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Kidney Damage during Sharp’s Syndrome: About Two Cases

Open Journal of nephrology 2020年第4期10卷 290-297页

作者： Saharé Fongoro Seydou Sy Magara Samaké Hamadoun Yattara Moctar Coulibaly Aboubacar Sidiki Fofana Brahima Dégoga Atabième Kodio Eyram Yoan Makafui Amekoudi Djénèba Diallo Djénéba Maiga Aboudou M. dolo Moustapha Tangara Nouhoum Coulibaly Kalilou Coulibaly Ibrahima Koné nephrology and Haemodialysis Department of the University Teaching hospital of Point-G Bamako Mali Faculty of Medicine of Bamako Bamako Mali nephrology unit of the Fousseyni DAOU hospital in Kayes Kayes Mali nephrology unit of the Mali GAVARDO hospital Bamako Mali nephrology unit of Sikasso hospital Sikasso Mali nephrology unit of somino dolo hospital in Mopti Mopti Mali

Context: The coexistence in the same patient of a mixed connectivitis or Sharp’s syndrome is a rare eventuality. Objective: To underline the presence of this mixed connectivitis in our practice, whose prevalence remains unknown, particularly in Africa and more precisely in Mali. Case Presentations: We report two cases of Sharp’s syndrome in a 48-year-old man and a 40-year-old woman with impaired renal function. The picture achieved associated massive proteinuria, hypoalbuminemia, moderate renal failure and edematous syndrome in men. In women, the picture was associated with accelerated to malignant hypertension and severe renal failure. There were no osteoarticular manifestations and the diagnosis of Sharp’s syndrome was based on the presence of high levels of antibodies to U1RNP. Therapeutic management has been that of predominantly associated connective tissue disease (systemic lupus erythematosus). Conclusion: Mixed connectivitis or Sharp’s syndrome is increasingly recognized as a separate entity thanks to advances in molecular biology. Its prevalence is low in sub-Saharan African countries with renal disease that manifests itself as proteinuria or nephrotic syndrome associated with microscopic hematuria, renal failure, and hypertension. This renal impairment is more likely to occur in severe forms of the disease.

关键词： Sharp Syndrome/Mixed Connectivitis Renal Failure Mali

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Interest of Beta-2-Microglobilin Plasma Assay in Iterative Haemodialysis in the nephrology and Haemodialysis Department of University Teaching hospital of Point G, Bamako, Mali

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Open Journal of nephrology 2020年第4期10卷 282-289页

作者： Saharé Fongoro Magara Samaké Seydou Sy Hamadoun Yattara Djénèba Diallo Jacques Coulibaly Moctar Coulibaly Aboubacar Sidiki Fofana Atabième Kodio Djénéba Maiga Aboudou M. dolo Moustapha Tangara Nouhoum Coulibaly Brahima Dégoga Ibrahima Koné nephrology and Haemodialysis Department of the University Teaching hospital of Point-G Bamako Mali Faculty of Medicine of Bamako Bamako Mali nephrology unit of the Fousseyni DAOU hospital in Kayes Kayes Mali nephrology unit of Ségou hospital Ségou Mali nephrology unit of the Mali GAVARDO hospital of Sébénicoro Bamako Mali nephrology unit of Sikasso hospital Sikasso Mali nephrology unit of somino dolo hospital in Mopti Mopti Mali

Beta-2-microglobulin (B2M) is a low molecular weight polypeptide (11,800 Da) that exists in a free form and a form bound to cell membranes (light chains of HLA class I molecules). Their dosage is used in the exploration and monitoring of renal function in haemodialysis patients, hence the interest of this study, the objective of which is to study the different players involved in the increase of beta-2-microglobulin. Materials and Methods: This was a prospective and descriptive study from January 1st, 2017 to August 31, 2017 (08 months). All patients with chronic hemodialysis for 3 years or more were included. We analyzed sociodemographic, clinical and paraclinical data. Results: We collected 50 patients. The mean age was 50 ± 4.6 years with extremes of 30 and 82 years. The female sex predominated (52%). Chronic end-stage renal failure was hypertensive (86%), diabetic (4%). All patients benefited from intermittent hemodialysis for 8 hours per week using a low permeability membrane (cuprophane). The average duration of hemodialysis was 68 ± 6.4 months with extremes of 36 and 204 months. Twenty percent (20%) and four percent (4%) of chronic dialysis patients had joint pain and sensory deficit. Phalen’s sign was positive in 2% (1 case), Tinel’s sign in 2% (1 case) and carpal tunnel syndrome in 2% (1 case). The mean serum beta-2-microglobulin level was 58.34 ng/l with extremes of 16.99 and 112.24 ng/l. There was a correlation between hypertensive nephropathies and beta-2-microglobulin levels above 50 ng/l (P Conclusion: Our study has objectified factors such as inadequate dialysis (8 hours/week), use of low permeability membrane in the increase of beta-2-microglobulin. The increase in serum beta-2-microglobulin levels in our patients is evidence of poor purification of medium molecules. Its reduction can be established by improving the quality of dialysis, in particular by

