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Acute Kidney Injury in the Nephrology Department of the Brazzaville University Hospital: Epidemiological, Clinical and Evolutionary Aspects

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Open Journal of Nephrology 2024年第2期14卷 196-215页

作者： Daniel Tony Eyeni Sinomono gael honal mahoungou Eric Gabdzali Ngabé Audrey Missamou Mavi Bouloupy Richard Loumingou Department of Nephrology Brazzaville University Hospital Brazzaville Congo Department of Nephrology Adolphe Ciss General Hospital Pointe Noire Congo

Introduction: Acute kidney injury (AKI) is defined as a sudden and reversible deterioration in renal function. It is a life-threatening condition in hospitalized patients. Our objectives were to determine the prevalence of AKI in a nephrology department, list the causes, describe the evolutionary profile and identify the factors associated with death. Patients and Methods: We reviewed the records of patients hospitalised between 1 January 2016 and 31 October 2020 in the nephrology department of Brazzaville University Hospital. We included patients aged at least 18 years whose discharge diagnosis included the item AKI. Study variables were socio-demographic data, clinical and paraclinical signs, stage and type of AKI, etiology and evolutionary profile. Results: Of the 1823 patients hospitalised, 244 (13.38%) were hospitalised for AKI. Of these, 60.2% were boys and 39.8% girls, with an average age of 47 19 years. The average consultation time was 10 6.5 days. AKI was stage 3 in 69.57% of cases. It was functional, organic and obstructive in the order of 55.28%, 36.02% and 8.69%. Dialysis was indicated in 62 patients (38.51%) and performed in 24 patients (14.9%). In-hospital mortality was 27.95%, with an average hospital stay of 9.6 5.8 days. Metabolic acidosis and anemia were the main causes of death in 14.28% and 4.35% of patients respectively. Factors associated with death were male sex, socioeconomic level, coma, indication for dialysis and absence of dialysis, with a p Conclusion: AKI is more common in young adult males. Mortality is relatively low. Improving prognosis requires early management and access to dialysis.

关键词： AKI Epidemiology Diagnosis Evolution Brazzaville

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Epidemiological Clinical Profile of Chronic Kidney Disease in Adults under 50 at the University Hospital of Brazzaville

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Open Journal of Nephrology 2021年第3期11卷 358-369页

作者： Daniel Tony Eyeni Sinomono Ginesse Ndinga-Okaka Sedan gael honal mahoungou Eric Pierre Gandzali Ngabe Richard Moukengue Loumingou Bertrand Ellenga-Mbolla Mohamed Arrayhani Tarik Sqalli Houssain Department of Nephrology and Dialysis University Hospital of Brazzaville Brazzaville Congo Hemodialysis Unit of the Medical Center for Specialists of the 15 years old plateau of Brazzaville Brazzaville Congo Departement of Nephrology Edith Lucie Bongo General Hospital of Oyo Oyo Congo Department of Cardiology and Internal Medicine University Hospital of Brazzaville Brazzaville Congo Departement of Nephrology University Hospital Hassan II of Fez Fez Morocco

Introduction: Chronic Kidney Disease (CKD) is a major global public health problem. In Congo, we have very few studies on it. Patients and Methods: We carried out an analytical cross-sectional study with retrospective data collection including patients aged 18 to 49 years, hospitalized for CKD in the nephrology department of University Hospital of Brazzaville, during the period from January 1, 2016 to August 31, 2020. The variables considered were socio-demographic, clinical, paraclinical, therapeutic and evolutionary. The statistical test used was Pearson’s chi-square test. Results: CKD in those under 50 represented 21.1% of admissions and 35.6% of CKD. The mean age was 35.9 ± 8.4 years. There was a male predominance with a sex ratio of 1.27. Hypertension was the most common comorbidity (49.2%), followed by HIV (13.6%) and diabetes mellitus (13.2%). Stage 5 CKD was most prevalent (82.7%). Indeterminate kidney disease was in the order of 55.9%. The low socioeconomic level (74.9% of cases) hampered the achievement of dialysis in 66.3% of patients for whom this treatment was indicated. Failure to perform dialysis significantly influenced the occurrence of death (p-value = 0.005). Conclusion: CKD is common among people under 50 and more affects males with a high mortality rate due to lack of access to dialysis. The main causes are hypertension and HIV.

关键词： Chronic Kidney Disease Epidemiology Brazzaville

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Bone Dysmorphia-Induced Blindness Following a Secondary Hyperparathyroidism: A Case Report

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Open Journal of Nephrology 2021年第4期11卷 489-494页

作者： gael honal mahoungou Daniel Tony Eyeni Sinomono Ghislain Armel Mpandzou Regis Franck Moyikoua Josue Euberma Diatewa Dinah Happhia Motoula Benedicte Diatewa Helena Botokoto Bothard Richard Loumingou Faculty of Health Sciences of Brazzaville Marien Ngouabi University Brazzaville Republic of Congo Department of Nephrology University Hospital of Brazzaville Brazzaville Republic of Congo

