Introduction: End-stage renal disease (ESRD), requiring purification during Child Hood, is a rare situation and a source of high morbidity and mortality, raising ethical questions. In Guinea, the lack of national regi...Introduction: End-stage renal disease (ESRD), requiring purification during Child Hood, is a rare situation and a source of high morbidity and mortality, raising ethical questions. In Guinea, the lack of national registers of pediatric chronic kidney disease, the absence of a nephropediatric service, the treatment of certain pediatric cases of CKD in the adult hemodialysis center, and the consequence on the evolution of children undergoing replacement therapy is not evaluated in terms of survival. We are conducting this study to assess the prognosis of CKD and chronic hemodialysis in patients under 20 years of age. The survival of patients under 20 years of age on chronic hemodialysis in an adult hemodialysis center is considerable. Material and Methods: This is a retrospective study of chronic end-stage renal disease in patients under 20 years of age, who may or may not have received chronic hemodialysis in an adult hemodialysis center. In our study, we included the records of patients under 20 years of age, with a creatinine clearance of less than 15 mL/min/1.73m2 according to the Schwartz formula, who did or did not accept chronic hemodialysis. Results: out of 724 patients hospitalized with all pathologies during the study period, we obtained 55 patients under 20 years of age with chronic end-stage renal disease, i.e., a frequency of 8 %, representing our study population. The mean age was 13 ± 3 years, with extremes ranging from 9 to 19 years. We found a predominance in the 15 - 19 age group, numbering 49 patients, or 89.09%. Of 55 patients under 20 years of age with chronic end-stage renal failure, 34 patients who had received chronic hemodialysis, only 24 patients (70.59%) were still alive, while 10 patients (29.41%) had died. Conclusion: The aim of this retrospective study on the prognosis of chronic end-stage renal failure in patients under 20 years of age, enabled us to obtain a hospital frequency equal to 8%. The main cause of chronic renal disease was glomerular nephropathy. The death rate was essentially due to the lack of nephropediatric services, and the lack of equipment for suppletive treatment adapted to children.展开更多
Introduction: Acute obstructive renal failure (AORF) is a frequent clinical situation, secondary to obstruction of the urinary excretory tract. Whatever the cause, urinary tract obstruction suddenly opposes glomerular...Introduction: Acute obstructive renal failure (AORF) is a frequent clinical situation, secondary to obstruction of the urinary excretory tract. Whatever the cause, urinary tract obstruction suddenly opposes glomerular filtration and is responsible for tubulointerstitial lesions. It accounts for 10% of acute renal failure (ARF). The aim of this study was to identify the causes and prognosis of cases of acute obstructive renal failure managed at the Centre National d’hémodialyse Donka. Material and Methods: This was a prospective descriptive study lasting 6 months, from September 1, 2022 to February 29, 2023. All patients undergoing haemodialysis for acute obstructive renal failure who agreed to participate in the study and whose medical records were complete were included. Results: During the course of the study, we registered 97 haemodialysis patients, including 20 cases (20.62%) of acute obstructive renal failure. The mean age of the patients was 57.8 ± 10.54 years, with a male predominance of 11 cases (55%) and a sex ratio of 1.22. The reasons for consultation were dominated by physical asthenia 11 cases (55%), lumbar pain 9 cases (50%), vomiting 6 cases (30%) and acute urine retention 6 cases (30%). Arterial hypertension 16 cases (80%) and urinary tract infection 10 cases (50%) were the most common antecedents. The etiologies of RAOI were dominated by lithiasis 10 cases (50%), neoplasia 6 cases (30%) and benign prostatic hypertrophy 3 cases (15%). mean creatinine was 1267.60 ± 710.76 μmol/l with extremes of 243 μmol/l and 2822 μmol/l, mean urea was 39.56 ± 18.36, hyperkalemia in 14 cases (70%) and hyponatremia in 8 cases (40%). After hemodialysis, 9 cases (45%) recovered renal function, 4 cases (20%) became chronic and 7 cases (35%) died. Conclusion: The frequency of AKI remains non-negligible in our department, and early detection and prompt management would considerably reduce the morbidity and mortality associated with this pathology.展开更多
