Background: Anemia is a frequent and disabling complication in hemodialysis patients. The main objective of this work was to study the factors associated with anemia in chronic hemodialysis patients at CNHU-HKM in 2023. Methods: This was a cohort study, descriptive and analytical in nature, conducted from July 1, 2023 to September 31, 2023. The diagnosis of anemia was based on the criteria of the KDIGO 2012 recommendations. Associated factors were investigated by logistic regression in univariate analysis. The significance threshold p was set below 0.05. Results: Out of a total of 133 hemodialysis patients included, almost all presented with anemia, i.e., 90.98%, with male predominance (61.65%) and a sex-ratio of 1.6. The mean age of the participants was 49.99 years. Absolute iron deficiency was found in 39.85% and functional iron deficiency in 33.83%. The most frequently encountered type of anemia was normochromic normocytic aregenerative (71.36%). Factors associated with anemia were advanced age (P = 0.022), dialysis vintage (p = 0.015), blood transfusion (P = 0.016), and urea reduction percentage (P = 0.000). Conclusion: Anemia is very frequent and alters the quality of life of hemodialysis patients. It is multifactorial and requires rigorous investigation for adequate management.
Introduction: Acute Kidney Injury (AKI) is associated with high morbidity and mortality due to the severity of the underlying diseases and related complications. The aim of this study was to investigate acute kidney injury at CNHU-HKM in Cotonou. Methods: This was a cross-sectional study with retrospective data collection, descriptive and analytical in aim, including patients followed for acute kidney injury at the University Clinic of Nephrology and Hemodialysis (CUNH) of CNHU-HKM from January 1, 2020 to December 31, 2021. AKI was defined according to the KDIGO criteria: an absolute increase in serum creatinine ≥ 3 mg/L within ≤ 48 hours, or an increase in serum creatinine ≥ 50% over 1 to 7 days. Factors associated with AKI were investigated by logistic regression. The significance threshold p was set at 5%. Results: A total of 111 patients were included. The frequency of acute kidney injury was 18.32%. Infections (p < 0.001), toxic causes (p < 0.001), hemorrhages (p < 0.001), severe pre- eclampsia (p < 0.001), intravascular hemolysis (p < 0.001), extracellular dehydration (p = 0.001), tumors (p = 0.2), prostatic hypertrophy (p < 0.001), disseminated intravascular coagulation (p = 0.035), heart failure (p = 0.003), and shock states (p = 0.003) were the main etiologies of AKI. A history of hypertension (p < 0.001), diabetes (p = 0.001), and sickle cell disease (p = 0.004) was associated with AKI. In multivariate analysis, the presence of an obstruction (adjusted OR = 29.35; p = 0.033) and hypovolemia (adjusted OR = 13.80; p < 0.0001) were the factors associated with the occurrence of AKI. Altered level of consciousness (adjusted OR = 219.37; p = 0.001) and diabetes (adjusted OR = 72; p = 0.001) were the independent predictors of AKI-related mortality. Conclusion: The frequency of AKI was 18.32% at the CUNH of CNHU-HKM. In multivariate analysis, urinary tract obstruction and hypovolemia were the factors independently associated with AKI occurrence. Altered level of consciousness and diabetes were the independent predictors of AKI-related mortality. Early referral of patients, prevention of hypovolemia in at-risk subjects, and appropriate hydration strategies are essential to reduce the burden of AKI.
Introduction: Knowledge of the determinants of the rate of decline of renal function can be influenced by factors predictive of dialysis and are very important in delaying disease progression. The aim was to determine the prevalence of chronic end-stage renal failure at the Donka national hemodialysis center and the factors predictive of patients going on dialysis. Patients and methods: This was a retrospective descriptive study of 4.5 years duration that included all records of patients with a GFR ≤ 15 ml/ minute regardless of etiology during the study period. Our study variables were quantitative and qualitative, divided into epidemiological, clinical, therapeutic and evolutionary data. Our data were analyzed using jamovi software. Results: We reviewed 784 medical records and identified 579 cases of Chronic Kidney Disease (CKD) across all stages, of which 153 were at stage 5, representing 26.42%. The mean age of the patients was 42.57 ± 16.45 years. Predictive factors included, among others: diabetes, anuria, and a moderate decrease in Glomerular Filtration Rate (GFR) below 5 mL/min/1.73 m2 at the first observation. Conclusion: Knowledge of the factors predictive of dialysis in patients with stage 5 chronic kidney disease may influence the course of the disease, hence the need to implement a follow-up strategy for these patients.
Introduction: The current use of new emerging drugs exposes consumers to risks of acute intoxication, which can sometimes cause kidney damage. The aim of our study was to describe the epidemiological and evolutionary aspects of acute and chronic renal failure observed during acute intoxication related to drug use in Conakry. Methods: This was a descriptive, multicenter, longitudinal study conducted from January 1 to December 31, 2024. All patients admitted for acute intoxication attributable to narcotics, regardless of dose and mode of admission, and who had a creatinine level greater than or equal to 120 µmol/L during follow-up were included. The parameters studied were epidemiological, clinical, paraclinical, and evolutionary. Results: Of 125 cases of acute drug poisoning, 116 cases of renal failure were identified, representing a frequency of 92.8%. The subjects were predominantly young people under the age of 40. Fishermen and patients with a secondary school education were the most represented. In addition to neurological and respiratory signs, oliguria was found in 87.06% of patients. Kush users presented with acute renal failure, and those using Chicha progressed to stage 5 chronic kidney disease. Conclusion: The kidney damage observed in users of the emerging drugs Kush and shisha is a major public health issue in Conakry. Urgent preventive, regulatory, and community awareness measures are needed to limit the scale of this phenomenon.
Background: Peritoneal Dialysis (PD) related peritonitis remains a major cause of morbidity, hospitalization, and technique failure. Local microbiological surveillance is essential to guide empirical antimicrobial therapy, particularly in underrepresented regions. Methods: We conducted a retrospective, descriptive study including all PD-related peritonitis episodes occurring between November 2023 and January 2024 at a tertiary referral hospital in the Dominican Republic. Microbiological findings from peritoneal effluent cultures, descriptive antibiotic susceptibility patterns, recurrence, hospitalization, and clinical outcomes were analyzed. Results: Thirty peritonitis episodes were identified among 307 patients enrolled in the PD program, corresponding to an estimated peritonitis rate of 0.39 episodes per patient-year. Episodes occurred more frequently in male patients, and the most affected age group was 51-65 years. Staphylococcus aureus was the most frequently isolated microorganism, followed by Pseudomonas aeruginosa and Acinetobacter baumannii. Ten episodes were culture-negative, and four were polymicrobial (4/30 episodes). Polymicrobial peritonitis involved clinically relevant microorganism combinations and included the only case with multiple recurrences. Gram-positive organisms showed susceptibility mainly to vancomycin and amikacin, while Gram-negative organisms demonstrated predominant susceptibility to meropenem. Six patients required transition to hemodialysis, and two deaths occurred due to septic shock. Conclusion: Staphylococcus aureus remains the leading cause of PD-related peritonitis in our center, with a significant contribution from Gramnegative organisms. Polymicrobial and culture-negative peritonitis episodes were clinically relevant and associated with a more complicated course. These findings highlight the importance of continuous local microbiological surveillance, optimized diagnostic practices, and targeted infection prevention strategies to improve outcomes and preserve PD technique survival.
