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Epidemiological and Clinical Aspects of Chronic Renal Failure in the Medical Department at the Hospital of Sikasso

Open Journal of Nephrology 2023年第1期13卷 57-66页

作者： Djénéba Maïga Drissa Goïta magara samaké Aboudou Messoum Dolo Yohanna Koné Aboubacar Sidiki Fofana Seydou Sy Moctar Coulibaly Atabième Kodio Sahdit Baba Coulibaly Saharé Fongoro Nephrology Unit of Sikasso Hospital Sikasso Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Service de Médecine CHU Mère-Enfant le Luxembourg Bamako Mali Nephrology Unit of the Fousseyni DAOU Hospital Kayes Mali Nephrology and Hemodialysis Service CHU du Point-G Bamako Mali Faculty of Medicine of Bamako Bamako Mali Nephrology Unit of Mali GAVARDO Hospital of Sebenicoro Bamako Mali

Introduction: Chronic renal failure is a real public health problem because of its prevalence, the cost of its management and the high morbidity and mortality rate associated with it. The objective of this study was to determine the frequency, causes and main aggravating factors of chronic renal failure in the medical department of the hospital of Sikasso. Materials and Methods: This was a cross-sectional, retrospective, descriptive study conducted in the medical department of the Sikasso hospital from January 1, 2021 to November 30, 2022. It covered all the records of patients with chronic renal failure hospitalized in the department during this period. The MDRD formula was used to estimate the glomerular filtration rate. The KDIGO 2012 classification was used to stage CKD. Results: Of 820 patient records reviewed, we retained 197 records. The mean age of our patients was 42.25 ± 10 years. The male sex represented 114 (57.9%). The socio-economic level was considered low and precarious in 79.8% of cases. The frequency of chronic renal failure was 24%. The reason for hospitalization was mostly hyper creatinine > 185 μmol/l (92.4%). Herbal medicine was reported in 103 cases (52.3%). Medical history was hypertension 101 cases (51.3%), undocumented gastro duodenal ulcer (UGD) 14 cases (7.6%), hypertension and diabetes 11 cases (5.1%), diabetes 8 cases (4%), lower limb edema 9 cases (4.6%). Hypocalcemia was 147 cases (75.6%) with hyper phosphoremia was 153 cases (77.7%). Hemoglobin level was: <6 g/dl, 44 cases (22.3%);between 6 - 8 g/dl, 77 cases (39.1%), from 8 - 10 g/dl, 54 cases (27.4%). The etiologies of CKD were vascular nephropathy 106 cases (53.8%), interstitial nephropathy, 44 cases (22.3%), glomerular nephropathy, 33 cases (16.8%), diabetic nephropathy, 12 cases (6.1%) and polycystic kidney disease 2 (1%). CKD was classified as stage 5, 171 cases (86.8%), stage 4, 11 cases (5.6%), stage 3, 13 cases (6.6%) and stage 2, 2 cases (1%.) Dialysis was performed in 1095 (5.3%) of our patients. All these patients star

关键词： Epidemiology Clinical Chronic Renal Failure Sikasso Mali

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Centropontine Myelinolysis after Conservative Correction of Hyponatremia: A Case Report and Review of Contributing Factors

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Open Journal of Nephrology 2022年第2期12卷 187-194页

作者： Aboubacar Sidiki Fofana magara samaké Sah dit Baba Coulibaly Seydou Sy Atabième Kodio Moctar Coulibaly Christophe Bouaka Ghassan Alchahin Hermione Deudjeu Youmbissie Hamadoun Yattara Nouhoum Coulibaly Saharé Fongoro Nephrology Unit Fousseyni Daou Hospital in Kayes Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Nephrology Unit Somino Dolo Hospital in Mopti Mopti Mali Nephrology and Hemodialysis Department University Teaching Hospital of Point-G Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali Nephrology Unit Mali Gavardo Hospital Bamako Mali Nephrology and Hemodialysis Department Martigues Hospital Martigues France Medical Imaging Department Martigues Hospital Martigues France

