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Chronic Kidney Disease in Sub-Saharan Africans: A Study of 462 Patients

Open Journal of Nephrology 2021年第1期11卷 114-122页

作者： Mbengue Mansour Ba Djenaba lemrabott tall ahmed Cissé Mouhamadou Moustapha Niang Abdou Department of Nephrology Dalal Jamm University Hospital Dakar Senegal Department of Nephrology Aristide Le Dantec University Hospital Dakar Senegal Department of Nephrology El Hadji Amadou Sakhir Ndiéguéne Hospital Thiés Senegal

Chronic kidney disease is a global public health problem due to its increasing prevalence as well as its main risk factors such as hypertension and diabetes. However, in Africa, few studies have been done on chronic kidney disease. The aim of our study is to describe the epidemiological, clinical, paraclinical and therapeutic aspects of chronic kidney disease. It was a retrospective and descriptive study carried out from the first of January 2004 to the 31st of December 2013 at Principal hospital in Dakar. Records of any patient aged 18 and over with chronic kidney disease were included. Chronic kidney disease was defined according to the KDIGO 2012 recommendations. Among the 8873 patient records used during our study, 462 presented with chronic kidney disease, which was a hospital prevalence of 5.2%. The sex ratio was 1.61. The mean age of the patients was 58.37 ± 19.97 years. There were 75.32% of the patients who were aged 50 and over. The mean serum creatinine was 49.14 ± 56.83. The mean glomerular filtration rate was 27.47 ± 19.86 ml/min/1.73 m2. Chronic renal failure was diagnosed in 92% of patients, including 34.9% in the end-stage of the renal disease. The mean proteinuria was 3.07 ± 4.92 g/24 h. Leukocyturia was present in 34.17% of patients. Hematuria was present in 25% of patients. Hypertension and diabetes were the most common causes, found in 61.25% and 35.93% of patients, respectively. Hemodialysis was performed in 49 patients. Peritoneal dialysis was performed in 2 patients. One patient had undergone a kidney transplant. This study establishes the relatively high prevalence of chronic kidney disease and its risk factors including hypertension and diabetes. It also reveals the late diagnosis of chronic kidney disease in our pa

关键词： Chronic Kidney Disease Hypertension Diabetes

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Quality of Life of Patients on Peritoneal Dialysis in Dakar: A Senegalese Single Centre Experience

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Open Journal of Nephrology 2016年第2期6卷 37-42页

作者： Kane Yaya Cisse Mouhamadou Moustapha Seck Sidy Mohamed lemrabott ahmed tall Faye Maria Hounsounou Christian Diallo Kalilou Ka El Hadji Fary Niang Abdou Diouf Boucar Nephrology and Internal Medicine Department of Assane Seck University Ziguinchor Senegal Nephrology Department of Teaching Hospital Aristide Le Dantec Dakar Senegal Nephrology Department of Gaston Berger University Saint-Louis Senegal

Introduction: Measuring the quality of life (QOL) in recent years has become an indispensable tool in monitoring patients suffering from chronic diseases. We conducted this study to assess QOL of patients undergoing peritoneal dialysis in Dakar, and to identify associated factors. Patients and Methods: This is a cross-sectional study which was carried out from 10 to 30 June, 2011 in the peritoneal dialysis unit at university hospital in Dakar. We included all patients with end-stage renal disease (ESRD) of any age, who were on PD since at least six months and who gave their consent. The QOL was assessed using the Kidney Disease Quality of Life Short-Form 1.2 (KDQoL-SF). Results: Sixteen patients were included with a mean age of 50.25 ± 13.48 years and a sex-ratio of 1.27. Considering SF-36, the overall mean score (SMG) was 60.11 ± 15.96 with a Mean Physical Component Summary Scale of 53.66 ± 16.98 and a Mental Component Summary Scale of 70.85 ± 6.14. Concerning the KDQoL-SF, the global mean score was 61.83 ± 19.35 with a mean physical score of 50.55 ± 16.52 and a mean mental score of 62.52 ± 21.53. The mean dialysis specific dimension score was 62.52 ± 21.53 and the mean mental health score was 85.93 ± 12.06. Age, weight, level of instruction and social support were correlated with a worse QOL. Conclusion: This study showed an alteration of our PD patients’ QOL, particularly in their physical health. However, the number of patients included in the study is not enough to permit a formal conclusion.

