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“A Real and Measurable Impact on the Provision of Kidney Care to the People of Rivers State in the Niger Delta Region” – Sister Renal Centers Partnership Graduates the Program  

The multidisciplinary renal team comprising renal consultants, doctors in renal training, and nurses at the University of Port Harcourt Teaching Hospital

The University of Port Harcourt Teaching Hospital UPTH in Nigeria established a Sister Renal Centers (SRC) partnership in 2017 with support from the Salford Royal Hospital (in Manchester, UK. This partnership has now graduated from the program, having significantly impacted kidney care services in the Niger Delta region.

According to Professor Pedro Emem-Chioma, liaison officer at the emerging center, local kidney services were limited before the SRC partnership was established. There was inadequate hemodialysis and no peritoneal dialysis (PD) services, along with limited awareness of early recognition and diagnosis of acute kidney injury (AKI) amongst non-nephrologist doctors and the general public.

The partnership had several overlapping objectives:

  • To support continuing medical education in general nephrology, dialysis, and kidney transplant
  • To develop peritoneal dialysis (PD) services to manage AKI
  • To implement preventive and management initiatives for AKI
  • To provide training in kidney biopsy techniques

Hosting the first international nephrology webinar in the Niger Delta Region

The SRC pair organized the first-ever international nephrology webinar in the region, featuring speakers from the UK. The conference promoted best practices in renal care and provided cutting-edge updates on clinical nephrology. One hundred and twenty participants from across the region joined. Since then, three more such webinars have been held.

This was one of many webinars held within the SRC program focusing on general nephrology, dialysis and transplants. Several educational meetings and training programs were held within the program with visits from staff at the SRH, including annual training in interventional nephrology. In addition, a member of the UPTH kidney care team spent time at the center in the UK.

Equipping staff with essential skills: virtual training in peritoneal dialysis

Through the partnership, nurses and doctors were trained in PD care via virtual lessons from staff at SRH. They also learned through educational material from the SRH YouTube channel. UPTH staff learned various aspects of PD treatment, including catheter placement, insertion pathway and patient selection. Additionally, they were trained in kidney biopsy procedures and post-procedure care. Through this training, an acute PD program was set up using locally made PD fluids.

According to Professor Ibi Erekosima, ISN Liaison officer at the supporting center, “The ISN SRC partnership has enabled the promotion of best practices in kidney care and provided cutting-edge knowledge and skills in clinical nephrology at the Port Harcourt hospital.”

A member of the Salford renal team demonstrates tunneled line insertion

Proactive strategies: AKI early detection and management initiatives

The centers collaborated to implement point-of-care creatinine for the early detection and management of community-acquired AKI and to educate local communities on preventing and treating AKI in line with the ISN 0by25 Initiative.

Staff from the University of Port Harcourt Teaching Hospital and the Salford Royal Hospital in Port Harcourt at one of the AKI workshops held as part of SRC partnership activities. The late Professor Wokoma (3rd from right) was the first consultant nephrologist who started the renal unit at UPTH.

Three AKI workshops were held for community health workers, clinicians, and nurses. A risk stratification algorithm for AKI in adults was developed and used successfully at UPTH for the early identification of AKI. This program is now being rolled out across community health centers in the region with support from the Primary Health Care Board to ensure sustainability. Five AKI-related and other abstracts were accepted and presented at congresses, including WCN’20

Participants at one of the AKI workshops

Collaborative efforts reshape local kidney care landscape

The program’s success alongside ISN advocacy efforts may have contributed to the local government building an ultra-modern regional kidney center, which now receives patients from other parts of the country.

The new renal center in the Niger Delta region

Kidney care staff at UPTH received an ISN Clinical Research Grant in 2021 for the study “Goal-directed Incremental Peritoneal Dialysis in Nigeria,” which integrated patient-reported outcomes. The Nigerian team produced two abstracts from this project, presented at the World Congress of Nephrology (WCN) 2022 and published in the supplement to Kidney International Reports®.

From beneficiary to supporter: Future expansion in the region

According to  Professor Emem-Chioma, the SRC partnership has had “a real and measurable impact on the provision of kidney care to the people of Rivers State in the Niger Delta region of Nigeria.”

The UPTH intends to form a partnership as a supporting center with the new renal unit mentioned above.

This collaboration will seek to address ongoing issues in the area, such as poor accessibility to kidney care services in other parts of the Niger Delta region, the expense of imported PD fluids, and negative misconceptions about PD.

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