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Acute Kidney Injury during Malaria in Togolese Children

Open Journal of Nephrology 2018年第4期8卷 85-93页

作者： Kossi Akomola Sabi Befa Noto Kadou Kaza Eyram Yoan Makafui Amekoudi Weu Melanie Tia Jacques Vigan Hamat Ibrahim guillaume abderhamman mahamat Sandra Amouzou-Glikpa Edem Djadou Service de néphrologie et hémodialyse CHU SylvanusOlympio Lomé Togo Service de néphrologie et d’hémodialyse CHU de YOPOUGON Abidjan République de C&ocirc te d’Ivoire Clinique de néphrologie CNHU Cotonou. Bénin Service de néphrologie et d’hémodialyse h&ocirc pital universitaire de N’djaména Tchad Service de pédiatrie CHU SylvanusOlympio Lomé Togo

Objective: To describe clinical, biological and evolutionary profile of Acute Kidney Injury (AKI) due to Severe Malaria in the pediatric department. Methodology: This was a retrospective descriptive study that took place from January to December 2012. It has been included children aged 0 - 15 years admitted for severe malaria with positive thick drop. AKI was defined by using the modified RIFLE (Risk Injury Failure Loss End stage) classification for Pediatrics. Results: 338 children admitted for severe malaria were included. AKI was diagnosed in 24 children, a prevalence of 7.1% according to pRIFLE classification: RISK in 10 (3%), INJURY in 9 (2.6%) and FAILURE in 5 (1.5%). The average age was 8.16 ± 4.2 years. Clinical features were dominated by hemoglobinuria in 87.5%, oliguria, vomiting and fever in 75%. The biological features were dominated by severe anemia (Hb 5.5 mmol/l) was found in 2 cases. The mean parasitic density was 22,120 trophozoites. Malaria was treated primarily with artemether in 83.3% of the cases. Dialysis was indicated in 2 cases for menacing hyperkalaemia, but was not done because of lack of financial means. In one case, hyperkalaemia was successfully treated with symptomatic measures, but in the second case, these measures were not allowed to normalize kalaemia, and death occurred. Conclusion: Acute post-malarial renal failure secondary to tubular necrosis may be the dominant clinical features of severe malaria. Death may occur. Preventing malaria would be the best way to avoid it.

关键词： AKI Severe Malaria Haemoglobinuria Togo

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Epidemiological, Clinical and Biological Aspects of Kidney Disease in People Living with HIV Naive Antiretroviral Therapy at CHU Sylvanus Olympio of Lome (TOGO)

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Open Journal of Nephrology 2019年第1期9卷 26-34页

作者： Kossi Akomola Sabi Badomta Dolaama Eyram Yoan Makafui Amekoudi Awereou Kotosso Befa Noto-Kadou-Kaza Claude Mawufemo Tsevi Komlan George Tona Eugene Ametepe Attisso Schyldia Bonou-Selegbe Hamat Ibrahim guillaume abderhamman mahamat Jaques Vigan Majeste Ihou Wateba Service de Néphrologie et Hémodialyse CHU Sylvanus Olympio Lomé Togo Service des Maladies Infectieuses et Tropicales du CHU Sylvanus Olympio de Lomé Lomé Togo Service de Néphrologie et d’Hémodialyse H&ocirc pital Universitaire de N’djaména N’djamena Tchad Clinique de Néphrologie CNHU Cotonou Bénin

