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First Emergency Hemodialysis Session at the Nephrology Department of the Teaching Hospital of Yopougon: About 146 Cases

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Open Journal of Nephrology 2020年第4期10卷 338-347页

作者： Konan Serge Didier Kissou Pegdebamba François Guei Monlet Cyr diopoh sery patrick Aka Jean Astrid Yao Kouamé Hubert Nephrology-Internal Medicine Department D CHU Treichville Abidjan Ivory Coast Department of Nephrology CHU Yopougon Abidjan Ivory Coast

Context: Due to the late referral of the pads to the nephrologist and the lack of medical follow-up, many patients are admitted with complications from kidney disease requiring the urgent start of hemodialysis sessions. Purpose: Study the profile of emergency hemodialysis patients in order to ease their management. Methods: This was a retrospective, descriptive and analytical study carried out at the Nephrology Department of the Teaching Hospital of Yopougon from January 1st to December 31st, 2016. This study included all patients who had received a first session of hemodialysis in an emergency context. Results: We collected 146 patients with an average age of 39.80 ± 14.55 years and a sex ratio of 0.6 for men. Before admission, patients were known as hypertensives (63.9%), followed by CKD (23.9%) and HIV-infected (8.2%). The main clinical signs were hypertension (64.3%), edema (44.5%) and coma (30.1%). Anemia was observed in 97.2% of cases and it was less than 8 g/dl in 57.5%. Kidney failure was chronic in 75.3% and acute in 24.6%. Chronic nephropathies were glomerular (54.1%), vascular (20.5%). The main indications for hemodialysis were encephalopathy (33.5%), severe uremia (28%), acute pulmonary edema (19.8%), persistent anuria (11.6%) and hyperkalemia (5.4%). The vascular approach was a catheter in 97.2% (femoral site in 53.4% and jugular in 43.8% and arteriovenous fistula in 2.7%). Death was observed in 17.8%. In univariate analysis, age > 65 years (p = 0.04), coma (p = 0.004) and acute kidney failure (p = 0.02) were associated with the risk of death, and in multivariate analysis, only coma (p = 0.024, OR = 5.88) seemed to be associated with mortality risk for our patients. Conclusion: Hemodialysis in an emergency situation is a common practice in the Teaching Hospital of Yopougon and mainly concerns patients with CKD.

关键词： Kidney Failure Hemodialysis Emergency

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Evolution of Proteinuria and Renal Function in Women with Pre-Eclampsia at the Gynecology Department of the Teaching Hospital of Cocody

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Open Journal of Nephrology 2023年第4期13卷 405-419页

作者： Ouattara Kolo Claude Meudje Youmbi Chimène diopoh sery patrick Konan Serge Didier Kouadio Marie Dominique Gnamon Ophélia Aka Marie Josiane Yao Kouamé Hubert Nephrology-Internal Medicine Department D CHU Treichville Université Felix Houphouet Boigny Abidjan C&ocircte d’Ivoire

Background: Pre-eclampsia has long been considered as a disease that disappears after the removal of the placenta. It has now been shown that its symptoms can persist for months after giving birth. Objectives: To study the evolution of proteinuria and renal function in women with pre-eclampsia. Patients and Methods: An analytical prospective study was carried out in the Hospitalization Unit of the Gynecology Department of the Teaching Hospital of Cocody (Abidjan) from May 3, 2021 to November 15, 2021. It focused on the follow-up of proteinuria and renal function in 50 women who had pre-eclampsia during their pregnancy, in the three months following their delivery. Results: The average age of the patients was 30.38 ± 6 years (range 18 and 40 years). Thirty-two percent were nulliparous and 62% had no risk factors for pre-eclampsia. The diagnosis of pre-eclampsia was made in 52% of cases before 37 weeks of amenorrhea. Sixty-two percent had Grade 3 arte-rial hypertension. The average proteinuria/creatininuria ratio was 3592.08 ± 7009.57 mg/g and 32% of women had glomerular grade proteinuria. The mean serum creatinine was 13.61 ± 12.62 mg/l. AKI (Acute Renal Failure) was present in 30% of women. All patients had received a central antihypertensive drug of which 88% were a calcium channel blocker. For the delivery mode, a Caesarean section was performed in 88% of cases. In the three months postpartum, 40% of women had persistent hypertension, 58% had persistent proteinuria and 6% had persistent impaired renal function. Prematurity (p = 0.0091), IUGR (intrauterine growth restriction) (p = 0.0012) and IUFD (intrauterine fetal death) (p = 0.0012) were associated with the persistence of proteinuria at M3 postpartum. Conclusion: Symptoms of pre-eclampsia do not automatically disappear after the delivery. Proteinuria and renal failure can persist beyond three months after the delivery and require treatment by a nephrologist.

