Chronic Hemodialysis in a Nigerian Teaching Hospital
Identifieur interne : 000949 ( Istex/Corpus ); précédent : 000948; suivant : 000950Chronic Hemodialysis in a Nigerian Teaching Hospital
Auteurs : E. I. Agaba ; A. Lopez ; I. Ma ; R. Martinez ; R. A. Tzamaloukas ; D. J. Vanderjagt ; R. H. Glew ; A. H. TzamaloukasSource :
- Hemodialysis International [ 1492-7535 ] ; 2004-01.
Abstract
The Jos University Teaching Hospital (JUTH) has dialyzed >320 patients with ESRD since 1993. Objective: To identify differences, and their causes, in the practice of dialysis between Nigerian state‐owned dialysis units and U.S.A. Methods: We analyzed the characteristics of chronic dialysis at JUTH. Results: At JUTH, chronic dialysis is started at development of frank uremia (K/DOQI standard: creatinine clearance >10 mL/min, no overt uremia). Frequency of hemodialysis was 3 times weekly in 2 patients, twice weekly in 1 and once weekly or longer in 7 patients. Breakdowns in the dialysis machinery, which is outdated, forced additional decreases in the frequency of dialysis. Duration of a dialysis session was 4 h by prescription, but much longer in several sessions because of dialysis machine breakdown during the session (US standard: 4 h). 2 patients were dialyzed through arterio‐venous fistulas and 8 patients were dialyzed though temporary femoral vein dialysis catheters removed after each dialysis session. A vascular surgeon was unavailable. The urea reduction ratio was 45.38.6% (U.S.A target: 65%). The cost of the first dialysis session at JUTH is $160. With reuse of dialysis supplies, including dialyzers, dialysis tubing, femoral catheters, and guide wires, the cost of each subsequent dialysis session is $33. The minimal cost of dialysis with 3 dialysis sessions weekly and a new dialyzer every week is $501 per month. The cost of dialysis is borne exclusively by the patient. For comparison, average monthly income is $74 for unskilled laborers, $222 for dialysis technicians, $296 for dialysis nurses, and $889 for academic nephrologists. The low dose of dialysis has adverse effects on patient quality of life (frequent admissions with uremia). Despite notable exceptions (2 patients on dialysis for 12 and 9 years, respectively), survival of dialysis patients at JUTH appears to be poor. Conclusions: Underdialysis is frequent in Nigeria and is the consequence of socioeconomic conditions and technologic deficits. Removal of the economic burden of dialysis from the patients with ESRD is the first logical step toward correction of underdialysis.
Url:
DOI: 10.1111/j.1492-7535.2004.0085v.x
Links to Exploration step
ISTEX:811FC20D1E5DAF0C46BB3315588BDF7B333E6E77Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Chronic Hemodialysis in a Nigerian Teaching Hospital</title>
<author><name sortKey="Agaba, E I" sort="Agaba, E I" uniqKey="Agaba E" first="E. I." last="Agaba">E. I. Agaba</name>
<affiliation><mods:affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Lopez, A" sort="Lopez, A" uniqKey="Lopez A" first="A." last="Lopez">A. Lopez</name>
<affiliation><mods:affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Ma, I" sort="Ma, I" uniqKey="Ma I" first="I." last="Ma">I. Ma</name>
<affiliation><mods:affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Martinez, R" sort="Martinez, R" uniqKey="Martinez R" first="R." last="Martinez">R. Martinez</name>
<affiliation><mods:affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Tzamaloukas, R A" sort="Tzamaloukas, R A" uniqKey="Tzamaloukas R" first="R. A." last="Tzamaloukas">R. A. Tzamaloukas</name>
<affiliation><mods:affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Vanderjagt, D J" sort="Vanderjagt, D J" uniqKey="Vanderjagt D" first="D. J." last="Vanderjagt">D. J. Vanderjagt</name>
<affiliation><mods:affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Glew, R H" sort="Glew, R H" uniqKey="Glew R" first="R. H." last="Glew">R. H. Glew</name>
<affiliation><mods:affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Tzamaloukas, A H" sort="Tzamaloukas, A H" uniqKey="Tzamaloukas A" first="A. H." last="Tzamaloukas">A. H. Tzamaloukas</name>
<affiliation><mods:affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</mods:affiliation>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">ISTEX</idno>
<idno type="RBID">ISTEX:811FC20D1E5DAF0C46BB3315588BDF7B333E6E77</idno>
<date when="2004" year="2004">2004</date>
<idno type="doi">10.1111/j.1492-7535.2004.0085v.x</idno>
<idno type="url">https://api.istex.fr/ark:/67375/WNG-CPDNLMP1-X/fulltext.pdf</idno>
<idno type="wicri:Area/Istex/Corpus">000949</idno>
<idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000949</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title level="a" type="main">Chronic Hemodialysis in a Nigerian Teaching Hospital</title>
<author><name sortKey="Agaba, E I" sort="Agaba, E I" uniqKey="Agaba E" first="E. I." last="Agaba">E. I. Agaba</name>
<affiliation><mods:affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Lopez, A" sort="Lopez, A" uniqKey="Lopez A" first="A." last="Lopez">A. Lopez</name>
<affiliation><mods:affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Ma, I" sort="Ma, I" uniqKey="Ma I" first="I." last="Ma">I. Ma</name>
<affiliation><mods:affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Martinez, R" sort="Martinez, R" uniqKey="Martinez R" first="R." last="Martinez">R. Martinez</name>
<affiliation><mods:affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Tzamaloukas, R A" sort="Tzamaloukas, R A" uniqKey="Tzamaloukas R" first="R. A." last="Tzamaloukas">R. A. Tzamaloukas</name>
<affiliation><mods:affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Vanderjagt, D J" sort="Vanderjagt, D J" uniqKey="Vanderjagt D" first="D. J." last="Vanderjagt">D. J. Vanderjagt</name>
<affiliation><mods:affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Glew, R H" sort="Glew, R H" uniqKey="Glew R" first="R. H." last="Glew">R. H. Glew</name>
<affiliation><mods:affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Tzamaloukas, A H" sort="Tzamaloukas, A H" uniqKey="Tzamaloukas A" first="A. H." last="Tzamaloukas">A. H. Tzamaloukas</name>
<affiliation><mods:affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</mods:affiliation>
</affiliation>
</author>
</analytic>
<monogr></monogr>
<series><title level="j" type="main">Hemodialysis International</title>
<title level="j" type="alt">HEMODIALYSIS INTERNATIONAL</title>
<idno type="ISSN">1492-7535</idno>
<idno type="eISSN">1542-4758</idno>
<imprint><biblScope unit="vol">8</biblScope>
<biblScope unit="issue">1</biblScope>
<biblScope unit="page" from="87">87</biblScope>
<biblScope unit="page" to="87">87</biblScope>
<biblScope unit="page-count">100</biblScope>
<publisher>Blackwell Science Inc</publisher>
<pubPlace>Oxford, UK; Malden, USA</pubPlace>
<date type="published" when="2004-01">2004-01</date>
</imprint>
<idno type="ISSN">1492-7535</idno>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><idno type="ISSN">1492-7535</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">The Jos University Teaching Hospital (JUTH) has dialyzed >320 patients with ESRD since 1993. Objective: To identify differences, and their causes, in the practice of dialysis between Nigerian state‐owned dialysis units and U.S.A. Methods: We analyzed the characteristics of chronic dialysis at JUTH. Results: At JUTH, chronic dialysis is started at development of frank uremia (K/DOQI standard: creatinine clearance >10 mL/min, no overt uremia). Frequency of hemodialysis was 3 times weekly in 2 patients, twice weekly in 1 and once weekly or longer in 7 patients. Breakdowns in the dialysis machinery, which is outdated, forced additional decreases in the frequency of dialysis. Duration of a dialysis session was 4 h by prescription, but much longer in several sessions because of dialysis machine breakdown during the session (US standard: 4 h). 2 patients were dialyzed through arterio‐venous fistulas and 8 patients were dialyzed though temporary femoral vein dialysis catheters removed after each dialysis session. A vascular surgeon was unavailable. The urea reduction ratio was 45.38.6% (U.S.A target: 65%). The cost of the first dialysis session at JUTH is $160. With reuse of dialysis supplies, including dialyzers, dialysis tubing, femoral catheters, and guide wires, the cost of each subsequent dialysis session is $33. The minimal cost of dialysis with 3 dialysis sessions weekly and a new dialyzer every week is $501 per month. The cost of dialysis is borne exclusively by the patient. For comparison, average monthly income is $74 for unskilled laborers, $222 for dialysis technicians, $296 for dialysis nurses, and $889 for academic nephrologists. The low dose of dialysis has adverse effects on patient quality of life (frequent admissions with uremia). Despite notable exceptions (2 patients on dialysis for 12 and 9 years, respectively), survival of dialysis patients at JUTH appears to be poor. Conclusions: Underdialysis is frequent in Nigeria and is the consequence of socioeconomic conditions and technologic deficits. Removal of the economic burden of dialysis from the patients with ESRD is the first logical step toward correction of underdialysis.</div>
</front>
</TEI>
<istex><corpusName>wiley</corpusName>
<keywords><teeft><json:string>hemodialysis</json:string>
<json:string>international society</json:string>
<json:string>annual dialysis conference</json:string>
<json:string>renal</json:string>
<json:string>nephrology</json:string>
<json:string>fistula</json:string>
<json:string>hemodialysis patient</json:string>
<json:string>dialyzer</json:string>
<json:string>heparin</json:string>
<json:string>dialysate</json:string>
<json:string>datum</json:string>
<json:string>urea</json:string>
<json:string>online</json:string>
