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Predictive factors of Renal failure in COVID-19 Patients at the Anti-COVID Center in Lome, Togo

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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Emphysematous Pyelonephritis in a Black African Woman Managed with Antibiotics Alone

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Open Journal of Nephrology 2016年第4期6卷 151-156页

作者： Kossi Akomola Sabi Béfa noto kadou kaza Eyram Yoan Amekoudi Jacques Vigan Vicko Manou Dazé Apollinaire Gnionsahe Department of Nephrology and Hemodialysis Sylvanus Olympio University Teaching Hospital Lomé Togo

Introduction: Emphysematous pyelonephritis (EPN) is a severe, life-threatening infection of the renal parenchyma. This condition is characterized by the production of intrarenal and perinephric gas. In the world, the EPN is currently limited to case series reported. No cases have been described in black Africa. Aims: Related a first case of EPN diagnosed and treated in the University Hospital Center Sylvanus Olympio of Lomé in Togo. Observation: A 40 years old woman, with antecedent of diabetes presented pyelonephritis emphysematous class 2. She was treated successfully with antibiotic alone without using percutaneous drainage or nephrectomy. Conclusion: As reported in every case series, it was a young diabetic patient with a clinical features of acute pyelonephritis which CT scan had helped lay the EPN class 2 diagnosed. The germ was Klebsiella pneumoniae. She was treated with adapted antibiotic alone.

关键词： Emphysematous Pyelonephritis Africa 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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Erectile Dysfunction in Hemodialysis in Togo

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Open Journal of Nephrology 2016年第4期6卷 145-150页

作者： Kossi Akomola Sabi Béfa noto kadou kaza Eyram Yoan Amekoudi Jacques Vigan Souleymane Pessinaba Kafui Avouwadan Kodjo Tengue Tchilabalo Matchona Kpatcha Dazé Apollinaire Gnionsahe Departement of Nephrology and Hemodialysis Sylvanus Olympio University Teaching Hospital Lomé Togo Departement of Nephrology and Hemodialysis University Teaching Hospital of Cotonou Cotonou Benin Departement of Cardiology Campus University Teaching Hospital of Lomé Lomé Togo Departement of Urology and Andrology Sylvanus Olympio University Teaching Hospital Lomé Togo Departement of Nephrology and Hemodialysis University Teaching Hospital of Yopougon Abidjan Ivoiry Coast

Objectives: To determine the prevalence and risk factors of erectile dysfunction (ED) in men on hemodialysis in Togo. Methods: Prospective cross-sectional study, descriptive and analytical ranging from December 2015 to February 2016 in the hemodialysis unit of CHU SO, only dialysis center in the country. The evaluation of the ED was made through IIEF-5 questionnaire. Results: 39 men (67.2%) of 58 hemodialysis is a sex ratio M/F of 2.05. The average age was 43.5 years with extremes of 25 and 59 years. The majority of men had a profession in 19 cases (48.7%). The mean duration of dialysis was 30 months with a range of 4 months and 90 months. Initial glomerular nephropathy was in 19 cases (48.7%) and vascular in 14 cases (35.9%). 38 patients were hypertensive (97.4%) and 6 diabetic men (15.4%). The prevalence of ED was 74.3% (29 cases). ED score was less than 10 points in 14 cases (35.9%);01 case (2.6%) between 11 and 16 points;06 cases (15.4%) between 17 to 21 points;08 cases (20.5%) between 22 and 25 points;and 10 cases (25.6%) between 26 and 30 points. Age, profession and duration of dialysis were risk factors associated with ED (P 0.001). Conclusion: The prevalence of ED is very high in Togo.

关键词： Erectile Dysfunction Hemodialysis Togo

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Determinants and Risks factors of Renal failure in Patients with Heart failure in Cardiology Department of CHU Sylvanus Olympio of Lomé(Togo)

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Open Journal of Nephrology 2019年第3期9卷 65-76页

作者： Kossi Akomola Sabi Eyram Yoan Makafui Amekoudi Soudougoua Baragou Komlan Georges Tona Yaovi Afassinou Machioude Pio Béfa noto-kadou-kaza Badomta Dolaama Eugene Ametepe Attisso Anani Amen Tevi Mawusse Koffi Mensah Mindessou Murielle Schyldia Bonou-Selegbe Jaques Vigan Department of Nephrology and Hemodialysis CHU Sylvanus Olympio Lomé Togo Department of cardiology CHU Sylvanus Olympio Lomé Togo Clinique de Néphrologie CNHU Cotonou Bénin

