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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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Intra-Dialytique Hypotension: Prevalence and Associated Factors in 2 Haemodialysis Centres in Senegal

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Open Journal of Nephrology 2022年第4期12卷 361-368页

作者： Ba A. Mamadou Yaya Kane moustapha faye Ameth Dieng Ba Bacary Niakhalen Keita Babacar Ndiaye Modou Ndongo Sy Abou Maria faye Ahmed Tall Lemrabott Ka E. Fary Department of Nephrology Internal Medicine Faculty of Health Sciences Assane Seck University Ziguinchor Senegal Department of Nephrology ALDH Cheikh Anta Diop University Dakar Senegal

Introduction: This study aimed to assess the prevalence of Intra-dialytic hypotension (IDH) according to the European Best Practice Guidelines (EBPG) definition in relation to the number of haemodialysis sessions and the number of chronic haemodialysis patients and to identify its associated factors. Patients and Methods: We conducted an observational, multicentre and looking-forward study of descriptive and analytical purposes over a 4-week period. The study included all patients with regular chronic haemodialysis with at least two sessions per week and a duration of 180 minutes, who consented to participate in the study and were over 15 years of age. Data collection was done with pre-established forms. The following data were collected: blood pressure before each session, at 30, 60, 120, 180 and 240 minutes of each session;socio-demographic data;dialysis data;clinical, paraclinical, therapeutic data and nursing interventions. Results: The mean age of the patients was 43.84 ± 12.10 years. Among 568 haemodialysis sessions recorded in 50 patients, IDH was noted in 12 haemodialysis sessions, representing a prevalence of 2.11%. Fatigue was found in 5 sessions with IDH episodes (41.66%) followed by yawning (25%), nausea ± vomiting (16.66%) and cramps (16.66%). As nursing interventions, Trendelenburg position and normal saline administration were performed in all IDH episodes. High blood pressure, inter-dialytic weight gain greater than 3 kg, Uf/H > 10 ml/kg/H, anaemia and hypoalbuminaemia were associated with the occurrence of IDH. Conclusion: The prevalence of IDH according to the EBPG definition is low. However, it is an important cause of morbidity and mortality, especially cardiovascular involvement, and the factors associated with its presence have been clearly identified.

关键词： Intra-Dialytic Hypotension Chronic Hemodialysis Patients Dakar Ziguinchor

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Humoral Response and Tolerance of Vaccination against SARS-CoV-2 in Adults Senegalese Patients Undergoing Hemodialysis: A Multicenter Prospective Study

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Open Journal of Nephrology 2024年第1期14卷 70-80页

作者： Lot Nehemie Motoula Latou moustapha Mbow Modou Ndongo Gnagna faye Gora Lo Sidy Mohamed Seck Department of Nephrology and Dialysis Military Hospital of Ouakam Dakar Senegal Immunology Laboratory Military Hospital of Ouakam Dakar Senegal Department of Nephrology and Dialysis Regional Hospital of Kedougou Kedougou Senegal Department of Nephrology Idrissa Pouye General Hospital Dakar Senegal Bacterioloy and Virology Laboratory CMIA Dakar Senegal IRL-3189 ESS/UGB/CNRS/UCAD/CNRST/USTB Faculty of Health Sciences University Gaston Berger Saint-Louis Senegal

Introduction: Following the COVID-19 pandemic, vaccination has been proposed in several countries as the main preventive measure despite very limited data, particularly in dialysis patients. We conducted this study to assess the immunological response to vaccination in Senegalese hemodialysis patients. Patients and Methods: We conducted a prospective study, in two dialysis centers in Dakar from March 30th to August 30th, 2021 including patients on hemodialysis for >6 months, vaccinated against SARS-CoV-2 according to the vaccination schedule recommended by WHO. A vaccine response was considered positive when seroconversion was observed after one dose of vaccine. The clinical efficacy of immunization was defined as the absence of new COVID-19 infection in patients who received a complete vaccination. Results: Among the 81 patients included in the study, 7.4% had anti-Spike IgM antibodies before their first vaccination. Seroprevalence of IgM antibodies was 38.3% one month after the first vaccine dose (at M1) and 8.6% one month after the second dose (at M4). Anti-Spike IgG antibodies were present in 40.3% of patients before vaccination, in 90.1% at M1, and in 59.7% at M4. Among patients previously infected with SARS-CoV-2, 10.2% had IgM antibodies at M0, 31.6% at M1, and 10.5% at M4 post-vaccination. Similarly, seroprevalences of IgG antibodies in this subgroup were 31.5%, 61.3%, and 50.0% respectively at M0, M1, and M4 post-vaccination. A comparison of seroconversion rates between M0 and M4 showed significant differences only for IgG in COVID-19 naive patients. Mean duration in dialysis and the existence of previous COVID-19 infection were associated with patients’ vaccinal response after the two doses. Age, gender and the use of immunosuppressive treatment did not influence post-vaccinal antibody production. Conclusion: Vaccination against COVID-19 in Senegalese hemodialysis patients induced a low seroconversion rate but it was well tolerated. M