关键词： Proteinuria Pre-Eclampsia Renal Function

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Outcomes of Hemodialysis Patients in Public Centres in Abidjan from September 2018 to October 2021: Data from the Renal Registry of Cote d’Ivoire

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Open Journal of Nephrology 2024年第3期14卷 413-426页

作者： sery patrick diopoh Arthur Kanganga Serge Didier Konan Kolo Claude Ouattara Marie-Dominique Kouadio Mohamed Alex Moudachirou Kouamé Hubert Yao Department of Medicine and Medical Specialties University Flix Houphout-Boigny Abidjan Cote dIvoire National Centre for Prevention and Treatment of Renal Failure Abidjan Cte dIvoire

Background: Hemodialysis is the most widely used renal replacement therapy in developing countries such as Cote d’Ivoire. Objective: To study the outcome of chronic hemodialysis patients in public centres in Abidjan using data from the Renal Registry of Cote d’Ivoire (2RCI). Method: This was a prospective analytical cohort study of End Stage Kidney Disease (ESKD) patients undergoing iterative hemodialysis in the network of public hemodialysis centres in Abidjan and who had been registered in the 2RCI register by September 2018. Results: Our study involved 363 cases out of 379 patients registered in the 2RCI registry database in 2018. The mean age of the patients was 47.3 ± 12.1 years, with a male predominance (sex ratio 1.97). In 70.24% of cases, they had no health insurance. The average duration of dialysis for our patients was 6.94 ± 4.1 years, with extremes of 2 and 28 years. This duration was less than 5 years in 44.3% of cases, between 6 and 10 years in 42.9% and more than 10 years in 12.6% of cases. The comorbidities found were hypertension in 95.6% of cases, diabetes in 7.8% and HIV in 4.6%. Anemia was found in 68% of cases and stroke in 8.6%. During the study period, 161 deaths were observed, representing a mortality rate of 44.35%. Acute lung oedema (29.8%), stroke (6.8%) and other cardiovascular diseases (19.3%) were the main causes of death. In multivariate analysis, factors such as age ≥ 65 years (HR = 3.66;CI 95% = 1.55 - 8.67;p = 0.003), “married/coupled” status (HR = 2.02;CI 95% = 1.24 - 3.31;p = 0.005) and normal weight at the start of dialysis (OR = 9.59, CI95% = 4.19 - 21.95;p = 0.001) were associated with the risk of death. Conclusion: Hemodialysis is performed in Abidjan on young patients. The mortality rate after three years of dialysis is very high. Hence the need to pursue the policy of decentralizing public centres and optimizing access to dialysis in terms of quality and quantity in order to improve patient survival.

关键词： Chronic Hemodialysis Death Renal Registry Cote d’Ivoire

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COVID-19 Infection and Acute Kidney Injury: About 43 Cases Report Collected at the Nephrology Department of the Farah Polyclinic in Abidjan

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Open Journal of Nephrology 2022年第4期12卷 410-425页

作者： Badomta Dolaama Serge Didier Konan sery patrick diopoh Mohamed Alex Moudachirou Komlan Georges Tona Eyram Yoan Makafui Amekoudi Mawufemo Claude Tsevi Kouamé Hubert Yao Farah Polyclinic Abidjan Cote d’Ivoire Nephrology and Hemodialysis Department Teaching Hospital of Sylvanus Olympio Lome Togo Nephrology Department Teaching Hospital of Treichville Treichville Cote d’Ivoire Nephrology Department Teaching Hospital of Kara Lome Togo

