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Prevalence and Associated Factors of diabetic Kidney disease in Senegalese Patients: A Cross-Sectional Study in Saint-Louis

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Open Journal of Nephrology 2020年第1期10卷 23-33页

作者： sidy m.ham.d seck dominique doupa Seraphin Ahou Serigne Gueye macia Engerran Lamine Gueye Internal medicine-Nephrology department Faculty of Health Sciences University Gaston Berger Saint-Louis Senegal UmI 3189 Environnement santé sociétés (CNRS/UCAD/Université de Bamako/CNRST Burkina-Faso) Faculté de Médecine de Pharmacie et d’Odontostomatologie Dakar Senegal Nephrology department Faculty of Health Sciences University of Parakou Parakou Benin Nephrology and Hemodialysis department CH Cahors Cahors France

Introduction: diabetes is a leading cause of chronic kidney disease in the world. during the next decade, its burden is expected to increase in Africa with potential complications such as chronic kidney disease. However, epidemiology and risk factors of diabetic kidney disease are poorly described at population level. This study aimed to determine prevalence of diabetic kidney disease (dKd) in adult diabetics living in Saint-Louis, northern Senegal. methods: A cross-sectional study including diabetic patients followed-up aged ≥18 years during a five-year period (2013-2018) in Saint-Louis. Clinical and biological parameters were collected during annual community-based mass screening. diabetes was defined as fasting blood glucose ≥ 1.26 g/L confirmed by a second lab dosage. dKd was defined as persistence of albuminuria ≥ 30 mg/24h and/or estimated glomerular filtration rate (eGFR) 2. data were analyzed with Stata 12.0. Results: We included a total of 1310 diabetic patients among whom 3.7% (95% CI = 1.4% - 9.8%) presented dKd. Their mean age was 46.2 ± 11.8 years and sex-ratio was 0.7. micro-albuminuria and macro-albuminuria were present respectively in 59.2% and 18.4% of patients with dKd and half of them had a normal eGFR. Before the survey 89.8% of patients with dKd were not aware of their renal disease and only four of them had seen a nephrologist. After multivariate analysis, age (OR = 1.5;95% CI = 1.1 - 3.4), duration of diabetes (OR = 1.2;95% CI = 1.6 - 4.4) and hypertension (OR = 2.5;95% CI = 1.4 - 4.6) were associated with the presence of dKd in diabetic patients while no significant association was not found with gender, blood glucose level, smoking and familial history. Conclusion: dKd is a frequent complication in diabetic adult population living in Saint-Louis. Early detection and management should be promoted in order to prevent progression to end-stage renal disease.

关键词： diabetes Kidney disease Epidemiology Saint-Louis

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Evaluation of Access to Care for Patients with Chronic Kidney disease Not on dialysis in Saint-Louis Region (SENEGAL)

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Open Journal of Nephrology 2020年第1期10卷 1-10页

作者： seck sidy m.ham.d doupa dominique Ndongo modou Ahoui Seraphin diop-dia Amadou dia diatou Gueye Ngouampa Blaise magloire Enguerran macia Internal medicine and Nephrology department University Gaston Berger Saint-Louis Senegal UmI 3189 Environnement santé sociétés (CNRS/Université Cheikh Anta Diop/Université de Bamako/CNRST Burkina-Faso) Faculté de Médecine de Pharmacie et d’Odontostomatologie Dakar Senegal Biochemistry department University Gaston Berger Saint-Louis Senegal Nephrology department Borgou Regional Teaching Hospital Parakou Benin

Introduction: Patients with chronic diseases, especially kidney diseases, frequently use the health care system and free dialysis policies are being implemented in many countries in Africa. This study aimed to evaluate access to care for patients with chronic kidney disease (CKd) in northern region of Saint-Louis. methodology: In a cross-sectional survey, we included non-dialyzed CKd patients aged ≥20 years who attended outpatient nephrology clinic at University Hospital of Saint-Louis between January 1st and January 31st 2018. Access to care was measured using a questionnaire that integrated dimensions such as availability, geographic and financial accessibility, convenience, acceptability, effectiveness of care and quality of information. Socio-demographic and clinical data were also collected and analyzed with Epi Info 7. Results: Among 97 surveyed patients, 90 were included (response rate of 92.8%). Patients’ mean age was 35.2 years (20 - 89 years) and 55% were male. Only 30% of patients had health coverage either by the government, or private insurance or community health insurance. Access to care was rated as globally low by 73% of participants. However, we noticed some variations according to dimensions of access. Geographical accessibility and convenience of delivered care were good for the majority of patients, while financial access and acceptability of care were considered as very limited. Bivariate analysis showed that acceptability and effectiveness of care were linked to CKd stage while the quality of patients’ information was correlated with their educational level. Furthermore, health coverage was also associated with financial accessibility of care but not with its availability. Conclusion: This study showed that access to care is poor for majority of patients with CKd in Saint-Louis. Identification of the main barriers will help define appropriate strategies to achieve universal access to quality renal care.

关键词： Access to Care Chronic Kidney disease Saint-Louis

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