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Safe and effective vaccination of patients living with chronic kidney disease requires an understanding of the unique immunological milieu of this population and of their potential for disease-specific side effects. This Position Statement, issued on behalf of the South African Nephrology Society, provides recommendations for local policy development and for individual practice administration and monitoring of SARS-CoV-2 vaccinations in patients living with chronic kidney disease.

Background The estimation of glomerular filtration rate (GFR) plays a vital role in assessment of the renal function . This study evaluated the performance of the CKD-EPI creat and MDRD equations in the South African Kwa-Zulu Natal population. Objectives The objectives if the study were to compare the of CKD-EPIcreat and MDRD equations in the selected population to the measured GFR using Sodium Technetium-99 m-diethylene-triamine-pentaacetate clearance derived GFR. Method Records of adult patients with measured GFR performed at the Nuclear Medicine Department at Inkosi Albert Luthuli Central Hospital, Durban, South Africa from 1 April 2014 to 31 March 2016 were reviewed. eGFR for all included patients was calculated using the MDRD equation without African American correction factor and the CKD-EPIcreat equation with and without the African American correction factor for the Black African patients. Statistical comparison of the eGFR with measured GFR was performed with Bland Altman bias plots, Wilcoxon match pairs signed ranks test and accuracy within 10% and 30%.ROC curve analysis assessed the sensitivity and specificity at eGFR Results After exclusion, 287 patients were included for analysis with sufficient numbers for only the Black African and Indian patients. None of the equations showed accuracy of eGFR within 30% of measured GFR for 90% of patients. In the Black African population, the CKD-EPIcreat equation without the correction factor performed best. 17% and 14.4% of the Black African participants would be reclassified with the CKD-EPIcreat equation without and with the African American correction factor respectively compared to mGFR at a cut-off of 60 mls/min/1.73m2. Conclusion None of the evaluated equations attained the 2002 KDOQI benchmark of P30 >90%. 11.1–17% of individuals would have been incorrectly classified using the CKD-EPIcreat equation.

Hypertension in childhood leads to hypertension in adult life, the strongest risk factor being obesity. This study determined the prevalence of primary hypertension and its risk factors in Grade XII learners in KwaZulu-Natal, South Africa, from March 2016 to June 2017. Weight, height, body mass index (BMI), random finger prick cholesterol and glucose, and spot urine for an albumin : creatinine ratio were measured. An average of three separate blood pressure readings taken was at least 5 minutes apart. Five hundred and sixty-four learners had weight, height, and BMI; 536 had random blood glucose; and 545 had cholesterol and random spot urine albumin : creatinine ratios measured. Prehypertension was detected in 168 (29.7%) and hypertension in 77 (13.7%) of learners. Ninety (15.9%) were overweight and 75 (13,3%) were obese. Hypercholesterolaemia was present in 58 (10.8%) and a high spot random urine albumin : creatinine ratio in 5 (1.0%). None had a high blood glucose level. Both prehypertension and hypertension in all learners showed a significant increase with increasing BMI. Six (1.0%) learners had metabolic syndrome. Female learners in other racial groups (defined as Indian, mixed race, and White learners), overweight, and obese learners showed significantly higher rates of hypercholesterolaemia. We showed overweight and obesity as risk factors for prehypertension and hypertension. This presages the need for an appropriate diet and adequate exercise in a child’s school career.

Background: The profiles of patients with chronic kidney disease (CKD) in rural areas have long been thought to differ from those of their urban counterparts. However, there have been few local studies to confirm this. Methods : A retrospective review was conducted to compare the characteristics of patients with CKD from rural and urban areas in the South African province of KwaZulu-Natal that were referred to Inkosi Albert Luthuli Central Hospital (IALCH) from April 2012 to April 2013. Results: A total of 529 patients were included. The mean age of patients from rural areas was lower (40.6 vs. 53.4 years) and all these patients were Black. The rural patients had lower estimated glomerular filtration rates (mean values of 16.3 vs. 25.4 ml/min/1.73 m², p < 0.001). Regarding the prevalence of comorbid conditions, rural patients had higher rates of HIV infection (47.9% vs. 18.3%) but lower rates of hypertension (69.6% vs. 83.9%) and diabetes (20.3% vs. 54.1%). Conclusions: In this study, patients with CKD referred from rural areas differed significantly from those from urban areas. Rural patients presented at a younger age, had a higher prevalence of HIV infection, and had more advanced kidney disease at referral. Poor socio-economic circumstances limiting access to health care and less screening for CKD may contribute to delayed referrals from rural areas.

This correction serves to update the reported numbers of new kidney transplants performed annually since 2012 in the public sector in the province of KwaZulu-Natal.