Introduction: Centropontine myelinolysis (CPM) is a rare pathology, a delayed neurological complication corresponding to massive demyelination of the protrusion. Its exact pathogenesis is poorly understood. Rapid correction of sodium hyponatremia has been implicated as a potent causative factor. We report a case of CPM despite a priori conservative correction of hyponatremia with a favorable course in a 61-year-old alcoholic-smoker diabetic. Case Presentation: A 61-year-old man with chronic alcoholism presented to the emergency department (D0) with physical asthenia and anorexia. He was treated for severe hyponatremia at 104 mmol/L by careful rehydration with saline before being transferred to a nephrological hospital. Magnetic resonance imaging (MRI) performed at D14 for locked-in syndrome showed osmotic demyelination syndrome (Figure 1). The evolution was favorable after 3 months of rehabilitation marked by a progressive and clear improvement of clinical signs. Conclusion: This observation suggests an evaluation of the benefit/risk ratio of the short-term prognosis of profound hyponatremia with that of the metabolic stress induced by a still too rapid correction. Particular attention should be paid to diabetic patients in the context of chronic alcoholism or nutritional deficiencies.

关键词： Centropontine Myelinolysis Hyponatremia Alcoholism

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Epidemiological, Clinical and Echocardiographic Aspects of Non-Obstructive Hypertrophic Cardiomyopathy in the Nephrology and Haemodialysis Department of the POINT G University Hospital

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Open Journal of Nephrology 2023年第2期13卷 81-90页

作者： Hamadoun Yattara Nouhoum Coulibaly Yohana Koné Atabieme Kodio Seydou Sy Aboubacar Sidiki Fofana Abdou Messoum Dolo Djenebou Maiga magara samaké Alkaya Touré Abdoul Karim Traoré Mahamadoun Kougouliba Moustapha Tangara Sahare Fongoro Point G University Hospital Bamako Mali Sikasso Regional Hospital Sikasso Mali Kayes Regional Hospital Kayes Mali Segou Regional Hospital Segou Mali Faculty of Medicine and Odontostomatology University of Science Technique and Technologies of Bamako Bamako Mali

Introduction: LVH is the earliest cardiovascular abnormality in CKD. It is a significant risk factor for mortality and cardiovascular morbidity in patients with chronic kidney disease. The objective of this study was to investigate non-obstructive hypertrophic cardiomyopathy in CKD patients hospitalised in the nephrology and haemodialysis department of the POINT G University Hospital. Methods: This is a prospective study carried out from January 1, 2021 to December 31, 2021 and concerned chronic renal failure patients with non-obstructive hypertrophic cardiomyopathy. Results: During our study, we recorded 89 cases of non-obstructive hypertrophic cardiomyopathy, a prevalence of 42.8%. The sex ratio was 1.2 in favour of men. The average age of the patients was 45 ± 14.4 years with extremes of 16 and 78 years. The risk factors frequently found were anaemia (100%) and hypertension (92.1%). The clinical picture was dominated by the left heart failure syndrome (66.3% of cases). The different types of echocardiographic hypertrophy found were concentric (72%), eccentric (18%) and septal hypertrophy (10%). Conclusion: Non-obstructive hypertrophic cardiomyopathy is the early cardiovascular abnormality encountered in CKD. It is associated with cardiovascular risk factors such as hypertension, anaemia and phosphocalcic disorders.

关键词： LVH Risk Factor Chronic Renal Failure Echocardiography

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Epidemiological and Clinical Profile of Patients Undergoing Primary Nephrological Consultation at the Fousseyni DAOU Hospital in Kayes, Mali

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Open Journal of Nephrology 2022年第1期12卷 142-153页

作者： magara samaké Seydou Sy Aboubacar Sidiki Fofana Hamadoun Yattara Sah Dit Baba Coulibaly Djénéba Diallo Nanko Doumbia Moctar Coulibaly Kodio Atabieme Djénéba Maiga Aboudou Messoum Dolo Nouhoum Coulibaly Saharé Fongoro Nephrology Unit Fousseyni DAOU Hospital Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Nephrology and Hemodialysis Department Point G Teaching Hospital Bamako Mali Faculty of Medicine of Bamako University of Bamako Bamako Mali Nephrology Unit Somine DOLO Hospital Mopti Mali Department of Medicine Mali Hospital Bamako Mali Nephrology Unit Mali GAVARDO Hospital Sebenicoro Bamako Mali Nephrology Unit Sikasso Hospital Sikasso Mali