<json:string>venous</json:string>
<json:string>esrd</json:string>
<json:string>creatinine</json:string>
<json:string>hemodialysis hemodialysis international</json:string>
<json:string>pediatric</json:string>
<json:string>solute</json:string>
<json:string>nhhd</json:string>
<json:string>viral</json:string>
<json:string>serum level</json:string>
<json:string>sars</json:string>
<json:string>hemodialysis international</json:string>
<json:string>graft</json:string>
<json:string>lifesite</json:string>
<json:string>internal medicine</json:string>
<json:string>sepsis</json:string>
<json:string>daugirdas</json:string>
<json:string>dialysis patient</json:string>
<json:string>pepa</json:string>
<json:string>ultrafiltration</json:string>
<json:string>sickle</json:string>
<json:string>hypotension</json:string>
<json:string>dialysis</json:string>
<json:string>systolic</json:string>
<json:string>extracorporeal</json:string>
<json:string>lithium</json:string>
<json:string>predialysis</json:string>
<json:string>thrombotic</json:string>
<json:string>einc</json:string>
<json:string>erythropoietin</json:string>
<json:string>comorbidity</json:string>
<json:string>blood flow rate</json:string>
<json:string>carotid</json:string>
<json:string>blood flow</json:string>
<json:string>blood pressure</json:string>
<json:string>viral load</json:string>
<json:string>renal failure</json:string>
<json:string>catheter</json:string>
<json:string>dialysis adequacy</json:string>
<json:string>renal disease</json:string>
<json:string>uremic</json:string>
<json:string>filtration</json:string>
<json:string>ultrasonography</json:string>
<json:string>morbidity</json:string>
<json:string>cytokine</json:string>
<json:string>vascular access</json:string>
<json:string>hypertension</json:string>
<json:string>fresenius</json:string>
<json:string>daily hemodialysis</json:string>
<json:string>rawt</json:string>
<json:string>dialysis therapy</json:string>
<json:string>diabetic</json:string>
<json:string>pentosidine</json:string>
<json:string>body weight</json:string>
<json:string>serum creatinine</json:string>
<json:string>arthroplasty</json:string>
<json:string>ferritin</json:string>
<json:string>mmhg</json:string>
<json:string>uncoated</json:string>
<json:string>sickle cell ulcer</json:string>
<json:string>bioartificial</json:string>
<json:string>1department</json:string>
<json:string>gluconate</json:string>
<json:string>tesio</json:string>
<json:string>fibrinogen</json:string>
<json:string>thrombosis</json:string>
<json:string>vascular</json:string>
<json:string>endothelial</json:string>
<json:string>cardiovascular</json:string>
<json:string>thrombotic event</json:string>
<json:string>platelet count</json:string>
<json:string>fresenius medical care</json:string>
<json:string>hemodialysis nurse</json:string>
<json:string>catheter patient</json:string>
<json:string>doppler ultrasonography</json:string>
<json:string>venous side</json:string>
<json:string>acute renal failure</json:string>
<json:string>inflammation</json:string>
<json:string>phosphorus</json:string>
<json:string>dos</json:string>
<json:string>baseline</json:string>
<json:string>doppler</json:string>
<json:string>dialysis time</json:string>
<json:string>conventional dialysis</json:string>
<json:string>elderly patient</json:string>
<json:string>diabetic patient</json:string>
<json:string>chronic dialysis</json:string>
<json:string>significant difference</json:string>
<json:string>lifesite patient</json:string>
<json:string>bioartificial tubule device</json:string>
<json:string>dialysis unit</json:string>
<json:string>catholic university</json:string>
<json:string>watson volume</json:string>
<json:string>mortality rate</json:string>
<json:string>urea extraction</json:string>
<json:string>online conductivity</json:string>
<json:string>control group</json:string>
<json:string>chronic hemodialysis</json:string>
<json:string>inflammatory</json:string>
<json:string>cardiac</json:string>
<json:string>adequacy</json:string>
<json:string>university hospital</json:string>
<json:string>cardiac surgery</json:string>
<json:string>dialysate flow</json:string>
<json:string>blood sample</json:string>
<json:string>dialysis dose</json:string>
<json:string>inadequate dialysis dose</json:string>
<json:string>conventional hemodialysis</json:string>
<json:string>ferric gluconate</json:string>
<json:string>lynchburg nephrology dialysis</json:string>
<json:string>central greece</json:string>
<json:string>independent risk factor</json:string>
<json:string>dialysis access</json:string>
<json:string>clinical characteristic</json:string>
<json:string>daily dialysis</json:string>
<json:string>serum albumin</json:string>
<json:string>endothelial cell</json:string>
<json:string>second group</json:string>
<json:string>abstract hemodialysis international</json:string>
<json:string>uremia</json:string>
<json:string>intimal</json:string>
<json:string>modality</json:string>
<json:string>linear regression</json:string>
<json:string>significance level</json:string>
<json:string>sick child</json:string>
<json:string>multiple regression analysis</json:string>
<json:string>transcultural nursing</json:string>
<json:string>unidad moncloa</json:string>
<json:string>significant correlation</json:string>
<json:string>index resistance</json:string>
<json:string>first month</json:string>
<json:string>nephrogenic fibrosing dermopathy</json:string>
<json:string>first week</json:string>
<json:string>stable patient</json:string>
<json:string>short daily dialysis</json:string>
<json:string>first time</json:string>
<json:string>sickle cell disease</json:string>
<json:string>exchange volume</json:string>
<json:string>patient group</json:string>
<json:string>bone resorption</json:string>
<json:string>adequate dialysis dose</json:string>
<json:string>anuric patient</json:string>
<json:string>time weekly</json:string>
<json:string>dialysis session</json:string>
<json:string>radial artery</json:string>
<json:string>access blood</json:string>
<json:string>important factor</json:string>
<json:string>depth consideration</json:string>
<json:string>early death</json:string>
<json:string>dialysis treatment</json:string>
<json:string>dialysis machine</json:string>
<json:string>normal population</json:string>
<json:string>intact renal function</json:string>
<json:string>chronic hemodialysis patient</json:string>
<json:string>cukurova university</json:string>
<json:string>access flow</json:string>
<json:string>fluid level</json:string>
<json:string>significant positive correlation</json:string>
<json:string>positive correlation</json:string>
<json:string>tumor necrosis</json:string>
<json:string>ventricular hypertrophy</json:string>
<json:string>laboratory datum</json:string>
<json:string>albumin level</json:string>
<json:string>nocturnal hemodialysis</json:string>
<json:string>endothelial function</json:string>
<json:string>esrd patient</json:string>
<json:string>pulse rate</json:string>
<json:string>dialysis center</json:string>
<json:string>regression analysis</json:string>
<json:string>primary cause</json:string>
<json:string>kidney center</json:string>
<json:string>heparin requirement</json:string>
<json:string>hemodialysis treatment</json:string>
<json:string>pediatric nephrology</json:string>
<json:string>hemodialysis catheter</json:string>
<json:string>renal replacement therapy</json:string>
<json:string>whole region</json:string>
<json:string>brachial artery diameter</json:string>
<json:string>hollow fiber polysulfone membrane</json:string>
<json:string>intermittent elevation</json:string>
<json:string>uncoated one</json:string>
<json:string>intimal thickness</json:string>
<json:string>extracorporeal method</json:string>
<json:string>diastolic blood pressure</json:string>
<json:string>chronic renal insufficiency</json:string>
<json:string>significant change</json:string>
<json:string>chronic kidney disease</json:string>
<json:string>urea clearance</json:string>
<json:string>histologic examination</json:string>
<json:string>membrane area</json:string>
<json:string>leak rate</json:string>
<json:string>blood compatibility</json:string>
<json:string>filtration characteristic</json:string>
<json:string>medical university hospital</json:string>
<json:string>standard dialysate liquid</json:string>
<json:string>sodium citrate</json:string>
<json:string>first session</json:string>
<json:string>second session</json:string>
<json:string>third session</json:string>
<json:string>spss software package</json:string>
<json:string>significant decrease</json:string>
<json:string>lower albumin</json:string>
<json:string>nutrition supplement</json:string>
<json:string>training course</json:string>
<json:string>other baseline characteristic</json:string>
<json:string>contingency table</json:string>
<json:string>split catheter</json:string>
<json:string>nocturnal</json:string>
<json:string>membrane</json:string>
<json:string>patient</json:string>
<json:string>correlated</json:string>
<json:string>hypotensive episode</json:string>
<json:string>bodily pain</json:string>
<json:string>mental health</json:string>
<json:string>multivariate analysis</json:string>
<json:string>alert value</json:string>
<json:string>thrombotic thrombocytopenic uremic syndrome</json:string>
<json:string>renal disease secondary</json:string>
<json:string>plasma exchange</json:string>
<json:string>subsequent improvement</json:string>
<json:string>laboratory abnormality</json:string>
<json:string>case study</json:string>
<json:string>colloid osmotic pressure</json:string>
<json:string>other abstract</json:string>
<json:string>further study</json:string>
<json:string>hemodynamic status</json:string>
<json:string>plasma osmolality</json:string>
<json:string>attention parameter</json:string>
<json:string>other hand</json:string>
<json:string>coronary artery</json:string>