Context and Object: Late nephrology case management for patients with chronic renal failure is consistently associated with high morbidity rate. The objectives of this study were to determine the factors associated wi...Context and Object: Late nephrology case management for patients with chronic renal failure is consistently associated with high morbidity rate. The objectives of this study were to determine the factors associated with late nephrology case management and to describe the evolution of patients depending on the time of care nephrology. Material and Methods: It was a 5-year prospective study, observational type, going from January 1st, 2010 to December 31th, 2014. We studied all the patients hospitalized with chronic renal failure with dialysis or not and we excluded the patients hospitalized for acute renal failure. Results: The study population includes 307 men (53.4%) and 268 women (46.6%) with a sex ratio of 1.14. Age population ranged between 15 and 85 years old with a mean of 44.4 ± 16.20 years old. Their profession was distributed as follows: 220 housewives (38.3%), 181 workers (31.5%), 104 civil servants (18.1%), 56 students (9.7%) and 14 unemployed (2.4%). Patients came from all regions of the country: Conakry: 389 patients (67.6%);Lower Guinea: 82 (14.3%);Middle-Guinea: 57 (9.9%);Upper Guinea: 31 (5.4%);Guinea Forest Region: 16 (2.8%). In this study population, 48 patients were admitted in emergency (8.3%);105 were scheduled (18.3%) and 422 were referred to the nephrology department (73.4%). Reasons for the emergency admission were acute pulmonary edema in 21 patients (43.7%), decompensated anemia in 13 patients (27.1%), loss of consciousness in 9 patients (18.7%) and malignant hypertension in 5 patients (10.4%). The reference patterns was uremic syndrome in 312 patients (54.3%), followed by high blood pressure in 247 patients (42.9%), an edematous syndrome in 234 patients (40.7%), oligoanuria in 222 patients (38.6%), morphological abnormalities on the renal ultrasound in 4 patients (0.7%). The functional symptoms were vomiting in 379 patients (65.9%), followed by dyspnea in 290 patients (50.4%), headaches in 287 patients (49.9%). Among them, 121 patients could handle alone, 431 were borne by their families and 23 were indigent;181 patients had consulted before 1 month of the beginning of the signs, 238 between 1 and 2 months and 156 after 2 months;48 were admitted in emergency, 105 were programmed by the Nephrology Department and 422 were referred to the other health structures of the country. Conclusion: Several factors contributed to the delay in treatment, among which: the low socioeconomic level, the delay of the reference of the patients, the long distance of the regions, the lack of Nephrology units in the country.展开更多
Introduction: Multiple myeloma is a haematological malignancy characterised by monoclonal plasma cell proliferation in the bone marrow, which synthesises a serum and/or urinary monoclonal protein, associated with one ...Introduction: Multiple myeloma is a haematological malignancy characterised by monoclonal plasma cell proliferation in the bone marrow, which synthesises a serum and/or urinary monoclonal protein, associated with one or more manifestations including (anaemia, hypercalcaemia, bone lesions, renal failure). The aim of our work was to determine the prevalence, clinico-biological, histological and therapeutic manifestations of renal damage during multiple myeloma. Methodology: This is a retrospective descriptive study spread over a period of 2 years from 01 January 2020 to 31 December 2021 carried out in the nephrology department of the louis pasteur hospital of the CH of Chartres. All patients treated for multiple myeloma with renal involvement were included, whether the renal involvement was revelatory or diagnosed during the follow-up of the multiple myeloma. Results: We collected 20 cases of myeloma. Renal involvement was present in 19 cases (95%). The mean age was 68.78 ± 10.77 years with extremes ranging from 44 to 82 years. Males were more prevalent, with an M/F sex ratio of 3.75. The most common antecedent condition was hypertension in 14 cases (73.7%) and diabetes in 4 cases (21.1%). The circumstances of discovery were renal failure in 16 cases (84.2%), followed by bone pain in 6 cases (31.6%). Renal involvement was dominated by renal failure in 18 cases (94.7%), hypercalcaemia in 14 cases (73.7%), para protein in 9 cases (47.4%), haematuria and leukocyturia in 5 cases (26.3%). On plasma protein electrophoresis, 11 cases (57.9%) had kappa light chain multiple myeloma, 8 cases (42.1%) had lambda light chain multiple myeloma. We noted 9 cases (69%) of myelomatous cylinder nephropathy at renal biopsy, Randall’s disease in 2 cases (15%), AL amyloidosis and acute tubular necrosis in 1 case (8%). First-line chemotherapy treatment was dominated by the combination of Velcade, cyclophosphamide and dexamethasone in 5 cases (79%). Conclusion: Renal involvement in myeloma is still common;it may be isolated and precede the first signs of myeloma by several months;the most common histological forms are myelomatous cylinder nephropathy and Randall’s disease.展开更多