Introduction: The first nephrological consultation is often late, even in developed countries. This delay is related to the insidious nature of renal disease, the lack of qualified personnel and structures for the management of these conditions and the context of chronic insecurity in our country. In Kayes, there is no data related to the first consultations of patients with the nephrologist, hence the interest of this study, which aimed to describe the epidemiological and clinical characteristics of patients undergoing a first nephrological consultation in Kayes hospital. Materials and methods: This was a retrospective, descriptive study conducted from January 1 to December 31, 2020 at the nephrology unit of the Fousseyni DAOU hospital in Kayes. All patients received for nephrological consultation for whom a medical record was made were included. The following data were collected and analyzed: the specialty of the medical referent, the reason for consultation, sociodemographic characteristics and the renal assessment of patients. Patients who consulted for non-nephrological pathologies and those who had no medical record were not included. Results: We collected the records of 346 patients, composed of 180 (52%) women and 166 (48%) men, i.e. a sex ratio of 0.92. The age group [20 - 40 years] was the most represented, 107 cases or 30.9%, with a mean age of 48.84 ± 21.33 years and extremes of 1 and 90 years. Housewives were the most consulted population, 149 cases (41.33%). Patients consulted more between the months of January and February, 116 cases (33.5%), this period was followed by the months of October-December, July-September and April-June with respectively 94 cases (27.2%), 76 cases (22.0%) and 60 cases (17.3%). The patients were referred by the general practitioner in 59.5% (209 cases), specialist doctor, 26.0% (90 cases). The patients came mainly from hospital practitioners, 172 cases (49.7%), private clinic and practice 81 cases (23.4%), community health center (CSCOM), 69 cases (19.9%). The main reason

关键词： Primary Consultation Nephrology Kayes Mali

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Single-Centre Descriptive Epidemiological Study of Emergency Haemodialysis Patients in the Haemodialysis Unit of the CHU Point G (Mali)

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Open Journal of Nephrology 2023年第3期13卷 246-255页

作者： Hamadoun Yattara Nouhoum Coulibaly Abdoul Karim Traoré Seydou Sy Atabieme Kodio Karamoko Djiguiba Mahamadoun Kougoulba Moctar Coulibaly Sah Dit Baba Coulibaly Modi Sidibé Abdou Messoum Dolo Yohana Koné Moustapha Tangara Alkaya Touré Aboubacar Sididki Fofana magara samaké Sahare Fongoro Point G University Hospital Bamako Mali Regional Hospital of Segou Segou Mali Hopital Mère-Enfant le Luxembourg Bamako Mali Mali Gavardo Hospital Bamako Mali Infirmary Garnison de Kati Kati Mali Sikasso Regional Hospital Sikasso Mali Kayes Regional Hospital Sikasso Mali Faculty of Medicine and Ondotostomatology of Bamako Bamako Mali

Introduction: Haemodialysis is an exchange of solutes and water between the patient’s blood and a dialysis solution with a composition close to that of normal extracellular fluid, through a semi-permeable membrane. It is used in the treatment of acute or chronic renal failure. The aim was to study the clinical and paraclinical aspects and the outcome of patients starting dialysis treatment for renal failure in an emergency setting. Method: This was a prospective study from 1 January to 31 July 2020, with a sample of 62 patients receiving haemodialysis in an emergency setting in the nephrology department of the Point G University Hospital. Results: The study showed that the sex ratio was 1.38 in favour of men and that the mean age of patients was 36.82 years. The group of patients with a low socio-economic standard of living dominated, accounting for 71% of cases. Hypertension and anaemia were the predominant risk factors in 77.4% and 87.3% respectively. Hyperphosphaemia, hypocalcaemia and secondary hyperparathyroidism accounted for 94.7%, 98.2% and 97.7% respectively. Left ventricular hypertrophy was 29.27% on electrocardiogram and 22% on cardiac ultrasound. Isolated cardiomegaly was found in 30.76% of patients. The main indications for dialysis were uraemic syndrome (69.2%), pericardial friction (27.4), anuria for 48 hours (20.1%), hyperkalaemia (17.7%) and acute lung oedema (16.1%). The mean duration of haemodialysis was less than one month in one out of two cases. There was no significant association between age and time on dialysis (p = 0.178). The death rate was 20.97%. Case fatality was higher in patients whose duration of dialysis was less than one month than in the others (p = 0.0006). Conclusion: CKD is a public health problem in Mali. It affects young people, especially males. Low economic income is an obstacle to the management of this disease.