<json:string>relative risk</json:string>
<json:string>present study</json:string>
<json:string>body mass index</json:string>
<json:string>total blood loss</json:string>
<json:string>comparative study</json:string>
<json:string>up gastrointestinal</json:string>
<json:string>classic method</json:string>
<json:string>urea sensor</json:string>
<json:string>same period</json:string>
<json:string>frequent cause</json:string>
<json:string>ischemic heart disease</json:string>
<json:string>transcultural nursing model</json:string>
<json:string>patient day</json:string>
<json:string>pediatric patient</json:string>
<json:string>nutrition index</json:string>
<json:string>carotid einc</json:string>
<json:string>carotid pulse pressure</json:string>
<json:string>many patient</json:string>
<json:string>protein catabolic rate</json:string>
<json:string>sepsis infection rate</json:string>
<json:string>cardiovascular complication</json:string>
<json:string>important role</json:string>
<json:string>several study</json:string>
<json:string>general population</json:string>
<json:string>adequacy target</json:string>
<json:string>time course</json:string>
<json:string>vascular responsiveness</json:string>
<json:string>vascular smooth muscle cell function</json:string>
<json:string>urea reduction ratio</json:string>
<json:string>occasional hypotension</json:string>
<json:string>study group</json:string>
<json:string>total cholesterol</json:string>
<json:string>phosphorus level</json:string>
<json:string>cardiovascular risk factor</json:string>
<json:string>inadequate dialysis</json:string>
<json:string>dialysis prescription</json:string>
<json:string>drug therapy</json:string>
<json:string>reactive hyperemia</json:string>
<json:string>cardiovascular instability</json:string>
<json:string>dependent variable</json:string>
<json:string>vascular access management program</json:string>
<json:string>systolic blood pressure</json:string>
<json:string>independent variable</json:string>
<json:string>texas medical branch</json:string>
<json:string>skin lesion</json:string>
<json:string>mortality risk</json:string>
<json:string>dialysis center profit status</json:string>
<json:string>urine volume</json:string>
<json:string>private center</json:string>
<json:string>similar result</json:string>
<json:string>target hemoglobin</json:string>
<json:string>index hospitalization</json:string>
<json:string>arterial side</json:string>
<json:string>early intervention</json:string>
<json:string>good result</json:string>
<json:string>up extremity</json:string>
<json:string>heparin dose</json:string>
<json:string>blood pressure control</json:string>
<json:string>daily home hemodialysis</json:string>
<json:string>louisiana state university health science center</json:string>
<json:string>financial burden</json:string>
<json:string>access patency rate</json:string>
<json:string>home hemodialysis</json:string>
<json:string>gauge needle</json:string>
<json:string>convective transfer</json:string>
<json:string>clinical situation</json:string>
<json:string>intensive care unit</json:string>
<json:string>endothelial dysfunction</json:string>
<json:string>daily hemofiltration</json:string>
<json:string>significant negative correlation</json:string>
<json:string>intimal hyperplasia</json:string>
<json:string>clinical consequence</json:string>
<json:string>clinical datum</json:string>
<json:string>blood cell</json:string>
<json:string>erythropoietin resistance</json:string>
<json:string>infectious complication</json:string>
<json:string>general surgery</json:string>
<json:string>locking device</json:string>
<json:string>severe lithium poisoning</json:string>
<json:string>hypophosphatemic patient</json:string>
<json:string>lithium poisoning</json:string>
<json:string>more hypophosphatemic</json:string>
<json:string>valproic acid toxicity</json:string>
<json:string>larger solute</json:string>
<json:string>continuous hemodiafiltration</json:string>
<json:string>respiratory failure</json:string>
<json:string>valproic acid level</json:string>
<json:string>drug removal</json:string>
<json:string>extraction ratio</json:string>
<json:string>caucasian female</json:string>
<json:string>ultrapure dialysate</json:string>
<json:string>predialysis diabetic</json:string>
<json:string>small solute</json:string>
<json:string>home hemodialysis patient</json:string>
<json:string>long patient</json:string>
<json:string>1shonan institute</json:string>
<json:string>recombinant human erythropoietin</json:string>
<json:string>positive effect</json:string>
<json:string>blood condition</json:string>
<json:string>marrow stimulation</json:string>
<json:string>hippokratio general hospital</json:string>
<json:string>serum iron</json:string>
<json:string>pediatric hemodialysis unit</json:string>
<json:string>small number</json:string>
<json:string>solute concentration</json:string>
<json:string>internal filtration flow rate</json:string>
<json:string>internal filtration</json:string>
<json:string>analytical model</json:string>
<json:string>home nocturnal hemodialysis program</json:string>
<json:string>northern alberta renal program</json:string>
<json:string>home program</json:string>
<json:string>nocturnal program</json:string>
<json:string>more effective</json:string>
<json:string>nightly home hemodialysis</json:string>
<json:string>eptfe graft</json:string>
<json:string>normal renal function</json:string>
<json:string>bioartificial kidney</json:string>
<json:string>accurate tool</json:string>
<json:string>clinical practice</json:string>
<json:string>albumin addition</json:string>
<json:string>bone formation</json:string>
<json:string>carotid artery</json:string>
<json:string>bone mineral density</json:string>
<json:string>hydrophilic agent</json:string>
<json:string>alkaline phosphatase</json:string>
<json:string>acute phase protein</json:string>
<json:string>university faculty</json:string>
<json:string>hepatocyte growth factor</json:string>
<json:string>viral load variation</json:string>
<json:string>university teaching hospital</json:string>
<json:string>viral load decrease</json:string>
<json:string>lifesite system</json:string>
<json:string>normal group</json:string>
<json:string>patient year</json:string>
<json:string>infection marker</json:string>
<json:string>online clearance monitoring</json:string>
<json:string>high prevalence</json:string>
<json:string>central venous catheter</json:string>
<json:string>early access failure</json:string>
<json:string>beneficial effect</json:string>
<json:string>esrd network</json:string>
<json:string>renal research institute</json:string>
<json:string>biochemical datum</json:string>
<json:string>diabetic nephropathy</json:string>
<json:string>previous month</json:string>
<json:string>dianet dialysis centre</json:string>
<json:string>nocturnal home hemodialysis</json:string>
<json:string>average time</json:string>
<json:string>first group</json:string>
<json:string>nurse training</json:string>
<json:string>week time period</json:string>
<json:string>week period</json:string>
<json:string>radial artery wall thickness</json:string>
<json:string>prospective study</json:string>
<json:string>unsung hero</json:string>
<json:string>saint hospital</json:string>
<json:string>provincial emergency</json:string>
<json:string>probable case</json:string>
<json:string>hemodialysis unit</json:string>
<json:string>study period</json:string>
<json:string>arterial blood pressure</json:string>
<json:string>physical health</json:string>
<json:string>relative donor</json:string>
<json:string>tremendous improvement</json:string>
<json:string>significant independent predictor</json:string>
<json:string>individual scale</json:string>
<json:string>general hospital</json:string>
<json:string>heart failure</json:string>
<json:string>tesio catheter</json:string>
<json:string>dialysis catheter</json:string>
<json:string>average staff time</json:string>
<json:string>extracorporeal serum</json:string>
<json:string>urea kinetics</json:string>
<json:string>body size</json:string>
<json:string>urea mass</json:string>
<json:string>dialysis modality</json:string>
<json:string>initial flow</json:string>
<json:string>vascular surgeon</json:string>
<json:string>causative agent</json:string>
<json:string>precautionary measure</json:string>
<json:string>peer pressure</json:string>
<json:string>syndrome</json:string>
<json:string>ontario</json:string>
<json:string>albumin</json:string>
<json:string>clearance</json:string>
<json:string>mortality</json:string>
<json:string>complication</json:string>
<json:string>hemoglobin</json:string>
<json:string>diabetes</json:string>
<json:string>infection</json:string>
</teeft>
</keywords>
<author><json:item><name>E.I. Agaba</name>
<affiliations><json:string>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</json:string>
</affiliations>
</json:item>
<json:item><name>A. Lopez</name>
<affiliations><json:string>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</json:string>
</affiliations>
</json:item>
<json:item><name>I. Ma</name>
<affiliations><json:string>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</json:string>
</affiliations>
</json:item>
<json:item><name>R. Martinez</name>
<affiliations><json:string>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</json:string>
</affiliations>
</json:item>
<json:item><name>R.A. Tzamaloukas</name>
<affiliations><json:string>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</json:string>
</affiliations>
</json:item>
<json:item><name>D.J. Vanderjagt</name>
<affiliations><json:string>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</json:string>
</affiliations>
</json:item>
<json:item><name>R.H. Glew</name>
<affiliations><json:string>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</json:string>
</affiliations>
</json:item>