Introduction: Uremic pericarditis is a major complication of renal disease, occurring in patients with chronic renal failure, prior to dialysis or during dialysis treatment. Our aim was to determine the prevalence and...Introduction: Uremic pericarditis is a major complication of renal disease, occurring in patients with chronic renal failure, prior to dialysis or during dialysis treatment. Our aim was to determine the prevalence and clinique aspect of uremic pericarditis in our center. Material and Methods: This was a dynamic descriptive study covering the period from August 1 to March 30, 2022. Recruitment was exhaustive of all chronic hemodialysis patients over three months of age, and only those presenting with uremic pericarditis after our means of investigation were included in the study. The sample size was obtained after counting and showed a total of 47 patients with uremic pericarditis. Data were entered and analyzed in SPSS v21. Results: The prevalence of uremic pericarditis in this study was 17.54%;the mean age of patients was 34.42 ± 12.38 years;vascular nephropathy accounted for 57.45% of cases;clinical signs were dominated by pericardial friction (91.50%) and liquid pericarditis (89.36%);more than half of patients (93.62%) received two hemodialysis sessions per week. Late discovery of CKD was 74.47%. The mortality rate in this study was 34.04%. There was no statistically significant association between late onset of CKD and uremic pericarditis (p-value = 0.59). Conclusion: Late diagnosis of CKD is often accompanied by serious complications, including uremic pericarditis, which is responsible for early morbidity and mortality in new hemodialysis patients.展开更多
High blood pressure (HBP) is a public health problem worldwide. The objective of this study is to determine the prevalence of hypertension in military garrisons in Conakry, the capital. Material and Methods: The study...High blood pressure (HBP) is a public health problem worldwide. The objective of this study is to determine the prevalence of hypertension in military garrisons in Conakry, the capital. Material and Methods: The study was done in military garrisons. The data concern 1025 soldiers. This prospective and cross-sectional study took place from 13 November 2014 to 13 February 2015. Only the military who had agreed to participate in the study were included. Sociodemographic, clinical data and urine dipsticks were collected. Results: Among 1025 soldiers, 222 cases of HPB were observed, that was 21.66%. They were 193 men (86.94%) and 29 women (13.06%). The mean age was 46.05 years (range: 18 - 77 years). HPB cases were discovered in 155 soldiers (69.82%) in random observations. Following the grade of hypertension: 124 were of grade I, 62 of grade II, 35 of grade III and 1 case of isolated systolic hypertension was identified. Urinary dipstick tests showed that, 3 patients had proteinuria, 26 patients suffered from leucocyturia, 11 patients suffered from glycosuria and 1 case of hematuria was also identified. More than half of the soldiers (41%) were in the army. Officers were strongly affected (80.18%), followed by non-commissioned officers (17.12%) and finally enlisted men (2.70%). Risk factors were multiple: 78.82% ate very salty food;emotional stress;physical inactivity was observed in over half of the cases. Conclusion: This study gives an overall picture of the prevalence of hypertension in the military in Guinea. The discovery of the symptom lies on the systematic measurement of blood pressure.展开更多
A hypernatremia severity is often associated with a poor prognosis, especially if it is associated with multiple organ failure. In a country with very limited resources, the prognosis may be favorable in the absence o...A hypernatremia severity is often associated with a poor prognosis, especially if it is associated with multiple organ failure. In a country with very limited resources, the prognosis may be favorable in the absence of renal replacement. We report the case of a 63 years old woman, hypertensive and diabetic, admitted to the ICU for unconsciousness. Clinically, neurological examination notes a Glasgow of 8/15 (Y2, V2, M4) and a left hemiplegia. Temperature was 39°C. Diuresis was 100 ml during the first 24 hours. Blood pressure was 90/60 mmHg, tachycardia at 133/min. Cardiac auscultation is normal. Vascular axes were weakly perceptible. Oxygen saturation was 95%. The skin examination notes a dry skin and mucous membranes, a flattening of the superficial veins, sunken eyes and a persistent skin fold. There is no hepatomegaly or splenomegaly, or jaundice. Biological point of view note natremia: 176 mmol/L;osmolarity: 390 mosmol/kg;creatinin: 300 μmol/L;glycemia > 6 g/L;transaminases 217 UI. Diagnostics: malignant hypernatremia with a high plasma osmolarity associated with an acute anuric renal failure, hydro electrolytic disorders, an abnormal liver function, a fever of central origin and a stroke. The treatment consisted of a correction of the electrolyte disorders by infusion of isotonic and hypotonic fluids with insulin. In a country with very limited resources, the severe hypernatremia prognosis associated with anuric acute renal failure may be favorable in the absence of renal replacement.展开更多
