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Open Journal of Nephrology 2015年第1期5卷 14-24页

作者： Jean jacques Sehonou jacques vigan Bruno Léopold Agboton Gbètondji Michel Massi University Clinic of Internal Medicine of the National Teaching Hospital “Hubert K Maga” (CNHU-HKM) Cotonou Benin University Clinic of Nephrology and Hemodialysis of the National Teaching Hospital “HKM” of Cotonou Cotonou Benin

Aim: To study the functional dyspepsia in chronic hemodialysis patients of CNHU-HKM of Cotonou. Methods: This descriptive, analytical and cross-sectional study ran from 1 September 2013 to 28 February 2014 in the University Clinic of Nephrology Dialysis of CNHU-HKM of Cotonou. It included all chronic renal failure patients on hemodialysis for at least 9 months prior to the survey. After identifying the patients with upper gastrointestinal disorders, we had submitted to clinical Rome III criteria for functional dyspepsia. Upper endoscopy was performed in patients with clinical criteria of functional dyspepsia. Clinical factors associated, paraclinical and therapeutic were sought by logistic regression in univariate analysis. Data were analyzed using EPI DATA version 3.1. Results: 1) One hundred and thirty-one haemodialysis patients had participated in the study (sex ratio: 1.5, average age 49.6 ± 12.4 years). 2) The prevalence was 71.8% for upper gastrointestinal disorders, 64.9% for dyspeptic syndrome and 1.5% for functional dyspepsia. 3) They were associated to clinical criteria of functional dyspepsia of Roma III, the presence of high blood pressure, hypocalcaemia, treatment with calcic inhibitors and iron supplementation. Conclusion: Functional dyspepsia is uncommon in hemodialysis. The search of an organic cause is imperative for every dyspepsia.

关键词： Benin Chronic Haemodialysis Functional Dyspepsia Dyspepsia Upper Gastrointestinal Disorders

Effectiveness and Safety of Tenofovir Disoproxil Fumarate in Patients Treated for Hepatitis B in the National University Hospital of Cotonou

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Open Journal of Gastroenterology 2018年第6期8卷 213-222页

作者： Jean Sehonou Aboudou Raimi Kpossou Samuel Guido Comlan N’dehougbea Martin Sokpon Koffi Rodolph Vignon jacques vigan Department of Gastroenterology and Hepatology National University Hospital Center-Hubert Koutoukou Maga(CNHU-HKM)of CotonouCotonouBenin Department of Nephrology-Hemodialysis CNHU-HKM of CotonouCotonouBenin

Introduction: Viral hepatitis B (VHB) is a serious and global public health issue, particularly in sub-Saharan Africa where it is endemic. The objective of this work was to evaluate the effectiveness and safety of tenofovir disoproxil fumarate (TDF) in the treatment of chronic VHB in Cotonou. Methods: This was a descriptive cross-sectional study with a retrospective collection of data from January 1st, 2015 to December 31st, 2016 (24 months) and prospective from May to August 2017 (4 months). Chronic VHB patients treated with TDF for at least 6 months were included. The non-detectability of HBV DNA and the normalization of aminotransferases defined the virological and biochemical responses, respectively. The evaluation of the treatment response on liver fibrosis was done by using APRI score. Renal impairment was assessed by a reduction in glomerular filtration rate according to MDRD (Modifications of the Diet in Renal Disease) formula below 90 mL/min/1.73 m2. Results: In all, 42 patients treated with TDF were included. The average age was 46.7 ± 13.8 years. The study population was predominantly male with a sex ratio of 2.5. Among the 42 patients treated with TDF for an average of 60 weeks (24 to 96 weeks), 36 patients (85.7%) had a virological response;21 patients (50%) had a biochemical response. Virologic response was 70% at week 24 (W24), 92.6% at W48, 87.5% at W72 and 100% at W96 without significant difference between W24 and W48;between W48 and W72 then between W72 and W96. There was a regression of fibrosis and cirrhosis but not significantly. Renal involvement occurred in 3 out of 19 cases (15.8%) including a case of chronic end stage renal failure and 2 cases of mild chronic renal failure. Conclusion: The treatment with TDF is effective and globally safe in our patients with chronic viral hepatitis B in Cotonou.

