This is a report of observations on a hospital-based study over the prevalence of obesity and dyslipidaemia seen in hypertensives attending our hypertension clinic. 409 patients were screened and 315 (77%) found hypertensive (BP>140/70 mmHg): 71.6% of 109 women screened (mean systolic 165 mmHg) were obese (BMI>30) as against 50.5% of 184 men (mean systolic 161 mmHg). Total cholesterol (TC) concentration was higher in women (mean, 5.28 mmol/L) [4.9-5.8 mmol/L] than in men (mean, 5.1 mmol/L) [5,0-5.4 mmol/L] but the mean atherogenic index (TC/HDL-cholesterol) was higher in men (4.8) than in women (4.1) (normal <4.5). The aim of this study is to sensitise our relevant clinicians to look for obesity and dyslipidaemia coexisting with hypertension, treat such cases aggressively to avoid coronary event and progressive renal disease. This study is to be extended to other geopolitical zones in Nigeria through the coordination of Nigerian Association of Clinical Chemists (NACC).

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IntroductionContinuous ambulatory peritoneal dialysis (CAPD) is the ideal modality for renal replacement therapy in most African settings given that it is relatively cheaper than haemodialysis (HD) and does not require in-centre care. CAPD is, however, not readily utilised as it is often complicated by peritonitis leading to high rates of technique failure. The objective of this study is to assess the prevalence of CAPD-related peritonitis and all-cause mortality in patients treated with CAPD in Africa.Methods and analysisWe will search PubMed, EMBASE, SCOPUS, Africa Journal Online and Google Scholar for studies conducted in Africa from 1 January 1980 to 30 June 2017 with no language restrictions. Eligible studies will include cross-sectional, prospective observational and cohort studies of patients treated with CAPD. Two authors will independently screen, select studies, extract data and conduct risk of bias assessment. Data consistently reported across studies will be pooled using random-effects meta-analysis. Heterogeneity will be evaluated using Cochrane’s Q statistic and quantified using I2 statistics. Graphical and formal statistical tests will be used to assess for publication bias.Ethics and disseminationEthical approval will not be needed for this study as data used will be extracted from already published studies. Results of this review will be published in a peer-reviewed journal and presented at conferences. The Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015) framework guided the development of this protocol.PROSPERO registration numberCRD42017072966.

Delivery of kidney care in Africa is significantly constrained by various factors. In this review, we used International Society of Nephrology–Global Kidney Health Atlas (ISN–GKHA) data for Africa to address sub-regional differences in care delivery in the continent with focus on infrastructure, workforce, and the economic aspects of kidney care. Forty two African countries participated in the survey conducted in 2018. North Africa had the highest proportions of nephrologists [12.53 per million population (pmp)], nephrology trainees (2.19 pmp) and haemodialysis (HD) centres (8.58 pmp); whereas southern Africa had the highest proportions of peritoneal dialysis (PD) centres (0.89 pmp) and kidney transplant (KT) centres (0.29 pmp); West Africa had the greatest nephrology workforce shortages. The annual median costs of HD (US$22,731 [interquartile range (IQR): US$1,560–43,902]) and PD (US$34,165 [US$34,165–34,165]) were highest in Central Africa and only Algeria, Egypt and South Africa reported zero co-payment for all modalities of kidney replacement therapy in the public sector. Policies on chronic kidney disease and non-communicable diseases were scarcely available across all African sub-regions. The ISN–GKHA African data highlight a stark difference in kidney care measures between North and sub-Saharan Africa and also suggest the need for a more cohesive approach to policy formulations that support and protect patients with kidney disease in the continent, especially from the excessive costs associated with care. Using the World Health Organization (WHO) Global Action Plan for noncommunicable diseases, this paper proposes an African roadmap for optimal kidney care. Keywords: CKD, kidney failure, dialysis, transplantation, cost, policy

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