Introduction: Dialytic high blood pressure (DHBP), although often ignored, is now recognized as a recurring and persistent phenomenon in a subgroup of hemodialysized patients. Its occurrence is associated with an incr...Introduction: Dialytic high blood pressure (DHBP), although often ignored, is now recognized as a recurring and persistent phenomenon in a subgroup of hemodialysized patients. Its occurrence is associated with an increased risk of hospitalization and death. The objective of the study was to determine the prevalence of intradialytic hypertension and the factors associated with it. Methods: Study was cross-sectional, monocentric, descriptive and analytical over a three-month period from April 22 to July 22, 2019. Included were all patients 18 years of age or older, chronic hemodialysis for at least three months, with intra-dialytic high blood pressure. The blood pressure machine used for the majority of patients was an electronic “OMRON” blood pressure monitor. Epidemiological, clinical, para clinical and dialysis parameters were studied. The data were collected, captured and analyzed using IBM SPSS Statistics Version 20 software. The factors associated with intradialytic high blood pressure were searched using a univariate logistic regression model. The significance threshold for all statistical tests has been set at 5%. Results: Of our 131 patients, 53 had intradialytic hypertension, a frequency of 40.5%. The time of (DHBP) occurrence was more frequent at the 3rd and 2nd hour, 94.34% and 86.79%, respectively. The average age of patients was 45.51 years with extremes ranging from 19 to 70 years. The average Systolic Blood Pressure (SBP) before dialysis was 148 mm Hg ?16.62 and the average Diastolic Blood Pressure (DBP) before dialysis was 88 mm Hg ?12.50. Pre-dialysis Blood Pressure—140/90 mm Hg was noted in 18 cases, or 34.0%. The intradialytic average SBP was 164 mm Hg ?17.25 with extremes of 121 to 202 mm Hg. The intradialytic average DBP was 92 mm Hg ?12.52 with extremes 67 to 124 mm Hg. The main risk factors associated with intra-dialytic hyperation were: Age range (40 - 50 years), Duration on dialysis (Conclusion: This study, the first of its kind in Guinea, was able to determine the frequency of intradialytic hypertension and the factors associated with it.展开更多
<strong>Introduction:</strong><span style="font-family:Verdana;"> Cardiovascular disease has become a major concern for the nephrologist as it is the leading cause of morbidity and mortalit...<strong>Introduction:</strong><span style="font-family:Verdana;"> Cardiovascular disease has become a major concern for the nephrologist as it is the leading cause of morbidity and mortality in patients with chronic kidney disease, and affects all stages of the disease, including the earliest stages of the disease. The goal of this work was to determine the frequency of cardiovascular complications during chronic kidney failure.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Patients and methods:</span></b><span style="font-family:Verdana;"> This was a six-month, descriptive cross-sectional study from March 01 to August 31, 2018. It covered all patients with chronic kidney disease hospitalized in the ward during the study period. Included were all chronic kidney failure patients with at least one cardiac and/or vascular complication diagnosed either on clinical examination, and/or paraclinical examination (Electrocardiogram or cardiac ultrasound, vessel echodoppler, scan)</span><span style="font-family:Verdana;">.</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Res</span></b></span><b><span style="font-family:Verdana;">ults:</span></b><span style="font-family:Verdana;"> During the study period, 84 out of 378 patients or 22.22% had at least one cardiovascular complication. Cardiovascular complications were hypertrophy of the left ventricle with 49/84 (44 at Electrocardiogram and 5 at cardiac echodoppler), valvulopathy with 33.33%, stroke with 50% of cases, obliterating arterial disease of the lower limbs 25%, hypokinetic dilated cardiomyopathy with 9/36 cases and pericarditis with 2/36.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Cardiovascular complications affect both sexes and all ages. They were dominated by enlarged left ventricle, valvulopathy and dilated cardiomyopathy.</span>展开更多