<json:item><name>A.H. Tzamaloukas</name>
<affiliations><json:string>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</json:string>
</affiliations>
</json:item>
</author>
<articleId><json:string>HDI085V</json:string>
</articleId>
<arkIstex>ark:/67375/WNG-CPDNLMP1-X</arkIstex>
<language><json:string>eng</json:string>
</language>
<originalGenre><json:string>abstract</json:string>
</originalGenre>
<abstract>The Jos University Teaching Hospital (JUTH) has dialyzed >320 patients with ESRD since 1993. Objective: To identify differences, and their causes, in the practice of dialysis between Nigerian state‐owned dialysis units and U.S.A. Methods: We analyzed the characteristics of chronic dialysis at JUTH. Results: At JUTH, chronic dialysis is started at development of frank uremia (K/DOQI standard: creatinine clearance >10 mL/min, no overt uremia). Frequency of hemodialysis was 3 times weekly in 2 patients, twice weekly in 1 and once weekly or longer in 7 patients. Breakdowns in the dialysis machinery, which is outdated, forced additional decreases in the frequency of dialysis. Duration of a dialysis session was 4 h by prescription, but much longer in several sessions because of dialysis machine breakdown during the session (US standard: 4 h). 2 patients were dialyzed through arterio‐venous fistulas and 8 patients were dialyzed though temporary femoral vein dialysis catheters removed after each dialysis session. A vascular surgeon was unavailable. The urea reduction ratio was 45.38.6% (U.S.A target: 65%). The cost of the first dialysis session at JUTH is $160. With reuse of dialysis supplies, including dialyzers, dialysis tubing, femoral catheters, and guide wires, the cost of each subsequent dialysis session is $33. The minimal cost of dialysis with 3 dialysis sessions weekly and a new dialyzer every week is $501 per month. The cost of dialysis is borne exclusively by the patient. For comparison, average monthly income is $74 for unskilled laborers, $222 for dialysis technicians, $296 for dialysis nurses, and $889 for academic nephrologists. The low dose of dialysis has adverse effects on patient quality of life (frequent admissions with uremia). Despite notable exceptions (2 patients on dialysis for 12 and 9 years, respectively), survival of dialysis patients at JUTH appears to be poor. Conclusions: Underdialysis is frequent in Nigeria and is the consequence of socioeconomic conditions and technologic deficits. Removal of the economic burden of dialysis from the patients with ESRD is the first logical step toward correction of underdialysis.</abstract>
<qualityIndicators><score>10</score>
<pdfWordCount>24342</pdfWordCount>
<pdfCharCount>151874</pdfCharCount>
<pdfVersion>1.4</pdfVersion>
<pdfPageCount>33</pdfPageCount>
<pdfPageSize>595 x 782 pts</pdfPageSize>
<pdfWordsPerPage>738</pdfWordsPerPage>
<pdfText>true</pdfText>
<refBibsNative>false</refBibsNative>
<abstractWordCount>328</abstractWordCount>
<abstractCharCount>2178</abstractCharCount>
<keywordCount>0</keywordCount>
</qualityIndicators>
<title>Chronic Hemodialysis in a Nigerian Teaching Hospital</title>
<genre><json:string>abstract</json:string>
</genre>
<host><title>Hemodialysis International</title>
<language><json:string>unknown</json:string>
</language>
<doi><json:string>10.1111/(ISSN)1542-4758</json:string>
</doi>
<issn><json:string>1492-7535</json:string>
</issn>
<eissn><json:string>1542-4758</json:string>
</eissn>
<publisherId><json:string>HDI</json:string>
</publisherId>
<volume>8</volume>
<issue>1</issue>
<pages><first>87</first>
<last>87</last>
<total>100</total>
</pages>
<genre><json:string>journal</json:string>
</genre>
</host>
<namedEntities><unitex><date><json:string>8/1/03</json:string>
<json:string>2/8/03</json:string>
<json:string>between May 2002 and September 2003</json:string>
<json:string>2001</json:string>
<json:string>1993</json:string>
<json:string>1971</json:string>
<json:string>1998</json:string>
<json:string>6050</json:string>
<json:string>1203</json:string>
<json:string>1999</json:string>
<json:string>4445</json:string>
<json:string>1990</json:string>
<json:string>2/10/03</json:string>
<json:string>2003</json:string>
<json:string>1995</json:string>
<json:string>2/3/03</json:string>
<json:string>2001 and 6/2003</json:string>
<json:string>1087</json:string>
<json:string>1117</json:string>
<json:string>2004</json:string>
<json:string>3706</json:string>
</date>
<geogName></geogName>
<orgName><json:string>University of Toronto</json:string>
<json:string>Loyola University</json:string>
<json:string>Department of Internal Medicine</json:string>
<json:string>Genpharm</json:string>
<json:string>Saint Michael’s Hospital, Toronto, Ontario, Canada</json:string>
<json:string>Michael’s Hospital, Toronto, Ontario, Canada</json:string>
<json:string>Department of Internal Medicine, Yonsei University College of Medicine, Seoul</json:string>
<json:string>Air Force</json:string>
<json:string>Spokane Kidney Center</json:string>
<json:string>Kidney Center</json:string>
<json:string>Washington University</json:string>
<json:string>Amiens University Hospital, Amiens, France</json:string>
<json:string>Hospital ID</json:string>
<json:string>Department of Nephrology, Hippokratio General Hospital, Thessaloniki, Greece</json:string>
<json:string>Children’s Hospital, Vancouver, BC, Canada</json:string>
<json:string>University of Mississippi</json:string>
<json:string>University Hospital of Ioannina, Greece</json:string>
<json:string>University of Texas Medical Branch</json:string>
<json:string>Kalamazoo Center for Medical Studies</json:string>
<json:string>Health Sciences Center</json:string>
<json:string>US Vascular Access Protocol</json:string>
<json:string>China, Hong Kong, and Canada</json:string>
<json:string>The Catholic University</json:string>
<json:string>Medical Center</json:string>
<json:string>Barsoum Cairo Kidney Center, Cairo, Egypt</json:string>
<json:string>Department of General Surgery</json:string>
<json:string>Lynchburg Nephrology Dialysis Inc.</json:string>
<json:string>Louis University</json:string>
<json:string>US HD</json:string>
<json:string>Department of Internal Medicine, National Taiwan University Hospital</json:string>
<json:string>Department of Orthopaedic Surgery, Osaka Police Hospital, Osaka, Japan</json:string>
<json:string>Division of Nephrology</json:string>
<json:string>Minneapolis Medical Research Foundation, Minneapolis, MN</json:string>
<json:string>Department of Microbiology, Cukurova University, Adana, Turkey</json:string>
<json:string>Society for Hemodialysis Short Daily Hemodialysis</json:string>
<json:string>Renal Care Center, Yokohama</json:string>
<json:string>University of Missouri</json:string>
<json:string>InCube, Inc.</json:string>
<json:string>Shonan Institute of Technology, Fujisawa, Kanagawa</json:string>
<json:string>Clinical Laboratory, Medical University Hospital</json:string>
<json:string>Department of Nephrology, Hippokration General Hospital, Thessaloniki, Greece</json:string>
<json:string>Department of Internal Medicine, The Catholic University of Korea, Seoul, South Korea</json:string>
<json:string>Tuchiya General Hospital, Hiroshima, Hiroshima, Japan</json:string>
<json:string>University of California San Francisco Medical Center, San Francisco</json:string>
<json:string>En Chu Kong Hospital, Taipei, Taiwan</json:string>
<json:string>Society for Hemodialysis Daily Online Hemodia</json:string>
<json:string>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM</json:string>
<json:string>Ministry of Health</json:string>
<json:string>Department of Clinical Pathology, The Catholic University of Korea, Seoul, South Korea</json:string>
<json:string>Department of Nephrology, Papageorgiou General Hospital</json:string>
<json:string>Louis University Hospital, St</json:string>
<json:string>Renal Research Institute, New Haven, CT</json:string>
<json:string>Department of Nephrology</json:string>
<json:string>Department of Medicine, Semmelweis University, Budapest, Hungary</json:string>
<json:string>Dialysis Center</json:string>
<json:string>Department of Blood Puri</json:string>
<json:string>Division of Rheumatology</json:string>
<json:string>Department of Nephrology, Kobe General Hospital, Kobe, Japan</json:string>
<json:string>and US HD</json:string>
<json:string>Childrens Hospital, University of Texas Medical Branch, Galveston, TX</json:string>
<json:string>Abstracts Hemodialysis International</json:string>
<json:string>VA Hospital/Loyola University Medical Center, Chicago, IL</json:string>
<json:string>Department of Nephrology H</json:string>
<json:string>Division of Pediatric Nephrology</json:string>
<json:string>Baskent University</json:string>
<json:string>General Hospital, Athens, Greece</json:string>
<json:string>Consiglio</json:string>
<json:string>The Jos University</json:string>
<json:string>University of Texas Health Science Center, San Antonio</json:string>
<json:string>Department of Clinical Science, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden</json:string>
<json:string>University Faculty of Medicine</json:string>
<json:string>Virginia Commonwealth University</json:string>
<json:string>Medical University</json:string>
<json:string>Society for Hemodialysis</json:string>
<json:string>Shonan Institute of Technology, Fujisawa</json:string>
<json:string>Department of Chemical Pathology</json:string>
<json:string>Louisiana State University</json:string>
<json:string>Department of Pediatric Nephrology, University Children</json:string>
<json:string>Department of Nephrology, Hospital Universitario</json:string>
<json:string>University Hospitals of Cleveland</json:string>
<json:string>Division of Molecular Medicine</json:string>
<json:string>Department of Internal Medicine, University of Turin, Turin, Italy</json:string>