关键词： Chronic Hemodialysis Beta-2-Microglobulin Carpal Tunnel Syndrome

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Result of 10 Years of Experience in Echo-Guided Kidney Biopsy Punctures in the nephrology Department of the Martigues hospital Center, France

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Open Journal of nephrology 2021年第2期11卷 144-155页

作者： Aboubacar Sidiki Fofana Magara Samaké Seydou Sy Sah Dit Baba Coulibaly Christophe Bouaka Ghassan Alchahin Delphine Haussaire Simona Dorina Boncila Hamadoun Yattara Moctar Coulibaly Atabième Kodio Modi Sidibe Saharé Fongoro nephrology unit of the Fousseyni DAOU hospital Kayes Mali nephrology and Hemodialysis Department of the University Teaching hospital of Point-G Bamako Mali Faculty of Medicine and Odontostomatology of the University of Sciences Techniques and Technologies of Bamako Bamako Mali nephrology unit of somino dolo hospital Mopti Mali nephrology and Hemodialysis Department of the Martigues hospital Martigues France nephrology unit of Mali Gavardo hospital Sébénikoro Bamako Mali

Introduction: Percutaneous renal biopsy (PRB) is an essential procedure for the diagnosis and therapeutic management of many primary or secondary nephropathies. Objectives: To identify the indications, to determine the profile of the diagnosed nephropathies and to evaluate the short-term complications related to the practice of echo-guided PRB at the Martigues hospital center. Methodology: This was a retrospective and descriptive study carried out on the records of patients who underwent echo-guided native kidney biopsy from January 1, 2010 to December 31, 2019 in the nephrology department of the Martigues hospital. Results: The analysis of 123 cases of echo-guided PRB involved 76 men and 47 women with a sex ratio of 1.6. The mean age was 55.92 ± 17.80 with age extremes of 16 and 87 years. Glomerular syndromes were the main indication with 42 cases of nephrotic syndrome (34.1%), 15 cases of nephritic syndrome (12.2%), 11 cases of rapidly progressive glomerulonephritis syndrome (8.9%), and 6 cases of recurrent macroscopic hematuria syndrome (4.9%). The histological findings were 47 cases of primary glomerular lesions (38.3%), 32 cases of nephroangiosclerosis lesions (26%), 24 cases of secondary glomerulopathy (19.5%), 9 cases of interstitial nephritis (7.3%), 2 cases of myelomatous nephropathy (1.6%), and 9 cases (7.3%) of unclassified histological lesions. Twenty-two hypertensive patients (40.7%) had nephroangiosclerosis lesions (p = 0.001). The follow-up was simple in 119 patients (96.7%). Macroscopic hematuria was noted in 4 patients (3.3%). It was associated with a perirenal hematoma in 2 patients including 1 transfused case. Conclusion: Our data provide an important contribution to the understanding of the prevalence and clinical presentation of renal diseases in the nephrology department of the Martigues hospital center.