Introduction: In Guinea, data on the acute kidney injury (AKI) of women in the obstetrical context is still limited. This study attempted to determine the prevalence and the clinical signs of obstetric AKI in Guinea. ...Introduction: In Guinea, data on the acute kidney injury (AKI) of women in the obstetrical context is still limited. This study attempted to determine the prevalence and the clinical signs of obstetric AKI in Guinea. Patients and methods: The study population consisted of pregnant or postpartum women with AKI, whom we treated in this institute from August 2018 to January 2019. All had normal anterior renal function with serum creatinine clearance ≥ 120 μmol/L, and then suffered AKI. Patients characteristics were examined;maternal age, gestational weeks, AKI characteristics. Results: Of 2438 pregnant women admitted during the study period, 56 showed AKI. Antepartum and postpartum AKI accounted for approximately 80% and 17%, respectively. Regarding the maternal age, Conclusion: We here demonstrated peripartum AKI in Guinea, which findings may provide fundamental data to establish some strategy against this condition in this region.展开更多
文摘Introduction: End-stage renal disease (ESRD), requiring purification during Child Hood, is a rare situation and a source of high morbidity and mortality, raising ethical questions. In Guinea, the lack of national registers of pediatric chronic kidney disease, the absence of a nephropediatric service, the treatment of certain pediatric cases of CKD in the adult hemodialysis center, and the consequence on the evolution of children undergoing replacement therapy is not evaluated in terms of survival. We are conducting this study to assess the prognosis of CKD and chronic hemodialysis in patients under 20 years of age. The survival of patients under 20 years of age on chronic hemodialysis in an adult hemodialysis center is considerable. Material and Methods: This is a retrospective study of chronic end-stage renal disease in patients under 20 years of age, who may or may not have received chronic hemodialysis in an adult hemodialysis center. In our study, we included the records of patients under 20 years of age, with a creatinine clearance of less than 15 mL/min/1.73m2 according to the Schwartz formula, who did or did not accept chronic hemodialysis. Results: out of 724 patients hospitalized with all pathologies during the study period, we obtained 55 patients under 20 years of age with chronic end-stage renal disease, i.e., a frequency of 8 %, representing our study population. The mean age was 13 ± 3 years, with extremes ranging from 9 to 19 years. We found a predominance in the 15 - 19 age group, numbering 49 patients, or 89.09%. Of 55 patients under 20 years of age with chronic end-stage renal failure, 34 patients who had received chronic hemodialysis, only 24 patients (70.59%) were still alive, while 10 patients (29.41%) had died. Conclusion: The aim of this retrospective study on the prognosis of chronic end-stage renal failure in patients under 20 years of age, enabled us to obtain a hospital frequency equal to 8%. The main cause of chronic renal disease was glomerular nephropathy. The death rate was essentially due to the lack of nephropediatric services, and the lack of equipment for suppletive treatment adapted to children.
文摘Introduction: Acute obstructive renal failure (AORF) is a frequent clinical situation, secondary to obstruction of the urinary excretory tract. Whatever the cause, urinary tract obstruction suddenly opposes glomerular filtration and is responsible for tubulointerstitial lesions. It accounts for 10% of acute renal failure (ARF). The aim of this study was to identify the causes and prognosis of cases of acute obstructive renal failure managed at the Centre National d’hémodialyse Donka. Material and Methods: This was a prospective descriptive study lasting 6 months, from September 1, 2022 to February 29, 2023. All patients undergoing haemodialysis for acute obstructive renal failure who agreed to participate in the study and whose medical records were complete were included. Results: During the course of the study, we registered 97 haemodialysis patients, including 20 cases (20.62%) of acute obstructive renal failure. The mean age of the patients was 57.8 ± 10.54 years, with a male predominance of 11 cases (55%) and a sex ratio of 1.22. The reasons for consultation were dominated by physical asthenia 11 cases (55%), lumbar pain 9 cases (50%), vomiting 6 cases (30%) and acute urine retention 6 cases (30%). Arterial hypertension 16 cases (80%) and urinary tract infection 10 cases (50%) were the most common antecedents. The etiologies of RAOI were dominated by lithiasis 10 cases (50%), neoplasia 6 cases (30%) and benign prostatic hypertrophy 3 cases (15%). mean creatinine was 1267.60 ± 710.76 μmol/l with extremes of 243 μmol/l and 2822 μmol/l, mean urea was 39.56 ± 18.36, hyperkalemia in 14 cases (70%) and hyponatremia in 8 cases (40%). After hemodialysis, 9 cases (45%) recovered renal function, 4 cases (20%) became chronic and 7 cases (35%) died. Conclusion: The frequency of AKI remains non-negligible in our department, and early detection and prompt management would considerably reduce the morbidity and mortality associated with this pathology.