关键词： Quality of Life Peritoneal Dialysis Dakar

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Accidental Migration of a Guide Wire during Femoral Venous Catheterization for Hemodialysis: A Case Report

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Open Journal of Nephrology 2018年第2期8卷 38-41页

作者： Faye Moustapha Cisse Mouhamadou Moustapha Faye Maria Daher Abdoul Karim Omar lemrabott ahmed tall Fall Khodia Sakho Binta Keita Alex Mbengue Mansour Niang Abdou Diouf Boucar Ka Elhadji Fary Department of Nephrology Aristide Le Dantec Cheikh Anta Diop University Dakar Senegal

Femoral venous catheterization is the most used technic in emergency he-modialysis. Some uncommon mechanical complications can occur during a catheterization. We report the case of an accidental migration of a guide wire during the placement of a hemodialysis femoral catheter. The case of a patient admitted in the nephrology department at Aristide Le Dantec University Hospital for malignant hypertension was investigated. Emergency hemodialysis was indicated. Surgical extraction of the metal guide has been performed and the outcome was favorable.

关键词： Hemodialysis Catheter Complication Guide Wire Migration

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Multiple Myeloma Secondary to HIV Infection, Revealed by Renal Failure: About a Case

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Open Journal of Nephrology 2019年第1期9卷 20-25页

作者： Mbengue Mansour Cissé Mouhamadou Moustapha Faye Maria lemrabott tall ahmed Fall Khodia Keita Alex Faye Moustapha Ba Bakary Diagne Seynabou Keita Niakhaleen Ba Mamadou Aw Dieng Ameth Niang Abdou Ka El Hadji Fary Diouf Boucar Department of Nephrology Regional Hospital Thies Senegal Department of Nephrology Aristide Le Dantec University Hospital Dakar Senegal

Multiple myeloma is on the list of neoplasia that may be associated with human immunodeficiency virus infection. It is an affection that aggravates the prognosis in these particular patients. We present the case of a patient with multiple myeloma and HIV infection, revealed by renal failure. This was a 59-year-old patient who was received to the Department of nephrology for renal failure associated with severe aregenerative pancytopenia. In etiological investigations, multiple myeloma associated with HIV1 infection was found. The evolution was unfavorable, marked by the death of the patient caused by digestive haemorrhage before the start of antiretroviral treatment and chemotherapy.

关键词： Multiple Myeloma HIV Renal Failure

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Intradialytic Hypertension: Prevalence and Associated Factors in Chronic Hemodialysis Patients in Senegal

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Open Journal of Nephrology 2018年第2期8卷 29-37页

作者： Faye Moustapha lemrabott ahmed tall Kane Yaya Cisse Mouhamadou Moustapha Seck Sidy Mohamed Faye Maria Daher Abdoul Karim Omar Fall Khodia Sakho Binta Keita Rick Alex Ismael Mbengue Mansour Niang Abdou Diouf Boucar Ka Elhadji Fary Nephrology Department Aristide Le Dantec Hospital Cheikh Anta Diop University Dakar Senegal Department of Nephrology Regional Hospital Center Assane Seck University Ziguinchor Senegal Department of Nephrology Regional Hospital Center Gaston Berger University Saint Louis Senegal