Background: Acute kidney injury (AKI) is one of the increasingly described complications of coronavirus infection. Objectives: To identify factors associated with death in patients with acute kidney injury (AKI) during Coronavirus disease (COVID-19) in Abidjan, C?te d’Ivoire. Material and Method: This was a monocentric retrospective analytical study of all patients over 18 years of age with AKI during COVID-19 at the Farah Polyclinic in Abidjan, C?te d’Ivoire. AKI was defined and ranked according to Kidney Disease Improving Global Outcomes (KDIGO) 2012. The data were collected from the medical record and processed using RStudio. Results: Forty-three cases were collected. The average age was 58.5 12 years. The sex ratio (M/F) was 4.4. The main comorbidities were high blood pressure (60.4%) and diabetes (37.2%). AKI was at KDIGO stage 3 in 58%, KDIGO 2 in 21% and KDIGO 1 in 21%. The diagnosis of acute tubular necrosis was retained in 44.2% of patients followed by acute functional kidney injury in 32.6%. Hemodialysis was initiated in 48.8% of cases. The main indication of dialysis was anuria (46.6%). In total, 55.8% of patients died. Factors associated with death were KDIGO stage (p = 0.049), and invasive ventilation (p Conclusion: Mortality is high in patients with AKI during COVID-19 infection.

关键词： Coronavirus Acute Kidney Injury Abidjan 2020

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Epidemiological and Clinical Characteristics of Renal Diseases Diagnosed by Biopsies in Ivory Coast

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Open Journal of Pathology 2022年第3期12卷 100-113页

作者： Kouame Justin N’Dah Weu Melanie Tia Alain Didier Abouna Ibrahiman Toure Amelie Delphine Lagou Monley Cyr Guei Ibrahim Cherif Moussa Traore Eyram Amekoudi Attaah Ange Rebecca Kobenan sery patrick Olivier Diopo Kouame Hubert Yao N’Guessan Clement Ackoundou Koffi Laurence Adonis Dazé Apolinaire Gnionsahié Mohenou Isidore Jean Marie Diomande Department of Anatomic Pathology University Teaching Hospital of Bouake Bouake Ivory Coast Department of Nephrology University Teaching Hospital of Bouake Bouake Ivory Coast Department of Anatomic Pathology University Teaching Hospital of Cocody Abidjan Ivory Coast Department of Nephrology University Teaching Hospital of Yopougon Abidjan Ivory Coast Department of Nephrology University Teaching Hospital of Donka Conakry Guinea Department of Nephrology Sylvanus Olympio University Teaching Hospital Lomé Togo Department of Nephrology University Teaching Hospital of Treichville Abidjan Ivory Coast Department of Pediatric Nephrology University Teaching Hospital of Yopougon Abidjan Ivory Coast

Renal biopsy is an invasive procedure used to evaluate the activity and the therapeutic management of kidney disease and kidney transplantation. Objective: The aim of this study was to describe the epidemiological, clinical, and pathological features of kidney disease diagnosed by biopsy in the Ivory Coast. Materials and Methods: This was a descriptive and prospective study conducted between January 2015 and December 2018 in the Department of Anatomy and Cytology of the Pathology of Cocody (Abidjan) and Bouake. Specimens were obtained from the nephrology department of Ivory Coast and from teaching hospitals in Togo, Guinea, Burkina Faso, and Mali. Samples were analyzed according to standard renal biopsy procedures. One kidney fragment was fixed in acetic acid formalin (AAF) for optical microscopy examination. The other fragment, soaked in physiological water, was immediately sent for immunofluorescence examination. All renal pathologies were included in this study. The study parameters were frequency, age, sex, origin, occupation, clinical and biological signs, and pathological aspects with optical microscopy, and immunofluorescence. Results: 153 cases (2.23%) of kidney biopsies were examined on a total of 10,573 specimens. Ivory Coast specimens accounted for 91.5% of cases (n = 140). Nephrotic syndrome (49%) was the most common clinical sign and indication for renal biopsy, followed by acute renal failure (16.3%), chronic renal failure (19.6%), and a combination of chronic renal failure with hypertension (11.18%) and glomerulonephritis (4%). Mean proteinuria was 3.03 g/24h (range, 0.14 to 11.5 g/24h). Histologically, 90.8% (n = 139) were glomerular nephropathies, including 26.6% HIV-associated nephropathy, 17.3% focal segmental glomerulosclerosis, 13.6% nephroangiosclerosis, 11.5% post-infectious glomerulonephritis, 9.3% membranous glomerulonephritis, and 21.6% miscellaneous glomerular nephropathies (n = 30). The incidence of various tubulo-interstitial lesions was