Introduction: The morbidity and mortality of patients with heart failure are known to increase rapidly in the presence of renal insufficiency, which is usually the cause but may be a consequence. To organize better prevention of renal failure, we undertook this study to identify the determinants of renal failure in the population of patients with heart failure. Methodology: This was a retrospective descriptive and analytical study of heart failure (HF) cases hospitalized from January 1st to December 31st, 2016, over a period for twelve (12) months at CHU Sylvanus Olympio. Patients who performed cardiac Doppler ultrasound were included in our study. Renal failure was defined as eGFR (estimated glomerular filtration rate) less than 60 ml/min/1.73m2. Multivariate logistic regression was performed to investigate associated factors. The dependent variable was DFG status: coded 1 if the GFR is less than 60 ml/min and 0 if not. Results: A total of 216 patients were included. The majority were female (54.17%). The median age of patients was 53 years [IQI = 32 - 61 years] with extremes of 15 and 96 years. 16.49% of patients had a GFR of less than 60 ml/min. In multivariate analysis the average standard of living (OR = 2.40, p = 0.0456), diabetes (OR = 2.67, p = 0.0300), hypertension (OR = 5.66, p = 0.0399), alcoholism (OR = 4.00, p = 0.0063) were the main factors in the development of an RF/HF. Conclusion: The average standard of living, diabetes, hypertension, and chronic alcoholism are the determinants of renal failure in HF.

关键词： Heart failure Renal failure Determinants Togo

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Acute Kidney Injury during Malaria in Togolese Children

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Open Journal of Nephrology 2018年第4期8卷 85-93页

作者： Kossi Akomola Sabi Befa noto kadou kaza Eyram Yoan Makafui Amekoudi Weu Melanie Tia Jacques Vigan Hamat Ibrahim Guillaume Abderhamman Mahamat Sandra Amouzou-Glikpa Edem Djadou Service de néphrologie et hémodialyse CHU SylvanusOlympio Lomé Togo Service de néphrologie et d’hémodialyse CHU de YOPOUGON Abidjan République de C&ocirc te d’Ivoire Clinique de néphrologie CNHU Cotonou. Bénin Service de néphrologie et d’hémodialyse h&ocirc pital universitaire de N’djaména Tchad Service de pédiatrie CHU SylvanusOlympio Lomé Togo

Objective: To describe clinical, biological and evolutionary profile of Acute Kidney Injury (AKI) due to Severe Malaria in the pediatric department. Methodology: This was a retrospective descriptive study that took place from January to December 2012. It has been included children aged 0 - 15 years admitted for severe malaria with positive thick drop. AKI was defined by using the modified RIFLE (Risk Injury failure Loss End stage) classification for Pediatrics. Results: 338 children admitted for severe malaria were included. AKI was diagnosed in 24 children, a prevalence of 7.1% according to pRIFLE classification: RISK in 10 (3%), INJURY in 9 (2.6%) and faILURE in 5 (1.5%). The average age was 8.16 ± 4.2 years. Clinical features were dominated by hemoglobinuria in 87.5%, oliguria, vomiting and fever in 75%. The biological features were dominated by severe anemia (Hb 5.5 mmol/l) was found in 2 cases. The mean parasitic density was 22,120 trophozoites. Malaria was treated primarily with artemether in 83.3% of the cases. Dialysis was indicated in 2 cases for menacing hyperkalaemia, but was not done because of lack of financial means. In one case, hyperkalaemia was successfully treated with symptomatic measures, but in the second case, these measures were not allowed to normalize kalaemia, and death occurred. Conclusion: Acute post-malarial renal failure secondary to tubular necrosis may be the dominant clinical features of severe malaria. Death may occur. Preventing malaria would be the best way to avoid it.