关键词： Chronic Viral Hepatitis B Tenofovir Efficacy Safety Cotonou

Morphological and Structural Study of Native Kidneys in Chronic Kidney Disease Patients on Dialysis Compared to Non-Dialysis Patients

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Open Journal of Nephrology 2020年第4期10卷 348-360页

作者： jacques vigan Patricia Ahouansou Yekpe Sonia Adjanohoun Séraphin Ahoui Bruno Leopold Agboton Hosana Kpoviessi SM Olivier Biaou Nephrology and Hemodialysis Academic Clinic National University Hospital Center Hubert K Maga (CNHU-HKM) of Cotonou Cotonou Benin CNHU-HKM Medical Imaging Center Cotonou Benin Nephrology Healthcare Center Borgou Regional Hospital Parakou Benin

Whether on dialysis or not, native kidneys in chronic kidney disease (CKD) patients undergo morphological and structural changes. Objective: To study native kidney morphometric and structural aspects in CKD patients on dialysis and non-dialysis patients. Methods: It was a descriptive, analytical, and cross-sectional study conducted from May to December 2018. The study enrolled CKD patients on dialysis or not followed at CNHU-HKM in Cotonou. Renal ultrasound was performed to locate cysts and uroscanner completed in the presence of atypical cysts. Through logistic regression, associated factors were determined. Results: The sample size was 240 patients, of which 151 (62.9%) were receiving dialysis and 89 (37.1%) non-dialysis patients. Male subjects were predominant (sex ratio = 1.5). The average size of the right kidney, expressed in mm in patients on dialysis was: pole-to-pole length = 78.56;width = 42.06;cortical thickness = 11.80;and the left kidney: pole-to-pole length = 79.76;width = 41.53;cortical thickness = 12.6. For non-dialysis patients, the following size was recorded for the right kidney: pole-to-pole length = 92.35;width = 47.61;cortical thickness = 15.64;and left kidney: length = 92.13;width = 47.82;cortical thickness = 15.43. Predictive factors for the occurrence of acquired renal cysts were: old age (p = 0.0001), dialysis (p Conclusion: CKD patients on dialysis have small kidneys and are more likely to develop acquired renal cysts. There is a need to carry out an annual ultrasound screening for native kidneys in patients receiving dialysis.

关键词： Chronic Kidney Disease Dialysis Acquired Renal Cysts

Emphysematous Pyelonephritis in a Black African Woman Managed with Antibiotics Alone

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Open Journal of Nephrology 2016年第4期6卷 151-156页

作者： Kossi Akomola Sabi Béfa Noto Kadou Kaza Eyram Yoan Amekoudi jacques vigan Vicko Manou Dazé Apollinaire Gnionsahe Department of Nephrology and Hemodialysis Sylvanus Olympio University Teaching Hospital Lomé Togo

Introduction: Emphysematous pyelonephritis (EPN) is a severe, life-threatening infection of the renal parenchyma. This condition is characterized by the production of intrarenal and perinephric gas. In the world, the EPN is currently limited to case series reported. No cases have been described in black Africa. Aims: Related a first case of EPN diagnosed and treated in the University Hospital Center Sylvanus Olympio of Lomé in Togo. Observation: A 40 years old woman, with antecedent of diabetes presented pyelonephritis emphysematous class 2. She was treated successfully with antibiotic alone without using percutaneous drainage or nephrectomy. Conclusion: As reported in every case series, it was a young diabetic patient with a clinical features of acute pyelonephritis which CT scan had helped lay the EPN class 2 diagnosed. The germ was Klebsiella pneumoniae. She was treated with adapted antibiotic alone.