关键词： SARS-Cov2 Vaccination Humoral Response Tolerance Hemodialysis Senegal

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Velocity Form Calculations of Generalized Oscillator Strengths for 3s→ (3p, 4p, 5p, 6p) Dipole Transitions of Atomic Sodium in Debye Plasma

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Open Journal of Applied Sciences 2024年第6期14卷 1512-1529页

作者： Louis Gomis Clement Diatta moustapha Sadibou Tall Ibrahima Gueye faye Rama Gomis Yande Diouf Mamadou Coulibaly Laboratoire de Physique des Plasmas et de Recherches Interdisciplinaires Departement de Physique Universite Cheikh Anta Diop Dakar Senegal

In this paper, the generalized oscillator strengths (GOSs) of excitations of atomic sodium from ground state to 2p63s0 (3p, 4p, 5p, 6p) states, immersed in Debye plasma, were calculated by using wavefunctions which were obtained numerically from the restricted Hartree-Fock (RHF) equation. This RHF equation employs the local density approach for exchange interactions including plasma Debye screening. Theoretical RHF and random phase approximation with exchange (RPAE) velocity calculations have shown that the GOSs for excitations to 3 s0(3 p,4 p,5 p,6 p)depend on the plasma Debye screening effects, as shown by the reduction in the GOS amplitude with decreasing Debye length λD. The agreement between the present RPAE V results for the transitions 3 s→3 s0(3 p,4 p,5 p)and the length calculations of Martínez-Flores was satisfactory. Correlation effects were found quite to be significant in the vicinity of the maxima of the GOS of the 3 s→3 s0(4 p,5 p,6 p)excitations by using the RPAE V approach. We note the poor influence of many electron correlations on the GOS of (3 s→3 p)transition with the same principal quantum number. Finally, we comment that the RPAE V calculations are useful in investigating electron correlation effects on the transition GOS of atomic sodium planted in Debye plasma. The present velocity results also reveal that the 3 s→3 s0(5p, 6p)transition GOSs tend to be delocalized due to more significant screening effects at Debye lengths λD=20and 30 a.u. for excited subshells 5p and 6p, respectively. We report here novel results of GOS for 3 s→3 s06ptransition obtained from different Debye lengths.

关键词： Plasma Screening Effect Correlation Effect Sodium Atomic Velocity Form GOS Restricted Hatree-Fock Random Phase Approximation with Exchange

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Renal Disease among HIV Positive Patients in Senegal

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Open Journal of Nephrology 2017年第4期7卷 101-106页

作者： Khodia Fall Mouhamadou moustapha Cissé Ahmed Tall Lemrabott Maria faye Mouhamed Cherif Dial Atoumane faye Seynabou Fall moustapha faye Alex Keita Mansour Mbengue Seynabou Diagne Niakhaleen Keita Bacary Ba Abdou Niang Boucar Diouf El Hadji Fary Ka Nephrology and Hemodialysis Department CHU Aristide Le Dantec Dakar Senegal Cytology and Histopathology Department Grand-Yoff General Hospital Dakar Senegal Internal Medicine Department CHU Aristide Le Dantec Dakar Sénégal