关键词： AKI Severe Malaria Haemoglobinuria Togo

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Anxio-Depressive Morbidity in Chronic Hemodialysis at the CHU SO of Lome (Togo)

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Open Journal of Nephrology 2017年第2期7卷 25-37页

作者： Kokou Messanh Agbémélé Soedje Kossi Akomola Sabi Eyram Yoan Makafui Amekoudi Kparakate Bouboune Kota-Mamah Befa noto-kadou-kaza Bartholome Komivi Azorbly Joel Mawuko Gbetogbe Kolou Simliwa Dassa Clinic of Psychiatry and Medical Psychology CHU-Campus Lomé Togo Department of Nephrology and Hemodialysis Unit of CHU-Sylvanus Olympio Lomé Togo

Introduction: This work aims to identify and analyze the anxio-depressive morbidity that the renal insufficiency in hemodialysis can present. Methodology: The framework of this work was the department of nephrology and the hemodialysis unit of the CHU Sylvanus Olympio of Lome. This was a cross-sectional, single-pass, descriptive and analytical study that ran from January 1st, 2016 to June 30th, 2016. Included were all chronic hemodialysis patients who gave their free and well-informed consent and who have no psychiatric history. To assess anxiety and depression, the Hospital Anxiety and Depressive Scale of Zigmond and Snaith was used. The processing of the data was done with the software Epi Info 7 (version 7.***.2.0). Results: The number of patients was 91 and all were included. The mean age at 46.51 ± 14.41 years with extremes of 11 and 84 years and a sex ratio at 1.6 were observed. Anxiety (A3) was in 52.8% of women and depressed (D3) in 63.2% of men. The absence of social security increases the risk of anxiety disorders among respondents by three (RR = 2.6, p = 0.04). A duration of change of Chronic Renal failure (CRF) less than 6 months was associated with the occurrence of depression (p = 0.04) with hemodialysis patients. The relative risk of depressive episodes increased three-fold with the hemodialysis patients (RR = 2.7). Conclusion: Collaboration between psychiatrists, psychologists and somaticians (doctors of the body) can occur at different times during dialysis, in order to overcome the difficulties that may arise during the treatment.

关键词： Anxiety Depression Renal Dialysis Psychopathology Sub-Saharan Africa

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Epidemiological, Clinical and Biological Aspects of Kidney Disease in People Living with HIV Naive Antiretroviral Therapy at CHU Sylvanus Olympio of Lome (TOGO)

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Open Journal of Nephrology 2019年第1期9卷 26-34页

作者： Kossi Akomola Sabi Badomta Dolaama Eyram Yoan Makafui Amekoudi Awereou Kotosso Befa noto-kadou-kaza Claude Mawufemo Tsevi Komlan George Tona Eugene Ametepe Attisso Schyldia Bonou-Selegbe Hamat Ibrahim Guillaume Abderhamman Mahamat Jaques Vigan Majeste Ihou Wateba Service de Néphrologie et Hémodialyse CHU Sylvanus Olympio Lomé Togo Service des Maladies Infectieuses et Tropicales du CHU Sylvanus Olympio de Lomé Lomé Togo Service de Néphrologie et d’Hémodialyse H&ocirc pital Universitaire de N’djaména N’djamena Tchad Clinique de Néphrologie CNHU Cotonou Bénin

Introduction: Human immunodeficiency virus (HIV) infection is a common cause of kidney disease worldwide. HIV-related renal diseases are associated with high morbidity and mortality in Sub-Saharan African countries. The aim is to describe the epidemiological, clinical and biological aspects of kidney disease in people living with HIV naive antiretroviral therapy in Lomé in Togo. Methods: This was a cross-sectional study done in the department of Infectious and Tropical Diseases in Lomé from ESOPE database. Glomerular filtration rate (GFR) was calculated using the Modification of Diet in Renal Disease (MDRD) equation. Kidney disease was defined as GFR less than 90 mL/min/1.73 m2. Results: In total, 3118 HIV-infected ART-naive patients were included in this study. Among them, the prevalence of renal disease at the beginning of their care, was 41.8% or 1303 patients [95% CI: 40.0% - 43.5%]. The median estimated GFR was 94.7 ml/min/1.73 m2: 2.9% had eGFR 2. The median age was 40 years [IQR = 34 - 48 years] with a sex ratio at 0.45. BMI median was 20.6 Kg/m2. Most of patients (30.8%) were at clinic OMS stage 1. Median CD4 was 165/uL [IQR = 72 - 274/uL];median hemoglobin was 10.4 g/dl [IQR = 8.8 - 11.9 g/dl];median glycemia was 0.84 g/l [IQR = 0.75 - 0.95 g/l]. Most of patients (99.9%) had HIV-1. 8.5% had hyperleukocytosis, and all patients had thrombopenia. Conclusion: The incidence of kidney disease is high in Togolese HIV-infected ART naive patients.

关键词： HIV Kidney Disease Prevalence Togo

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