关键词： Haemodialysis Emergency CHU Point G

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Renal Failure of Lithiasis Origin: Frequency and Management in the Nephrology and Haemodialysis Department of the Point G University Hospital in Mali

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Open Journal of Nephrology 2022年第3期12卷 276-292页

作者： Seydou Sy magara samaké Aboubacar Sidiki Fofana Atabieme Kodio Oligue Prudence Oman Djibril Sy Hamadoun Yattara Djénèba Diallo Sah Dit Baba Coulibaly Nouhoum Coulibaly Modi Sidibé Alkaya Touré Moustapha Tangara Mamadou Lamine Diakité Assétou Soukho Kaya Saharé Fongoro Nephrology and Hemodialysis Department University Teaching Hospital of Point-G Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali Nephrology Unit Fousseyni Daou Hospital in Kayes Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Department of Internal Medicine University Teaching Hospital of Point-G Bamako Mali Department of Urology University Teaching Hospital of Point-G Bamako Mali

Background: The term urinary lithiasis (UL) from the Greek “lithos” refers to the disease characterised by the result of abnormal precipitation of normal constituents of the urine within the urinary tract. The aim of this work was to determine the frequency of obstructive renal failure (ORF) of lithiasis origin and to describe the therapeutic indications. Methods: This was a retrospective prospective study in patients hospitalised in the nephrology department of Point G University Hospital for ORF of lithiasis origin over a 26-month period from 1 January 2018 to 1 February 2020 inclusive. Results: Among 1898 hospitalized patients, 32 met the inclusion criteria, i.e. a frequency of 1.7%. The male sex was 68.75% with a sex ratio of 2.2. The mean age was 48.38 ± 13.423 years with extremes of 20 and 65 years. Dysuria and urinary bilharzia were the main uro-nephrological antecedents, accounting for 25% of the cases each. Pain syndrome was the main functional sign, accounting for 100%. Ultrasound of the urinary tract (n = 28) showed stones in 92.85%. These stones were bilateral in 22.22% of cases. The dilatation was pyelocalic in 14 cases (51.8%). The uroscanner showed a pyelic location of the stones in both kidneys;42.1% on the right and 33.3% on the left. Hydronephrosis was the most common dilatation: 37.8% on the right and 29.7% on the left. Renal lithiasis was complicated by acute kidney injury (ARI) in 17 cases (53.1%) versus 15 cases (46.9%) of chronic kidney disease (CKD). Urethral catheter was the means of drainage in 24 (75%) followed by nephrostomy in 8 cases (25%). Nephrolithotomy accounted for 9.4% of cases. The case fatality rate was 28.12% (9 cases). Deaths occurred in the context of uraemic coma 6 cases and cardiorespiratory arrest 3 cases. Conclusions: The management of urinary lithiasis complicated by renal failure calls for the correction of hydrolytic disorders, drainage of the excretory tract and treatment of the stone, of which percutaneous nephrolithotomy seems to be the modality of choice.

关键词： Renal Failure Urinary Lithiasis Nephrology University Teaching Hospital of Point-G

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Parathyroidectomy in Chronic Haemodialysis in the Nephrology and Haemodialysis Department at the University Hospital Center of Point G in Bamako, Mali

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Open Journal of Nephrology 2020年第2期10卷 135-143页

作者： Saharé Fongoro Hamadoun Yattara Seydou Sy magara samaké Djénèba Diallo Moctar Coulibaly Fatoumata Modjéré Doumbia Djibril samaké Moustapha Tangara Alkaya Touré Atabième Kodio Nouhoum Coulibaly Nephrology and Haemodialysis Department of the University Hospital Centre of Point G Bamako Mali Faculty of Medicine University of Bamako Bamako Mali Nephrology Unit of the Fousseyni Daou Hospital in Kayes Kayes Mali Nephrology Unit of the Mali Gavardo Hospital in Sébénikoro Bamako Mali ORL Unit Reference Health Center of the Municipality V Bamako Bamako Mali

