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Prevalence of Chronic Kidney Disease and Associated Factors among HIV Patients in the Era of HAART in Ivory Coast: A Cross Sectional, Analytical Study

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Open Journal of Nephrology 2023年第1期13卷 20-30页

作者： Wognin Manzan Anastasie Gonan Yannick kpan kehi jonathan Koffi Reine Abdul Khatibat Tia Weu Mélanie Bourhaima Ouattara Internal Medicine Teaching Hospital of Bouaké Alassane Ouattara University Bouaké Ivory Coast

Background: Chronic kidney disease (CKD) may be common among HIV patients living in sub-saharan Africa due to the confluence of CKD risk factors and genetic predisposition. Preventive strategy through early detection and treatment has been advocated for CKD in Africa where majority of patients present late and cannot afford the cost of renal replacement therapy which is not widely available. The purpose of this study was to identify the prevalence and factors associated with CKD among HIV infected adults receiving HAART in a teaching hospital in Ivory Coast. Methods: This is a cross-sectional study of HIV patients on Highly Active Anti Retroviral Therapy followed at the HIV clinic of the medical out-patient department of the University teaching hospital of Bouaké from January to December 2021. CKD was defined as a serum creatinine-based estimated glomerular filtration rate ≤ 60 ml/min/1.73 m2. The collected data was analyzed by using Epi Info 2002 software. Results: Four hundred and two HIV-infected adults 18 years and over were recruited during the study period. We noticed 123 (30.6%) males. The mean age was 40 years. CKD was observed in 42 (10.44) patients infected-HIV. Eighty eight point three percent of patients had CD4 more than 500 cells. Low eGFR correlated with age more than 60 years old, worker in public sector, unemployed, no formal education and HIV type 2. Conclusion: Our study identified a prevalence of CKD of 10.44% by CKD EPI equations among HIV patients on HAART that attended the teaching hospital of Bouaké in Ivory Coast. Early screening and follow up of renal functions is important to minimize the risk of developing end stage kidney disease.

关键词： HIV CKD Prevalence Africa

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Patterns of Acute Kidney Injury in a Medical Emergency Department in Sub-Saharan Africa

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Open Journal of Nephrology 2022年第3期12卷 267-275页

作者： Weu Mélanie Tia Mélanie Anastasie Wognin Christ Zahe Reine Marie Koffi Nathanael Mey kehi jonathan kpan Abdul Yannick Gonan Ouattara Bourhaima Department of Internal Medicine University Teaching Hospital of Bouaké University Alassane Ouattara of C&ocirc te d’Ivoire Bouaké C&ocirc te d’Ivoire

Background: Acute kidney injury (AKI) is a common in community and a serious outcome in hospital setting. Despite the progress of dialytic and non-dialytic therapeutic means, its mortality remains high. Our objective was to contribute to a better knowledge of how AKI managed in an emergency medical ward in an African country located in the southern part of the Sahara. Patients and Methods: We conducted a retrospective study from January 1 to December 31, 2019, conducted at the emergency department of the University Teaching Hospital of Bouake, on cases of AKI. Results: During the study period, we collected 221 cases of AKI out of a total of 1778 files giving a prevalence of 12.4%. The mean age was 54 ± 19 years. A male predominance with a sex ratio of 1.4 was observed. The main past histories were hypertension in 40.4%, cardiac disease in 16.9%, and diabetes in 14.3%. The patients in were classified in 63.8% of cases as stage I, in 22.1% as stage II and in 14.1% as stage III according to the AKIN criteria. AKI was functional in 93.2% of cases. Hemodialysis was indicated in 15 (6.8%) patients, but only 3 (1.4%) underwent it. The mortality rate was 45.2%. Factors associated with mortality were: creatinine level greater than or equal to 30 mg/l, sepsis and impaired vigilance. Conclusion: Acute renal failure was frequent in subjects under 60 years old. Its mechanism of occurrence is functional and therefore it can be prevented by vascular filling. The majority of patients were seen at AKIN Stage I. The outcome was favorable in more than one third of the cases and the mortality rate remains high.

关键词： AKI African Setting High Mortality

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Factors Associated with Echocardiographic Abnormalities in Patients with Chronic Kidney Disease in a Tertiary Hospital in Ivory Coast

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Open Journal of Nephrology 2022年第1期12卷 36-47页

作者： Weu M. Tia Abdoulaye Togo Manzan A. Wognin Reine M. Koffi jonathan kpan Bourhaima Ouattara Dame A. Gnionsahe Department of Internal Medicine University Teaching Hospital (CHU) of Bouaké Bouaké C&ocirc te d'Ivoire Nephrology-Hemodialysis Department University Teaching Hospital (CHU) of Yopougon Abidjan C&ocirc te d'Ivoire

Background: Cardiovascular risk factors (CVRF) are very frequent in pa-tients with chronic kidney disease (CKD) and impose a new environment to which the heart must adapt. Cardiac ultrasound is a non-invasive and easy-to-perform examination that allows quantitative and qualitative assessment of the anatomy and function of the heart. The objectives of this study were to describe abnormalities observed on trans-thoracic Doppler-echocar-diography and to investigate the factors associated with them. Materials and Method: This was a monocentric retrospective cross-sectional study conducted in CKD patients hospitalized in a hospital center in Côte d'Ivoire from January 2017 to December 2018. Results: One hundred and four cases were collected with a mean age of 48.87 ± 14.47 years and a sex ratio of 1.7. Patients with end-stage-renal-disease (ESRD) represented 83.7% with 55.8% of cases of chronic glomerulonephritis. Cardiovascular risk factors were 100% anemia, 84.6% inflammatory profile, 77.9% hypertension, 76.9% hypocalcemia and in 67.3% oedema. Cardiac abnormalities were observed in 78.8% of patients. Left ventricular hypertrophy (LVH), accounting for 20.2% of cases, was associated with male gender (OR 0.127 CI 0.025 - 0.643;p = 0.013) and hypertensive nephropathy (OR 0.189 CI 0.056 - 0.637;p = 0.007). History of hypertension (OR 0.297 CI 0.084 - 1.050;p = 0.060) and diabetes (OR 5.315 CI 1.260 - 22.419;p = 0.023), hypertensive nephropathy (OR 0.174 CI 0.052 - 0.585;p = 0.005) and hypocalcemia (OR 6.094 CI 1.723 - 21.559;p = 0.005) are incriminated in the development of left ventricular dilatation (LVD) which accounted for 38.5% of cases. Conclusion: Left ventricular hypertrophy and dilatation are the main echocardiographic abnormalities observed in our population.

关键词： Chronic Renal Failure Left Ventricular Hypertrophy Ivory Coast

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