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Intra-Dialytique Hypotension: Prevalence and Associated Factors in 2 Haemodialysis Centres in Senegal

Open Journal of nephrology 2022年第4期12卷 361-368页

作者： Ba A. Mamadou Yaya Kane Moustapha Faye Ameth Dieng Ba Bacary Niakhalen Keita Babacar Ndiaye Modou Ndongo Sy Abou Maria Faye Ahmed Tall Lemrabott Ka E. Fary department of nephrology Internal Medicine Faculty of Health Sciences Assane Seck University Ziguinchor Senegal department of nephrology ALDH Cheikh Anta Diop University Dakar Senegal

Introduction: This study aimed to assess the prevalence of Intra-dialytic hypotension (IDH) according to the European Best Practice Guidelines (EBPG) definition in relation to the number of haemodialysis sessions and the number of chronic haemodialysis patients and to identify its associated factors. Patients and Methods: We conducted an observational, multicentre and looking-forward study of descriptive and analytical purposes over a 4-week period. The study included all patients with regular chronic haemodialysis with at least two sessions per week and a duration of 180 minutes, who consented to participate in the study and were over 15 years of age. Data collection was done with pre-established forms. The following data were collected: blood pressure before each session, at 30, 60, 120, 180 and 240 minutes of each session;socio-demographic data;dialysis data;clinical, paraclinical, therapeutic data and nursing interventions. Results: The mean age of the patients was 43.84 ± 12.10 years. Among 568 haemodialysis sessions recorded in 50 patients, IDH was noted in 12 haemodialysis sessions, representing a prevalence of 2.11%. Fatigue was found in 5 sessions with IDH episodes (41.66%) followed by yawning (25%), nausea ± vomiting (16.66%) and cramps (16.66%). As nursing interventions, Trendelenburg position and normal saline administration were performed in all IDH episodes. High blood pressure, inter-dialytic weight gain greater than 3 kg, Uf/H > 10 ml/kg/H, anaemia and hypoalbuminaemia were associated with the occurrence of IDH. Conclusion: The prevalence of IDH according to the EBPG definition is low. However, it is an important cause of morbidity and mortality, especially cardiovascular involvement, and the factors associated with its presence have been clearly identified.

关键词： Intra-Dialytic Hypotension Chronic Hemodialysis Patients Dakar Ziguinchor

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Quality of Life of Patients on Peritoneal Dialysis in Dakar: A Senegalese Single Centre Experience

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Open Journal of nephrology 2016年第2期6卷 37-42页

作者： Kane Yaya Cisse Mouhamadou Moustapha seck Sidy Mohamed Lemrabott Ahmed Tall Faye Maria Hounsounou Christian Diallo Kalilou Ka El Hadji Fary Niang Abdou Diouf Boucar nephrology and internal medicine department of assane seck university Ziguinchor Senegal nephrology department of Teaching Hospital Aristide Le Dantec Dakar Senegal nephrology department of Gaston Berger university Saint-Louis Senegal

Introduction: Measuring the quality of life (QOL) in recent years has become an indispensable tool in monitoring patients suffering from chronic diseases. We conducted this study to assess QOL of patients undergoing peritoneal dialysis in Dakar, and to identify associated factors. Patients and Methods: This is a cross-sectional study which was carried out from 10 to 30 June, 2011 in the peritoneal dialysis unit at university hospital in Dakar. We included all patients with end-stage renal disease (ESRD) of any age, who were on PD since at least six months and who gave their consent. The QOL was assessed using the Kidney Disease Quality of Life Short-Form 1.2 (KDQoL-SF). Results: Sixteen patients were included with a mean age of 50.25 ± 13.48 years and a sex-ratio of 1.27. Considering SF-36, the overall mean score (SMG) was 60.11 ± 15.96 with a Mean Physical Component Summary Scale of 53.66 ± 16.98 and a Mental Component Summary Scale of 70.85 ± 6.14. Concerning the KDQoL-SF, the global mean score was 61.83 ± 19.35 with a mean physical score of 50.55 ± 16.52 and a mean mental score of 62.52 ± 21.53. The mean dialysis specific dimension score was 62.52 ± 21.53 and the mean mental health score was 85.93 ± 12.06. Age, weight, level of instruction and social support were correlated with a worse QOL. Conclusion: This study showed an alteration of our PD patients’ QOL, particularly in their physical health. However, the number of patients included in the study is not enough to permit a formal conclusion.

