In view of the increasing number of patients requiring renal replacement therapy (RRT) every year worldwide, attention has focused over the last two decades on meeting the health care need of patients with end-stage renal failure (ESRF). More recently, increasing awareness of the growing burden of chronic kidney disease (CKD), with a large percentage of the population affected by early stages of CKD, has shifted attention and health care priority to the prevention and early detection of CKD. This article addresses issues related to general population as well as targeted screening, favoring the latter. It also examines some of the screening initiatives undertaken in both the developing and developed worlds. It also highlights the links between albuminuria, CKD, and cardiovascular disease (CVD) as an increasing number of studies identify albuminuria/proteinuria, as well as CKD as major markers of CVD. Finally, a brief review is included of primary and secondary intervention strategies for CKD and issues related to their implementation: manpower and funding.

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Background Despite available evidence based recommendations and guidelines there are differences in the preferred type of vascular access in use in different localities and geographical regions. This one center study on the practice pattern of vascular access was carried out in Maiduguri, Nigeria covering a period of the first 5 years of renal care in the area. Methods We analysed the dialysis and hospital records of consecutive patients that received hemodialysis in the renal center during the period between January 2000 and December 2004. Data comprised patients' demographics, vascular access used, complications encountered during the treatment period. Clinical and laboratory features of the patients were also recorded and analysed. Results The study involved one hundred and seventy-nine patients (M:F=2:1) who suffered kidney failure whose cause was clinically determined to be mainly due to chronic glomerulonephritis, hypertension, obstructive nephropathy and interstitial nephritis. Majority presented as late referrals to the nephrologist. Overall 9 % of the study population used AVFs while 91 % used catheters inserted into the femoral or internal jugular veins. Conclusion The use of catheters for vascular access was the practice in the majority of the patients and this is possibly related to the poor survival of the patients on hemodialysis. Socioeconomic circumstances of the patients in turn largely influenced the rate of AVF use.

The study investigated whether argument and self-efficacy would have an influence on marital distress among police personnel. A total number of one hundred and ninety-seven (197), Nigeria police force (NPF) personnel working in Police headquarters; served as participants for the study. They were selected using non-probability sampling (convenient sampling techniques). They consist of 87(44.2%) females and 110 (58.5%) males; their age ranged from 22-51 years and their mean age was 34.94 with standard deviation of 6.96. Three instruments were used namely: Marital Stress Inventory, Argumentativeness Scale and General Self-Efficacy Scale. Two by Two Factorial design was adopted. Two Way Analysis of Variance statistics was used to analyze the data.  Two hypotheses were tested: the result indicated that hypothesis one which stated that there will be a significant difference between those with positive argument and those with negative argument on marital distress among police personnel and hypothesis two which stated that there will be a significant difference between those with positive self-efficacy and those with negative self-efficacy on marital distress among police personnel were both not accepted at p>.05. Therefore, the study recommended that counselling/marital psychologist should intensify their efforts to organize seminars/conferences on the implications of these factors (argument and self-efficacy) on marital distress among police personnel.