<json:string>Luke’s Hospital, Chester</json:string>
<json:string>Hospital for Sick Children, Toronto, Ontario, Canada</json:string>
<json:string>Department of Internal Medicine, NHIC Ilsan Hospital, Goyang, Gyeonggi, Korea</json:string>
<json:string>Aksys Ltd.</json:string>
<json:string>Kingston General Hospital, Kingston, Ontario, Canada</json:string>
<json:string>Department of Biochemistry</json:string>
<json:string>Turkey Vascular</json:string>
<json:string>Mercy Hospital, Kansas City, MO</json:string>
<json:string>Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea</json:string>
<json:string>Hemodialysis Hemodialysis International</json:string>
<json:string>Lamentin Hospital, Martinique</json:string>
<json:string>Taiwan HD</json:string>
<json:string>Institute of Medical Science, Tokai University, Isehara, Japan</json:string>
<json:string>Department of Nephrology, SSMC</json:string>
<json:string>Department of Internal Medicine and General Surgery</json:string>
<json:string>Department of Biostatistics, Cukurova University, Adana, Turkey</json:string>
<json:string>Department of Internal Medicine, Medical Research Institute, Alexandria University, Alexandria, Egypt</json:string>
<json:string>Michael’s Hospital Infection Control Department and Health, Canada</json:string>
<json:string>Central Laboratory of Immunology and Microbiology</json:string>
<json:string>University of Washington</json:string>
<json:string>Aksys Ltd</json:string>
<json:string>Department of Nephrology, Overton Brooks Veterans Affairs Medical Center, and Nephrology, Louisiana State University Health Sciences Center, Shreveport, LA</json:string>
</orgName>
<orgName_funder></orgName_funder>
<orgName_provider></orgName_provider>
<persName><json:string>J. Mislang</json:string>
<json:string>M.M. Iqbal</json:string>
<json:string>D.C. Jin</json:string>
<json:string>Kong Wu</json:string>
<json:string>G. Sakellariou</json:string>
<json:string>D. Banik</json:string>
<json:string>G. Piccoli</json:string>
<json:string>V. Laugel</json:string>
<json:string>R. Diamond</json:string>
<json:string>N. Seyrek</json:string>
<json:string>M. Kasahara</json:string>
<json:string>R. Pecoits-Filho</json:string>
<json:string>S.Y. Hayashi</json:string>
<json:string>M. Utley</json:string>
<json:string>R.C. Manfro</json:string>
<json:string>S.K. Shin</json:string>
<json:string>R. Garsia</json:string>
<json:string>C. George</json:string>
<json:string>J.P. Ebben</json:string>
<json:string>S. Sugahara</json:string>
<json:string>M. Sharaf-El-Din</json:string>
<json:string>GI Sx</json:string>
<json:string>T. Sakai</json:string>
<json:string>J. Bower</json:string>
<json:string>J.S. Floras</json:string>
<json:string>A.M. Zaki</json:string>
<json:string>E. Kulah</json:string>
<json:string>J. Torrente</json:string>
<json:string>Y.J. Choi</json:string>
<json:string>K.E. Yeates</json:string>
<json:string>A. Arbeiter</json:string>
<json:string>Research</json:string>
<json:string>K. Schiro-Harvey</json:string>
<json:string>Q. Fan</json:string>
<json:string>K. Weigel</json:string>
<json:string>J.A. Traver</json:string>
<json:string>F.O. Finkelstein</json:string>
<json:string>M.M. Nascimento</json:string>
<json:string>A. Petropoulou</json:string>
<json:string>N. Azam</json:string>
<json:string>L. Nagy</json:string>
<json:string>H. Kawanishi</json:string>
<json:string>I. Stanchev</json:string>
<json:string>U.S.A. Objective</json:string>
<json:string>I. Ma</json:string>
<json:string>C. Liaskos</json:string>
<json:string>S. Christopoulou</json:string>
<json:string>I. Kulcsar</json:string>
<json:string>S. White</json:string>
<json:string>M. Sevilla</json:string>
<json:string>U.S.A. Bacteremia</json:string>
<json:string>R.S. Lockridge</json:string>
<json:string>J.C.D. Baylon</json:string>
<json:string>D.R. Ryu</json:string>
<json:string>S. Paydas</json:string>
<json:string>J. Samik</json:string>
<json:string>V.U. Dreizin</json:string>
<json:string>C.W. Yang</json:string>
<json:string>D.S. Han</json:string>
<json:string>S. Ferenczi</json:string>
<json:string>D. Hobbs</json:string>
<json:string>L. Flynn</json:string>
<json:string>J. Hynes</json:string>
<json:string>J. Terzic</json:string>
<json:string>M.F. Weiss</json:string>
<json:string>D.S. Lirenman</json:string>
<json:string>E.J. Choi</json:string>
<json:string>V. Methods</json:string>
<json:string>A. Jeantet</json:string>
<json:string>R. Halker</json:string>
<json:string>S. Yang</json:string>
<json:string>R. Carson</json:string>
<json:string>S. Cetiner</json:string>
<json:string>V. Liakopoulos</json:string>
<json:string>S.J. Oh</json:string>
<json:string>M. Velizatova</json:string>
<json:string>B.A. Warady</json:string>
<json:string>T. Gehr</json:string>
<json:string>C. Bainey</json:string>
<json:string>Y.S. Chang</json:string>
<json:string>Y.O. Kim</json:string>
<json:string>P. Karabatakis</json:string>
<json:string>Y.S. Kim</json:string>
<json:string>L.L. Jones</json:string>
<json:string>D.L. Campbell</json:string>
<json:string>R.H. Glew</json:string>
<json:string>A. Takesawa</json:string>
<json:string>S.H. Lee</json:string>
<json:string>C.T. Chan</json:string>
<json:string>T. Drossert</json:string>
<json:string>E.I. Agaba</json:string>
<json:string>K. Sakurai</json:string>
<json:string>S. Blankshaen</json:string>
<json:string>R.A. Tzamaloukas</json:string>
<json:string>S. Zarogiannis</json:string>
<json:string>K. McPhail</json:string>
<json:string>S. Hadjiev</json:string>
<json:string>E. Weinhandl</json:string>
<json:string>L. Paille</json:string>
<json:string>A.M. Belechri</json:string>
<json:string>P.F. Hoyer</json:string>
<json:string>T.S. Ing</json:string>
<json:string>L. Cantey</json:string>
<json:string>A.J. Collins</json:string>
<json:string>T. Fuji</json:string>
<json:string>M. Kreuzer</json:string>
<json:string>R. Nemec</json:string>
<json:string>M. Philipneri</json:string>
<json:string>J. Szegedi</json:string>
<json:string>B. Young</json:string>
<json:string>Z.J. Twardowski</json:string>
<json:string>A. Papagianni</json:string>
<json:string>N.K. Atray</json:string>
<json:string>G. Barril</json:string>
<json:string>V. Papazov</json:string>
<json:string>M. Burdese</json:string>
<json:string>M.S. Jackson</json:string>
<json:string>M.Y. Hassan</json:string>
<json:string>M. Gellens</json:string>
<json:string>I. El-Esper</json:string>
<json:string>U.S.A. Nephrogenic</json:string>
<json:string>M. Jayoma</json:string>
<json:string>E.A. Iliescu</json:string>
<json:string>E. Mitsopoulos</json:string>
<json:string>J. Traeger</json:string>
<json:string>L.A. Douglas</json:string>
<json:string>H.A. Maiza</json:string>
<json:string>B. Lindholm</json:string>
<json:string>U.S.A. Background</json:string>
<json:string>M.O. Spencer</json:string>
<json:string>A. Kroeker</json:string>
<json:string>N. Herian</json:string>
<json:string>A.C. Yamashita</json:string>
<json:string>A. Livolsi</json:string>
<json:string>C.M. Kjellstrand</json:string>
<json:string>C. Li</json:string>
<json:string>V. Carreno</json:string>
<json:string>P. Hann</json:string>
<json:string>T. Masuda</json:string>
<json:string>Hemodialysis</json:string>
<json:string>T. Eisen</json:string>
<json:string>G. Maranon</json:string>
<json:string>The</json:string>
<json:string>E.W. Kang</json:string>
<json:string>Have</json:string>
<json:string>I. Quality</json:string>
<json:string>U. Vester</json:string>
<json:string>J. Tsai</json:string>
<json:string>F.B. Atac</json:string>
<json:string>P. Caro</json:string>
<json:string>M. Ragab</json:string>
<json:string>R. Galland</json:string>
<json:string>E. Delawari</json:string>
<json:string>Anecdotal</json:string>
<json:string>P. Erhard</json:string>
<json:string>I. Kiss</json:string>
<json:string>J.A. Miller</json:string>
<json:string>Y. Sato</json:string>
<json:string>S. Sezer</json:string>
<json:string>L. Haglund</json:string>
<json:string>C. Carmicheal</json:string>
<json:string>E.K. Zervou</json:string>
<json:string>D. Hines</json:string>
<json:string>A. Jones</json:string>
<json:string>R.Z. Ismagilov</json:string>
<json:string>H. Vos</json:string>
<json:string>F. Boitte</json:string>
<json:string>T. Ing</json:string>
<json:string>S. Chaudhury</json:string>
<json:string>U.S.A. Central</json:string>
<json:string>G. Zabioglou</json:string>
<json:string>S.K. Banerjee</json:string>
<json:string>J. Bartolome</json:string>
<json:string>Any Relationship</json:string>
<json:string>E. Gonzalez</json:string>
<json:string>G.B. Piccoli</json:string>
<json:string>O.M. Cairoli</json:string>
<json:string>Nephrology</json:string>
<json:string>M. Shenouda</json:string>
<json:string>R.M. Hossain</json:string>
<json:string>M. Fischbach</json:string>
<json:string>K. Larson</json:string>
<json:string>A. Bruchfeld</json:string>
<json:string>A. Yoshimoto</json:string>
<json:string>V. Sreenarasimhaiah</json:string>
<json:string>F. Tio</json:string>
<json:string>P. Stenvinkel</json:string>
<json:string>M. Imran</json:string>
<json:string>Y. Chen</json:string>
<json:string>G. Wagner</json:string>
<json:string>H.M. Cho</json:string>
<json:string>Z. Arat</json:string>
<json:string>S. Yamasaki</json:string>
<json:string>H. Okada</json:string>
<json:string>H.S. Chae</json:string>
<json:string>N. Kojcheva</json:string>
<json:string>G. Kyriakopoulos</json:string>
<json:string>M. Yoshikawa</json:string>
<json:string>M.D. Lee</json:string>
<json:string>A. Verhallen</json:string>
<json:string>N. Islam</json:string>
<json:string>M.P. Kooistra</json:string>
<json:string>A. Grundy</json:string>
<json:string>K. Ako</json:string>
<json:string>L. Troidle</json:string>
<json:string>S.L. Johnson</json:string>
<json:string>A. Joseph</json:string>
<json:string>To</json:string>
<json:string>J.I. Kim</json:string>
<json:string>U.S.A. Introduction</json:string>
<json:string>A.S. Azhitaeva</json:string>
<json:string>S.J.A.M. Stokvis</json:string>
