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hemodialysis patients’ satisfaction and associated factors in National Teaching Hospital hemodialysis Center, Cotonou (Benin)

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Open Journal of nephrology 2019年第4期9卷 127-138页

作者： Séraphin Ahoui Jacques Vigan Bruno Léopold Agboton Evariste Eteka Francis Tchegnonsi Tognon A. Anselme Djidonou Prosper Gandaho Leonard Fourn Department of nephrology Borgou Regional Teaching Hospital Parakou Benin nephrology-hemodialysis University Clinic (CUNH) Hubert Koutoukou Maga National Teaching Hospital Cotonou (CNHU-HKM) Benin Department of Psychiatry Borgou Regional Teaching Hospital Parakou Benin Faculty of Health Sciences University of Abomey-Calavi Abomey-Calavi Benin

Background: Patients’ satisfaction is a relevant component in assessing healthcare services. The objective of this study was to study the level of satisfaction of chronic hemodialysis patients and the associated factors in Cotonou CNHU-HKM dialysis center. Patients and Methods: It was a cross-sectional, descriptive and analytical study conducted by administering a questionnaire on days off dialysis. It was carried out from 1st November 2015 to 1st January 2016 in CNHU-HKM nephrology University Clinic of Cotonou. hemodialysis patients aged 18 years and above having given their informed consent were included in the study. Patients’ recruitment was comprehensive. Likert scale was used in assessing the level of satisfaction with 4 as “very satisfied” and 1 for “very dissatisfied”. Satisfaction was evaluated on the basis of Ware dimensions. The threshold for satisfaction was 50. Outcomes: Overall, 377 patients were included in the study. Respondents’ mean age was 51.5 ± 13.3 years with 1.37 as sex ratio. Arteriovenous fistula was used for 80.1% of hemodialysis patients. 77.7% of the patients underwent dialysis twice a week while 45.9% were administered a four-hour dialysis. The overall average proportion of “satisfied” was 76.5%. The level of satisfaction was 52% for healthcare environment, 61% for service delivery, 73.9% for healthcare accessibility, 76.1% for healthcare structure, 77.5% for healthcare management, 90.3% for quality of healthcare, 88.3% for interpersonal relationship and 93.2% for efficiency and continuum of healthcare. Factors associated with satisfaction included age (p = 0.02), vascular access (p = 0.04) and urea reduction ratio (p = 0.01). In addition, the degree of satisfaction of hemodialysis patients was not statistically associated with sex, marital status, educational level, history of the disease, age of dialysis, number of sessions per week, and duration per session. Conclusion: The overall level of hemodialysis patients’ satisfaction is above

关键词： Satisfaction Chronic hemodialysis Cotonou

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Serum Levels of RBP4 Might Not Be Determined by Diabetes Mellitus but by Kidney Function and Renal Replacement Therapy

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Journal of Shanghai Jiaotong university(Science) 2016年第6期21卷 757-762页

作者：芦泽源张光远谢玉婷李军辉汪年松晏春根王锋 Department of nephrology Shanghai Eighth People's Hospital Department of nephrology Shanghai Jiaotong University Affiliated Sixth People's Hospital Department of Urology Zhongda Hospital of Southeast University Department of Internal Medicine Affiliated Hospital of Shaoxing University

It has been reported that retinol-binding protein 4(RBP4) is associated to adiposity,insulin resistance,and type 2 ***,circulating RBP4 levels are also affected by renal *** aim of the present study is to investigate whether serum levels of RBP4 are primarily associated with different stages of chronic kidney disease(CKD) or type 2 diabetes,if there is more potential relevance between RBP4 and renal replacement *** serum levels of RBP4 were assessed by commercial competitive enzyme-linked immunosorbent assay(ELISA)kit in 212 patients with the CKD stages 1—5 and in 24 healthy controls,while its correlation with clinical and metabolic parameters was *** serum level of RBP4 had a strong correlation with estimated glomerular filtration rate(e GFR)(P hemodialysis(HD) and peritoneal dialysis(PD);P > 0.05 for all].The elevation of RBP4 become higher in HD than in PD and ND in CKD5 patients(P = 0.008 and P = 0.04,respectively),while there was no significant difference between PD and ND *** linear regression analysis demonstrated three independent predictors of e GFR(β =-0.676,P < 0.001),C-reactive protein(CRP)(β =-0.573,P < 0.001) and creatine(β = 0.509,P = 0.024) in the study *** study results demonstrated that the serum level of RBP4 was negatively related to the e GFR,whether diabetes mellitus(DM) affected the blood concentration of RBP4 or *** the serum level of RBP4 exhibited significant difference in different renal replacement therapies.