Introduction: Human immunodeficiency virus (HIV) infection is a common cause of kidney disease worldwide. HIV-related renal diseases are associated with high morbidity and mortality in Sub-Saharan African countries. The aim is to describe the epidemiological, clinical and biological aspects of kidney disease in people living with HIV naive antiretroviral therapy in Lomé in Togo. Methods: This was a cross-sectional study done in the department of Infectious and Tropical Diseases in Lomé from ESOPE database. Glomerular filtration rate (GFR) was calculated using the Modification of Diet in Renal Disease (MDRD) equation. Kidney disease was defined as GFR less than 90 mL/min/1.73 m2. Results: In total, 3118 HIV-infected ART-naive patients were included in this study. Among them, the prevalence of renal disease at the beginning of their care, was 41.8% or 1303 patients [95% CI: 40.0% - 43.5%]. The median estimated GFR was 94.7 ml/min/1.73 m2: 2.9% had eGFR 2. The median age was 40 years [IQR = 34 - 48 years] with a sex ratio at 0.45. BMI median was 20.6 Kg/m2. Most of patients (30.8%) were at clinic OMS stage 1. Median CD4 was 165/uL [IQR = 72 - 274/uL];median hemoglobin was 10.4 g/dl [IQR = 8.8 - 11.9 g/dl];median glycemia was 0.84 g/l [IQR = 0.75 - 0.95 g/l]. Most of patients (99.9%) had HIV-1. 8.5% had hyperleukocytosis, and all patients had thrombopenia. Conclusion: The incidence of kidney disease is high in Togolese HIV-infected ART naive patients.

关键词： HIV Kidney Disease Prevalence Togo

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Outcome of Acute Kidney Injury in Pregnancy in N’Djamena, Chad

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Open Journal of Nephrology 2023年第4期13卷 369-377页

作者： guillaume mahamat Abderraman Senoussi Charfadine Adano Hissein Nephrology-Dialysis Department CHU la Renaissance N’Djamena Chad Gynecology-Obstetrics Department Mother and Child University Hospital of N’Djamena N’Djamena Chad

Introduction: Acute kidney injury (AKI) is a relatively rare but serious complication during pregnancy. It is often the consequence of a delay or poor management of a given complication that constitutes as a public health problem in developing countries. The objective of our study was to determine the epidemiological, diagnostic, therapeutic and evolutionary aspects of obstetric acute kidney injury in Chad. Methodology: This was a cross-sectional study with descriptive and analytical aims over a period of 6 months from June 1, 2020 to November 30, 2020 and conducted in the Gyneco-Obstetric Emergency Department of the Mother and Child University Hospital in N’Djamena. All patients admitted for obstetric AKI and requiring hemodialysis were referred to the Nephrology Department of the Renaissance University Hospital. AKI was defined according to the KDIGO 2012 classification. All pregnant women with more than 20 weeks of gestation until immediately postpartum who were admitted for acute kidney injury were included in the study. Results: During our work, 1238 patients were collected. Among them, 56 cases of obstetric AKI were included, representing a hospital prevalence of 4.5%. The average age was 26.1 ± 5.8 years (16 and 37 years). The majority of our patients were primigravidas which was 42%, rural women represented 35.7% of our sample and nearly 67.8% of pregnancies did not benefit from regular prenatal consultation. AKI during the 3rd trimester was found in 42.9% of cases. Oligo-anuria was present in 28.6% of cases. Acute tubular necrosis was found in 52 cases. It was secondary to preeclampsia in 60.7%, to HELLP syndrome in 17.9% and to a hemorrhagic delivery complicating a retroplacental hematoma in 7.1%. According to the KDIGO 2012 classification, Stages 1, 2 and 3 represented 32%, 23% and 25% of cases, respectively. Hemodialysis was initiated in 1/4 of cases. Recovery of renal function was complete in 78.6% of cases and partial in 7.1%. We recorded eight (14.3%)

关键词： Obstetric Renal Failure Preeclampsia Hemodialysis Chad

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Factors Associated with Poor Control of Hypertension in Patients with Non-Dialysis Chronic Renal Failure

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Open Journal of Nephrology 2023年第3期13卷 201-210页

作者： guillaume mahamat Abderraman Ali Adam Ahamat Charfadine Senousssi Doune Narcisse mahamat Hissein Ali Adamou Abbassi Mana Yusra Aboulbachar Mirene Bourdjo Service de Néphrologie CHU la Renaissance de N’Djamena N’Djamena Tchad Service de Cardiologie CHU la Renaissance de N’Djamena N’Djamena Tchad Service de Réanimation CHU la Renaissance de N’Djamena N’Djamena Tchad