Introduction: Secondary hyperparathyroidism is a common complication in chronic hemodialysis patients. It is characterized by hypersecretion of parathormone by the parathyroid glands to maintain phosphocalcium homeostasis in response to hypocalcemia, lowering of 1.25 dihydroxy vitamin D3 and hyperphosphatemia. Objective: To analyze the results of parathyroidectomy (PTX) in cases of secondary hyperparathyroidism (HPTS), report the post-operative course and early and late complications. Patients and Methods: We conducted a retrospective study of ten (10) patients with chronic renal failure operated on at the CHU of Point G over a 32-month period, from January 1, 2016 to August 31, 2019. We analyzed the clinical, biological, radiological and histological parameters of the thyroid glands. Results: We have collected 33 cases of secondary hyperparathyroidism. Ten (10) patients met the inclusion criteria. They were 45 years old on average, seven (7) women and three (3) men, in dialysis for an average of 6.8 years before parathyroidectomy. Half of the initial kidney disease was of vascular origin (HTA). No cases of diabetic nephropathy were identified. Symptoms were in order of frequency: bone pain (60%), paresthesia (50%), functional impotence of the lower limbs (50%). Radiological signs included demineralisation (5 out of 6 cases) and brown tumour associated with a fracture (1 out of 6 cases). The most frequent indication for parathyroidectomy (100%) was persistence despite treatment of a serum PTH concentration above 1000 pg/ml. Subtotal PTX (7/8) was performed after cervical ultrasound in all patients. Histological analysis of the parathyroid glands showed adenoma (60%) and hyperplasia in 40% of cases. The evolution was marked by a progressive reduction of the parathormone level over twelve (12) months, without achieving normalization. This could be related to sub-dialysis (generator failure with reduction of dialysis time). There were no cases of complications or mo

关键词： Chronic Renal Failure Secondary Hyperparathyroidism Dialysis Parathyroidectomy

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Acute Renal Failure Secondary to Paracetamol Intoxication: A Case Report

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Open Journal of Nephrology 2022年第3期12卷 235-240页

作者： Moctar Coulibaly magara samaké Konaré Samba Fofana Aboubacar Sidiki Ossil Ampion Marc Batcho Jimmy Mansour Janette Seydou Sy Hamadoun Yattara Atabième Kodio Djénéba Maiga Sah Dit Baba Coulibaly Djénèba Diallo Aboudou M. Dolo Moustapha Tangara Nouhoum Coulibaly Kalilou Coulibaly Ibrahima Koné Saharé Fongoro Nephrology Unit of Mali GAVARDO Hospital in Sebénicoro Bamako Mali Nephrology Unit of the Fousseyni DAOU Hospital Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Nephrology Department of the Soissons Hospital Soissons France Nephrology and Hemodialysis Department of the UHC du Point G Bamako Mali Faculty of Medicine of Bamako Bamako Mali Nephrology Unit of Sikasso Hospital Sikasso Mali Nephrology Unit of Somino DOLO Hospital Mopti Mali

Renal damage secondary to paracetamol intoxication is rare, estimated between 1% and 2% of intoxication cases. Its pathophysiology is still debated, the clinical involvement consisting in an acute tubular necrosis with a good prognosis if it is rapidly treated. Renal damage can sometimes occur without prior hepatic damage, and the onset of renal manifestations is generally between the 2nd and 7th day after taking paracetamol. If its management remains exclusively symptomatic, its late onset can sometimes lead to serious metabolic complications. It is therefore important to systematically monitor renal function following paracetamol drug intoxication. We report the case of a 60-year-old male subject hospitalized for the management of voluntary drug intoxication (VDI) with paracetamol complicated by acute hepatocellular failure and acute renal failure. His management required extrarenal purification (hemodialysis) and the evolution was favorable with recovery ad integrumof renal function. Conclusion: Although less known and of unelucidated physiopathology, nephrotoxicity secondary to voluntary drug intoxication with paracetamol is a reality and can lead in extreme cases to the use of extrarenal purification technique (hemodialysis).

关键词： Acute Renal Failure Paracetamol Intoxication Hemodialysis

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Prevalence of Severe Anemia (Hb ≤ 5 g/dl) in Non-Dialyzed Chronic Renal Failure Patients in the Nephrology and Hemodialysis Department of Point G University Hospital

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Open Journal of Nephrology 2021年第2期11卷 252-264页

作者： Seydou Sy magara samaké Aboubacar Sidiki Fofana Awa Diallo Moctar Coulibaly Djibril Sy Atabième Kodio Saharé Fongoro Mahamane Kalil Maïga Nephrology Department of Point G University Hospital Bamako Mali Faculty of Medicine of Bamako Bamako Mali Nephrology Unit of the Fousseyni Daou Hospital Kayes Mali Nephrology Unit of Mali Gavardo Hospital Bamako Mali Department of Internal Medicine Point G University Hospital Bamako Mali