关键词： chronic kidney disease(CKD) retinol binding protein 4(RBP4) renal replacement therapy diabetes mellitus(DM)

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Is hemodialysis a reason for unresponsiveness to hepatitis B vaccine? Hepatitis B virus and dialysis therapy

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World Journal of Hepatology 2015年第5期7卷 761-768页

作者： Dede Sit Bennur Esen Ahmet Engin Atay Hasan Kayabasi Department of Internal Medicine and nephrology Bagcilar Education and Research Hospital

Impaired renal function is associated with a high risk of chronicity of hepatitis B virus(HBV) *** on hemodialysis(HD) or peritoneal dialysis are at an increased risk of viral transmission due to frequent necessity of blood product transfer as well as use of contaminated dialysate or dialysis ***,health professionals may cause viral spread via contaminated hands and carelessness against hygiene *** frequency of chronic HBV infection may be as high as 80% in patients on renal replacement *** is because HBV vaccination is essential to eliminate chronic HBV ***,response rates of HD patients to HBV vaccination vary between 10%-50%.Dialysis adequacy and early vaccination before the onset of dialysis therapy seem to be major determinants of high seroconversion *** age,male gender,duration of dialysis therapy and nutritional status are other well-known factors associated with seroconversion *** are controversial reports regarding the role of the presence of diabetes mellitus,HCV positivity,erythropoietin resistance,hyperparathyroidism,and vitamin D *** role of genetic alteration in the functions or production of cytokines still needs to be elucidated.

关键词： Hepatitis B virus Vaccine hemodialysis Response End stage renal disease

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Roxadustat for treatment of erythropoietin-hyporesponsive anemia in a hemodialysis patient:A case report

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World Journal of Clinical Cases 2020年第23期8卷 6048-6055页

作者： Wei-Hong Yu Xie-Jia Li Fang Yuan Department of nephrology The Second Xiangya Hospital of Central South UniversityChangsha 410011Hunan ProvinceChina

BACKGROUND Hyporesponsiveness to erythropoiesis-stimulating agents(ESAs)is a prevalent problem in patients with chronic kidney *** is associated with increased morbidity and mortality in patients who undergo dialysis.A significant proportion of patients do not respond to iron supplementation and conventional *** report a case of severe ESA hyporesponsiveness-related anemia that was successfully treated with oral *** SUMMARY A 59-year-old Chinese woman had high blood glucose for 25 years,maintenance hemodialysis for 7 years,and recurrent dizziness and fatigue for more than 2 *** tests showed severe anemia(hemoglobin level of 54 g/L),though bone marrow biopsy,fluorescence in situ hybridization,and hemolysis tests were within normal *** initially administered first-line therapies and other adjuvant treatments,such as blood transfusions,ESAs,and adequate dialysis,but the patient did not respond as *** erythropoietinresistant anemia was probably not only due to chronic renal *** patient received the hypoxia-inducible factor prolyl hydroxylase inhibitor roxadustat(100 mg,three times weekly).After 12 wk of treatment,the patient’s hemoglobin increased significantly,and her symptoms were *** the follow-up period,adverse drug reactions were controllable and *** Oral roxadustat is effective and tolerable for the treatment of ESA hyporesponsiveness-related anemia in patients undergoing hemodialysis.

关键词： Renal anemia Erythropoietin hyporesponsiveness Hepcidin Interleukin 6 Roxadustat Case report

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Effect of renal function and hemodialysis on the serum tumor markers in patients with chronic kidney disease

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Frontiers of Medicine 2007年第3期1卷 308-311页

作者： YU Xiaofang XU Xialian YE Zhibin Department of nephrology Shanghai Zhongshan HospitalFudan UniversityShanghai 200032China

In patients with chronic renal failure,whether they have had hemodialysis or not,the specificity of some of the serum tumor markers for the diagnosis of the corresponding tumors is decreased while others remain as valuable as they are in patients with normal kidney *** detection of tumor markers is extensively used for the diagnosis of corresponding *** has been recently shown that some tumor markers are higher in patients with chronic kidney disease(CKD)than in the normal *** effects of renal function and hemodialysis were examined on serum levels of some of the tumor markers including CEA,CA_(199),CA_(125),AFP,CA_(153),CA_(724),CYFRA21-1,NSE,SCC-Ag,PSA,and *** 232 non-dialysis patients with CKD and 37 chronic uremic patients treated with maintenance hemodialysis were enrolled in this *** 232 non-dialysis patients were divided into three groups according to their *** group 1,Ccr wash25 mL/*** group 2,Ccr was between 25 and 50 mL/*** group 3,Ccr wasi50 mL/*** male patients were also divided into three groups to compare the serum levels of PSA and fPSA among the three *** tumor markers in 37 uremic patients were *** comparison,37 non-dialysis patients with similar Ccr of the same age and gender served as *** existed significant differences in serum levels of CEA,CA_(199),CYFRA21-1,NSE,and SCC-Ag among different Ccr groups and the markers bore a negative correlation with *** were no significant differences among the three groups in the serum concentrations of CA_(125),AFP,CA_(153),CA_(724),PSA and *** serum levels of CA125 and NSE were significantly higher(Phemodialysis patients than in the nondialysis control *** patients with chronic renal failure,who were or were not on hemodialysis,the specificity of serum CEA,CA_(199),CYFRA21-1,NSE,CA_(125) and SCC-Ag for the diagnosis of the corresponding tumors was decreased while serum AFP,CA153,CA724,PSA and fPSA were as va