文摘Context and Object: Late nephrology case management for patients with chronic renal failure is consistently associated with high morbidity rate. The objectives of this study were to determine the factors associated with late nephrology case management and to describe the evolution of patients depending on the time of care nephrology. Material and Methods: It was a 5-year prospective study, observational type, going from January 1st, 2010 to December 31th, 2014. We studied all the patients hospitalized with chronic renal failure with dialysis or not and we excluded the patients hospitalized for acute renal failure. Results: The study population includes 307 men (53.4%) and 268 women (46.6%) with a sex ratio of 1.14. Age population ranged between 15 and 85 years old with a mean of 44.4 ± 16.20 years old. Their profession was distributed as follows: 220 housewives (38.3%), 181 workers (31.5%), 104 civil servants (18.1%), 56 students (9.7%) and 14 unemployed (2.4%). Patients came from all regions of the country: Conakry: 389 patients (67.6%);Lower Guinea: 82 (14.3%);Middle-Guinea: 57 (9.9%);Upper Guinea: 31 (5.4%);Guinea Forest Region: 16 (2.8%). In this study population, 48 patients were admitted in emergency (8.3%);105 were scheduled (18.3%) and 422 were referred to the nephrology department (73.4%). Reasons for the emergency admission were acute pulmonary edema in 21 patients (43.7%), decompensated anemia in 13 patients (27.1%), loss of consciousness in 9 patients (18.7%) and malignant hypertension in 5 patients (10.4%). The reference patterns was uremic syndrome in 312 patients (54.3%), followed by high blood pressure in 247 patients (42.9%), an edematous syndrome in 234 patients (40.7%), oligoanuria in 222 patients (38.6%), morphological abnormalities on the renal ultrasound in 4 patients (0.7%). The functional symptoms were vomiting in 379 patients (65.9%), followed by dyspnea in 290 patients (50.4%), headaches in 287 patients (49.9%). Among them, 121 patients could handle alone, 431 were borne by their families and 23 were indigent;181 patients had consulted before 1 month of the beginning of the signs, 238 between 1 and 2 months and 156 after 2 months;48 were admitted in emergency, 105 were programmed by the Nephrology Department and 422 were referred to the other health structures of the country. Conclusion: Several factors contributed to the delay in treatment, among which: the low socioeconomic level, the delay of the reference of the patients, the long distance of the regions, the lack of Nephrology units in the country.
文摘Introduction: Multiple myeloma is a haematological malignancy characterised by monoclonal plasma cell proliferation in the bone marrow, which synthesises a serum and/or urinary monoclonal protein, associated with one or more manifestations including (anaemia, hypercalcaemia, bone lesions, renal failure). The aim of our work was to determine the prevalence, clinico-biological, histological and therapeutic manifestations of renal damage during multiple myeloma. Methodology: This is a retrospective descriptive study spread over a period of 2 years from 01 January 2020 to 31 December 2021 carried out in the nephrology department of the louis pasteur hospital of the CH of Chartres. All patients treated for multiple myeloma with renal involvement were included, whether the renal involvement was revelatory or diagnosed during the follow-up of the multiple myeloma. Results: We collected 20 cases of myeloma. Renal involvement was present in 19 cases (95%). The mean age was 68.78 ± 10.77 years with extremes ranging from 44 to 82 years. Males were more prevalent, with an M/F sex ratio of 3.75. The most common antecedent condition was hypertension in 14 cases (73.7%) and diabetes in 4 cases (21.1%). The circumstances of discovery were renal failure in 16 cases (84.2%), followed by bone pain in 6 cases (31.6%). Renal involvement was dominated by renal failure in 18 cases (94.7%), hypercalcaemia in 14 cases (73.7%), para protein in 9 cases (47.4%), haematuria and leukocyturia in 5 cases (26.3%). On plasma protein electrophoresis, 11 cases (57.9%) had kappa light chain multiple myeloma, 8 cases (42.1%) had lambda light chain multiple myeloma. We noted 9 cases (69%) of myelomatous cylinder nephropathy at renal biopsy, Randall’s disease in 2 cases (15%), AL amyloidosis and acute tubular necrosis in 1 case (8%). First-line chemotherapy treatment was dominated by the combination of Velcade, cyclophosphamide and dexamethasone in 5 cases (79%). Conclusion: Renal involvement in myeloma is still common;it may be isolated and precede the first signs of myeloma by several months;the most common histological forms are myelomatous cylinder nephropathy and Randall’s disease.
