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Indications for Renal Needle Biopsy and Histological Spectrum of Kidney Disease in Togo

Open Journal of Pathology 2024年第2期14卷 45-53页

作者： Eyram Makafui Yoan Yawo Amekoudi badomta dolaama Kossi Akomola Sabi Komlan Georges Tona Toyi Tchamdja Department of Nephrology Kara Teaching Hospital University of Kara Kara Togo Department of Nephrology and Hemodialysis Sylvanus Olympio Teaching Hospital University of Lomé Lomé Togo Department of Internal Medicine Kara Teaching Hospital University of Kara Kara Togo

Introduction: The frequent late-stage diagnosis of chronic kidney disease (CKD) constrains the treatment choices for nephrologists. Renal biopsy (RB) is crucial for accurately identifying renal lesions. This key nephrological procedure, however, is invasive and not without potential complications. The purpose of this study was to evaluate the indications, frequency, and histological lesion profiles of renal biopsies in Togo. Materials and Methods: We conducted a descriptive cross-sectional study encompassing all renal biopsies performed in Togo from the inception of nephrology services to the present. Data were compiled from the medical records of the patients. Results: From 2015 to 2023, 68 high-quality renal biopsies were executed in Togo. The patients had an average age of 30.6 years, with a predominance of males (69.1%). The most common indication was nephrotic syndrome, accounting for 66.2% of cases. Histologically, glomerulopathies were predominant, representing 61.8% of lesions, followed by vascular nephropathies (25%) and tubulointerstitial nephropathies (13.2%). The most frequently observed primary glomerulopathy was focal segmental glomerulosclerosis (FSGS). Gross hematuria was the sole complication, occurring in 1.4% of the cases. Conclusion: RB is an evolving practice in Togo. Glomerulopathies are the most commonly observed lesions. The histological categorization of renal lesions is vital for clinicians in their diagnostic reasoning and approach.

关键词： Renal Needle Biopsies Histology Kidney Failure Epidemiology Togo

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Risk Factors for Mortality in Acute Kidney Injury in Intensive Care Units in Togo

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Open Journal of Nephrology 2024年第1期14卷 37-47页

作者： Eyram Makafui Yoan Yawo Amekoudi Kossi Akomola Sabi Marcel David Keoula badomta dolaama Sarakawabalo Assenouwe Tabana Mouzou Department of Nephrology Kara University Hospital University of Kara Kara Togo Department of Nephrology and Haemodialysis Sylvanus Olympio University Hospital University of Lome Lomé Togo Department of Anaesthesia and Intensive Care University Hospital of Kara University of Kara Kara Togo

Context: Acute kidney injury (AKI) in intensive care unit (ICU) is common and associated with very high mortality. In Togo, a tropical country with limited resources and only one nephrology department in the north, acute kidney injury seems to be a real tragedy with high mortality. Aims: to determine risk factors for mortality in acute kidney injury in the intensive care units. Methods and Material: We made a multicentric cross sectional study during 6 months in the four referral centers in northern Togo. Univariate and multivariate logistic regression was used to identify factors associated with mortality. Data were analyzed using RStudio 2023.04.1. Results: A total of 12.6% of patients admitted to intensive care had presented with AKI. The mean age was 49.6 ± 17.9. The sex ratio (M/F) was 2.1. Community-acquired AKI was in the majority (67.7%). Oligo anuria was the most frequent functional sign (38.4%). In our series, 81.6% of patients were in KDIGO stages 2 to 3. AKI was organic in 56.2% of cases. Mortality was 44.3%. In multivariate analysis, the main factors predictive of death were: respiratory distress (OR = 2.36;p Conclusions: Acute kidney injury in intensive care is common in northern Togo, and mortality is high. Identification of associated factors should help anticipate prognosis.