关键词： Emphysematous Pyelonephritis Africa Togo

Hemodialysis patients’ satisfaction and associated factors in National Teaching Hospital Hemodialysis Center, Cotonou (Benin)

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Open Journal of Nephrology 2019年第4期9卷 127-138页

作者： Séraphin Ahoui jacques vigan Bruno Léopold Agboton Evariste Eteka Francis Tchegnonsi Tognon A. Anselme Djidonou Prosper Gandaho Leonard Fourn Department of Nephrology Borgou Regional Teaching Hospital Parakou Benin Nephrology-Hemodialysis University Clinic (CUNH) Hubert Koutoukou Maga National Teaching Hospital Cotonou (CNHU-HKM) Benin Department of Psychiatry Borgou Regional Teaching Hospital Parakou Benin Faculty of Health Sciences University of Abomey-Calavi Abomey-Calavi Benin

Background: Patients’ satisfaction is a relevant component in assessing healthcare services. The objective of this study was to study the level of satisfaction of chronic hemodialysis patients and the associated factors in Cotonou CNHU-HKM dialysis center. Patients and Methods: It was a cross-sectional, descriptive and analytical study conducted by administering a questionnaire on days off dialysis. It was carried out from 1st November 2015 to 1st January 2016 in CNHU-HKM Nephrology University Clinic of Cotonou. Hemodialysis patients aged 18 years and above having given their informed consent were included in the study. Patients’ recruitment was comprehensive. Likert scale was used in assessing the level of satisfaction with 4 as “very satisfied” and 1 for “very dissatisfied”. Satisfaction was evaluated on the basis of Ware dimensions. The threshold for satisfaction was 50. Outcomes: Overall, 377 patients were included in the study. Respondents’ mean age was 51.5 ± 13.3 years with 1.37 as sex ratio. Arteriovenous fistula was used for 80.1% of hemodialysis patients. 77.7% of the patients underwent dialysis twice a week while 45.9% were administered a four-hour dialysis. The overall average proportion of “satisfied” was 76.5%. The level of satisfaction was 52% for healthcare environment, 61% for service delivery, 73.9% for healthcare accessibility, 76.1% for healthcare structure, 77.5% for healthcare management, 90.3% for quality of healthcare, 88.3% for interpersonal relationship and 93.2% for efficiency and continuum of healthcare. Factors associated with satisfaction included age (p = 0.02), vascular access (p = 0.04) and urea reduction ratio (p = 0.01). In addition, the degree of satisfaction of hemodialysis patients was not statistically associated with sex, marital status, educational level, history of the disease, age of dialysis, number of sessions per week, and duration per session. Conclusion: The overall level of hemodialysis patients’ satisfaction is above

关键词： Satisfaction Chronic Hemodialysis Cotonou

Knowledge Attitude and Practice of General Physicians for Early Detection of Diabetic Nephropathy in Cotonou

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Open Journal of Nephrology 2016年第4期6卷 122-131页

作者： vigan jacques Akoha T. Mauriac Agboton B. Leopold Akomola K. Sabi Assogba-Gbindou Ubald Attolou Vénérand Djrolo François Nephrology Hemodialysis University Clinic of Hubert K. Maga Teaching Hospital (CNHU-HKM) Cotonou Benin Endocrinology and Metabolism University Clinic of CNHU-HKM Cotonou Benin