Introduction: Intradialytic hypertension is defined as elevation of blood pressure to more than 10 mmHg in the post-dialysis period as compared to the pre-dialysis one. It is an important factor of morbidity and mortality in hemodialysis patients. The aim of our study is to assess the prevalence and associated factors of intradialytic hypertension. Patients and methods: This is a descriptive and analytical cross-sectional study that was conducted over a period of 3 weeks in the hemodialysis units of Aristide Le Dantec Hospital in Dakar and Regional Hospital Center in Ziguinchor. Chronic he-modialysis patients who are at least 18 years old and agreed to participate in study have been included. Patients who did not have 4 measures or those who decided to withdraw from the study were excluded. Intradialytic hypertension was restrained by an increase in systolic blood pressure immediately after the hemodialysis session > 10 mmHg compared to that recorded before session, with a repetition of this phenomenon for at least 4 hemodialysis sessions. Results: Our study included 539 hemodialysis sessions for 93 hemodialysis patients with a mean age of 48.72 ± 14.06 years and a sex ratio (M/F) of 1.21. The mean duration of dialysis was 64.22 ± 45.63 months. Hypertensive nephropathy was significantly common, noted in 38.7% (36 patients). Mean inter dialytic weight gain was 2.04 ± 1.06 kg, and the average dry weight was 62.71 ± 13.69 kg. The average hemoglobin level was 9.27 ± 1.91 g/dl. The mean albumin level was 35.4 ± 7.48 g/l. Nineteen (19) patients were administered erythropoietin stimulating agents (20.4%), and 59 patients were given antihypertensive drugs (63.4%). An elevation of more than 10 mmHg of post-dialysis BP compared to pre-dialysis was noted in 179 sessions, which is 33.2 per 100 hemodialysis sessions. IDH was noted in 21 patients, which represents 22.6%. The factors associated with IDH were as follows: high post-dialysis pulse pressure (PP) (p = 0.0008), pre-dial

关键词： Intradialytic Hypertension-Hemodialysis-Senegal

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Prognostic Aspects of Lupus Nephritis at Aristide Le Dantec University Hospital in Dakar

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Open Journal of Nephrology 2018年第4期8卷 124-132页

作者： Mbengue Mansour Faye Maria Cissé Mouhamadou Moustapha lemrabott tall ahmed Fall Khodia Keita Alex Faye Moustapha Ba Bakary Diagne Seynabou Keita Niakhaleen Ba Mamadou Aw Dieng Ameth Motula Latou Lot Niang Abdou Diouf Boucar Ka El Hadji Fary Department of Nephrology Aristide Le Dantec University Hospital Dakar Senegal

Introduction: Kidney injury is common in the course of lupus and affects the functional and vital prognosis. The risk of progression to end-stage renal failure can reach 40% to 60%. Thus we carried out this work for the purpose of an evaluation of the renal and vital prognosis and to deduce the factors of poor prognosis. Patients and method: This was a retrospective, descriptive and analytical study conducted over a period of 10 years from January 1, 2007 to December 31, 2016, performed in the Nephrology Department of Aristide Le Dantec Hospital in Dakar. Patients with lupus nephritis were included. The studied parameters were epidemiological, clinical, paraclinical and progression. We had done a crossover of the patients to look for the factors of poor renal and vital prognosis. Results: Out of 93 cases of lupus patients, 64 were included, a prevalence of 69%. The mean age of the patients was 31.97 ± 10.44 years old. There were 81% women and 19% men, a sex ratio of 0.23. Class III was found in 24 cases (37.5%), Class IV in 20 cases (31.25%), Class V in 15 cases (23.4%), Class II in 4 cases (6.25%) and Class I in 1 case (1.6%). The combination of corticosteroids and immunosuppressants was used in 56.25% of cases. After a follow-up of six months, 19 patients were in complete remission, 21 had resistance and 9 had partial remission. Of the 21 patients who had resistance, 8 were in chronic renal failure. Death was observed in 5 patients and the causes were in 3 patients: pulmonary embolism, bacterial meningitis and pulmonary tuberculosis. The cause of death was unknown in 2 patients. The factors of poor renal prognosis were lymphopenia, the presence of anti-native DNA antibodies, nephrotic syndrome, microscopic hematuria, tubular atrophy and interstitial fibrosis. Risk factors affecting renal survival were the presence of native anti-DNA antibodies, microscopic hematuria, leukocyturia and the presence of a proliferative class. The factors of poor prognosis were renal f