关键词： serum kidney failure,chronic metabolic clearance rate renal dialysis

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Mediation of serum albumin in the association of serum potassium with mortality in Chinese dialysis patients:a prospective cohort study

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Chinese Medical Journal 2023年第2期136卷 213-220页

作者： Naya Huang Yuanying Liu Zhen Ai Qian Zhou Haiping Mao Xiao Yang Yuanwen Xu Xueqing Yu Wei Chen Department of nephrology The First Affiliated HospitalKey Laboratory of NephrologyMinistry of Health of ChinaGuangdong Provincial Key Laboratory of NephrologySun Yat-Sen UniversityGuangzhouGuangdong 510080China Department of Medical Statistics Clinical Trials UnitThe First Affiliated HospitalSun Yat-Sen UniversityGuangzhouGuangdong 510080China Department of nephrology Guangdong Provincial People’s Hospital and Guangdong Academy of Medical SciencesGuangzhouGuangdong 510080China

Background: The clinical importance of hypokalemia is likely underrecognized in Chinese dialysis patients, and whether its clinical effect was mediated by serum albumin is not fully elucidated. This study aimed to explore the association between serum potassium and mortality in dialysis patients of a Chinese nationwide multicenter cohort, taking albumin as a consideration. Methods: This was a prospective nation-wide multicenter cohort study. Restricted cubic splines were used to test the linearity of serum potassium and relationships with all-cause (AC) and cardiovascular (CV) mortality and a subsequent two-line piecewise linear model was fitted to approach the nadir. A mediation analysis was performed to examine relations of albumin to potassium and mortalities. Results: A total of 10,027 patients were included, of whom 6605 were peritoneal dialysis and 3422 were hemodialysis patients. In the overall population, the mean age was 51.7 ± 14.8 years, 55.3%(5546/10,027) were male, and the median dialysis vintage was 13.60 (4.70, 39.70) months. Baseline serum potassium was 4.30 ± 0.88 mmol/L. After a median follow-up period of 26.87 (14.77, 41.50) months, a U-shape was found between potassium and mortality, and a marked increase in risk at lower potassium but a moderate elevation in risk at higher potassium were observed. The nadir for AC mortality risk was estimated from piecewise linear models to be a potassium concentration of 4.0 mmol/L. Interestingly, the significance of the association between potassium and mortality was attenuated when albumin was introduced into the extended adjusted model. A subsequent significant mediation by albumin for potassium and AC and CV mortalities were found ( P < 0.001 for both), indicating that hypokalemia led to higher mortality mediated by low serum albumin, which was a surrogate of poor nutritional status and inflammation. Conclusions: Associations between potassium and mortalities were U-shaped in the overall population. The nad

关键词： Potassium Mortality Dialysis Albumin Hypokalemia

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Chronic Nephropathies in the Internal Medicine Department of the Sylvanus Olympio University Hospital

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Open Journal of Internal Medicine 2021年第3期11卷 140-150页

作者： Agbeko Kodjo Djagadou Toyi Tchamdja Abdou-Bakari Tchala Yawovi Mawufemo Tsevi Abago Balaka Awalou Mohaman Djibril Department of Internal Medicine Sylvanus Olympio University Hospital University of Lomé Lomé Togo Department of Internal Medicine Kara University Hospital University of Kara Kara Togo Department of nephrology and hemodialysis Sylvanus Olympio University Hospital University of Lomé Lomé Togo

Introduction: The chronic nephropathies constitute a real global public health concern due to the constant increase in the prevalence estimated between 10% and 15%. In Sub-Saharan Africa, this prevalence has been estimated at 13.9%. This study will allow knowing the epidemiological, clinical, paraclinical and etiological aspects of chronic kidney disease in the internal medicine department of CHU-SO Lomé. Method: This was a cross-sectional, retrospective and descriptive study. It concerned all the patients suffering from a chronic kidney disease, hospitalized between the 1st of January 2014 and the 31st of December 2018, for a duration of 5 years. Results: During our study, 330 cases of chronic nephropathy were identified. The prevalence of chronic kidney disease was 8.3% of admissions. The mean age of the patients was 46.3 years with extremes of 19 and 86 years and a sex ratio of 1.32. A low socio-economic level of patients was observed in 63.9% with an urban origin in 69.7%. The main risk factors for renal impairment were hypertension (55.2%), diabetes mellitus (29.1%), obesity (20.6%), use of nephrotoxic products (19.4%), HIV infection (17%) and smoking (16.1%). The causes were dominated by nephroangiosclerosis (33.3%), followed by diabetic nephropathy (25.5%) and HIV-associated nephropathy (17%). Chronic renal failure was present in 95.8% of cases and was end stage in 69.7% of cases. Anemia was the main complication during the evolution of chronic kidney disease (98.2%). Mortality was 57.3% during hospitalization. Conclusion: Chronic kidney disease is a fairly common reason for hospitalization in the internal medicine department. Emphasis should therefore be placed on preventive measures for hypertension, diabetes and HIV.