关键词： Quality of Life Peritoneal Dialysis Dakar

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Assessing the Nutritional Status of Hemodialysis Patients in Sub-Saharan Africa: Experience of Two Hemodialysis Centers in Niger

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Open Journal of nephrology 2016年第4期6卷 161-166页

作者： Hassan Diongole Moussa Zeinabou Maiga Moussa Tondi Yaya Kane Mahamane Aminou Mahamane Sani Ide Abdou Illiassou Touré Aichatou Illa Adehossi Eric Omar nephrology department of Zender university Zender Niger nephrology department and internal Medecine of Abdou Moumouni university Niamey Niger nephrology department of assane seck university Ziguinchor Senegal Hospital Center of Cahors

Introduction: Patients with end-stage chronic renal failure (ESKD) have a significant impairment in their nutritional status. Our study is aiming at evaluating the nutritional status based on clinical and biological parameters. Patient and method: This is a prospective, cross-sectional, descriptive and analytical study carried out in two departments of nephrology/dialysis in Niger from 1 December 2014 to 31 March 2015. The assessment of nutritional status relied on the Body Mass Index (BMI), albuminemia, serum phosphate, hemoglobin, CRP, urea, creatinine levels. Results: Sixty-five patients were involved in the study. The mean age was 44.35 ± 13 years with a sex ratio of 2.09 in favor of men and an average dialysis duration of 43.47 ± 36.55 months. The mean BMI was 21.60 ± 4.47 kg/m2. Undernutrition was noted in 19 patients (29.23%), hypoalbuminemia was found in 13 patients, C-reactive protein (CRP) level was high in 11 patients. In comparative analysis according to the BMI, several parameters were significantly related to undernutrition: hypo-albuminemia, hyperphosphatemia, high CRP, hyperazotemia, anorexia, MUAC, comorbidities, central venous catheter. Conclusion: The prognostic value of undernutrition in chronic hemodialysis patients fosters early recognition and management of all nutritional disturbances in these patients. Assessment and monitoring of nutritional status in chronic hemodialysis require the simultaneous determination of several markers in order to weight the limits of each of the criteria taken in isolation.

关键词： Nutrition Hemodialysis Niger

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Non-Infectious Complications of Peritoneal Dialysis in Senegal

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Open Journal of nephrology 2020年第1期10卷 43-49页

作者： Ahmed Tall Lemrabott Maria Faye Moustapha Faye Abdoul Hassane Sanlé Traoré Mouhamadou Moustapha Cissé Khodia Fall Yaya Kane Zeinabou Maiga Moussa Tondi Mansour Mbengue Bacary Ba Niakhalee Keita Seynabou Diagne Abdou Niang Boucar Diouf El Hadji Fary Ka department of nephrology Aristide Le Dantec University Hospital Dakar Senegal department of nephrology Thies University Thies Senegal internal medicine and nephrology Assane Seck University Ziguinchor Senegal department of nephrology and Haemodialysis Faculty of Sciences and Health of the Abdou Moumouni University of Niamey Niamey Niger