Introduction: Arterial hypertension is frequently encountered in patients with chronic renal failure. Whether primary or secondary to kidney disease, hypertension remains an important risk factor not only for the progression of kidney disease but also for the occurrence of cardiovascular events. Currently, there is no data on the control of hypertension in CKD patients in Chad. The main objective of this study was to determine the factors of poor control of hypertension during CKD and their therapeutic modalities. Methodology: This is a cross-sectional, descriptive and analytical study carried out over a period of 8 months from September 1, 2021 to May 31, 2022 in the Nephrology Department of the Renaissance University Hospital Center in N’Djamena, Chad. During the study period, patients aged 18 years and above, which were hospitalized and/or followed for CKD with uncontrolled hypertension were included. Results: A total of 1013 patients were consulted during the study period, however, 36 cases were included, with a hospital prevalence of 3.5%. The mean age of the patients was 60 ± 9.68 years [22 and 75 years]. The patient’s history was dominated by hypertension (94.4%) and diabetes (41.7%). The main risk factors of hypertension found were diabetes (38.9%), physical inactivity (19.4%) and obesity (36.1%). Type 2 diabetes was pre-sent in 38.9% (n = 14) of the patients. There was a statistical relationship between unbalanced diabetes and poor blood pressure control (p Conclusion: Patients with chronic renal failure are at a risk of developing hypertension. Good control of blood pressure prevents deterioration of kidney function.

关键词： Hypertension Chronic Kidney Disease Chad

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Epidemiological Profile of Chronic Kidney Disease at the General Hospital of National Reference of N’Djamena (Chad)

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Open Journal of Nephrology 2016年第3期6卷 78-85页

作者： Ibrahim Hamat guillaume mahamat Abderraman Zeinab Maïga Moussa Tondi mahamat Youssouf Mouhammadou Moustapha Cisse Fotclossou Tara Elhaj Fary Ka Abdou Niang Boucar Diouf Nephrology-Hemodialysis Unit General Hospital of National Reference of N’Djamena N’Djamena Chad Service of Nephrology National Hospital of Lamordé of Niamey Niamey Niger Internal medicine Renaissance Hospital of N’Djamena N’Djamena Chad Service of Nephrology Aristide Le Dantec Hospital Dakar Senegal

Introduction: Chronic renal failure is a disease that affects many patients worldwide and increasingly in Africa. At the end of 2003, about 1.1 million people were suffering from End-Stage Renal Disease (ESRD) and were treated with periodic dialysis [12]. In Africa, CKF represents 2% to 10% of hospital admissions and is responsible for 4% to 22% of deaths [14]. So, this study is conducted for the first time in Chad, with the aims to determine the prevalence of CKD. Methods: This was a retrospective, descriptive and analytical study over a period of 12 months from April 29, 2011 to April 28, 2012. All patients with chronic renal failure regardless of etiology and stage of chronic kidney disease were included in the study. Chronic renal failure was defined as a glomerular filtration rate below 60 ml/min/1.73m (MDRD) for more than 3 months. This study was conducted in several departments of the National General Reference Hospital (NGRH) of N’Djamena. Result: Among 2039 inpatients, 195 patients had chronic renal failure, as a frequency of 9.6%. The average age of our patients was 51 ± 16.8 years, ranging from 11 to 85 years. Male predominance was noted to be 59% of men against 41% of women. We noted that high blood pressure accounted for 66.2% (N = 129) of cases, diabetes in 48.2% (N = 94), alcoholism in 28.7% (N = 56), smoking in 14.9% (N = 29) and the association alcoholism-smoking in 19.5% (N = 38). Hypertension was the leading cause of chronic renal failure (66.2%). All patients had a serum creatinine and creatinine clearance was assessed. Among them, we noted 57 patients (29%) with end-stage renal failure. The average calcium and phosphate serum were 1.8 mmol/l and 1.6 mmol/l, respectively. We noted that 120 patients as 61.5%, currently took herbal medicine. 48 out of 57 of our patients with ESRD as 24.6% of patients in the study had received replacement therapy (hemodialysis) with 12.5% of deaths. Conclusion: Chad, who compiled the first study with 195 patients at

关键词： Chronic Kidney Disease Epidemiology N’djamena Chad

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Profile of Patients with Acute Renal Injury in N’Djamena: About 36 Cases