Introduction: Renal disease (RD) in human immunodeficiency virus (HIV) infection is a decisive turning point in the development and prognosis of this disease. In Africa, the prevalence varies between 2.5% and 48.6%. In Senegal, little data are available in the literature. The objective of our study was to describe the epidemiological, clinical, paraclinical, therapeutic and progressional aspects in patients living with HIV (PLWHIV). Patients and methods: This was a retrospective, descriptive and analytical study carried out over a 10-year period in the Department of Internal Medicine and Nephrology at the Aristide Le Dantec Hospital in Dakar, Senegal. We included all 15-year old and above PLHIV with available CD4 count and viral load. Results: Out of 248 PLHIV, 32 had kidney disease (KD), which means a hospital prevalence of 12.9%. The mean age was 51.22 ± 10 years (extremes of 36 and 77 years) with a sex ratio (male/female) of 1.28. Renal signs were dominated by glomerular nephropathy syndrome. It was present at 80%. Tubulo-interstitial nephropathy syndrome and chronic uremic syndrome accounted for 6.25% and 3.1% of cases, respectively. Renal function Impairment was present in 21 patients with 18 cases of acute kidney injury (85.7%) and 3 cases of chronic renal failure (14.3%), including 2 in stage 5 of chronic kidney disease. Renal biopsy (RB) was indicated and performed in 20 (62.5%) patients with glomerular signs in 12 patients (60%). Glomerular lesions were dominated by focal and segmental glomerulosclerosis (FSGS) in 6 cases, membraneous nephropathy (MN) in 4 cases and minimal change disease (MCD) in 2 cases. Tubulo-interstitial and vascular lesions were present in 45% and 12.5% of cases, respectively. In highly active antiretroviral therapy (HAART), 12 (37.5%) patients had total remission, 9 (28.12%) had partial remission. One (3.12%) death from severe metabolic acidosis on chronic renal failure was deplored. Conclusion: This study illustrates the high preval

关键词： Kidney Disease HIV HIVAN Senegal

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Idiopathic Adult Nephrotic Syndrome: A Clinicopathological Study and Response to Steroid in a Sub-Saharan African Country

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Open Journal of Nephrology 2016年第2期6卷 61-65页

作者： Maria faye Ahmed Tall Lemrabott Mouhamadou moustapha Cisse Jean De Dieu Nzambaza Cherif Mouhamed Dia Sidy Mohamed Seck Khodia Fall moustapha faye Elhadji Fary Ka Abdou Niang Boucar Diouf Department of Nephrology Aristide Le Dantec University Hospital Dakar Senegal Anatomo-Pathology Laboratory Grand-Yoff General Hospital Dakar Senegal Faculty of Medicine Gaston Berger University Saint-Louis Senegal

Introduction: Idiopathic nephrotic syndrome represents 25% to 30% of glomerulonephritis in adults. These glomerulonephritides are responsible of about the half of chronic kidney failure examined as well in United States as in Europe or Africa. The aim of this study was to determine the anatomoclinic, therapeutic and progression patterns of idiopathic nephritic syndrome in Dakar. Patients and Methods: It is a retrospective ten-year study in the nephrology department of Aristide Le Dantec Hospital. Patients with idiopathic nephrotic syndrome were included. We analyzed anatomoclinic, therapeutic and progression data of idiopathic nephrotic syndrome. Results: On 202 patients with nephrotic syndrome, 156 (77%) were primitive. The mean age was 29.7 ± 12 years with a sex ratio of 2.4. Edema was found in 98 patients (62.8%) and hypertension in 63 patients (40%). The mean proteinuria was 6.8 ± 4.8 g/24h. Histologic lesions found at renal biopsy were focal segmental glomerulosclerosis in 71 patients (45.5%), minimal change disease in 68 patients (43.5%) and membranous nephropathy in 8 patients (5%). 134 patients (85.8%) received steroids alone, 12 patients (7.6%) received cyclophosphamide and 4 patients (2.5%) azathioprine in association with steroids. 44 patients (28.2%) reached remission. The factors of poor prognosis were: age, above 40 years, proteinuria above 10 g/24h, existence of renal failure at admission, absence of use of steroids therapy. Conclusion: This study shows that idiopathic nephrotic syndrome is frequent in our country with a prevalence of 77%. The most common lesion found at the renal biopsy is the focal segmental glomerulosclerosis. Remission is found only in 28% which is very low. 33% of patients progress towards chronic kidney disease due to the lack of early diagnosis and the use of traditional medicine.

关键词： Idiopathic Nephrotic Syndrome Focal Segmental Glomerulosclerosis Minimal Change Disease Membranous Glomerulonephritis

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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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