<json:string>L. Extracorporeal</json:string>
<json:string>S.A. Yoon</json:string>
<json:string>Day Length</json:string>
<json:string>S. Gorogh</json:string>
<json:string>D. Kirmizis</json:string>
<json:string>M.A. Pachaly</json:string>
<json:string>T. Nakai</json:string>
<json:string>S. Chiang</json:string>
<json:string>W.S. Andrews</json:string>
<json:string>P. Kiriklidou</json:string>
<json:string>A. Stein</json:string>
<json:string>K.H. Choi</json:string>
<json:string>H. Nemoto</json:string>
<json:string>D.J. Vanderjagt</json:string>
<json:string>G.N. Dalekos</json:string>
<json:string>S.S. Haqqie</json:string>
<json:string>F. Dapena</json:string>
<json:string>G. Soragna</json:string>
<json:string>F. Coronel</json:string>
<json:string>P. Helms</json:string>
<json:string>L. Wales</json:string>
<json:string>C. Adams</json:string>
<json:string>Blood Bank</json:string>
<json:string>J.E. Carter</json:string>
<json:string>S.W. Kang</json:string>
<json:string>P. Sanz</json:string>
<json:string>E. Hryciw</json:string>
<json:string>R.N. Foley</json:string>
<json:string>Y.M. Ku</json:string>
<json:string>S. Peng</json:string>
<json:string>M. Gai</json:string>
<json:string>T.J. Vachharajani</json:string>
<json:string>M.C. Riella</json:string>
<json:string>S.B. Chebrolu</json:string>
<json:string>J. Campbell</json:string>
<json:string>M.J. Thomas</json:string>
<json:string>A.M. Verhallen</json:string>
<json:string>R. Martinez</json:string>
<json:string>Doppler</json:string>
<json:string>Y.S. Shin</json:string>
<json:string>C. Holloman</json:string>
<json:string>C.A. Solid</json:string>
<json:string>H.C. Song</json:string>
<json:string>R. Selgas</json:string>
<json:string>I. Sakaji</json:string>
<json:string>M. Agraharkar</json:string>
<json:string>A. Rico</json:string>
<json:string>A. Rahman</json:string>
<json:string>J. Buss</json:string>
<json:string>S. Islam</json:string>
<json:string>A. Saito</json:string>
<json:string>B. Borbas</json:string>
<json:string>J. Valente</json:string>
<json:string>D. Shore</json:string>
<json:string>A. Bidani</json:string>
<json:string>Ht</json:string>
<json:string>E. Tutal</json:string>
<json:string>N. Kanbara</json:string>
<json:string>T. Suzuki</json:string>
<json:string>L. Renner</json:string>
<json:string>T. McComb</json:string>
<json:string>A. Zolota</json:string>
<json:string>S.W. McConnell</json:string>
<json:string>C. Rizos</json:string>
<json:string>Y. Kanno</json:string>
<json:string>G. Seydaoglu</json:string>
<json:string>M. Oadri</json:string>
<json:string>D. Motta</json:string>
<json:string>M. Salomone</json:string>
<json:string>D.C. Holland</json:string>
<json:string>Val Val</json:string>
<json:string>Elevation</json:string>
<json:string>K. Masuhara</json:string>
<json:string>M.P. Ruiz</json:string>
<json:string>A. Pierratos</json:string>
<json:string>S. Dobrev</json:string>
<json:string>M.F. Pipkin</json:string>
<json:string>El Pilar</json:string>
<json:string>H.Y. Choi</json:string>
<json:string>C.R. Blagg</json:string>
<json:string>D.T. Gilbertson</json:string>
<json:string>U. Princesa</json:string>
<json:string>R.M. Lindsay</json:string>
<json:string>E. Alexopoulos</json:string>
<json:string>U.S.A. Methods</json:string>
<json:string>C. Siegel</json:string>
<json:string>K. Chiang</json:string>
<json:string>Factor</json:string>
</persName>
<placeName><json:string>TX</json:string>
<json:string>U.S.</json:string>
<json:string>Menlo Park</json:string>
<json:string>Leiden</json:string>
<json:string>IL</json:string>
<json:string>MS</json:string>
<json:string>Utrecht</json:string>
<json:string>Terashima</json:string>
<json:string>Ankara</json:string>
<json:string>Columbia</json:string>
<json:string>Germany</json:string>
<json:string>Greece</json:string>
<json:string>Shreveport</json:string>
<json:string>Mineshima</json:string>
<json:string>Edmonton</json:string>
<json:string>NY</json:string>
<json:string>Dallas</json:string>
<json:string>Bangladesh</json:string>
<json:string>Korea</json:string>
<json:string>Seoul</json:string>
<json:string>Brazil</json:string>
<json:string>Spokane</json:string>
<json:string>Albany</json:string>
<json:string>Dhaka</json:string>
<json:string>Turkey</json:string>
<json:string>Richmond</json:string>
<json:string>Matsushima</json:string>
<json:string>Taiwan</json:string>
<json:string>Canada</json:string>
<json:string>LA</json:string>
<json:string>VA</json:string>
<json:string>Lynchburg</json:string>
<json:string>American</json:string>
<json:string>Madrid</json:string>
<json:string>HEL</json:string>
<json:string>Lincolnshire</json:string>
<json:string>U.S.</json:string>
<json:string>Kazakhstan</json:string>
<json:string>Seattle</json:string>
<json:string>MO</json:string>
<json:string>Jackson</json:string>
<json:string>China</json:string>
<json:string>Bulgaria</json:string>
<json:string>Toronto</json:string>
<json:string>Galveston</json:string>
<json:string>Japan</json:string>
<json:string>Strasbourg</json:string>
<json:string>America</json:string>
<json:string>Nigeria</json:string>
<json:string>Brussels</json:string>
<json:string>EPS</json:string>
<json:string>Tokyo</json:string>
<json:string>Chicago</json:string>
<json:string>CA</json:string>
<json:string>Palm Beach</json:string>
<json:string>U.S.</json:string>
<json:string>Saint Michael</json:string>
<json:string>France</json:string>
<json:string>Essen</json:string>
<json:string>WA</json:string>
<json:string>Cleveland</json:string>
<json:string>Spain</json:string>
<json:string>Lyon</json:string>
<json:string>Belgium</json:string>
<json:string>OH</json:string>
<json:string>Netherlands</json:string>
<json:string>Osaka</json:string>
</placeName>
<ref_url></ref_url>
<ref_bibl><json:string>second session, 4390</json:string>
<json:string>April 2001</json:string>
<json:string>second session, 6167</json:string>
<json:string>third session, 4775</json:string>
<json:string>Devereaux et al.</json:string>
<json:string>first session, 4477</json:string>
<json:string>third session, 5178</json:string>
<json:string>second session, 4167</json:string>
<json:string>first session, 5443</json:string>
<json:string>first session, 4633</json:string>
<json:string>third session, 5078</json:string>
<json:string>March 2003</json:string>
<json:string>September 1997</json:string>
</ref_bibl>
<bibl></bibl>
</unitex>
</namedEntities>
<ark><json:string>ark:/67375/WNG-CPDNLMP1-X</json:string>
</ark>
<categories><wos><json:string>1 - science</json:string>
<json:string>2 - urology & nephrology</json:string>
</wos>
<scienceMetrix><json:string>1 - health sciences</json:string>
<json:string>2 - clinical medicine</json:string>
<json:string>3 - urology & nephrology</json:string>
</scienceMetrix>
<scopus><json:string>1 - Health Sciences</json:string>
<json:string>2 - Medicine</json:string>
<json:string>3 - Nephrology</json:string>
<json:string>1 - Health Sciences</json:string>
<json:string>2 - Medicine</json:string>
<json:string>3 - Hematology</json:string>
</scopus>
<inist><json:string>1 - sciences appliquees, technologies et medecines</json:string>
<json:string>2 - sciences biologiques et medicales</json:string>
<json:string>3 - sciences medicales</json:string>
</inist>
</categories>
<publicationDate>2004</publicationDate>
<copyrightDate>2004</copyrightDate>
<doi><json:string>10.1111/j.1492-7535.2004.0085v.x</json:string>
</doi>
<id>811FC20D1E5DAF0C46BB3315588BDF7B333E6E77</id>
<score>1</score>
<fulltext><json:item><extension>pdf</extension>
<original>true</original>
<mimetype>application/pdf</mimetype>
<uri>https://api.istex.fr/ark:/67375/WNG-CPDNLMP1-X/fulltext.pdf</uri>
</json:item>
<json:item><extension>zip</extension>
<original>false</original>
<mimetype>application/zip</mimetype>
<uri>https://api.istex.fr/ark:/67375/WNG-CPDNLMP1-X/bundle.zip</uri>
</json:item>
<istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/WNG-CPDNLMP1-X/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main">Chronic Hemodialysis in a Nigerian Teaching Hospital</title>
<title level="a" type="short">24th Annual Dialysis Conference: Abstracts</title>
</titleStmt>
<publicationStmt><authority>ISTEX</authority>
<publisher>Blackwell Science Inc</publisher>
<pubPlace>Oxford, UK; Malden, USA</pubPlace>
<date type="published" when="2004-01"></date>
</publicationStmt>
<notesStmt><note type="content-type" subtype="abstract" source="abstract" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-HPN7T1Q2-R">abstract</note>
<note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note>
</notesStmt>
<sourceDesc><biblStruct type="abstract"><analytic><title level="a" type="main">Chronic Hemodialysis in a Nigerian Teaching Hospital</title>
<title level="a" type="short">24th Annual Dialysis Conference: Abstracts</title>
<author xml:id="author-0000"><persName><forename type="first">E.I.</forename>
<surname>Agaba</surname>
</persName>
<affiliation><orgName type="institution">Jos University Teaching Hospital</orgName>
<address><addrLine>Jos</addrLine>
<addrLine>Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</addrLine>
<country key="US" xml:lang="en">UNITED STATES</country>
</address>
</affiliation>
</author>
<author xml:id="author-0001"><persName><forename type="first">A.</forename>
<surname>Lopez</surname>
</persName>
<affiliation><orgName type="institution">Jos University Teaching Hospital</orgName>
<address><addrLine>Jos</addrLine>
<addrLine>Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</addrLine>
<country key="US" xml:lang="en">UNITED STATES</country>
</address>
</affiliation>
</author>
<author xml:id="author-0002"><persName><forename type="first">I.</forename>
<surname>Ma</surname>
</persName>
<affiliation><orgName type="institution">Jos University Teaching Hospital</orgName>
<address><addrLine>Jos</addrLine>
<addrLine>Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</addrLine>