关键词： AKI Intensive Care Unit Dialysis Epidemiology Togo

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

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

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

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

关键词： COVID-19 Renal Failure Risk Factors Togo

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Indications for Renal Needle Biopsy and Histological Spectrum of Kidney Disease in Togo

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Open Journal of Pathology（病理学期刊） 2024年第2期 45页

作者： Eyram Makafui Yoan Yawo Amekoudi badomta dolaama Kossi Akomola Sabi Komlan Georges Tona Toyi Tchamdja

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Risk Factors for Mortality in Acute Kidney Injury in Intensive Care Units in Togo

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Open Journal of Nephrology（肾脏病） 2024年第1期 37页

作者： Eyram Makafui Yoan Yawo Amekoudi Kossi Akomola Sabi Marcel David Keoula badomta dolaama Sarakawabalo Assenouwe Tabana Mouzou

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

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Open Journal of Nephrology（肾脏病） 2024年第2期 125页

作者： Kossi Akomola Sabi Yoan Makafui Amekoudi Awéréou Kotosso Laune Odilon Blatome badomta dolaama Ayodélé Jonathan Sabi Oscar Gnirimi Gbahbang Loutou Ahoub-Laye Affo Béfa Noto-Kadou-Kaza

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Renal Risk among Diabetic Patients in Togo

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Open Journal of Nephrology 2022年第3期12卷 249-261页

作者： Kodjo Kossi Tsevi Yawovi Mawufemo dolaama badomta Tona Komlan Georges Balaka Abago Yao K. Hubert Gnionsahe Daze Apollinaire Centre Hospitalier Universitaire Sylvanus Olympio Lome Togo Centre Hospitalier Universitaire de Treichville Abidjan Cote d’Ivoire Centre Nationale de Prévention et de Traitement de l’Insuffisance Renal Abidjan Cote d’Ivoire

Background: Diabetic patients have risk of kidney disease. The aim of this study was to assess the level of renal risk in our study population and to identify the associated predictive factors. Methods: It was a descriptive and analytical cross-sectional study carried out over 5 years (January 1, 2016 to December 31, 2020). All patients were included regardless of the duration of diabetes and having achieved at least one serum creatinine and at least two (2) proteinuria in the 24 hours over a period of at least three months. The level of renal risk was assessed using the KDIGO 2012 classification. Results: A total of 320 patient medical files were retained. The sex ratio M/F was 1.2. The average age was 57.2 ± 11.8 years. Hypertension was the most common comorbidity (84.4%). Diabetic nephropathy was found in 177 patients, a frequency of 42.8%. The very significant renal risk was found in 174 patients (54.4%). In multivariate logistic regression, the risk factors significantly associated with renal risk were: Male sex (OR = 2.50;95% CI = 1.29 - 4.84, p-value = 0.006);microangiopathy (OR = 5.54;95% CI = 1.82 - 16.85 p = 0.002) and beta-blockers (OR = 5.64;95% CI = 1.04 - 30.53 p = 0.004). The Oral Antidiabetes (OR = 0.23;95% CI = 0.10 - 0.55, p = 0.001), the blockers of Renin-Angiotensin system (OR = 0.58;95% CI = 0.41 - 0.90, p = 0.040) and the average socioeconomic level (OR = 0.50;95% CI = 0.25 - 0.98, p = 0.044) were rather the protective factors.

关键词： Diabetic Kidney Disease Kidney Risk Togo

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Predictors of Mortality in Chronic Kidney Disease Patients with Covid-19 in Togo

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Advances in Infectious Diseases 2022年第4期12卷 838-846页

作者： Yawovi Mawufemo Tsevi Lidaw Déassoua Bawe badomta dolaama Eyram Yoan Makafui Amekoudi Komlan Georges Tona Awalou Mohaman Djibril Lomé-Commune Regional Hospital National Center for the Care of Covid-19 in Togo Sylvanus Olympio University Hospital of Lomé Lomé Togo University Hospital of Kara Kara Togo

Background: Coronavirus disease mortality is high in people with chronic kidney disease. Method: we present the characteristics and factors associated with mortality of patients hospitalized for Covid-19 and with chronic kidney disease in a descriptive and analytical cross-sectional study of CKD patients admitted to the Lomé Commune Regional Hospital Center (CHR-LC) from March 2020 to August 2021. Results: A total of 127 patients met our inclusion criteria. We found a mortality rate of 48.8% in Lomé (Togo). Factors associated with this mortality in our study were severity of Covid-19 (p Conclusion: Mortality is very high in CKD patients with Covid-19.

