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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 t

关键词： Chronic Renal Failure Secondary Hyperparathyroidism Dialysis Parathyroidectomy

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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)

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

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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

关键词： Epidemiology Clinical Chronic Renal Failure Sikasso Mali

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Prevalence of Cardiovascular Risk Factors in Chronic Hemodialysis Patients 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 125-134页

作者： Seydou Sy magara samaké Moctar Coulibaly Massama Konaté Djénèba Diallo Hamadoun Yattara Aboubacar Sidiki Fofana Atabieme Kodio Modi Sidibé Nouhoum Coulibaly Alkaya Touré Djibril Sy Moustapha Tangara Saharé Fongoro Nephrology and Haemodialysis Department of the CHU of Point G Bamako Mali Faculty of Medicine University of Bamako Bamako Mali Nephrology Unit of the Fousseyni DAOU Hospital of Kayes Kayes Mali Nephrology Unit of Mali GAVARDO Hospital Bamako Mali Cardiology Department of Mali Hospital Bamako Mali Internal Medicine Service at the University Hospital Center of Point G Bamako Mali

Introduction: A cardiovascular risk factor (FDRCV) is defined as a physiological, pathological or environmental attribute or characteristic that results in an increased likelihood of developing cardiovascular disease in the individual in whom it is detected. The objective of this study was to determine the prevalence of cardiovascular risk factors in hemodialysis patients on hemodialysis at the University Hospital of Point G. Patients and Methods: This was a cross-sectional descriptive study with prospective data collection from March 3, 2009 to March 5, 2010 (13 months). Included were all patients with end-stage renal disease (ESRD) receiving chronic hemodialysis in the Nephrology and Hemodialysis Department of the University Hospital of Point G during the study period. Results: Eighty-eight patients were enrolled. The M/F sex ratio was 1.26. The mean age was 41.32 years with extremes of 17 and 81 years. The classic cardiovascular risk factors in order of frequency were: hypertension (90.9%), sedentary lifestyle (71.6%), male sex (54.5%), age ≥ 55 years (21.6%), obesity (13.6%), diabetes (8%), tobacco (8%), alcohol (3.4%). Cardiovascular risk factors related to CKD were: anemia (98.9%), phosphocalcic disorders (85.2%), arteriovenous fistula (AVF) (80%), lipid abnormalities (36.5%), hydrosodium inflation (29.5%). Predominant cardiovascular complications were hypertensive heart disease (62.5%), acute pulmonary oedema (APO) (50%), rhythm disorders (23.9%), coronary insufficiency (18.2%). The mortality rate was 17%. Conclusion: Cardiovascular risk factors are frequent in chronic hemodialysis. They contribute to the excess mortality of these patients. Adequate management of these risk factors can slow down serious cardiovascular complications and reduce the risk of mortality in this fragile population.

关键词： Cardiovascular Risk Factors Haemodialysis Mali

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Estimation of Glomerular Filtration Rate: Which Formula to Apply in G-Spot Subjects Aged 1 - 17 Years?

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Open Journal of Nephrology 2021年第3期11卷 397-402页

作者： Hamadoun Yattara Djibril Mamadou Couliblay Nouhoum Coulibaly Pamela Samiza Seydou Sy Arboncana Maiga Djeneba Diallo Moustapha Tanagra Alkaya Touré magara samaké Niagalé Diakité Aboubacar Sidiki Fofana Ibrahim Izetiengou Maiga Sahare Fongoro Nephrology and Hemodialysis Department of the Point G University Hospital Bamako Mali Medical biology Laboratory Service of the Point G University Hospital Bamako Mali Nephrology Department of the Regional Hospital of Kayes Kayes Mali

Introduction: Morbidity and mortality in paediatric practice is dominated in Africa by malaria, diarrhoeal diseases and acute respiratory infections. Aim: In order to evaluate the Glomerular Filtration Rate (GFR) with the formulas commonly used by medical laboratories, we proposed to undertake this study. Patients and Method: This was a descriptive, prospective and cross-sectional study conducted at the PA and KA medical biology laboratory in Bamako Hamdalaye ACI 2000 in collaboration with the medical biology and hospital hygiene laboratory service at the Point G University Hospital. Results: During the study period, we recruited 360 subjects, 189 of whom were male (52.5%) and 171 female (47.5%). The mean age was 8.75 ± 4.8 years with extremes of 1 and 17 years. Subjects aged 15 to 17 years were the most numerous. The reference means GFR of the subjects according to age was with the SCHWARTZ formula 179.16 ± 50.47 with extremes of 173.93 and 184.39;with CKD-Epi 37.63 ± 11.25 with extremes of 36.46 and 38.79;with MAYO 107.87 ± 18.11 with extremes of 105.99 and 109.75 and MDRD 350.83 ± 251.15 with extremes of 324.79 and 376.86. Conclusion: The Mayo formula showed a better distribution around the mean than other formulas for estimating the glomerular filtration rate.