文摘Introduction: Uremic pericarditis is a major complication of renal disease, occurring in patients with chronic renal failure, prior to dialysis or during dialysis treatment. Our aim was to determine the prevalence and clinique aspect of uremic pericarditis in our center. Material and Methods: This was a dynamic descriptive study covering the period from August 1 to March 30, 2022. Recruitment was exhaustive of all chronic hemodialysis patients over three months of age, and only those presenting with uremic pericarditis after our means of investigation were included in the study. The sample size was obtained after counting and showed a total of 47 patients with uremic pericarditis. Data were entered and analyzed in SPSS v21. Results: The prevalence of uremic pericarditis in this study was 17.54%;the mean age of patients was 34.42 ± 12.38 years;vascular nephropathy accounted for 57.45% of cases;clinical signs were dominated by pericardial friction (91.50%) and liquid pericarditis (89.36%);more than half of patients (93.62%) received two hemodialysis sessions per week. Late discovery of CKD was 74.47%. The mortality rate in this study was 34.04%. There was no statistically significant association between late onset of CKD and uremic pericarditis (p-value = 0.59). Conclusion: Late diagnosis of CKD is often accompanied by serious complications, including uremic pericarditis, which is responsible for early morbidity and mortality in new hemodialysis patients.
文摘High blood pressure (HBP) is a public health problem worldwide. The objective of this study is to determine the prevalence of hypertension in military garrisons in Conakry, the capital. Material and Methods: The study was done in military garrisons. The data concern 1025 soldiers. This prospective and cross-sectional study took place from 13 November 2014 to 13 February 2015. Only the military who had agreed to participate in the study were included. Sociodemographic, clinical data and urine dipsticks were collected. Results: Among 1025 soldiers, 222 cases of HPB were observed, that was 21.66%. They were 193 men (86.94%) and 29 women (13.06%). The mean age was 46.05 years (range: 18 - 77 years). HPB cases were discovered in 155 soldiers (69.82%) in random observations. Following the grade of hypertension: 124 were of grade I, 62 of grade II, 35 of grade III and 1 case of isolated systolic hypertension was identified. Urinary dipstick tests showed that, 3 patients had proteinuria, 26 patients suffered from leucocyturia, 11 patients suffered from glycosuria and 1 case of hematuria was also identified. More than half of the soldiers (41%) were in the army. Officers were strongly affected (80.18%), followed by non-commissioned officers (17.12%) and finally enlisted men (2.70%). Risk factors were multiple: 78.82% ate very salty food;emotional stress;physical inactivity was observed in over half of the cases. Conclusion: This study gives an overall picture of the prevalence of hypertension in the military in Guinea. The discovery of the symptom lies on the systematic measurement of blood pressure.
文摘A hypernatremia severity is often associated with a poor prognosis, especially if it is associated with multiple organ failure. In a country with very limited resources, the prognosis may be favorable in the absence of renal replacement. We report the case of a 63 years old woman, hypertensive and diabetic, admitted to the ICU for unconsciousness. Clinically, neurological examination notes a Glasgow of 8/15 (Y2, V2, M4) and a left hemiplegia. Temperature was 39°C. Diuresis was 100 ml during the first 24 hours. Blood pressure was 90/60 mmHg, tachycardia at 133/min. Cardiac auscultation is normal. Vascular axes were weakly perceptible. Oxygen saturation was 95%. The skin examination notes a dry skin and mucous membranes, a flattening of the superficial veins, sunken eyes and a persistent skin fold. There is no hepatomegaly or splenomegaly, or jaundice. Biological point of view note natremia: 176 mmol/L;osmolarity: 390 mosmol/kg;creatinin: 300 μmol/L;glycemia > 6 g/L;transaminases 217 UI. Diagnostics: malignant hypernatremia with a high plasma osmolarity associated with an acute anuric renal failure, hydro electrolytic disorders, an abnormal liver function, a fever of central origin and a stroke. The treatment consisted of a correction of the electrolyte disorders by infusion of isotonic and hypotonic fluids with insulin. In a country with very limited resources, the severe hypernatremia prognosis associated with anuric acute renal failure may be favorable in the absence of renal replacement.