<country key="US" xml:lang="en">UNITED STATES</country>
</address>
</affiliation>
</author>
<author xml:id="author-0003"><persName><forename type="first">R.</forename>
<surname>Martinez</surname>
</persName>
<affiliation><orgName type="institution">Jos University Teaching Hospital</orgName>
<address><addrLine>Jos</addrLine>
<addrLine>Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</addrLine>
<country key="US" xml:lang="en">UNITED STATES</country>
</address>
</affiliation>
</author>
<author xml:id="author-0004"><persName><forename type="first">R.A.</forename>
<surname>Tzamaloukas</surname>
</persName>
<affiliation><orgName type="institution">Jos University Teaching Hospital</orgName>
<address><addrLine>Jos</addrLine>
<addrLine>Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</addrLine>
<country key="US" xml:lang="en">UNITED STATES</country>
</address>
</affiliation>
</author>
<author xml:id="author-0005"><persName><forename type="first">D.J.</forename>
<surname>Vanderjagt</surname>
</persName>
<affiliation><orgName type="institution">Jos University Teaching Hospital</orgName>
<address><addrLine>Jos</addrLine>
<addrLine>Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</addrLine>
<country key="US" xml:lang="en">UNITED STATES</country>
</address>
</affiliation>
</author>
<author xml:id="author-0006"><persName><forename type="first">R.H.</forename>
<surname>Glew</surname>
</persName>
<affiliation><orgName type="institution">Jos University Teaching Hospital</orgName>
<address><addrLine>Jos</addrLine>
<addrLine>Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</addrLine>
<country key="US" xml:lang="en">UNITED STATES</country>
</address>
</affiliation>
</author>
<author xml:id="author-0007"><persName><forename type="first">A.H.</forename>
<surname>Tzamaloukas</surname>
</persName>
<affiliation><orgName type="institution">Jos University Teaching Hospital</orgName>
<address><addrLine>Jos</addrLine>
<addrLine>Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</addrLine>
<country key="US" xml:lang="en">UNITED STATES</country>
</address>
</affiliation>
</author>
<idno type="istex">811FC20D1E5DAF0C46BB3315588BDF7B333E6E77</idno>
<idno type="ark">ark:/67375/WNG-CPDNLMP1-X</idno>
<idno type="DOI">10.1111/j.1492-7535.2004.0085v.x</idno>
<idno type="unit">HDI085V</idno>
<idno type="toTypesetVersion">file:HDI.HDI085V.pdf</idno>
</analytic>
<monogr><title level="j" type="main">Hemodialysis International</title>
<title level="j" type="alt">HEMODIALYSIS INTERNATIONAL</title>
<idno type="pISSN">1492-7535</idno>
<idno type="eISSN">1542-4758</idno>
<idno type="book-DOI">10.1111/(ISSN)1542-4758</idno>
<idno type="book-part-DOI">10.1111/hdi.2004.8.issue-1</idno>
<idno type="product">HDI</idno>
<idno type="publisherDivision">ST</idno>
<imprint><biblScope unit="vol">8</biblScope>
<biblScope unit="issue">1</biblScope>
<biblScope unit="page" from="87">87</biblScope>
<biblScope unit="page" to="87">87</biblScope>
<biblScope unit="page-count">100</biblScope>
<publisher>Blackwell Science Inc</publisher>
<pubPlace>Oxford, UK; Malden, USA</pubPlace>
<date type="published" when="2004-01"></date>
</imprint>
</monogr>
</biblStruct>
</sourceDesc>
</fileDesc>
<encodingDesc><schemaRef type="ODD" url="https://xml-schema.delivery.istex.fr/tei-istex.odd"></schemaRef>
<appInfo><application ident="pub2tei" version="1.0.10" when="2019-12-20"><label>pub2TEI-ISTEX</label>
<desc>A set of style sheets for converting XML documents encoded in various scientific publisher formats into a common TEI format.
<ref target="http://www.tei-c.org/">We use TEI</ref>
</desc>
</application>
</appInfo>
</encodingDesc>
<profileDesc><abstract xml:lang="en" style="main"><p>The Jos University Teaching Hospital (JUTH) has dialyzed >320 patients with ESRD since 1993.</p>
<p><hi rend="bold">Objective: </hi>
To identify differences, and their causes, in the practice of dialysis between Nigerian state‐owned dialysis units and U.S.A.</p>
<p><hi rend="bold">Methods: </hi>
We analyzed the characteristics of chronic dialysis at JUTH.</p>
<p><hi rend="bold">Results: </hi>
At JUTH, chronic dialysis is started at development of frank uremia (K/DOQI standard: creatinine clearance >10 mL/min, no overt uremia). Frequency of hemodialysis was 3 times weekly in 2 patients, twice weekly in 1 and once weekly or longer in 7 patients. Breakdowns in the dialysis machinery, which is outdated, forced additional decreases in the frequency of dialysis. Duration of a dialysis session was 4 h by prescription, but much longer in several sessions because of dialysis machine breakdown during the session (US standard: 4 h). 2 patients were dialyzed through arterio‐venous fistulas and 8 patients were dialyzed though temporary femoral vein dialysis catheters removed after each dialysis session. A vascular surgeon was unavailable. The urea reduction ratio was 45.38.6% (U.S.A target: 65%). The cost of the first dialysis session at JUTH is $160. With reuse of dialysis supplies, including dialyzers, dialysis tubing, femoral catheters, and guide wires, the cost of each subsequent dialysis session is $33. The minimal cost of dialysis with 3 dialysis sessions weekly and a new dialyzer every week is $501 per month. The cost of dialysis is borne exclusively by the patient. For comparison, average monthly income is $74 for unskilled laborers, $222 for dialysis technicians, $296 for dialysis nurses, and $889 for academic nephrologists. The low dose of dialysis has adverse effects on patient quality of life (frequent admissions with uremia). Despite notable exceptions (2 patients on dialysis for 12 and 9 years, respectively), survival of dialysis patients at JUTH appears to be poor.</p>
<p><hi rend="bold">Conclusions: </hi>
Underdialysis is frequent in Nigeria and is the consequence of socioeconomic conditions and technologic deficits. Removal of the economic burden of dialysis from the patients with ESRD is the first logical step toward correction of underdialysis.</p>
</abstract>
<textClass><keywords rend="tocHeading1"><term>Hemodialysis Abstracts from the 24th Annual Dialysis Conference</term>
</keywords>
</textClass>
<langUsage><language ident="en"></language>
</langUsage>
</profileDesc>
<revisionDesc><change when="2019-12-20" who="#istex" xml:id="pub2tei">formatting</change>
</revisionDesc>
</teiHeader>
</istex:fulltextTEI>
<json:item><extension>txt</extension>
<original>false</original>
<mimetype>text/plain</mimetype>
<uri>https://api.istex.fr/ark:/67375/WNG-CPDNLMP1-X/fulltext.txt</uri>
</json:item>
</fulltext>
<metadata><istex:metadataXml wicri:clean="Wiley component found"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration>
<istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Science Inc</publisherName>
<publisherLoc>Oxford, UK; Malden, USA</publisherLoc>
</publisherInfo>
<doi origin="wiley" registered="yes">10.1111/(ISSN)1542-4758</doi>
<issn type="print">1492-7535</issn>
<issn type="electronic">1542-4758</issn>
<idGroup><id type="product" value="HDI"></id>
<id type="publisherDivision" value="ST"></id>
</idGroup>
<titleGroup><title type="main" sort="HEMODIALYSIS INTERNATIONAL">Hemodialysis International</title>
</titleGroup>
</publicationMeta>
<publicationMeta level="part" position="01001"><doi origin="wiley">10.1111/hdi.2004.8.issue-1</doi>
<numberingGroup><numbering type="journalVolume" number="8">8</numbering>
<numbering type="journalIssue" number="1">1</numbering>
</numberingGroup>
<coverDate startDate="2004-01">January 2004</coverDate>
</publicationMeta>
<publicationMeta level="unit" type="abstract" position="0008700" status="forIssue"><doi origin="wiley">10.1111/j.1492-7535.2004.0085v.x</doi>
<idGroup><id type="unit" value="HDI085V"></id>
</idGroup>
<countGroup><count type="pageTotal" number="100"></count>
</countGroup>
<titleGroup><title type="tocHeading1">Hemodialysis Abstracts from the 24th Annual Dialysis Conference</title>
</titleGroup>
<eventGroup><event type="firstOnline" date="2004-01-23"></event>
<event type="publishedOnlineFinalForm" date="2004-01-23"></event>
<event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.15 mode:FullText source:Header result:Header" date="2010-07-19"></event>
<event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-26"></event>
<event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-24"></event>
</eventGroup>
<numberingGroup><numbering type="pageFirst" number="87">87</numbering>
<numbering type="pageLast" number="87">87</numbering>
</numberingGroup>
<linkGroup><link type="toTypesetVersion" href="file:HDI.HDI085V.pdf"></link>
</linkGroup>
</publicationMeta>
<contentMeta><countGroup><count type="figureTotal" number="0"></count>
<count type="tableTotal" number="0"></count>
<count type="formulaTotal" number="0"></count>
<count type="referenceTotal" number="0"></count>
<count type="wordTotal" number="0"></count>
<count type="linksPubMed" number="0"></count>
<count type="linksCrossRef" number="0"></count>
</countGroup>
<titleGroup><title type="main">Chronic Hemodialysis in a Nigerian Teaching Hospital</title>
<title type="shortAuthors">24th Annual Dialysis Conference: Abstracts</title>
<title type="short">24th Annual Dialysis Conference: Abstracts</title>
</titleGroup>
<creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a2004-1"><personName><givenNames>E.I.</givenNames>
<familyName>Agaba</familyName>
</personName>
</creator>
<creator creatorRole="author" xml:id="cr2" affiliationRef="#a2004-1"><personName><givenNames>A.</givenNames>
<familyName>Lopez</familyName>
</personName>
</creator>
<creator creatorRole="author" xml:id="cr3" affiliationRef="#a2004-1"><personName><givenNames>I.</givenNames>
<familyName>Ma</familyName>
</personName>
</creator>
<creator creatorRole="author" xml:id="cr4" affiliationRef="#a2004-1"><personName><givenNames>R.</givenNames>
<familyName>Martinez</familyName>