Introduction: General physicians can play an important role in the early detection of diabetic nephropathy (DN). Purpose: To assess the levels of general physicians’ knowledge, attitude and practice in terms of early detection of DN in Cotonou. Method: It was a cross-sectional, analytical and descriptive study which was conducted from 1st March 2015 to 30th September 2015. Every general physician working in a health structure in Cotonou who consented to participate in the study was included. We did not included medical specialists and general physicians working in nephrology department. Data were collected through a survey form designed with a score to assess the various items such as: knowledge, attitude and practice. The significance threshold is set to below 0.05. Results: In total, 202 general physicians were included. The average age was 30.9 ± 6.9 years ranging from 24 to 68 years. A male predominance was observed with 2.2 sex ratio. The majority of respondent medical physicians had poor knowledge in 76.2% cases, bad attitudes (61%) and bad practices (64.9%) in terms of early detection of diabetic nephropathy. There was positive impact of continuing medical training focused on diabetic nephropathy on attitudes (p = 0.016) and practices (p = 0.001) of these physicians. Conclusion: Diabetic nephropathy requires particular attention. General physicians’ continuous training is a principal solution.

关键词： Attitude Benin Knowledge Early Detection Practice Diabetic Nephropathy

Erectile Dysfunction in Hemodialysis in Togo

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Open Journal of Nephrology 2016年第4期6卷 145-150页

作者： Kossi Akomola Sabi Béfa Noto Kadou Kaza Eyram Yoan Amekoudi jacques vigan Souleymane Pessinaba Kafui Avouwadan Kodjo Tengue Tchilabalo Matchona Kpatcha Dazé Apollinaire Gnionsahe Departement of Nephrology and Hemodialysis Sylvanus Olympio University Teaching Hospital Lomé Togo Departement of Nephrology and Hemodialysis University Teaching Hospital of Cotonou Cotonou Benin Departement of Cardiology Campus University Teaching Hospital of Lomé Lomé Togo Departement of Urology and Andrology Sylvanus Olympio University Teaching Hospital Lomé Togo Departement of Nephrology and Hemodialysis University Teaching Hospital of Yopougon Abidjan Ivoiry Coast

Objectives: To determine the prevalence and risk factors of erectile dysfunction (ED) in men on hemodialysis in Togo. Methods: Prospective cross-sectional study, descriptive and analytical ranging from December 2015 to February 2016 in the hemodialysis unit of CHU SO, only dialysis center in the country. The evaluation of the ED was made through IIEF-5 questionnaire. Results: 39 men (67.2%) of 58 hemodialysis is a sex ratio M/F of 2.05. The average age was 43.5 years with extremes of 25 and 59 years. The majority of men had a profession in 19 cases (48.7%). The mean duration of dialysis was 30 months with a range of 4 months and 90 months. Initial glomerular nephropathy was in 19 cases (48.7%) and vascular in 14 cases (35.9%). 38 patients were hypertensive (97.4%) and 6 diabetic men (15.4%). The prevalence of ED was 74.3% (29 cases). ED score was less than 10 points in 14 cases (35.9%);01 case (2.6%) between 11 and 16 points;06 cases (15.4%) between 17 to 21 points;08 cases (20.5%) between 22 and 25 points;and 10 cases (25.6%) between 26 and 30 points. Age, profession and duration of dialysis were risk factors associated with ED (P 0.001). Conclusion: The prevalence of ED is very high in Togo.

关键词： Erectile Dysfunction Hemodialysis Togo

Prevalence of Metabolic Syndrome and Associated Factors among Hemodialysis Patients Monitored at the National Teaching Hospital, Hubert Koutoucou Maga in 2015

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Open Journal of Nephrology 2016年第4期6卷 167-175页

作者： jacques vigan Adébayo S. C. Alassani Mahoussi M. A. Ahissou Akomola K. Sabi Ubald Assogba-Gbindou Vénérand Attolou François Djrolo Nephrology Hemodialysis Department Sylvanus Olympio Teaching Hospital Centre Lomé Togo Nephrology Hemodialysis University Clinic of Hubert K Maga Teaching Hospital (CNHU-HKM) Cotonou Benin Endocrinology and Metabolism University Clinic of CNHU-HKM Cotonou Benin Nephrology Hemodialysis Department Sylvanus Olympio Teaching Hospital Centre Lomé Togo

