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In April 2011, at the 8th Conference on Kidney Disease in Disadvantaged Populations: Disparities in Renal Disease – Moving Towards Solutions, Dr Samuel from Calgary and Dr Ademola from Ibadan met and initiated a collaboration. Soon afterwards the Ibadan and Calgary centers secured an ISN clinical research grant. Subsequently, in 2017, the Emerging Centre (EC) Ibadan – Supporting Centre (SC) Calgary ISN SRC program was established to improve paediatric kidney care in Ibadan and throughout Nigeria.
EC and SC faculty taught research methodology and paediatric nephrology topics at four Continuing Medical Education (CME) events at the EC in 2017, 2019, 2020 and 2023. Two were pre-conference workshops for the Paediatric Nephrology Association of Nigeria (PNAN) and Nigerian Association of Nephrology (NAN) meetings to maximise attendance from Nigeria and, post COVID, virtually from other African countries. To meet EC educational needs SC faculty included an expert in prenatal detection of Congenital Abnormalities of the Kidney and Urinary Tract in 2020 and a paediatric rheumatologist in 2023.
Dr Ademola visited the SC to observe clinical practice, attend presentations and also give Grand Rounds on the challenges of paediatric practice at the EC and treatment/equipment modifications that have been adopted to overcome these challenges. A newly qualified paediatric nephrologist from the EC participated in an 8-week research course at the SC.
Additional funding was obtained from the SC and International Pediatric Nephrology Association Teaching Course grants. During COVID and subsequently the EC faculty have had virtual access to SC educational rounds. The primary physicians from each centre have maintained monthly Zoom contact.
At the EC, before the SRC partnership, hemodialysis (HD) was limited to older children with acute kidney injury (AKI). In kind SC donations of HD catheters were adapted for PD in infants and young children. The EC used HD catheter introducers to insert nasogastric tubes as PD catheters. The donations enhanced acute PD and acute and long-term HD in younger children. The SRC collaboration has permitted the publishing of manuscripts that have contributed significantly to peritoneal dialysis appropriate to the Nigerian/African context.
The CME events have enhanced training of Nigerian paediatric residents who have returned to their centers to implement HD and/or PD for children with AKI. As part of a proposed ISN trio SRC program a resident from Akure, a second Nigerian centre, has a one-year fellowship at the SC to further develop nephrology in his center.
In 2023, following a joint EC and SC physician visit to the Nigerian Federal Ministry of Health in Abuja, a concept note was submitted requesting government support for immunosuppressive medications and extra training required to establish a successful transplant program in Nigeria.
The ISN SRC program can facilitate ongoing research, understanding the burden and the challenges of management of chronic kidney disease and support for enhancing kidney health in less resourced countries.