Abstract

The purpose of this study was to assess nurses’ knowledge of the prevalence of chronic renal failures at the Buea regional hospital.

A cross-sectional study was conducted at the Buea Regional Hospital from February to March 2021, and a total of 110 nurses were assessed, and questionnaires were given to them and pleased for them to answer, and data was collected and analyzed using micro excel.

A total of 13 patients were assessed at the Buea regional hospital’s hemodialysis unit, with males accounting for 9 and females for 4, resulting in a prevalence of 69.2 percent and 30.8 percent, respectively. Males, especially those aged 40 and up, were found to have a higher rate of this result than females.

According to the findings, high blood pressure should be properly managed, and cigarettes and tobacco-related items should be consumed less frequently.

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 To The Study

Chronic renal failure was classified into five phases by the National Institute for Health and Care Excellence (NICE.2015) based on the estimated glomerular filtration rate (eGFR) and proof of kidney damage.

Step 5 Chronic renal failures, where the eGFR is less than 15 ml/minute/1.73 m2, are the most serious of these levels, also known as end-stage kidney failure (ESKF).

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 the 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 the 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 failure 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 populations 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 increases with age and in person’s age 64 years and above, the prevalence rose 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 and it is still a major call for health challenges in Africa. (Johan et al 2017).

In a cross-sectional population study, that involved over 8000 participants aged 40–60 years at six centers 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 and et al 2020) Chronic renal failure 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 failure is becoming a world challenge mostly in developing countries.(WHO 2015).

From the above, the rate of the disease is at 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 witnessed many people with chronic renal failures and end-stage kidney diseases at the Dschang district hospital when on an internship in the year 2019 and these people are a liability to their families and the population around them as it makes these patients depend on them and also in relation to finance and care.

All these bring up the question of whether the nurses are aware of the diseases, it’s risk factors, and the means by which it could be prevented.

This is important to them because it will limit mortality rate and other kidney-related diseases thereby making me carry out research on assessing Nursing Knowledge On The prevalence of 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 on chronic renal failures At The Buea Regional Hospital
2. To evaluate nurse’s knowledge on the causes and risk factors of chronic renal failures At The Buea Regional Hospital
3. To assess nurse’s knowledge on the consequences of chronic renal failures At The Buea Regional Hospital

1.4 Research Questions

1. What knowledge do nurses have on chronic renal failures At The Buea Regional Hospital?
2. Do nurses have adequate knowledge on the prevalence of chronic renal failures At The Buea Regional Hospital?
3. What knowledge do nurses have on the consequences of chronic renal failures At The Buea Regional Hospital?