Introduction: Conjunctival-corneal or choroidal calcifications are frequent in SHPT, blindness is however exceptional. We report a case of blindness secondary to compressive ischemic optic neuropathy. Case Report: Mr. B.E.K., 49 years old, has a chronic renal failure secondary to unlabeled glomerular nephropathy for 17 years. He has been on chronic hemodialysis for 12 years and has had SHPT for nine years. He secondarily developed disabling segmental osteoarticular deformities associated with kyphoscoliosis, “drumstick” fingers and facial dysmorphism. Five months before admission he developed eye pain and reduced visual acuity progressing within one month to blindness. Biology noted: serum creatinine at 726 umol/l (60 - 120 umol/L), azotemia at 14.3 mmol/l (2.5 - 7.5 mmol/L), serum calcium at 2.25 (2.25 - 2.55 mmol/L), phosphatemia at 1.13 (0.8 - 1.35 mmol/L), alkaline phosphatases at 2196 (5 - 270 IU/L) and parathyroid hormone level at 2257 (10 - 60 pg/mL). Retinal angiography revealed lesions suggestive of ischemic neuropathy. The orbit CT scan with 3D coronal reconstruction revealed narrowing of the caliber of the optical channels with dystrophic thickening of the skull base and cranial vault. Cranioencephalic and orbital MRI revealed diffuse brown tumors and pre-chiasmatic optic atrophy. Discussion: The most frequent ocular complications of SHPT are conjunctival-corneal or sclero-choroidal calcifications, asymptomatic, associated with hypercalcemia. Compressive manifestations are rarer, represented mainly by an amputation of the visual field, diplopia, ptosis or blindness, as described in our patient. The main cause is osteodystrophy and brown tumors of the skull base (1% - 2%). Conclusion: This case report underlines the importance of early detection of SHPT, in order to avoid its major complications, such as blindness, especially since current preventive and curative measures have proven their

关键词： Blindness Secondary Hyperparathyroidism Bone Dysmorphism

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Quality of Life of Chronic Kidney Disease Patients in the Republic of the Congo

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Open Journal of Nephrology 2021年第4期11卷 495-505页

作者： gael honal mahoungou Daniel Tony Eyeni Sinomono Yannick Dimi Nyanga Tanee Fomum Steve Ondziel Opara Helena Botokoto Bothard Jean Lucien Mobengo Richard Loumingou Blaise Iréné Atipo Ibara Department of Nephrology University Hospital of Brazzaville Brazzaville Republic of the Congo Faculty of Heath Sciences University Marien Ngouabi Brazzaville Republic of the Congo Department of Urology University Hospital of Brazzaville Brazzaville Republic of the Congo Department of Gastroenterology University Hospital of Brazzaville Brazzaville Republic of the Congo

Background: Chronic kidney disease could impair the quality of life of patients regardless of the stage of the disease. So far, there is no data on this subject in the Congolese population. The objective of this study was to assess the quality of life of patients with chronic kidney disease in Congo. Patients and methods: We conducted a cross-sectional, descriptive study of 91 patients followed in the department of nephrology and in dialysis centers in Brazzaville, Pointe-Noire and Oyo from July 1st to November 30th, 2020, i.e. five months. We used the Kidney disease quality of life short form health survey score (KDQOL-SF 36) to assess the quality of life of patients and a questionnaire was used to determine socio-demographic, clinical and therapeutic features. Data analysis was done on SPSS 2.2 software. Result: The average age was 51.9 ± 15 years. The sex ratio M/F was 2.03. The average time of patient follow-up was 15 months;90% of them had hypertension. The overall average score of specific dimensions was 52 ± 18;disease burden was the dimension most affected;that of the generic dimensions was 34 ± 25 with the limitation of physical activity dimension being the most affected. No patient had received psychological follow-up. Conclusion: This study indicates the value of a systematic assessment of the quality of life of patients with chronic kidney disease as well as the need for assistance for these patients in different areas of their life.

关键词： Chronic Kidney Disease Quality of Life KDQOL

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Evolutionary and Pronostic Aspects of Cirrhosis at the University Hospital of Brazzaville (Congo)

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Open Journal of Gastroenterology 2020年第1期10卷 23-29页

作者： Jile Florient Mimiesse Ngalessami Mouakosso Marlyse Ahoui Apendi Clausina Mongo Onkouo Arnaud Atipo-Ibara Ollandzobo Lucie Firmin Bossali Akoa Ngala Itoua-Ngaporo Rody Stéphane Ngami mahoungou gael honal Deby Gassaye Atipo Ibara Blaise Irénée Ibara Jean-Rosaire Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Gastroenterology Service University Hospital of Brazzaville Brazzaville Congo

Introduction: cirrhosis is a serious pathology that leads to complications whose management remains difficult in our country. This study aimed to evaluate the evolutionary aspects of cirrhosis at the Brazzaville University Hospital. Patients and methods: this was a retrospective study over a period of 18 months (from January 2015 to July 2016), performed in the Gastroenterology Department of the Brazzaville University Hospital. All patients regularly followed for decompensated cirrhosis were included. The studied variables were the epidemiological, clinical and paraclinical characteristics, the occurrence of complications, the survival, and the causes of death. Univariate analysis was used to determine prognostic factors based on the Child Pugh score. Results: There were 43 patients, including 32 men and 11 women, with a mean age of 52 ± 9.5 years. Viral hepatitis B was the most common etiology (39.5%). Child Pugh stage C was found in 60.5%. Oesophageal varices were present in 93% of cases. Survival at 18 months was 72%. In univariate analysis, two variables were significantly associated with decreased survival, including Child Pugh stage C and esophageal varices (grade II and III). Conclusion: cirrhosis remains a worrying pathology because the diagnosis is often made at the stage of often serious complications putting at risk of vital prognosis.

关键词： Cirrhosis Evolution Brazzaville

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