Introduction: Senegal has pioneered the implementation of peritoneal dialysis (PD) in West Africa, practicing it since 2004. Non-infectious complications are a significant cause of failure of this technique and the transfer of patients to haemodialysis. The aim of this study was to determine the prevalence and the different types of non-infectious complications in our context. Patients and Methods: This was a 5-year, descriptive, retrospective study of patients on chronic peritoneal dialysis for more than 3 months. Results: During the study period, 75 patients were included. The prevalence of non-infectious complications was 88%, including 45.3% mechanical complications and 76% metabolic complications. Catheter migration was the most common mechanical complication (55.9%), followed by catheter blockage (23.5%). Metabolic complications were dominated by hypoalbuminemia (76.3%). Dyslipidaemia and hypokalaemia affected more than 50% of patients, occurring in 59.3% and 56.9% of cases, respectively. Conclusion: In our study, non-infectious complications related to PD were frequent and varied. They remain a significant cause of technical failure. Mechanical complications are often the cause of permanent transfer to haemodialysis.

关键词： Peritoneal Dialysis Non-Infectious Complications Catheter Migration Hypoalbuminemia Hypokalaemia

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Secondary Hypertension in Sub-Saharan African Populations: A Retrospective Study between 2011 and 2016 at Regional Hospital of Saint-Louis, Senegal

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Open Journal of nephrology 2016年第3期6卷 93-97页

作者： Yaya Kane Joel Simon Manga Diatou Gueye Dia Maiga Moussa Zeinabou Tondi Ahmed Tall Lemrabott Maria Faye Sidy Mouhamed seck Mouhamadou Moustapha Cisse Alex Ismael Keita Kalilou Diallo El Hadj Fary Ka Abdou Niang Boucar Diouf nephrology-Cardiology and internal medicine department Assane Seck University Ziguinchor Sénégal nephrology and internal medicine department Gaston Berger University Saint-Louis Sénégal nephrology department Abdou Moumouni University Niamey Niger nephrology department Teaching Hospital Aristide Le Dantec Dakar Senegal

Introduction: High blood pressure (HBP) is a worldwide health issue responsible of high cardiovascular morbidity and mortality. Even though essential HBP is far the most frequently reported in patients, secondary causes must be known because of their severity and the possibility of aetiological treatment. No recent epidemiological data are available about secondary causes of HBP in black African populations. The aim of this study was to describe aetiological patterns of secondary HBP in patients followed at Saint-Louis Hospital. Patients and Method: We conducted a retrospective and descriptive study in regional hospital of Saint-Louis. All patients aged ≥15 years old admitted from January 1st 2011 to January 31st 2015 in internal medicine, nephrology, emergency and cardiology departments were included. Clinical, paraclinical data and patients outcomes were collected from medical records. Hypertension was defined according to JNC8 criteria. Secondary HBP was considered if explorations identified a clear aetiology to hypertension. Statistical analysis was done with Excel 2010 and STATA 12.0. Results: We included 9253 patients with mean age of 35 ± 12 years (15 - 83 years) and sex-ratio of 1.6. Overall 67.5% of patients had hypertension and secondary causes were found in 10.5% of them. The majority of patients presented clinical symptoms suggesting a secondary cause of HBP and first-line laboratory explorations were normal in half of cases. Renal diseases were responsible for 79.1% of secondary HBP cases mainly dominated by glomerulonephritis (22.6%), vascular nephropathies (18.7%) and autosomal dominant polycystic kidney disease (5.8%). They were followed by preeclampsia (13.6%) and endocrinal aetiologies such as hyperthyroidism (5.8%), hypercorticism (0.5%), pheochromcytoma (0.5%), primary hyperparathyroidism (0.4%) and Conn’s adenoma (0.1%). Combination of ≥3 antihypertensive drugs was necessary in 71.5% of cases and surgical treatment was performed in three patient

关键词： Secondary High Blood Pressure internal medicine Black Africans

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Tuberculosis among Chronic Hemodialysis Patients: A Senegalese Single Center Experience

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Open Journal of nephrology 2015年第4期5卷 117-122页