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Open Journal of Nephrology 2017年第1期7卷 1-8页

作者： guillaume mahamat Abderraman Hamat Ibrahim Moussa Tondi Zeinabou Maiga Tall Ahmed Lemrabott Faye Maria Kossi Akomola Sabi mahamat Youssouf Cisse Mouhamadou Moustapha Ka Elhaj Fary Ka Niang Abdou Diouf Boucar Hemodialysis Unit H&#244pital Général de Référence Nationale N’Djamena Tchad Medical Department-FSS/Université Abdou Moumouni de Niamey Service de Néphrologie et Hémodialyse H&#244pital National Lamordé de Niamey Niamey Niger Nephrology service H&#244pital Aristide Le Dantec de Dakar Dakar Sénégal Nephrology and Hemodialysis Service CHU SO Lomé Lomé Togo

Introduction: The incidence of acute renal injury (AKI) has increased in recent decades. Acute renal failure is defined by the abrupt arrest (within hours or days) of the kidney excretory function. Oliguria (urine output 24h) is presented in about half of the cases. The circumstances of the occurrence of AKI are multiple: surgical, traumatic, obstetric, medical, often obvious. Its prognosis depends on the speed of management and the associated organ failure. The objective of this study is to describe the profile of patients in emergency hemodialysis at the Nephrology Unit of the National Reference General Hospital (HGRN) in N’Djamena, Chad. Methods: This was a multicenter, descriptive study in patients with acute renal failure place over a period of 12 months in the emergency departments of the 2 hospitals in N’Djamena. Defined as carriers of an AKI (RIFLE criteria), patients with: 1) Oliguria: urinary output 400 ml/24h ( 350 μmol/l or decrease of GFR by 75%. Results: Of the 311 patients admitted, 36 cases met the inclusion criteria, a frequency of 11.57%. The mean age was 34.46 years with extremes ranging from 7 to 80 years. The female sex predominated with 52.80% as sex ratio of 0.91. Isolated hypertension was noted with 38.88%. Dyspnea accounted for 41.66% of patients admitted to emergency departments. In our series, 50% of our patients had hyperthermia at admission. Oliguria was observed in 41.70% of the cases. Edema accounted for 33.33% of cases. The AKI with the “failure” criterion was 58.34% (21/36), with the criterion “injury” 25% (9 cases) and the criterion “risk” 16.66 (6 cases). AKI were organic in 83.34% (30/36). It was noted that 14 patients, 38.8% had an infectious syndrome. There were 6 patients who had (16.66%) an obstructive AKI, 5 patients (13.88%) had eclampsia, 4 patients (11.12%) had hepatoce

关键词： Acute Renal Injury Hemodialysis Epidemiology Chad Component Formatting Style Styling

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Prognosis of Acute Renal Failure of the Child during Severe Malaria in Niamey-Niger

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Open Journal of Nephrology 2018年第1期8卷 10-17页

作者： Zeinabou Maiga Moussa Tondi Moumouni Garba guillaume mahamat Abderraman Hassane Diongole Moussa Ibrahim Hamat Elmoctar Seydou Toure Ide Abdou Illiassou Soumeila Toure Aboubacar Illiassou Salamatou Niourou Service de Nephrologie Hemodialyse Faculte des sciences de la sante Universite Abdou Moumouni NigerNiameyNiger Service de Pediatrie Hopital National de NiameyNiameyNiger Service de Nephrologie Hemodialyse Hopital de la Renaissance de N’DjamenaN’DjamenaTchad Service de Nephrologie Hopital National de ZinderZinderNiger