关键词： Remission Resistance Chronic Renal Failure Lupus Nephritis

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Chronic Kidney Disease in Sub-Saharan Africans: A Study of 462 Patients

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Open Journal of Nephrology 2021年第1期

作者： Mbengue Mansour Ba Djenaba lemrabott tall ahmed Cissé Mouhamadou Moustapha Niang Abdou

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Contribution to the Study of Diabetic Kidney Disease in a Sub-Saharan Environment: An Example of the Aristide Le Dantec University Hospital in Dakar

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Open Journal of Nephrology 2023年第4期13卷 339-348页

作者： ahmed tall lemrabott Maria Faye Niakhaleen Keita Seynabou Diagne Moustapha Faye Bacary Ba Abdou Niang El Hadji Fary Ka Nephrology Department Aristide Le Dantec University Hospital Dakar Senegal Nephrology Department Dalal Jamm National Hospital Center Dakar Senegal

Introduction: Diabetic kidney disease (DKD) is a leading cause of chronic kidney disease and dialysis admission. Few studies are available in Sub-Saharan Africa. The objective of this work was to study the epidemiological, clinical, diagnostic and therapeutic characteristics of DKD in our context. Patients and Methods: We conducted an observational, exhaustive and retrospective study focusing on diabetic patients seen in consultation or hospitalized in the Nephrology Department of at the Aristide Le Dantec University Hospital in Dakar during a period of 5 years from January 1, 2017 to December 31, 2021. Results: Of 4735 patients seen during the study period, 491 had DKD, i.e. a hospital prevalence of 10.36%. The average age was 59.1 ± 11.4 years with a sex ratio of 0.95. Type 2 diabetes predominated with 93.4%. The average duration of diabetes was 11.5 ± 7.6 years. Diabetes was associated with high blood pressure in 78.81% of cases, dyslipidemia in 23.2% of cases, active smoking in 6.7% of cases and obesity in 1.6% of cases. Renal failure was the main reason for referral 72.3%. One hundred and forty-eight patients (30.1%) had uncontrolled diabetes. Macroalbuminuria was found in 64.8% and microalbuminuria in 18.7% of cases. One hundred and eighty-five patients (37.7%) were in Stage V of kidney disease and 137 patients were in Stage III (18.1% in Stage IIIb and 9.8% in Stage IIIa). Diabetic nephropathy was the main etiology at 61.30%. Nephropathy was mixed (diabetic and hypertensive) in 18.12 cases. Renin-angiotensin-aldosterone system (RAAS) blockers were prescribed in 83.5% of patients. Conclusion: The different etiologies encountered during the study show the diversity of diabetic kidney disease. Diabetic nephropathy is not the only kidney damage that can occur in diabetics in our context.

关键词： Diabetic Kidney Disease (DKD) Microalbuminuria Diabetic Nephropathy

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Pathological Fractures in Chronic Hemodialysis Patients in a Teaching Hospital in Senegal: Prevalence and Associated Risk Factors

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Open Journal of Nephrology 2023年第3期13卷 211-219页

作者： ahmed tall lemrabott Baratou Coundoul Niakhaleen Keita Maria Faye Moustapha Faye Mansour Mbengue Bacary Ba Seynabou Diagne Abdou Niang El Hadji Fary Ka Department of Nephrology Aristide Le Dantec University Hospital Dakar Senegal Department of Nephrology Dalal Jamm National Hospital Center Dakar Senegal Dialysis Center National Hospital Center of Pikine Pikine Senegal

