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Predictive Factors of Renal Failure in COVID-19 Patients at the Anti-COVID Center in Lome, Togo

Open Journal of Nephrology 2024年第2期14卷 125-135页

作者： Kossi Akomola Sabi Yoan Makafui Amekoudi Awéréou Kotosso laune odilon blatome Badomta Dolaama Ayodélé Jonathan Sabi Oscar Gnirimi Gbahbang Loutou Ahoub-Laye Affo Béfa Noto-Kadou-Kaza Nephrology-Hemodialysis Department of CHU Sylvanus Olympio University of Lom Lom Togo Faculty of Health Sciences University of Lom Lom Togo Nephrology Department of the CHU Kara University of Kara Kara Togo Centre Hospitalier Universitaire Pointe--Pitre Pointe--Pitre Guadeloup

Background: Angiotensin-converting enzyme 2 has been identified as the receptor that allows the entry of SarsCov2 into the human cell. Its expression in the kidney is 100 times higher than in the lung;thus, making the kidney an excellent target for SarsCov2 infection manifesting as renal failure (RF). The objective of this study was to determine the predictive factors of RF during COVID-19 in the Togolese context. Patients and Methods: This was a retrospective descriptive and analytical study conducted at the Lomé Anti-COVID Center including the records of patients hospitalized for COVID-19, of age ≥ 18 years and having performed a creatinemia. RF was defined by a GFR 2 calculated according to the MDRD formula. Patients were randomized into 2 groups according to GFRResults: 482 patients were selected for this study with a mean age of 58.02 years. Sixty-five percent of the patients were men, i.e., a sex ratio of 1.88. Fifty-two patients had RF, i.e., a frequency of 10.8%.There were 65% men (315 cases), for a sex ratio (M/F) of 1.88. Risk factors for renal failure in COVID-19 were age ≥ 65 years (ORa 2.42;CIa95% [1.17 - 4.95];p = 0.016), anemia (ORa 2.49;CIa95% [1.21 - 5.26];p = 0.015), moderate (ORa 13;CIa95% [2.30 - 2.44];p = 0.017), severe (ORa 26.2;CIa95% [4.85 - 4.93];p = 0.002) and critical (ORa 108;CIa95% [16.5 - 21.76];p Conclusion: Renal failure would therefore be related to the severity of COVID-19 and is the most formidable factor, conditioning the course of the disease and the patient’s vital prognosis.

关键词： COVID-19 Renal Failure Risk Factors Togo

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Management and Evolution of Multiple Myeloma with Renal Failure in Developing Countries: The Case of the Sylvanus Olympio University Hospital in Lome, Togo

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Open Journal of Nephrology 2022年第4期12卷 441-450页

作者： Kossi Akomola Sabi Eyram Fianyo Yoan Makafui Amekoudi Viwale Koffi Tessio laune odilon blatome Badomta Dolaama Ayodélé Jonathan Sabi Abdou-Raouf Sibabi Zamarou Tchablinam Naleta Owonayo Oniakitan Nephrology Hemodialysis Department of CHU Sylvanus Olympio University of Lomé Lomé Togo Rheumatology Department of The Secondary Hospital of Bè University of Lomé Lomé Togo Nephrology Department of CHU Kara University of Kara Kara Togo Rheumatology Department of CHU Sylvanus Olympio University of Lomé Lomé Togo

Background: Renal failure (RF) is a frequent complication during multiple myeloma (MM) and sometimes reveals the disease. The median survival of MM patients with RF is shorter than that of patients with myeloma without renal involvement. Although patient survival has been prolonged with the new therapies, the median survival does not exceed five to seven years. Few data on this subject are available in sub-Saharan Africa. Objectives: To describe the therapeutic management and evolution of MM with RF in a developing country like Togo. Method: This was a retrospective descriptive and analytical study which took place over a period of ten years (2010-2019) and included the records of patients with MM according to the 2009 and/or 2014 IMWG criteria, hospitalized or followed up in the nephrology and rheumatology departments of the CHU-SO with a GFR Results: During the study period, 78 patients with MM had renal failure (55.7%). Therapeutically, hygienic and dietary measures were dictated in 84.6% of cases (68 patients). Rehydration was performed in 38 cases (48.7%);alkalinization of urine in 10 cases (12.8%);use of antibiotics in 36 cases (46.2%), NSAIDs in 51 cases (65.4%);use of biphosphonates in 36 cases (46.6%). Surgical immobilization by screw-plate osteosynthesis was performed in 02 patients. Nephrologically, 8 patients underwent ESRD. The different chemotherapy protocols used were Melphalan-Prednisone in 70% of cases, Melphalan-Cyclophosphamide-Prednisone in 26.7% of cases and Cyclophosphamide-Prednisone in 3.3%. The median overall survival was 8 months. The median survival was 13 months in patients who recovered from renal failure versus 2 months in those who did not recover from renal failure (p = 0.0030). Of the 78 patients in our series, 22 patients had died (28.2%). Conclusion: Despite renal failure, the Alexanian protocol and biphosphonates are still widely used in combination with symptomatic treatment with significant results.

关键词： Renal Failure Multiple Myeloma Management Evolution Togo

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