作者： Mouhamadou Moustapha Cisse Rachid El Kabouss Yaya Kane Sidy Mouhamed seck Ahmed Tall Lemrabott Maria Faye El Hadji Fary Ka Ansoumana Diatta Abdou Niang Boucar Diouf nephrology department of Teaching Hospital Aristide le Dantec Dakar Senegal department of nephrology Assane Seck University Ziguinchor Senegal department of nephrology Gaston Berger University Saint Louis Senegal

Summary: Tuberculosis is a common infectious disease in chronic hemodialysis due to alteration of the immune system associated with chronic kidney disease. The objectives of this study are to determine the prevalence of tuberculosis in chronic hemodialysis patients and to identify its diagnostic and therapeutic difficulties. Methods and patients: This was a descriptive retrospective study over a period of 20 years (1994-2014). It includes the records of periodic hemodialysis patients in the nephrology department of the Aristide Le Dantec university Teaching Hospital in Dakar which clinical symptoms and laboratory favor tuberculosis. Results: Of 258 chronic hemodialysis patients treated in Hospital Aristide Le Dantec hemodialysis center, 29 cases (11.4%) of tuberculosis disease are diagnosed. The mean age is 43.21 ± 12.48 years, and the sex-ratio is 0.8. The median time to onset of tuberculosis after initiation of hemodialysis is 22.86 ± 28.86 months. The diagnosis of tuberculosis is sure only in 17% of cases. Extra-pulmonary sites are found in 79% of cases. The average duration of treatment is 9.39 ± 1.64 months (6 - 13 months). Various treatment protocols are adopted. Mortality is 21%, 50% due to disseminated tuberculosis. Conclusion: The diagnosis of tuberculosis in the chronic hemodialysis patients is often difficult due to the atypical symptoms, the frequency of extra-pulmonary location and the lack of evidence of sure diagnosis.

关键词： Tuberculosis Hemodialysis Dakar

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Intradialytic Hypertension: Prevalence and Associated Factors in Chronic Hemodialysis Patients in Senegal

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Open Journal of nephrology 2018年第2期8卷 29-37页

作者： Faye Moustapha Lemrabott Ahmed Tall Kane Yaya Cisse Mouhamadou Moustapha seck Sidy Mohamed Faye Maria Daher Abdoul Karim Omar Fall Khodia Sakho Binta Keita Rick Alex Ismael Mbengue Mansour Niang Abdou Diouf Boucar Ka Elhadji Fary nephrology department Aristide Le Dantec Hospital Cheikh Anta Diop University Dakar Senegal department of nephrology Regional Hospital Center Assane Seck University Ziguinchor Senegal department of nephrology Regional Hospital Center Gaston Berger University Saint Louis Senegal

Introduction: Intradialytic hypertension is defined as elevation of blood pressure to more than 10 mmHg in the post-dialysis period as compared to the pre-dialysis one. It is an important factor of morbidity and mortality in hemodialysis patients. The aim of our study is to assess the prevalence and associated factors of intradialytic hypertension. Patients and methods: This is a descriptive and analytical cross-sectional study that was conducted over a period of 3 weeks in the hemodialysis units of Aristide Le Dantec Hospital in Dakar and Regional Hospital Center in Ziguinchor. Chronic he-modialysis patients who are at least 18 years old and agreed to participate in study have been included. Patients who did not have 4 measures or those who decided to withdraw from the study were excluded. Intradialytic hypertension was restrained by an increase in systolic blood pressure immediately after the hemodialysis session > 10 mmHg compared to that recorded before session, with a repetition of this phenomenon for at least 4 hemodialysis sessions. Results: Our study included 539 hemodialysis sessions for 93 hemodialysis patients with a mean age of 48.72 ± 14.06 years and a sex ratio (M/F) of 1.21. The mean duration of dialysis was 64.22 ± 45.63 months. Hypertensive nephropathy was significantly common, noted in 38.7% (36 patients). Mean inter dialytic weight gain was 2.04 ± 1.06 kg, and the average dry weight was 62.71 ± 13.69 kg. The average hemoglobin level was 9.27 ± 1.91 g/dl. The mean albumin level was 35.4 ± 7.48 g/l. Nineteen (19) patients were administered erythropoietin stimulating agents (20.4%), and 59 patients were given antihypertensive drugs (63.4%). An elevation of more than 10 mmHg of post-dialysis BP compared to pre-dialysis was noted in 179 sessions, which is 33.2 per 100 hemodialysis sessions. IDH was noted in 21 patients, which represents 22.6%. The factors associated with IDH were as follows: high post-dialysis pulse pressure (PP) (p = 0.0008), pre-dial