关键词： Chronic Kidney Disease Profile CHU Lomé (Togo)

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Lipids, Lipoproteins and Apolipoproteins Abnormalities inPatients undergoing Dialysis

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Journal of Huazhong University of Science and Technology(Medical Sciences) 1997年第2期17卷 126-128页

作者：杨晓王惠玲朱忠华邓安国 Department of nephrology Xiehe Hospital Tongji Medical University Wuhan

Twenty hemodialysis (HD) patients and 20 patients on continuous am-bulatory peritoneal dialysis (CAPD) were investigated for lipids, lipoproteins andapolipoproteins abnormalities. HD patients had elevated serum triglyceride, de-creased high-density lipoprotein cholesterol (HDL-C ) and apolipoprotein A-I(Apo A-I ), whi1e CAPD patients had elevated total cho1esterol, triglyceride,low-density lipoprotein cholesterol (LDL-C), Apolipoprotein B (Apo B), Apo B/Apo A-Iratio, and decreased HDL-C, Apo A-I. Because of the molecular sievingeffects of peritoneum, CAPD have a negative effect on these abnormalities. CAPDpatients might be at greater risk of developing coronary artery disease than HD patients who are also at increased riskas compared with normals.

关键词： lipoprotein apolipoprotein dialysis

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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 Mohamed 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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Prevalence of Cardiovascular Risk Factors in Chronic hemodialysis Patients at the University Hospital Center of Point G in Bamako, Mali

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Open Journal of nephrology 2020年第2期10卷 125-134页

作者： Seydou Sy Magara Samaké Moctar Coulibaly Massama Konaté Djénèba Diallo Hamadoun Yattara Aboubacar Sidiki Fofana Atabieme Kodio Modi Sidibé Nouhoum Coulibaly Alkaya Touré Djibril Sy Moustapha Tangara Saharé Fongoro nephrology and Haemodialysis Department of the CHU of Point G Bamako Mali Faculty of Medicine University of Bamako Bamako Mali nephrology unit of the Fousseyni DAOU Hospital of Kayes Kayes Mali nephrology unit of Mali GAVARDO Hospital Bamako Mali Cardiology Department of Mali Hospital Bamako Mali Internal Medicine Service at the University Hospital Center of Point G Bamako Mali

Introduction: A cardiovascular risk factor (FDRCV) is defined as a physiological, pathological or environmental attribute or characteristic that results in an increased likelihood of developing cardiovascular disease in the individual in whom it is detected. The objective of this study was to determine the prevalence of cardiovascular risk factors in hemodialysis patients on hemodialysis at the University Hospital of Point G. Patients and Methods: This was a cross-sectional descriptive study with prospective data collection from March 3, 2009 to March 5, 2010 (13 months). Included were all patients with end-stage renal disease (ESRD) receiving chronic hemodialysis in the nephrology and hemodialysis Department of the University Hospital of Point G during the study period. Results: Eighty-eight patients were enrolled. The M/F sex ratio was 1.26. The mean age was 41.32 years with extremes of 17 and 81 years. The classic cardiovascular risk factors in order of frequency were: hypertension (90.9%), sedentary lifestyle (71.6%), male sex (54.5%), age ≥ 55 years (21.6%), obesity (13.6%), diabetes (8%), tobacco (8%), alcohol (3.4%). Cardiovascular risk factors related to CKD were: anemia (98.9%), phosphocalcic disorders (85.2%), arteriovenous fistula (AVF) (80%), lipid abnormalities (36.5%), hydrosodium inflation (29.5%). Predominant cardiovascular complications were hypertensive heart disease (62.5%), acute pulmonary oedema (APO) (50%), rhythm disorders (23.9%), coronary insufficiency (18.2%). The mortality rate was 17%. Conclusion: Cardiovascular risk factors are frequent in chronic hemodialysis. They contribute to the excess mortality of these patients. Adequate management of these risk factors can slow down serious cardiovascular complications and reduce the risk of mortality in this fragile population.

关键词： Cardiovascular Risk Factors Haemodialysis Mali

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