Abstract

Introduction: This study was aimed at assessing nurses’ knowledge of the prevalence of chronic renal failures at the Buea regional hospital.

Method A cross sectional study was carried out from February to march 2021 at the Buea regional hospital  and a total number of 110 nurses were been assessed and questionnaires were been given to them and pleased for them to answer and data was been collected and analyzed using micro excel.

Results: A total of 13 patients were been assess at the hemodialysis center at the Buea regional hospital and from the results it shows males were 9 while females were just 4 in number giving a prevalence of 69.2% and 30.8% respectively.

Conclusion: the result was found higher in males especially of the age 40 and above more than females.

Recommendation: this study suggests that there should be an accurate management of high blood pressure and also a reduction in the consumption of tobacco and tobacco-related products.

CHAPTER ONE

INTRODUCTION

This chapter will be talking on background, the problem statement and the general objectives, specific objectives, the Research questions, the significance of the study, the scope of the study and the operational definition of terms used in chapter one.

1.1 BACKGROUND

According to national institute for health and care excellence (NICE.2015) chronic renal failures was categorized into five stages depending on the estimated glomerular filtration rate (eGFR) and evidence of kidney damage. The most severe of these stages, termed end-stage kidney failure (ESKF) is termed stage 5 Chronic renal failures where the eGFR is < 15 ml/minute/1.73 m2.

The initial recognition of kidney disease as independent from other medical conditions is widely attributed to Richard Bright’s 1827 book “Reports of Medical Cases,” which detailed the features and consequences of  kidney disease was used to refer to any type of kidney disease. Bright’s findings led to the widespread practice of testing urine for protein (Olivier 2000).

The study of kidney disease was furthered by William Howship Dickinson’s description of acute nephritis in 1875 and Frederick Akbar Mahomed’s discovery of the link between kidney disease and hypertension in the 1870s.In the twentieth century, investigators such as Homer Smith revealed the underlying physiology of the kidney. Smith’s findings led to important medical therapies for multiple kidney diseases.

As technology improved, therapy in the field of nephrology was further advanced with the first successful use of hemodialysis in 1945 by Willem Kolff. One of the first successful Case series describing the use of immunosuppression (azathioprine or 6-mercaptopurine and glucocorticoids) was reported in the New England Journal of Medicine in 1963 by Murray and colleagues.(Brandy 1996) Forty-seven years have passed since the first patient started treatment for chronic renal failure by repeated hemodialysis (HD) at the University of Washington Hospital in Seattle in March 1960, and some 34 years have elapsed since the United States started treatment(Christopher R Blaggel et al 2009)

According to Global burden of disease (GBD2015) study also estimated that, in 2015, 1.2 million people died from renal failure, an increase of 32% since 2005. In 2010, an estimated 2.3–7.1 million people with end-stage renal disease died without access to Dialysis. This therefore means at least 100 thousand people died in 2015 due to chronic renal failures. Globally, estimated CRF prevalence worldwide varies from 7% in South Asia and 8% in Africa to as high as 11% in North America and 12% in Europe, The Middle East, and East Asia, and Latin America.

Worldwide, an estimated 1 million people die each year from untreated renal failure (Irene 2019).chronic renal failures is a global problem with about 10% of the world’s population suffering from the disease. Another study carried out by  (Zhang et al 2008) chronic renal failures has become a leading care issue worldwide in a systematic review in 26 studies in different population worldwide, involving ten studies from America and 8 from Europe and 8 from Asia and Australia, the median Prevalence of CRF for  persons 30 years and above was 7.3%. the prevalence of CRF was mostly amongst the population and icreases with age and in person’s age 64 years and above, the prevalence rised from 24.5 to 35.5.More than 661,000 Americans have kidney failure.

Of these, 468,000 individuals are on dialysis, and roughly 193,000 live with a functioning kidney transplant.Kidney disease often has no symptoms in its early stages and can go undetected until it is very advanced. (For this reason, kidney disease is often referred to as a “silent disease.”The adjusted incidence rate of ESRD in the United States rose sharply in the 1980s and 1990s, leveled off in the early 2000s, and has declined slightly since its peak in 2006.(Murphy et al 2001)But in sub-Saharan Africa, about 14% of the adult population suffers from Chronic renal failures. Between 1999 and 2006, South Africa saw a rise of 67% in deaths as a result of Chronic renal failures an it is still a major call for health challenge in Africa. (Johan et al 2017).

In a cross-sectional population study, that involved over 8000 participants aged 40–60 years at six centres from four African countries, the overall prevalence of chronic kidney disease was reported as 10·7% (95% CI 9·9–11·7)(Gorge et al 2018)

The overall prevalence of CKD in Cameroon is unknown. However, prevalence rates of 10.9% and 14.1% have been reported in an urban and rural setting of the Western Region of Cameroon, respectively(Martin et al 2018).according to ( valerie ndip et al 2020) Chronic renal failures  affects about one in 10 adults in the general population in Cameroon The prevalence of CRF in adult Cameroonians varied between 11 and 14.2% .

The prevalence of hypertension (31%), diabetes mellitus (6%), and obesity (15%) are high with a prevalence of HIV of 4% Dialysis was introduced in Cameroon in the early 1980s, and included both peritoneal and hemodialysis. However, hemodialysis has been the only available modality of CRF for over two decades now. Patients with hypertension, diabetes mellitus, and human immunodeficiency virus bear the greatest burden of CRF in Cameroon. Advanced age, hypertension, diabetes mellitus, and obesity are major factors associated with CRF. Chronic renal failures in Cameroon is associated with high morbidity and mortality and huge economic cost on the patient.

The Research will be carried out at the Buea regional hospital to assess nursing knowledge on the prevalence of chronic renal failures at the Buea regional hospital during the month of February and early march.

1.2 PROBLEM STATEMENT

Based on the World Health Organization (WHO) chronic renal failures is becoming a world challenge  mostly in the developing countries.(WHO 2015). From the above the rate of the disease is on an alarming rate and it is an increasing psychological and social economic burden on the patients, family and friends and also the society and it is also exceeding with limited technologies such as a hemodialysis center which is been limited to treat these diseases.

The researcher has witness many people with chronic renal failures and end stage kidney diseases at the Dschang district hospital when on internship in the year 2019 and these people are liability to their family and the population around them as it make these patients depend on them and also in relation to finance and care.

All these brings up a question whether the nurses are aware of the diseases, it’s risk factors and the means to which it could be prevented. These is important to them because it   will limit mortality rate and other kidney related diseases thereby making me to carry out research on assessing Nursing Knowledge On The prevalence chronic renal failures at the Buea regional hospital.

1.3 OBJECTIVES

1.3.1 GENERAL OBJECTIVES

To assess nursing knowledge on the prevalence of chronic renal failures

1.3.2 SPECIFIC OBJECTIVES

1) To investigate nurse’s knowledge of chronic renal failures

2) To evaluate nurse’s knowledge of the causes and risk factors of chronic renal failures

3) To assess nurse’s knowledge of the consequences of chronic renal failures

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