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The ISN Sister Renal Centers Program Supports Advancements in Kidney Care for Children in Nigeria

In 2017, through the ISN Sister Renal Centers Program, staff from the nephrology section of the Alberta Children’s Hospital (ACH) in Alberta, Canada, began supporting staff from the pediatric nephrology unit at the Department of Paediatrics, University College Hospital (UCH) in Ibadan, Nigeria.

The partnership’s primary goal was to develop pediatric nephrology at the center in Ibadan. The main priorities were to:

  • Increase the provision of acute peritoneal dialysis
  • Develop research in pediatric nephrology
  • Support pediatric hemodialysis
  • Establish chronic peritoneal dialysis
  • Improve the detection and management of kidney diseases, such as congenital anomalies of the kidneys and the urinary tract
  • Establish pediatric kidney transplantations
  • Improve management of conditions such as lupus nephritis

Transforming pediatric dialysis: Progress at the Ibadan Center

Prior to the SRC partnership, the center in Ibadan used nasogastric tubes as makeshift peritoneal dialysis (PD) catheters and hemodialysis was limited to older children.

The supporting center in Alberta donated pediatric nephrology supplies, including pediatric-sized temporary and permanent hemodialysis vascular catheters. According to SRC liaison officers Dr. Adebowale Ademola and Dr. Julian Midgley, these developments have significantly advanced the center’s capacity. Now, the team can provide care for all children needing acute PD and has offered hemodialysis to infants as small as 12 kg.

Alberta Children’s Hospital staff visit the pediatric nephrology unit at UCH. From left to right: Dr. Susan Samuel, Dr. Andrew Wade, Dr. Marinka Twilt, Dr. Lorraine Hamiwka

ISN Programs work together to enhance kidney care skills and knowledge

As part of the SRC collaboration, Dr. Ademola, from the UCH, spent two and a half weeks on an observational visit to the ACH and two days as a visiting scholar at the SickKids Hospital in Toronto. Dr. Tope from the UCH also visited the ACH and participated in an eight-week research course.

Four workshops were held as part of the SRC collaboration, some with support from the ISN Continuing Medical Education Program. They covered topics such as peritoneal dialysis, kidney transplant, hemodialysis, research methodology, glomerulonephritis, fluid and electrolytes, and congenital anomalies of the kidney and urinary tract. Several ACH doctors joined UCH staff to present talks at these meetings. Physicians, trainees and allied healthcare workers from the center and further afield in Nigeria and other countries in sub-Saharan Africa attended.

Representatives from both centers visited the Federal Ministry of Health in Abuja to advocate for improved treatment of kidney disease. The meeting resulted in the submission of a concept note to the permanent secretary requesting improved access to immunosuppressive medication for kidney transplant recipients, extra training to support transplant programs, and support for a flagship transplant center at the UCH.

Participants at one of the CME meetings held as part of ISN SRC activities

Advancing research on pediatric acute kidney injury (AKI)

Before joining the ISN SRC Program, the Ibadan and Calgary centers partnered on a research project supported by the ISN Clinical Research Program, which led to the publication of joint research papers in pediatric nephrology.

The SRC Program fostered additional research initiatives, resulting in published manuscripts that have increased understanding of pediatric acute kidney injury and dialysis in Nigeria and Africa. Papers include:

Acute Kidney Injury Among Pediatric Emergency Room Admissions in a Tertiary Hospital in South West Nigeria: A Cohort Study

Pediatric Dialysis at a Tertiary Hospital in South-West Nigeria: A Four-Year Report

The UCH is a trial site for the Human Health and Heredity Kidney Disease Research Network (H3KDRN).

Staff from the ACH Pediatric Nephrology Department and UCH management in Ibadan, Nigeria

Expanding collaboration to advance pediatric kidney care in Nigeria

Having recently graduated from the SRC Program, the two teams now plan to form an ISN SRC trio partnership with another center in Nigeria. The collaboration would seek to help develop pediatric kidney care, training and research there. One pediatric nephrologist from this center has already received some training from the UCH and has since begun a one-year fellowship at the ACH.

Left to right: Mrs. Popoola, head of pediatric nurses, UCH, Dr. Andrew Wade from the ACH, and Dr. Adanze Asinobi, head of the pediatric nephrology unit, UCH, during one of the CME events held at the UCH

In addition, the partnership between the UCH and ACH has further enhanced the position of UCH as a training center for resident doctors from different centers in Nigeria or West Africa, assisting them in preparing for professional exams and improving their skills in pediatric nephrology.

Dr. Adanze Asinobi, the head of pediatric nephrology at the UCH, stated: “We are grateful to the ISN for their tremendous support of the Ibadan SRC partnership with Calgary. Looking to the future, we plan to use additional ISN Granting Programs to build on our progress at the UCH pediatric nephrology unit and help expand kidney care in Nigeria and further afield.”

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