关键词： Renal Puncture Biopsy nephrology Martigues hospital Center

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Acute Renal Failure Secondary to Paracetamol Intoxication: A Case Report

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Open Journal of nephrology 2022年第3期12卷 235-240页

作者： Moctar Coulibaly Magara Samaké Konaré Samba Fofana Aboubacar Sidiki Ossil Ampion Marc Batcho Jimmy Mansour Janette Seydou Sy Hamadoun Yattara Atabième Kodio Djénéba Maiga Sah Dit Baba Coulibaly Djénèba Diallo Aboudou M. dolo Moustapha Tangara Nouhoum Coulibaly Kalilou Coulibaly Ibrahima Koné Saharé Fongoro nephrology unit of Mali GAVARDO hospital in Sebénicoro Bamako Mali nephrology unit of the Fousseyni DAOU hospital Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali nephrology Department of the Soissons hospital Soissons France nephrology and Hemodialysis Department of the UHC du Point G Bamako Mali Faculty of Medicine of Bamako Bamako Mali nephrology unit of Sikasso hospital Sikasso Mali nephrology unit of somino dolo hospital Mopti Mali

Renal damage secondary to paracetamol intoxication is rare, estimated between 1% and 2% of intoxication cases. Its pathophysiology is still debated, the clinical involvement consisting in an acute tubular necrosis with a good prognosis if it is rapidly treated. Renal damage can sometimes occur without prior hepatic damage, and the onset of renal manifestations is generally between the 2nd and 7th day after taking paracetamol. If its management remains exclusively symptomatic, its late onset can sometimes lead to serious metabolic complications. It is therefore important to systematically monitor renal function following paracetamol drug intoxication. We report the case of a 60-year-old male subject hospitalized for the management of voluntary drug intoxication (VDI) with paracetamol complicated by acute hepatocellular failure and acute renal failure. His management required extrarenal purification (hemodialysis) and the evolution was favorable with recovery ad integrumof renal function. Conclusion: Although less known and of unelucidated physiopathology, nephrotoxicity secondary to voluntary drug intoxication with paracetamol is a reality and can lead in extreme cases to the use of extrarenal purification technique (hemodialysis).

关键词： Acute Renal Failure Paracetamol Intoxication Hemodialysis

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Centropontine Myelinolysis after Conservative Correction of Hyponatremia: A Case Report and Review of Contributing Factors

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Open Journal of nephrology 2022年第2期12卷 187-194页

作者： Aboubacar Sidiki Fofana Magara Samaké Sah dit Baba Coulibaly Seydou Sy Atabième Kodio Moctar Coulibaly Christophe Bouaka Ghassan Alchahin Hermione Deudjeu Youmbissie Hamadoun Yattara Nouhoum Coulibaly Saharé Fongoro nephrology unit Fousseyni Daou Hospital in Kayes Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali nephrology unit Somino Dolo Hospital in Mopti Mopti Mali nephrology and Hemodialysis Department University Teaching Hospital of Point-G Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali nephrology unit Mali Gavardo Hospital Bamako Mali nephrology and Hemodialysis Department Martigues Hospital Martigues France Medical Imaging Department Martigues Hospital Martigues France

Introduction: Centropontine myelinolysis (CPM) is a rare pathology, a delayed neurological complication corresponding to massive demyelination of the protrusion. Its exact pathogenesis is poorly understood. Rapid correction of sodium hyponatremia has been implicated as a potent causative factor. We report a case of CPM despite a priori conservative correction of hyponatremia with a favorable course in a 61-year-old alcoholic-smoker diabetic. Case Presentation: A 61-year-old man with chronic alcoholism presented to the emergency department (D0) with physical asthenia and anorexia. He was treated for severe hyponatremia at 104 mmol/L by careful rehydration with saline before being transferred to a nephrological hospital. Magnetic resonance imaging (MRI) performed at D14 for locked-in syndrome showed osmotic demyelination syndrome (Figure 1). The evolution was favorable after 3 months of rehabilitation marked by a progressive and clear improvement of clinical signs. Conclusion: This observation suggests an evaluation of the benefit/risk ratio of the short-term prognosis of profound hyponatremia with that of the metabolic stress induced by a still too rapid correction. Particular attention should be paid to diabetic patients in the context of chronic alcoholism or nutritional deficiencies.