关键词： Intradialytic Hypertension-Hemodialysis-Senegal

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Cardio-Renal Syndrome at the Cardiology department of the Hopital De La Paix of Ziguinchor (Senegal)

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Open Journal of internal medicine 2021年第4期11卷 238-245页

作者： Simon Joël Manga Glorieuse Peace Ayaba Yenou Malick Bodian Yaya Kane Sidy Lamine Sy Quinta Te Indafa Cardiology department De la Paix Hospital Assane Seck University of Ziguinchor Ziguinchor Sénégal Cardiology department Aristide Le Dantec Hospital Cheikh Anta Diop University Dakar Sénégal nephrology department De la Paix Hospital Assane Seck University of Ziguinchor Ziguinchor Sénégal Cardiologie department Fann National University Center Dakar Cheikh Anta Diop University Dakar Sénégal

Context and Objectives: Cardio-renal syndrome is a pathophysiological disorder of the heart and kidneys frequent in hospitalization for cardiology. The objective of this work is to study the frequency, clinical characteristics and treatment of cardio-renal syndrome (CRS) at the Hôpital de la Paix in Ziguinchor. Methodology: This is a retrospective study, from January 16, 2017 to September 16, 2020, including patients hospitalized in the cardiology department for heart failure associated with impaired renal function. Results: 92 patients were included, i.e. a hospital frequency of 9.15% with a predominance of men (sex ratio of 1.19). The average age was 60.05 years. High blood pressure (75%) was the main risk factor. The clinical symptomatology was dominated by dyspnea (69.6%). The average creatinine clearance was 24.40 ml/minute/1.73 m2 and stage 5 renal failure was noted in 39 patients (42.4%). Echocardiography detected systolic dysfunction of the left ventricle in 53 patients (64.6%). The kidney ultrasound was normal in half of the cases. The most observed CRS in our study was type I (60.9%). Therapeutically, the most widely used drugs were diuretics (85.9%) and ACE inhibitors (71.7%). The death rate was 28.3%. The average cost of inpatient care was 149,466 CFA francs. The poor prognosis elements were stage IV dyspnea (p = 0.006), cardiomegaly (p = 0.047) and the presence of pericardial effusion (p = 0.021). Conclusion: Cardio-renal syndrome is a condition to be systematically looked for in cases of heart failure because it is associated with severe mortality.

关键词： Cardio-Renal Syndrome Prevalence Clinic Ziguinchor

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Deep Venous Thrombosis of Lower Limbs: Prevalence, Risk Factors and Treatment in Semi-Urban Areas in Senegal

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Open Journal of internal medicine 2021年第4期11卷 194-200页

作者： S. J. Manga A. Ben Haj Younes M. Dioum S. L. Sy Q. Te Indafa M. B. C. Leye Cardiology department Hospital de la Paix Assane Seck University of Ziguinchor Ziguinchor Sénégal Cardiologie department Fann National University Center Dakar Cheikh Anta Diop University Dakar Sénégal Cardiology department Regional Hospital of Mbour Thiès University Thiès Sénégal