Introduction: Metabolic syndrome is one of the main risk factors of cardiovascular disease among hemodialysis patients. Objective: The main objective of this study was to determine the prevalence and factors associated with metabolic syndrome among hemodialysis patients in Cotonou in 2015. Patients and methods: It was a cross-sectional, descriptive and analytical study conducted from 05th October to 02nd November 2015 at the National Teaching Hospital, Hubert Koutoucou Maga of Cotonou. All patients aged 18 years and above, regularly under hemodialysis for the past 3 months and who gave their informed consent were included in the study. Those excluded were: currently hospitalized hemodialysis patients, hemodialysis patients hospitalized in the last three months, hemodialysis patients whose general condition deteriorated or unable to answer the questionnaire. Metabolic syndrome was defined according to the International Diabetes Federation’s criteria. Factors associated with metabolic syndrome were sought using logistic regression in univariate analysis. Confidence intervals were calculated at 95% and alpha significance threshold at 5%. Outcomes: In total 165 patients were included in the study. Male predominance was observed, with 1.27 sex-ratios. Average age was 49.3 ± 12.9 years with extremes ranging from 18 to 78 years. Metabolic syndrome is observed among 46 patients undergoing hemodialysis or 27.9% prevalence rate. Factors associated with the metabolic syndrome in univariate analysis were: gender (p 0.001), age (p = 0.007), body mass index (p = 0.029) and prior diabetes history (p = 0.011). Conclusion: Metabolic syndrome is common among hemodialysis patients. Early screening and fighting against associated risk factors are very important.

关键词： Benin Associated Factors Hemodialysis Patients Prevalence Metabolic Syndrome

Acute Kidney Injury during Malaria in Togolese Children

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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

Quality of Life of Chronic Haemodialytic Patients at Cotonou Teaching Hospital (BENIN)

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Open Journal of Nephrology 2014年第4期4卷 131-141页

作者： Elhadji Fary Ka jacques vigan Ahmed Tall Lemrabott Noriace Excelle Zohoun Mohamedou Moustapha Cissé Séraphin Ahoui Maria Faye Younoussa Keita Khodia Fall Bruno Léopold Agboton Abdou Niang Boucar Diouf Nephrology Department Aristide Le Dantec Hospital Dakar Senegal Nephrology and Hemodialysis Clinic Hubert Koutoukou Maga Teaching Hospital Cotonou Benin

Introduction: The objectives of this work were to assess haemodialytic patients’ quality of life (QoL) and to identify factors affecting this QoL. Patients and Methods: It was a three (03) month monocentric and transversal study (from October 24, 2011 to January 27, 2012) conducted in the haemodialysis unit at Hubert Koutoukou Maga Teaching Hospital (CNHU-HKM) in Cotonou. Patients included were residents of Benin, aged 18 years and above, chronic haemodialysis in this unit for over 3 months, and willfully gave their consent. Quality of life was evaluated using questionnaire on Kidney Disease Quality of Life Short-Form French version 1.2 (KDQoL-SF 36). Epidemiological data, nephropathy etiologies and purification parametres were recorded in patients files. Data statistical analysis was performed using SPSS software 11.5. Results: In total 131 patients were involved in the study. The average age was 50.27 ± 12.17 years with a sex ratio of 1.69. Nephroangiosclerosis was the 1st cause. Most patients 128 (97.71 %) received two haemodialysis sessions on weekly basis. The Average Overall Score (AOS) based respectively on SF 36 and KDQoL was 48.55 and 58.55. The average of both SF 36 and KDQoL AOS was 53.55. Factors affecting hemodialytic patients quality of life were vitality, limitations related to mental health and physical condition, burden of kidney disease, effect of the disease on daily life and occupational status. The study revealed that: Patients education level was correlated with vitality

关键词： Quality of Life Haemodialysis Patients Chronic Kidney Disease Benin