关键词： Centropontine Myelinolysis Hyponatremia Alcoholism

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Profile of Urinary Tract Infections in the Elderly in the Internal Medicine Department of the University hospital Center of Point G, Bamako, Mali

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Open Journal of nephrology 2021年第2期11卷 217-229页

作者： Drissa Sangaré Magara Samaké Nanko Doumbia Aboubacar Sidiki Fofana Sékou Mamadou Cissé Seydou Sy Atabième Kodio Moctar Coulibaly Sah dit Baba Coulibaly Djibril Sy Kaya Assétou Soucko Mamadou Dembélé Saharé Fongoro Department of Medicine and Medical Specialty The Fousseyni Daou Hospital Kayes Mali Faculty of Medicine of Bamako Bamako Mali nephrology unit of Fousseyni Daou hospital Kayes Mali Medicine Department of Mali hospital Bamako Mali nephrology Department of the University hospital Center of Point G Bamako Mali nephrology unit of Mali Gavardo hospital Bamako Mali nephrology unit of somino dolo hospital Mopti Mali Internal Medicine Department of the University hospital Center of Point G Bamako Mali

Introduction: Urinary tract infections (UTI) are frequent and of polymorphous clinical symptomatology in elderly subjects both in and out of hospital. In Mali, to our knowledge, no study concerning UTIs in the elderly has been conducted, hence the interest in this innovative work. Objectives: To determine the prevalence and clinical and paraclinical aspects of urinary tract infections in the elderly. Materials and Methods: This was a prospective descriptive and cross-sectional study from September 1, 2013 to August 31, 2014, i.e. duration of 12 months. All patients aged 65 years and over, hospitalized or ambulatory in the internal medicine department with a documented urinary tract infection were included. Results: We collected and examined 194 patients. The cytobacteriological study of urine (CBSU) was positive in 28 patients, i.e. a prevalence of 14.43%. The male sex represented 59.8% of the cases, the sex ratio was equal to 1.46. The age groups between 65 - 69 and 70 - 74 years were the most affected, respectively 28.57% and 39.28%. The main clinical signs were: asthenia, anorexia, dependence, fever, urinary burning, dysuria. hospitalization was associated with urinary tract infection with P = 0.01. The group of enterobacteria were incriminated in 75% of cases. Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa represented 39.28%, 14.28% and 10.71% of cases. Urinary tract infections were represented by pyelonephritis, acute prostatitis, orchi-epididymitis and simple cystitis. Conclusion: Urinary tract infection is frequent in the elderly, its clinical presentation is polymorphic and enterobacteria are the most incriminated group of bacteria.

关键词： Urinary Tract Infection Elderly Subject Internal Medicine Point G hospital Mali

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Severe Thromboembolic Complication Revealing a Nephrotic Syndrome Due to Segmental and Focal Hyalinosis: A Case Report

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Open Journal of nephrology 2021年第3期11卷 450-457页

作者： Sah Dit Baba Coulibaly Magara Samaké Aboubacar Sidiki Fofana Seydou Sy Hamadoun Yattara Nanko Doumbia Katilé Drissa Moctar Coulibaly Kodio Atabieme Djénéba Maiga Aboudou Messoum dolo Nouhoum Coulibaly Hamat Ibrahim Saharé Fongoro Konaté Anselme nephrology unit of somino dolo hospital Mopti Mali nephrology unit of the Fousseyni DAOU hospital Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Faculty of Medicine of Bamako Bamako Mali Department of nephrology and Haemodialysis University Teaching Hospital of Point-G Bamako Mali Medicine Department of Mali hospital Bamako Mali Gastrohepato-Enterology unit of the Fousseyni DAOU hospital Kayes Mali nephrology unit of the Mali GAVARDO hospital of Sebenicoro Bamako Mali nephrology unit of Sikasso hospital Sikasso Mali Department of nephrology-Hemodialysis National General Reference Hospital N'Djamena Chad Department of Gastro-Hepato-Enterology Gabriel Touré University Hospital Bamako Mali

Adult Nephrotic Syndrome (NS) is defined by proteinuria > 3 g/24h or 50 mg/kg/day, hypoprotidemia < 60 g/24h, hypoalbuminemia < 30 g/L. It is a disease with high thromboembolic risk. Peripheral vein thrombosis is common, while its association with pulmonary localizations has been more rarely reported. We report a case of nephrotic syndrome revealed by an association of pulmonary embolism, renal vein and inferior vena cava thrombosis. The diagnosis was confirmed by thoracic angioscan. Renal biopsy revealed Focal Segmental Hyalinosis (FSH). An anti-coagulant treatment and an anti-proteinuric treatment were instituted based on a calcium channel blocker (amlodipine) associated with the conversion enzyme inhibitor (perindopril).