关键词： Glomerular Filtration Rate Reference Value Young Subjects

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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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Result of 10 Years of Experience in Echo-Guided Kidney Biopsy Punctures in the Nephrology Department of the Martigues Hospital Center, France

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Open Journal of Nephrology 2021年第2期11卷 144-155页

作者： Aboubacar Sidiki Fofana magara samaké Seydou Sy Sah Dit Baba Coulibaly Christophe Bouaka Ghassan Alchahin Delphine Haussaire Simona Dorina Boncila Hamadoun Yattara Moctar Coulibaly Atabième Kodio Modi Sidibe Saharé Fongoro Nephrology Unit of the Fousseyni DAOU Hospital Kayes Mali Nephrology and Hemodialysis Department of the University Teaching Hospital of Point-G Bamako Mali Faculty of Medicine and Odontostomatology of the University of Sciences Techniques and Technologies of Bamako Bamako Mali Nephrology Unit of Somino DOLO Hospital Mopti Mali Nephrology and Hemodialysis Department of the Martigues Hospital Martigues France Nephrology Unit of Mali Gavardo Hospital Sébénikoro Bamako Mali

Introduction: Percutaneous renal biopsy (PRB) is an essential procedure for the diagnosis and therapeutic management of many primary or secondary nephropathies. Objectives: To identify the indications, to determine the profile of the diagnosed nephropathies and to evaluate the short-term complications related to the practice of echo-guided PRB at the Martigues hospital center. Methodology: This was a retrospective and descriptive study carried out on the records of patients who underwent echo-guided native kidney biopsy from January 1, 2010 to December 31, 2019 in the nephrology department of the Martigues Hospital. Results: The analysis of 123 cases of echo-guided PRB involved 76 men and 47 women with a sex ratio of 1.6. The mean age was 55.92 ± 17.80 with age extremes of 16 and 87 years. Glomerular syndromes were the main indication with 42 cases of nephrotic syndrome (34.1%), 15 cases of nephritic syndrome (12.2%), 11 cases of rapidly progressive glomerulonephritis syndrome (8.9%), and 6 cases of recurrent macroscopic hematuria syndrome (4.9%). The histological findings were 47 cases of primary glomerular lesions (38.3%), 32 cases of nephroangiosclerosis lesions (26%), 24 cases of secondary glomerulopathy (19.5%), 9 cases of interstitial nephritis (7.3%), 2 cases of myelomatous nephropathy (1.6%), and 9 cases (7.3%) of unclassified histological lesions. Twenty-two hypertensive patients (40.7%) had nephroangiosclerosis lesions (p = 0.001). The follow-up was simple in 119 patients (96.7%). Macroscopic hematuria was noted in 4 patients (3.3%). It was associated with a perirenal hematoma in 2 patients including 1 transfused case. Conclusion: Our data provide an important contribution to the understanding of the prevalence and clinical presentation of renal diseases in the nephrology department of the Martigues hospital center.

关键词： Renal Puncture Biopsy Nephrology Martigues Hospital Center

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Bacteriological Profile of Pneumopathies in Chronic Renal Failure at the University Hospital Center of Point-G in Mali

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Open Journal of Clinical Diagnostics 2020年第1期10卷 18-28页

作者： Seydou Sy magara samaké Hamadoun Yattara Moctar Coulibaly Ba Oumou Diallo Aboubacar Sidiki Fofana Djénéba Diallo Atabieme Kodio Modi Sidibé Nouhoum Coulibaly Alkaya Touré Djibril Sy Moustapha Tangara Saharé Fongoro Nephrology and Haemodialysis Department of the University Hospital Center (CHU) of Point G Bamako Mali Faculty of Medicine of Bamako University of Bamako Bamako Mali Nephrology Unit of the Fousseyni DAOU Hospital of Kayes Kayes Mali Nephrology Unit of Mali GAVARDO Hospital Bamako Mali Internal Medicine Service of the University Hospital Center of Point G (CHU du Point-G) Bamako Mali

Introduction: Chronic renal failure (CKD) is defined as a glomerular filtration rate (GFR) of less than 60 ml/min/1.73m2 for more than 3 months [1]. Infectious complications are a major source of morbidity in patients with chronic renal failure. In Mali, we have no data on pneumopathies in this population, hence the interest of this study. The objective of this work was to determine the frequency of pneumopathies in patients with chronic renal failure, describe the clinical radio-types, identify the microorganisms involved, and assess the renal prognosis of pneumopathies. Materials and Methods: This was an 18-month prospective and descriptive study from January 1, 2018 to June 30, 2019 conducted in the nephrology and hemodialysis department of the University Hospital of Point G. Included were patients hospitalized during our study period with CKD associated with pneumopathy on a chest X-ray. Not included were all patients hospitalized outside the study period, all CKD cases without pneumonia, patients with incomplete records, and non-consenting patients. Results: We examined 1111 patients, 35 of whom presented an image on chest X-ray related to pneumopathy, a frequency of 3.15% of cases. Twenty-one men (60%) and 14 women (40%) with a sex ratio of 1.5. The mean age was 46.8 ± 13.9 years with extremes of 23 and 76 years. The types of pneumopathy on the chest X-ray were: alveolar pneumopathy: 23 cases (65.7%), pleuropneumopathy: 10 cases (28.6%) and cavitary pneumopathy: 2 cases (5.7%). Cytobacteriological sputum examination was positive in 65.7%;leukocytes (68.6% of cases). The germs found were: Klebsiella pneumoniae (25.7% of cases), Escherica coli (11.4%), Pseudomonas aeruginosa (5.7%), Staphylococcus aureus (5.7%), Citrobacter freundi (5.7%), Enterococus sp. (2.9%), Enterobacter cloacae (2.9%), Candida albicans (5.7%). The search for acid-alcohol-resistant bacilli (BAAR) in sputum was positive in 4 cases (11.4%). There was an association between the results of cyto

关键词： Renal Failure Dialysis Pneumopathy Mali

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