Introduction: Chronic renal failure (CRF) is defined as glomerular filtration rate (GFR) less than 60 ml/min/1.73m2 for at least three (3) months. Anemia is one of its most common complications. Anemia increases the risk factor for cardiovascular mortality by 18% per gram of hemoglobin loss. Objectives: To determine the prevalence and characteristics of this severe anemia, to determine the indications for transfusion, the complications related to this anemia, the evolution and the prognosis of these patients. Materials and Methods: This was a descriptive study with retrospective data collection over 18 months (January 1, 2017 to June 30, 2018) that included hospitalized CRF patients. Were included, non-dialyzed chronic renal failure patients with Hb ≤ 5 g/dl hospitalized during the said period. Not included were chronic renal failure patients with an Hb level ≥ 5 g/dl, those followed up and/or hospitalized outside the study period. Results: Among 1176 patients, 26 had severe anemia (Hb level ≤ 5 g/dl) on CRF, a prevalence of 2.21%. The mean age was 40 years ± 32.62 with extremes of 15 and 67 years. Seventeen women and 9 men. The etiology of chronic renal failure (CRF) was hypertensive vascular nephropathy in 50% of cases. CRF was end-stage in 18 patients (69.2%). The mean hemoglobin level was 4.10 g/dl ± 0.64 with extremes of 2 and 5 g/dl. The anemia was microcytic hypochromic in 50% and aregenerative (96.2%). The main symptoms were asthenia in 20 cases (76.9%), dizziness in 20 cases (76.9%), exertional dyspnea in 19 cases (73.1%). Signs of cardiac decompensation (n = 12) were jugular turgor 10 cases (38.5%), hepato-jugular reflux 06 cases (23.1%), mitral insufficiency murmur 06 cases (23.1%). The main complication was left ventricular hypertrophy 17 cases (77.3%). There was no correlation between anemia and sex (p = 0.291), age (p = 0.778), malaria (p = 0.158), etiology of CRF (p = 0.26). The evolution after treatment of anemia was fa

关键词： Severe Anemia Chronic Renal Failure Blood Transfusion Mali

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First Consultation in Nephrology: Case of the Point G University Hospital (Bamako-Mali)

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Open Journal of Nephrology 2021年第3期11卷 412-421页

作者： Hamadoun Yattara Nouhoum Coulibaly Djeneba Diallo Mamadou Sanogo Seydou Sy Pamela Samiza Moustapha Tanagra Alakay Touré magara samaké Sah Dit Baba Coulibaly Aboubacar Sidiki Fofana Atabieme Kodio Saharé Fongoro Nephrology and Hemodialysis Department of the Point G University Hospital Bamako Mali Nephrology Department of the Regional Hospital of Kayes Kayes Mali

Understanding the first consultation of people with kidney disease seems to us to be essential to understand the attitude of the referring physician and the nephrologist. The aim was to find out to whom a patient with kidney disease should be referred in the first instance and for what reason? Hence the evaluation of the prevalence of the first consultation in the nephrology department of the Point G University Hospital in Bamako was made. Patients and Method: This was a prospective descriptive study which took place from July 2017 to June 2018 in the nephrology department of the Point G University Hospital. The study included all patients who came to the nephrology department for the first time during this period. Results: Between July 2017 and June 2018 at the nephrology and haemodialysis service of the G point University Hospital, we retained 643 out of 1031 patients who came for their first consultation, i.e. 62.36%. There were many patients aged between 41 and 50 years. The average age was 42.6 ± 5.03 years with extremes of 30 and 82 years. The sex ratio (M/F) was in favor of males, 1.14. The majority of patients were referred/evacuated from the referral health centres (57.6%). The majority of patients were referred/evacuated by general practitioners (70.5%). Cardiologists were the main specialists to refer/evacuate patients (21.2%). The main reasons for consultation that led to the first diagnostic hypotheses were: arterial hypertension for vascular nephropathy, glomerular syndrome for glomerular nephropathy, acute uraemia syndrome for acute renal failure, hydronephrosis for obstructive uropathy and finally diabetes for diabetic nephropathy. Conclusion: The first consultation in nephrology remains an important step in the management of renal disease, especially when the referral is an emergency. The percentage of referrals is dominated by general practitioners.

关键词： Renal Failure First Consultation Nephrology CHU du Point G

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