关键词： Thromboembolic Complication Nephrotic Syndrome Segmental and Focal Hyalinosis Bamako/Mali

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Epidemiological and Clinical Profile of Patients Undergoing Primary Nephrological Consultation at the Fousseyni DAOU hospital in Kayes, Mali

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Open Journal of nephrology 2022年第1期12卷 142-153页

作者： Magara Samaké Seydou Sy Aboubacar Sidiki Fofana Hamadoun Yattara Sah Dit Baba Coulibaly Djénéba Diallo Nanko Doumbia Moctar Coulibaly Kodio Atabieme Djénéba Maiga Aboudou Messoum dolo Nouhoum Coulibaly Saharé Fongoro nephrology unit Fousseyni DAOU Hospital Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali nephrology and Hemodialysis Department Point G Teaching Hospital Bamako Mali Faculty of Medicine of Bamako University of Bamako Bamako Mali nephrology unit Somine DOLO Hospital Mopti Mali Department of Medicine Mali Hospital Bamako Mali nephrology unit Mali GAVARDO Hospital Sebenicoro Bamako Mali nephrology unit Sikasso Hospital Sikasso Mali

Introduction: The first nephrological consultation is often late, even in developed countries. This delay is related to the insidious nature of renal disease, the lack of qualified personnel and structures for the management of these conditions and the context of chronic insecurity in our country. In Kayes, there is no data related to the first consultations of patients with the nephrologist, hence the interest of this study, which aimed to describe the epidemiological and clinical characteristics of patients undergoing a first nephrological consultation in Kayes hospital. Materials and methods: This was a retrospective, descriptive study conducted from January 1 to December 31, 2020 at the nephrology unit of the Fousseyni DAOU hospital in Kayes. All patients received for nephrological consultation for whom a medical record was made were included. The following data were collected and analyzed: the specialty of the medical referent, the reason for consultation, sociodemographic characteristics and the renal assessment of patients. Patients who consulted for non-nephrological pathologies and those who had no medical record were not included. Results: We collected the records of 346 patients, composed of 180 (52%) women and 166 (48%) men, i.e. a sex ratio of 0.92. The age group [20 - 40 years] was the most represented, 107 cases or 30.9%, with a mean age of 48.84 ± 21.33 years and extremes of 1 and 90 years. Housewives were the most consulted population, 149 cases (41.33%). Patients consulted more between the months of January and February, 116 cases (33.5%), this period was followed by the months of October-December, July-September and April-June with respectively 94 cases (27.2%), 76 cases (22.0%) and 60 cases (17.3%). The patients were referred by the general practitioner in 59.5% (209 cases), specialist doctor, 26.0% (90 cases). The patients came mainly from hospital practitioners, 172 cases (49.7%), private clinic and practice 81 cases (23.4%), community health c

关键词： Primary Consultation nephrology Kayes Mali

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Therapeutic Profile and Prognostic Factors of Patients Suffering from Upper Digestive Bleeding at Sikasso Regional hospital

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Open Journal of Gastroenterology 2024年第9期14卷 300-312页

作者： Oumar Traoré Abdoul Salam Diarra Dramane Touré Tawfiq Abu Amadou Boubeye Maïga Kadiatou Cissé Saïdon Touré Mohomedine Touré Aboudou dolo Youana Koné Madou Traoré Mamadou Togo Kalba Péliaba Mamadou Samaké Hamadoun Sangho Service of Internal Medicine Regional Hospital Sikasso Mali National Center for Scientific and Technological Research Bamako Mali Department of Pediatric Health Referral Center of Kalaban Coro Koulikoro Mali Private Practice for Family and Emergency Medicine Casablanca Morocco Service of nephrology Regional Hospital Sikasso Mali Department of Infectious Disease Regional Hospital Sikasso Mali Service de Mdecine Interne CHU Gabriel Tour Bamako Mali Service dHpato-Gastro-Entrologie CHU Gabriel Tour Bamako Mali Department of Public Health Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali

Introduction: Upper digestive hemorrhage is one of the main digestive emergencies and remains a major cause of morbidity and mortality in Mali. The aim of this study was to describe the therapeutic profile and outcome of patients suffering from upper digestive haemorrhage. Methodology: This was a prospective study carried out in the internal medicine department of the Sikasso Regional hospital from August 2022 to July 2023. All adult patients presenting with upper digestive haemorrhage and having given their consent, were included. Data were analyzed using SPSS version 21 software. Results: Sixty-three patients were enrolled. The mean age was 49.7 ± 18.99 years, with a male-female sex ratio of 2.2. Ruptured esophageal varices (37.5%) and peptic ulcer (25%) were the main etiologies. Pharmacological treatment was dominated by proton pump inhibitors (85.7%). Hemostasis endoscopy accounted for 3.17%. The evolution was marked by hemorrhagic arrest (69.84%), recurrence of hemorrhage (11.11%) and death (19.04%), the main cause of which was hemorrhagic shock (58.3%). We found no statistically significant relationship between prognosis and etiologies (P = 0.11), and length of hospital stay (P = 0.18). Conclusion: Hemostasis endoscopy remains a challenge for Sikasso hospital. A holistic strategy of communication and community awareness-raising, combined with adequate technical facilities, will help to improve patient care and outcomes.

关键词： Digestive Hemorrhage Digestive Endoscopy Treatment Outcome

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Digestive Pathologies during Chronic Renal Failure in the nephrology and Haemodialysis Department at the University hospital Center of Point G in Mali

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Open Journal of Clinical Diagnostics 2020年第1期10卷 41-48页

作者： Magara Samaké Seydou Sy Hamadoun Yattara Moctar Coulibaly Mamadou Badou Sanogo Aboubacar Sidiki Fofana Aboudou Messoum dolo Djénéba Maiga Djénéba Diallo Atabieme Kodio Bakary Diarra Karamoko Djiguiba Djibril Sy Saharé Fongoro nephrology unit of the Fousseyni DAOU hospital Kayes Mali nephrology and Haemodialysis Department of the CHU of Point G Bamako Mali Faculty of Medicine of Bamako University of Bamako Bamako Mali nephrology unit of Mali GAVARDO hospital Bamako Mali nephrology unit of the Sikasso Regional hospital Sikasso Mali nephrology unit of the Mother and Child hospital The Luxembourg Bamako Mali Internal Medicine Service of the University hospital Center of Point G Bamako Mali

Introduction: Chronic kidney disease (CKD) is the progressive and irreversible loss of kidney function. It exposes to many complications, among which, digestive complications. In Mali, we do not have data on the prevalence of digestive pathologies in people with chronic renal failure, hence the interest of this study. Objective: To determine the prevalence of digestive pathologies and to describe their manifestations during chronic renal failure. Patients and Methods: This was a prospective cross-sectional study conducted from September 2016 to August 2017, a period of 12 months. Included were patients hospitalized in our department with CKD who received digestive endoscopy and/or liver serology. Results: Seventy-one patients underwent digestive endoscopy with oesogastroduodenal fibroscopy (60 patients), rectoscopy (6 patients) and anoscopy (5 patients), i.e. 15.9% of those hospitalized. The mean age of the patients was 48 ± 14 years with extremes of 15 and 84 years. The sample consisted of 59.2% men versus 40.8% women, for a sex ratio of 1.5. The functional signs are in order of frequency: vomiting (72.4%), anorexia (51.3%) and epigastralgia (48.7%). Terminal CKD by creatinine clearance accounted for 88.2% of cases, of which 47.4% were monitored by hemodialysis. Hepatitis C virus infection was present in 21.3% of cases, hepatitis B (18%) and HIV (7.5%). Endoscopic examinations were represented by fibroscopy (84.5%), rectoscopy (8.5%) and anuscopy (7%). The fibroscopic lesions were respectively gastric (96.8%), duodenal (14.1%) and esophageal (12.5%). They were dominated by gastritis (40.5%), duodeno-gastric reflux (16.4%), pyloric gap (12.6%). Rectoscopy found 4 cases of hemorrhoids, 2 cases of rectitis and no lesions were observed at anuscopy. Conclusion: The prevalence of these digestive manifestations and the endoscopic lesions encountered indicate the importance of digestive endoscopy and the performance of hepatic serologies in chronic renal failure patients w

关键词： Chronic Renal Failure Digestive Signs Mali

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