</personName>
</creator>
<creator creatorRole="author" xml:id="cr5" affiliationRef="#a2004-1"><personName><givenNames>R.A.</givenNames>
<familyName>Tzamaloukas</familyName>
</personName>
</creator>
<creator creatorRole="author" xml:id="cr6" affiliationRef="#a2004-1"><personName><givenNames>D.J.</givenNames>
<familyName>Vanderjagt</familyName>
</personName>
</creator>
<creator creatorRole="author" xml:id="cr7" affiliationRef="#a2004-1"><personName><givenNames>R.H.</givenNames>
<familyName>Glew</familyName>
</personName>
</creator>
<creator creatorRole="author" xml:id="cr8" affiliationRef="#a2004-1"><personName><givenNames>A.H.</givenNames>
<familyName>Tzamaloukas</familyName>
</personName>
</creator>
</creators>
<affiliationGroup><affiliation xml:id="a2004-1" countryCode="US"><unparsedAffiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</unparsedAffiliation>
</affiliation>
</affiliationGroup>
<abstractGroup><abstract type="main" xml:lang="en"><p>The Jos University Teaching Hospital (JUTH) has dialyzed >320 patients with ESRD since 1993.</p>
<p><b>Objective: </b>
To identify differences, and their causes, in the practice of dialysis between Nigerian state‐owned dialysis units and U.S.A.</p>
<p><b>Methods: </b>
We analyzed the characteristics of chronic dialysis at JUTH.</p>
<p><b>Results: </b>
At JUTH, chronic dialysis is started at development of frank uremia (K/DOQI standard: creatinine clearance >10 mL/min, no overt uremia). Frequency of hemodialysis was 3 times weekly in 2 patients, twice weekly in 1 and once weekly or longer in 7 patients. Breakdowns in the dialysis machinery, which is outdated, forced additional decreases in the frequency of dialysis. Duration of a dialysis session was 4 h by prescription, but much longer in several sessions because of dialysis machine breakdown during the session (US standard: 4 h). 2 patients were dialyzed through arterio‐venous fistulas and 8 patients were dialyzed though temporary femoral vein dialysis catheters removed after each dialysis session. A vascular surgeon was unavailable. The urea reduction ratio was 45.38.6% (U.S.A target: 65%). The cost of the first dialysis session at JUTH is $160. With reuse of dialysis supplies, including dialyzers, dialysis tubing, femoral catheters, and guide wires, the cost of each subsequent dialysis session is $33. The minimal cost of dialysis with 3 dialysis sessions weekly and a new dialyzer every week is $501 per month. The cost of dialysis is borne exclusively by the patient. For comparison, average monthly income is $74 for unskilled laborers, $222 for dialysis technicians, $296 for dialysis nurses, and $889 for academic nephrologists. The low dose of dialysis has adverse effects on patient quality of life (frequent admissions with uremia). Despite notable exceptions (2 patients on dialysis for 12 and 9 years, respectively), survival of dialysis patients at JUTH appears to be poor.</p>
<p><b>Conclusions: </b>
Underdialysis is frequent in Nigeria and is the consequence of socioeconomic conditions and technologic deficits. Removal of the economic burden of dialysis from the patients with ESRD is the first logical step toward correction of underdialysis.</p>
</abstract>
</abstractGroup>
</contentMeta>
</header>
</component>
</istex:document>
</istex:metadataXml>
<mods version="3.6"><titleInfo lang="en"><title>Chronic Hemodialysis in a Nigerian Teaching Hospital</title>
</titleInfo>
<titleInfo type="abbreviated" lang="en"><title>24th Annual Dialysis Conference: Abstracts</title>
</titleInfo>
<titleInfo type="alternative" contentType="CDATA" lang="en"><title>Chronic Hemodialysis in a Nigerian Teaching Hospital</title>
</titleInfo>
<name type="personal"><namePart type="given">E.I.</namePart>
<namePart type="family">Agaba</namePart>
<affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">A.</namePart>
<namePart type="family">Lopez</namePart>
<affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">I.</namePart>
<namePart type="family">Ma</namePart>
<affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">R.</namePart>
<namePart type="family">Martinez</namePart>
<affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">R.A.</namePart>
<namePart type="family">Tzamaloukas</namePart>
<affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">D.J.</namePart>
<namePart type="family">Vanderjagt</namePart>
<affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">R.H.</namePart>
<namePart type="family">Glew</namePart>
<affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">A.H.</namePart>
<namePart type="family">Tzamaloukas</namePart>
<affiliation>Jos University Teaching Hospital, Jos, Nigeria, and University of New Mexico, Albuquerque, NM, U.S.A.</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<typeOfResource>text</typeOfResource>
<genre type="abstract" displayLabel="abstract" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-HPN7T1Q2-R">abstract</genre>
<originInfo><publisher>Blackwell Science Inc</publisher>
<place><placeTerm type="text">Oxford, UK; Malden, USA</placeTerm>
</place>
<dateIssued encoding="w3cdtf">2004-01</dateIssued>
<copyrightDate encoding="w3cdtf">2004</copyrightDate>
</originInfo>
<language><languageTerm type="code" authority="rfc3066">en</languageTerm>
<languageTerm type="code" authority="iso639-2b">eng</languageTerm>
</language>
<physicalDescription><extent unit="figures">0</extent>
<extent unit="tables">0</extent>
<extent unit="formulas">0</extent>
<extent unit="references">0</extent>
<extent unit="linksCrossRef">0</extent>
<extent unit="words">0</extent>
</physicalDescription>
<abstract lang="en">The Jos University Teaching Hospital (JUTH) has dialyzed >320 patients with ESRD since 1993. Objective: To identify differences, and their causes, in the practice of dialysis between Nigerian state‐owned dialysis units and U.S.A. Methods: We analyzed the characteristics of chronic dialysis at JUTH. Results: At JUTH, chronic dialysis is started at development of frank uremia (K/DOQI standard: creatinine clearance >10 mL/min, no overt uremia). Frequency of hemodialysis was 3 times weekly in 2 patients, twice weekly in 1 and once weekly or longer in 7 patients. Breakdowns in the dialysis machinery, which is outdated, forced additional decreases in the frequency of dialysis. Duration of a dialysis session was 4 h by prescription, but much longer in several sessions because of dialysis machine breakdown during the session (US standard: 4 h). 2 patients were dialyzed through arterio‐venous fistulas and 8 patients were dialyzed though temporary femoral vein dialysis catheters removed after each dialysis session. A vascular surgeon was unavailable. The urea reduction ratio was 45.38.6% (U.S.A target: 65%). The cost of the first dialysis session at JUTH is $160. With reuse of dialysis supplies, including dialyzers, dialysis tubing, femoral catheters, and guide wires, the cost of each subsequent dialysis session is $33. The minimal cost of dialysis with 3 dialysis sessions weekly and a new dialyzer every week is $501 per month. The cost of dialysis is borne exclusively by the patient. For comparison, average monthly income is $74 for unskilled laborers, $222 for dialysis technicians, $296 for dialysis nurses, and $889 for academic nephrologists. The low dose of dialysis has adverse effects on patient quality of life (frequent admissions with uremia). Despite notable exceptions (2 patients on dialysis for 12 and 9 years, respectively), survival of dialysis patients at JUTH appears to be poor. Conclusions: Underdialysis is frequent in Nigeria and is the consequence of socioeconomic conditions and technologic deficits. Removal of the economic burden of dialysis from the patients with ESRD is the first logical step toward correction of underdialysis.</abstract>
<relatedItem type="host"><titleInfo><title>Hemodialysis International</title>
</titleInfo>
<genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre>
<identifier type="ISSN">1492-7535</identifier>
<identifier type="eISSN">1542-4758</identifier>
<identifier type="DOI">10.1111/(ISSN)1542-4758</identifier>
<identifier type="PublisherID">HDI</identifier>
<part><date>2004</date>
<detail type="volume"><caption>vol.</caption>
<number>8</number>
</detail>
<detail type="issue"><caption>no.</caption>
<number>1</number>
</detail>
<extent unit="pages"><start>87</start>
<end>87</end>
<total>100</total>
</extent>
</part>
</relatedItem>
<identifier type="istex">811FC20D1E5DAF0C46BB3315588BDF7B333E6E77</identifier>
<identifier type="ark">ark:/67375/WNG-CPDNLMP1-X</identifier>
<identifier type="DOI">10.1111/j.1492-7535.2004.0085v.x</identifier>
<identifier type="ArticleID">HDI085V</identifier>
<accessCondition type="use and reproduction" contentType="copyright">© Wiley. All rights reserved.</accessCondition>
<recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-L0C46X92-X">wiley</recordContentSource>
<recordOrigin>Converted from (version ) to MODS version 3.6.</recordOrigin>
<recordCreationDate encoding="w3cdtf">2019-11-14</recordCreationDate>
</recordInfo>
</mods>
<json:item><extension>json</extension>
<original>false</original>
<mimetype>application/json</mimetype>
<uri>https://api.istex.fr/ark:/67375/WNG-CPDNLMP1-X/record.json</uri>
</json:item>
</metadata>
<serie></serie>
</istex>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/CovidV1/Data/Istex/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000949 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Istex/Corpus/biblio.hfd -nk 000949 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Sante |area= CovidV1 |flux= Istex |étape= Corpus |type= RBID |clé= ISTEX:811FC20D1E5DAF0C46BB3315588BDF7B333E6E77 |texte= Chronic Hemodialysis in a Nigerian Teaching Hospital }}
![]() | This area was generated with Dilib version V0.6.33. | ![]() |