 ] ] "descripcion" => array:1 [ "en" => "Patients' characteristics" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Couser WG, Remuzzi G, Mendis S, Tonelli M. The contribution of chronic kidney disease to the global major\u{A0}noncommunicable diseases. Kidney Int 2011;80:1258-70. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21993585" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Naiker S. End-stage renal disease in sub-Saharan and South Africa. Kidney Int Suppl 2003;83:S119-22. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12864889" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Ribeiro R, Oliveira GA, Ribeiro D, Comelis D, Claudia-Bernardi C, Lima L, et al. Characterization and etiology of the chronic renal failure in a countryside nephrology unit of São Paulo State. Acta paul. enferm. [online] 2008;07-211." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Górriz-Teruel JL,\u{A0}Otero González A. Impacto socio sanitario de la enfermedad renal crónica avanzada. Nefrologia 2008;(Supl. 3):7-15." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Cusumano A, Garcia-Garcia G, Di Gioia C, Hermina O, Lavorato C, Carreno CA, et al. End-stage renal disease and its treatment in Latin America in the twenty-first century. Ren Fail 2006;28:631-7. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17162420" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003300000001/v0_201502091555/X2013251413002477/v0_201502091556/en/main.assets" "Apartado" => array:4 [ "identificador" => "35438" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor - Brief papers about basic research or clinical experiences" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003300000001/v0_201502091555/X2013251413002477/v0_201502091556/en/P1-E547-S3875-A11469-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251413002477?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 12 | 6 | 18 |
| 2024 October | 64 | 31 | 95 |
| 2024 September | 89 | 29 | 118 |
| 2024 August | 104 | 56 | 160 |
| 2024 July | 67 | 27 | 94 |
| 2024 June | 76 | 34 | 110 |
| 2024 May | 88 | 40 | 128 |
| 2024 April | 94 | 26 | 120 |
| 2024 March | 50 | 23 | 73 |
| 2024 February | 54 | 35 | 89 |
| 2024 January | 47 | 25 | 72 |
| 2023 December | 51 | 34 | 85 |
| 2023 November | 46 | 30 | 76 |
| 2023 October | 91 | 27 | 118 |
| 2023 September | 91 | 33 | 124 |
| 2023 August | 78 | 18 | 96 |
| 2023 July | 64 | 28 | 92 |
| 2023 June | 53 | 28 | 81 |
| 2023 May | 77 | 27 | 104 |
| 2023 April | 50 | 21 | 71 |
| 2023 March | 44 | 17 | 61 |
| 2023 February | 48 | 25 | 73 |
| 2023 January | 62 | 25 | 87 |
| 2022 December | 43 | 30 | 73 |
| 2022 November | 51 | 41 | 92 |
| 2022 October | 128 | 47 | 175 |
| 2022 September | 104 | 38 | 142 |
| 2022 August | 50 | 41 | 91 |
| 2022 July | 45 | 46 | 91 |
| 2022 June | 28 | 42 | 70 |
| 2022 May | 52 | 41 | 93 |
| 2022 April | 55 | 47 | 102 |
| 2022 March | 58 | 58 | 116 |
| 2022 February | 62 | 46 | 108 |
| 2022 January | 69 | 40 | 109 |
| 2021 December | 63 | 43 | 106 |
| 2021 November | 53 | 37 | 90 |
| 2021 October | 74 | 33 | 107 |
| 2021 September | 75 | 38 | 113 |
| 2021 August | 62 | 41 | 103 |
| 2021 July | 74 | 39 | 113 |
| 2021 June | 48 | 20 | 68 |
| 2021 May | 54 | 32 | 86 |
| 2021 April | 109 | 50 | 159 |
| 2021 March | 95 | 34 | 129 |
| 2021 February | 68 | 33 | 101 |
| 2021 January | 47 | 25 | 72 |
| 2020 December | 55 | 21 | 76 |
| 2020 November | 63 | 12 | 75 |
| 2020 October | 39 | 17 | 56 |
| 2020 September | 45 | 20 | 65 |
| 2020 August | 49 | 12 | 61 |
| 2020 July | 62 | 19 | 81 |
| 2020 June | 85 | 29 | 114 |
| 2020 May | 45 | 20 | 65 |
| 2020 April | 40 | 23 | 63 |
| 2020 March | 43 | 16 | 59 |
| 2020 February | 48 | 31 | 79 |
| 2020 January | 67 | 49 | 116 |
| 2019 December | 52 | 21 | 73 |
| 2019 November | 71 | 20 | 91 |
| 2019 October | 60 | 17 | 77 |
| 2019 September | 62 | 25 | 87 |
| 2019 August | 54 | 14 | 68 |
| 2019 July | 48 | 26 | 74 |
| 2019 June | 54 | 20 | 74 |
| 2019 May | 54 | 16 | 70 |
| 2019 April | 95 | 34 | 129 |
| 2019 March | 47 | 23 | 70 |
| 2019 February | 44 | 23 | 67 |
| 2019 January | 41 | 23 | 64 |
| 2018 December | 123 | 35 | 158 |
| 2018 November | 119 | 16 | 135 |
| 2018 October | 116 | 14 | 130 |
| 2018 September | 77 | 15 | 92 |
| 2018 August | 67 | 20 | 87 |
| 2018 July | 67 | 15 | 82 |
| 2018 June | 66 | 21 | 87 |
| 2018 May | 53 | 20 | 73 |
| 2018 April | 72 | 7 | 79 |
| 2018 March | 57 | 6 | 63 |
| 2018 February | 69 | 9 | 78 |
| 2018 January | 63 | 5 | 68 |
| 2017 December | 65 | 10 | 75 |
| 2017 November | 49 | 10 | 59 |
| 2017 October | 50 | 9 | 59 |
| 2017 September | 43 | 11 | 54 |
| 2017 August | 48 | 3 | 51 |
| 2017 July | 55 | 10 | 65 |
| 2017 June | 61 | 20 | 81 |
| 2017 May | 65 | 8 | 73 |
| 2017 April | 48 | 11 | 59 |
| 2017 March | 42 | 6 | 48 |
| 2017 February | 44 | 7 | 51 |
| 2017 January | 18 | 8 | 26 |
| 2016 December | 51 | 4 | 55 |
| 2016 November | 79 | 4 | 83 |
| 2016 October | 104 | 7 | 111 |
| 2016 September | 95 | 5 | 100 |
| 2016 August | 153 | 3 | 156 |
| 2016 July | 193 | 3 | 196 |
| 2016 June | 127 | 0 | 127 |
| 2016 May | 143 | 0 | 143 |
| 2016 April | 98 | 0 | 98 |
| 2016 March | 100 | 0 | 100 |
| 2016 February | 110 | 0 | 110 |
| 2016 January | 115 | 0 | 115 |
| 2015 December | 123 | 0 | 123 |
| 2015 November | 96 | 0 | 96 |
| 2015 October | 92 | 0 | 92 |
| 2015 September | 65 | 0 | 65 |
| 2015 August | 78 | 0 | 78 |
| 2015 July | 82 | 0 | 82 |
| 2015 June | 43 | 0 | 43 |
| 2015 May | 47 | 0 | 47 |
| 2015 April | 8 | 0 | 8 |
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