关键词： Kidney Biopsy Disease Pathology Ivory Coast

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Focal Segmental Glomerulosclerosis in Côte d’Ivoire: Epidemiological, Clinical and Pathological Aspects

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Open Journal of Pathology 2022年第4期12卷 146-155页

作者： N’Dah Kouame Justin Tia Weu Melanie Akpro Sedy Louess De Randorphe Lagou Delphine Amélie Toure Ibrahiman Kobenan Atta Anne Rebecca Abouna Alain Didier Guei Monley Cyr Tuo Wonko-Tian Alice Oka Kouamé Hubert Diopo sery patrick Olivier Delma Samuel Cherif Ibrahima Traore Moussa Amekoudi Eyram Ouattara Belarsi Safiatou Yao Kouame Hubert Ackoundou Nguessan Clément Adonis Koffi Laurence Yao Gnangoran Victor Gnionsahie Dazé Apolinaire Mohenou Isidore Jean-Marie Diomandé Department of Anatomic Pathology University Teaching Hospital of Bouake Bouake Ivory Coast Department of Nephrology University Teaching Hospital of Bouake Bouake Ivory Coast Department of Nephrology University Teaching Hospital of Yopougon Abidjan Ivory Coast Department of Anatomic Pathology University Teaching Hospital of Cocody Abidjan Ivory Coast Department of Nephrology University Teaching Hospital of Treichville Abidjan Ivory Coast Department of Nephrology University Teaching Hospital of Blaise Compaore Ouagadougou Burkina Faso Department of Anatomic Pathology University Teaching Hospital of Donka Conakry Guinea Department of Nephrology University Teaching Hospital of Sylvanus Olympio Lome Togo Department of Nephrology University Teaching Hospital of Treichville Abidjan Ivory Coast

Focal segmental glomerulosclerosis (FSGS) is characterized histologically by hyalinosis and sclerosis of glomeruli associated or not with podocyte involvement. The objective of our work was to clarify the epidemiological aspects and histological variants of FSGS in Côte d’Ivoire. Materials and Methods: This was a descriptive retrospective study, conducted from January 2015 to December 2019 using the renal biopsy registers (RB) of the Pathological Anatomy and Cytology departments of the Teaching Hospital of Cocody and Bouake in collaboration with the Nephrology Services of Côte d'Ivoire and the sub-region. The biopsies underwent conventional histopathology and/or immunofluorescence techniques. The parameters analyzed were: frequency, age, gender, proteinuria, biopsy indications and histological aspects and the different correlations between histological aspects and socio-demographic characteristics. Results: FSGS represented 58.1% (n = 104) of glomerular nephropathies. The average age of patients was 32.1 ± 13.3 years, with extremes of 13 and 70 years. The sex ratio was equal to 1. Nephrotic syndrome (68.9%), chronic renal failure (14.3%) and acute renal failure (10.1%) were the main indications for renal biopsy (RB). The mean proteinuria at the time of diagnosis was 4 ± 3.7 g/24 h. It was massive (3.5 g/24 h) in 42.3% of patients. FSGS was primary in 29.8% (n = 31) and secondary in 70.2% (n = 73) of patients, of which 27.9% (n = 35) was due to HIV. According to the Columbia classification, 62.5% NOS type was found;23.1% collapsing type;7.7% tip lesion type;4.8% cell type and 1.9% perihilary type. Conclusion: FSGS is a complex heterogeneous entity. It affects young people in our context with a homogeneous gender distribution. Understanding its histogenesis is essential for optimal patient management.

关键词： Kidney Glomerulus Histology FSGS Côte d’Ivoire

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