关键词： Mortality Covid-19 CKD Togo

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Acute Kidney Injury during Coronavirus Disease in Togo

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Open Journal of Internal Medicine 2023年第1期13卷 8-15页

作者： Yawovi Mawufemo Tsevi Lidaw Déassoua Bawe Kofi Atsu Aziagbe badomta dolaama Edem Cruz Affanou Kodjo Agbeko Djagadou Awalou Mohaman Djibril Lomé-Commune Regional Hospital National Center for the Care of COVID-19 in Togo Sylvanus Olympio University Hospital of Lomé Lomé Togo

Background: Acute kidney injury (AKI) is frequently reported in the context of coronavirus infection. The incidence of AKI, particularly in patients hospitalized in intensive care units, is high. The aim was to study the associated factors to mortality in acute kidney injury (AKI) during COVID-19 in Togo. Method: This was a cross-sectional analytical study with retrospective data collection. It involved all patients hospitalized at CHR-LC from March 2020 to August 2021 suffering from COVID-19 who presented an AKI. Results: We identified 113 cases of acute kidney injury according to the predefined criteria. The prevalence of AKI during COVID-19 was 3.90%. Subjects over 65 years of age were the most represented. The age extremes were 17 and 85 years. The sex ratio (M/F) was 2.89. The main factors significantly associated with the severity of acute kidney injury were diabetes, asthma, HIV infection, and stroke. There was a correlation between the degree of acute kidney failure and severity on admission. Patients with AKI severity 2 and 3 were on hemodialysis. There was a statistically significant correlation between intra-hospital mortality and the severity of acute kidney injury (p = 0.04). The intra-hospital mortality rate was 23%. Conclusion: Acute kidney injury (AKI) during COVID-19 is a real concern for clinicians. Its medical care involves a multidisciplinary team. Particular emphasis should therefore be placed on the management of comorbidities and preventive nephroprotection measures.

关键词： Acute Kidney Injury COVID-19 Lomé (Togo)

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Risk Factors of Renal Failure in HIV Patients at Initiation of ARV Treatment: Retrospective Study of 3118 Patients Followed in Infectious Diseases Department at LoméUniversity Hospital

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Open Journal of Nephrology 2019年第3期9卷 55-64页

作者： Eyram Yoan Makafui Amekoudi Kossi Akomola Sabi badomta dolaama Komlan Georges Tona Bé fa Noto-Kadou-Kaza Epiphane Kola Bayaki Saka Department of Nephrology and Hemodialysis CHU Sylvanus Olympio Lome Togo Department of Dermatology and Venerology CHU Sylvanus Olympio Lome Togo

HIV infection is a major cause of chronic kidney disease, associated with high morbidity and mortality in sub-Saharan Africa. The objective of this study is to assess the prevalence and risk factors of renal disease at initiation of antiretroviral therapy. This was a descriptive and analytical retrospective study carried out in the infectious and tropical diseases department at Sylvanus Olympio University Hospital. The data have been extracted from the ESOPE software. Kidney disease was defined by a GFR, estimated by MDRD (Modification of Diet in Renal Disease) formula, less than 60 ml/min/1.73 m2. Risk factors associated with kidney disease were assessed using univariate and multivariate analysis. There were 3118 HIV-infected patients included in our study. The median estimated filtration rate was 94.7 ml/min/1.73 m2: 2.9% had an eGFR 2. 1303 had kidney disease (41.8%). Most patients (30.8%) were in the WHO clinical stage 1. The median CD4 count was 165/μL [IQR = 72 - 274/μL];the median hemoglobin level was 10.4 g/dL [IQR = 8.8 - 11.9 g/dL];all patients had thrombocytopenia less than 100.000/mm3;8.5% had leukocytosis greater than 10.000/mm3. Most of patients had HIV1. In the multivariate analysis, age greater than 40 years (p 3 were significantly associated with renal disease. The prevention of kidney disease must go through the identification of its risk factors in the target populations.

关键词： HIV Chronic Kidney Disease Epidemiology Togo

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