Introduction: The lack of follow-up and adequate management of chronic kidney disease-mineral and bone disorder (CKD-MBD) in chronic hemodialysis patients is associated with pathological fractures. Few studies are available on the subject in sub-Saharan Africa. The objective of this work was to evaluate the prevalence of pathological fractures in our chronic hemodialysis patients, to analyze their clinical aspects and to determine the factors associated with their occurrence. Patients and Methods: We conducted a retrospective, descriptive and analytical study over 9 years (January 1, 2011, to December 31, 2020) based on the medical records of chronic hemodialysis patients at the CHU Aristide Le Dantec. The diagnosis of pathological fracture was retained in front of any fracture occurring spontaneously or following minimal trauma and confirmed by X-ray. Results: Nineteen cases of pathological fractures were collected with a hospital prevalence of 19.39%. The mean age was 53.32 ± 13.94 years with a sex ratio of 0.36. The average seniority in dialysis was 84.16 ± 29.88 months. Among these patients, one had had 3 episodes of fractures and another 6 episodes. The circumstances of occurrence of the fractures were the fall in 63% of the cases, spontaneously in 37% of the cases. The predominant site of fractures was the femoral neck (47.38% cases). Female gender (p 5 years (p = 0.049), gait disturbances prior to the fracture (p = 0.001), positive CRP (p = 0.028) and the presence of vascular calcifications (p = 0.002) were significantly associated with the occurrence of pathological fractures. Conclusion: This study has identified the factors associated with the occurrence of pathological invoices in hemodialysis patients in our context. These fractures are often associated with the lack of regular biological follow-up due to the low socioeconomic level of our patients.

关键词： Pathological Fractures CKD-MBD Hyperparathyroidism Osteomalacia Adynamic Bone Disease Chronic Hemodialysis

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Pulmonary Hypertension in Chronic Hemodialysis Patients at Aristide Le Dantec University Hospital

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Open Journal of Nephrology 2022年第1期12卷 93-100页

作者： Maria Faye ahmed tall lemrabott Niakhaleen Keita Moustapha Faye Romina Ghassani Mansour Mbengue Bacary Ba Seynabou Diagne Abdou Niang El Hadj Fary Ka Nephrology Department Aristide Le Dantec University Hospital Dakar Senegal Cheikh Anta Diop University Dakar Senegal Nephrology Department Dalal Jamm Hospital Dakar Senegal

Introduction: Pulmonary hypertension (PH) is defined as high blood pressure in the lungs. It is recently described as a vascular disease entity in chronic kidney disease, particularly for chronic hemodialysis patients. The aims of this study were to determine the prevalence of PH, to describe clinico-biological and morphological characteristics and to identify risk factors associated with PH in hemodialysis patients. Patients and methods: This is a cross-sectional, descriptive, and analytical study during a period of 8 months from January 1, 2019, to August 31, 2019, in the hemodialysis center of nephrology department of Aristide Le Dantec Hospital. All chronic hemodialysis patients for more than 3 months and with PH confirmed by cardiac doppler ultrasound were included. Results: During the study period, 25/94 patients on chronic hemodialysis, presented with pulmonary hypertension (26.6%). The mean age was 49.3 ± 12.9 years. The sex ratio (M/F) was 0.92. Exertional dyspnea was found in 18 patients (72%). Cardiac auscultation revealed an arrhythmia in 3 patients (12%), augmented second heart sound in 12 patients (48%). On transthoracic doppler ultrasound, pulmonary systolic arterial pressure was on average 51.4 ± 13.2 mmHg. PH was moderate in 13 patients (52%), mild in 9 patients (36%) and severe in 3 patients (12%). The left ventricular ejection fraction was altered in 9 patients (36%). Three patients (12%) had valve calcifications. They were mainly located at aortic valve (8%) and mitral valve (4%). The major risk factors associated to PH in our patients are pathological fractures (p = 0.023), aortic calcifications (p = 0.023), ischemic heart disease (p = 0.023). The duration of hemodialysis represents another favoring factor (p = 0.042). Also implicated are arrhythmias (p = 0.004), high cardiac index (p = 0.043), ventricular dilatation (p = 0.034) and left atrial dilation (p = 0.015), as well as dilation of the inferior vena cava (p = 0.048).

关键词： Pulmonary Hypertension Chronic Hemodialysis Patients Transthoracic Doppler Ultrasound Dakar

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