Introduction: In malaria-endemic areas, acute renal failure (ARF) is one of the most serious complications, it occurs in 40% of severe forms of malaria in adults and is linked to 75% of deaths, especially when extra-renal cleaning is not available. In children, studies of ARF during malaria are limited. We have no published studies on this topic in Niger. The main objective of our study is to evaluate the prognosis of ARF during severe malaria in children. Patients and Method: This is a one-year prospective study (January 1, 2016 to December 31, 2016) conducted in the resuscitation unit of the pediatric department of the National Lamordé Hospital of Niamey (Niger). We included in the study children aged 0 to 15 years hospitalized for severe malaria with impaired renal function. Patients who had chronic renal failure or who had acute renal failure with a thick negative drop were excluded from the study. Acute renal failure is defined according to Kidney Disease Improving Global Outcomes (KDIGO) criteria basing on creatinine clearance. Results: The incidence of ARF was 12.60%. The mean age of the patients was 4.25 ± 1.3 years [8 months - 15 years]. The mean hemoglobin level was 8.2 ± 2.7 g/dl. In 54.02% of cases, the hemoglobin level is ≤5 g/dl. Mean serum creatinine was 543.7 ± 69.5 μmol/l [107 - 2500 μmol/l] and mean azotemia was 27.5 ± 3.5 mmol/l. Severe anemia (54.02%) were more related to the occurrence of ARF(with p = 0.014). According to the RIFLE classification, 55 patients (63.22%) were in the Risk stage, 18 patients (20.69%) were in the injury stage and 14 patients (16.09%) in the failure stage. All patients were placed on injectable Artesunate. The average length of hospital stay was 8.6 ± 4.5 days [5 to 22 days]. Dialysis was reported in 15/87 (17.24%). For technical and financial reasons only 8 patients were hemodialysed. Indications for dialysis were severe uremic syndrome 7 cases (8.04%), fluid overload 5 cases (5.75%) and severe hyperkalemia 3 cases (3

关键词： Acute Renal Injury Malaria Niger

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Hyperuricemia in Patients with Chronic Renal Failure in the General Hospital of National Reference of N’Djamena (Chad)

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Open Journal of Nephrology 2017年第1期7卷 9-18页

作者： guillaume mahamat Abderraman Ibrahim Hamat Zeinabou Maiga Moussa Tondi Ahmed Tall Lemrabott Maria Faye Cisse Mouhamadou Moustapha Kossi Akomola Sabi Ka Elhaj Fary Ka Niang Abdou Diouf Boucar Hemodialysis Unit H&#244pital Général de Référence Nationale (HGRN) N’Djamena Tchad Medical Department FSS/ Université Abdou Moumouni de Niamey Service de Néphrologie et Hémodialyse H&#244pital National Lamordé de Niamey Niamey Niger Nephrology service H&#244pital Aristide Le Dantec de Dakar Dakar Sénégal Nephrology and Hemodialysis Service CHU SO Lomé Lomé Togo

Introduction: Hyperuricemia is defined as a level of serum uric acid greater than or equal to 70 mg/l (420 μmol/l) in men and 60 mg/l (360 μmol/l) in women. Several studies have shown that it is a risk factor or a factor of progression of chronic kidney disease. Recent experimental and epidemiological data correlate the association of hyperuricemia with chronic kidney disease (CKD), arterial hypertension and cardiovascular diseases, thus raising the question of the usefulness of therapeutics in the prevention of renal diseases. The objective of this study is to seek a link between chronic kidney disease and hyperuricemia. Materials and Methods: This is a descriptive and analytical study conducted at hemodialysis unit and cardiology service of General Hospital of National reference of N’Djamena (Chad) from 1th January to 1th October 2013 (10 months). We included all chronic kidney disease patients hospitalized in hemodialysis unit and cardiology service who presented associated hyperuricemia. Results: There were 712 CKD patients who were hospitalized. Among them, there were 108 patients who were included in the study and who had hyperuricemia as a prevalence of 15.20%. The average age of patients was 35.5 years and the sex ratio was 3/1. The age group between 40 to 60 years represented 54.6%. There were 41.7% of traders. Hypertensive patients accounted for 49.1%;association of diabetes and hypertension was noted in 12.90%. Renal insufficiency was moderate in 43.5% of patients. Hyperuricemia was present in more than 90% of patients. Profession, age, hematuria, proteinuria and hypertension were statistically positively related to hyperuricemia. Treatment consisted of prescribing allopurinol in 84% of patients. In more than 11% of patients the progression was unfavorable. Conclusion: The implication of hyperuricemia in chronic kidney disease has been proved in several recent studies. However, randomized studies at very long scales have to be carried out to conclude from

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