文摘Introduction: Dialytic high blood pressure (DHBP), although often ignored, is now recognized as a recurring and persistent phenomenon in a subgroup of hemodialysized patients. Its occurrence is associated with an increased risk of hospitalization and death. The objective of the study was to determine the prevalence of intradialytic hypertension and the factors associated with it. Methods: Study was cross-sectional, monocentric, descriptive and analytical over a three-month period from April 22 to July 22, 2019. Included were all patients 18 years of age or older, chronic hemodialysis for at least three months, with intra-dialytic high blood pressure. The blood pressure machine used for the majority of patients was an electronic “OMRON” blood pressure monitor. Epidemiological, clinical, para clinical and dialysis parameters were studied. The data were collected, captured and analyzed using IBM SPSS Statistics Version 20 software. The factors associated with intradialytic high blood pressure were searched using a univariate logistic regression model. The significance threshold for all statistical tests has been set at 5%. Results: Of our 131 patients, 53 had intradialytic hypertension, a frequency of 40.5%. The time of (DHBP) occurrence was more frequent at the 3rd and 2nd hour, 94.34% and 86.79%, respectively. The average age of patients was 45.51 years with extremes ranging from 19 to 70 years. The average Systolic Blood Pressure (SBP) before dialysis was 148 mm Hg ?16.62 and the average Diastolic Blood Pressure (DBP) before dialysis was 88 mm Hg ?12.50. Pre-dialysis Blood Pressure—140/90 mm Hg was noted in 18 cases, or 34.0%. The intradialytic average SBP was 164 mm Hg ?17.25 with extremes of 121 to 202 mm Hg. The intradialytic average DBP was 92 mm Hg ?12.52 with extremes 67 to 124 mm Hg. The main risk factors associated with intra-dialytic hyperation were: Age range (40 - 50 years), Duration on dialysis (Conclusion: This study, the first of its kind in Guinea, was able to determine the frequency of intradialytic hypertension and the factors associated with it.
文摘<strong>Introduction:</strong><span style="font-family:Verdana;"> Cardiovascular disease has become a major concern for the nephrologist as it is the leading cause of morbidity and mortality in patients with chronic kidney disease, and affects all stages of the disease, including the earliest stages of the disease. The goal of this work was to determine the frequency of cardiovascular complications during chronic kidney failure.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Patients and methods:</span></b><span style="font-family:Verdana;"> This was a six-month, descriptive cross-sectional study from March 01 to August 31, 2018. It covered all patients with chronic kidney disease hospitalized in the ward during the study period. Included were all chronic kidney failure patients with at least one cardiac and/or vascular complication diagnosed either on clinical examination, and/or paraclinical examination (Electrocardiogram or cardiac ultrasound, vessel echodoppler, scan)</span><span style="font-family:Verdana;">.</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Res</span></b></span><b><span style="font-family:Verdana;">ults:</span></b><span style="font-family:Verdana;"> During the study period, 84 out of 378 patients or 22.22% had at least one cardiovascular complication. Cardiovascular complications were hypertrophy of the left ventricle with 49/84 (44 at Electrocardiogram and 5 at cardiac echodoppler), valvulopathy with 33.33%, stroke with 50% of cases, obliterating arterial disease of the lower limbs 25%, hypokinetic dilated cardiomyopathy with 9/36 cases and pericarditis with 2/36.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Cardiovascular complications affect both sexes and all ages. They were dominated by enlarged left ventricle, valvulopathy and dilated cardiomyopathy.</span>
文摘Introduction: In Guinea, data on the acute kidney injury (AKI) of women in the obstetrical context is still limited. This study attempted to determine the prevalence and the clinical signs of obstetric AKI in Guinea. Patients and methods: The study population consisted of pregnant or postpartum women with AKI, whom we treated in this institute from August 2018 to January 2019. All had normal anterior renal function with serum creatinine clearance ≥ 120 μmol/L, and then suffered AKI. Patients characteristics were examined;maternal age, gestational weeks, AKI characteristics. Results: Of 2438 pregnant women admitted during the study period, 56 showed AKI. Antepartum and postpartum AKI accounted for approximately 80% and 17%, respectively. Regarding the maternal age, Conclusion: We here demonstrated peripartum AKI in Guinea, which findings may provide fundamental data to establish some strategy against this condition in this region.