Context and Objectives: Deep vein thrombosis (DVT) is a potentially serious affection because it can be complicated by life-threatening pulmonary embolism. Epidemiological data are scarce in Africa. The objective of this work was to describe the prevalence, risk factors and treatment of deep venous thrombosis (DVT) in Ziguinchor. Methodology: This was a retrospective study carried out at the Ziguinchor Peace Hospital from January 1, 2016 to June 30, 2020. We included in the study all patients of both sexes, aged at least 18 years and hospitalized with DVT of the lower limb confirmed by venous Doppler ultrasound. Results: A total of 64 patients were hospitalized for DVT of the lower limbs during the study, for a hospital prevalence of 3.9%. The average age of the patients was 53 years (±17.6). A female predominance was noted with an M/F sex ratio of 0.7. The main risk factors found were the age ≥ 60 years (36%) and infectious pathologies (17%). Clinical signs were dominated by lower limb pain (93.8%) and lower limb edema (92%). The lower limbs’ venous Doppler ultrasound showed a predominance of thrombosis in the left lower limb (56%). The femoral vein was the most affected in 90% of cases. The patients had all benefited from an anticoagulant treatment mainly by a low molecular weight heparin relayed from the 1st day by an antivitamin K that was acenocoumarol in 97% of the cases. The average length of hospitalization was 10 days. The complications found were pulmonary embolism (8%) and accident with anticoagulants (3%). Hospital mortality was 6%. The average cost of care was 164.000 CFA francs. Conclusion: DVT is a multifactorial pathology;its treatment requires the control of risk factors. In our study, it was more frequent in the elderly.

关键词： Deep Vein Thrombosis Risk Factors Pulmonary Embolism Ziguinchor

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Blood Count Abnormalities Associated with Death in Patients Infected with SARS-COV-2 at the Ziguinchor EpidemicTreatment Center (ETC)

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Open Journal of internal medicine 2023年第4期13卷 304-312页

作者： Coly Mame Ngoné Diallo Kalilou Sarr Habibou Diop Abdoulaye Manga Noel Magloire Diatta Alassane Medical Analysis Laboratory The Ziguinchor Peace Hospital Ziguinchor Senegal Health Sciences Training and Research Unit The Assane Seck University of Ziguinchor Ziguinchor Senegal Infectious Diseases department The Ziguinchor Peace Hospital/Ziguinchor Epidemic Treatment Center Ziguinchor Senegal Medical Analysis Laboratory The Ziguinchor Regional Hospital Ziguinchor Senegal

Introduction: SARS-COV-2 infection is a real public health challenge for the World Health Organization and for our country. It is responsible for numerous hematological abnormalities in infected patients. Objectives: To describe the haemogram abnormalities in patients infected with SARS-COV-2 and to determine which ones are associated with death. Material and Method: We conducted a retrospective, descriptive, analytical, cross-sectional study from March 2020 to September 2021. The study included all patients hospitalized with RT-PCR-confirmed COVID-19 who performed a blood count. We evaluated the blood count profile, the pathologies found and the associated blood count abnormalities. Results: A total of 263 patients were included. The mean age of the patients was 63.77 years (range 12 - 90 years). The male sex represented 54.75% (n = 144) while the female sex was 45.25% (n = 119) (sex ratio = 1.21). The most common pathologies were: diabetes: 30.03% (n = 79), high blood pressure: 41.04% (n = 108), and Chronic kidney disease: 7.98 (n = 21). The abnormalities of the haemogram found were essential: anaemia 28.13% (n = 121), hyperleukocytosis with neutrophilic predominance: 29.3% (126), lymphopenia: 34.41% (n = 148), thrombocytopenia: 8.16% (n = 35). The search for hematological factors associated with death in patients showed a significant difference between hyperleukocytosis (p = 0.000) and lymphopenia (p = 0.0001). Conclusion: SARS-COV-2 disease was a mortality factor when associated with lymphopenia and hyperleukocytosis in our series.

关键词： SARS-COV-2 Infection Abnormalities Blood Count Death

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