Kidney dysfunction (KD) and hypoxia on admission are separately associated with COVID-19 mortality. Estimation of GFR using creatinine and peripheral oxygen saturation (SpO2) may be useful for stratification of at-risk populations. We performed a two centers retrospective cohort study of 359 COVID-19 patients aged 18 years or older to explore the impact of admission kidney function and hypoxia in predicting COVID-19 mortality. KD at admission was defined as estimated glomerular filtration rate (eGFR) calculated by CKD EPI < 60 mL /min/1.73 m2 using creatinine and hypoxia as a SpO2 ˂ 90%. Survival (time-to death) curves were built using the Kaplan-Meier methods. Association between mortality, hypoxia and KD was evaluated by multivariate Cox regression models with a significance level of the p-value set at 0.05. There were 152 patients (42.3%) with an eGFR < 60 mL/min/1.73 m2 and 208 patients (74.8%) with hypoxia on admission. Overall in-hospital mortality was 27.6%, rising to 59.7% in patients with eGFR below 60 mL/min and hypoxia (p < 0.001). Survival was lower in the group of patients with a eGFR below 60 mL/min/1.73 m2 and hypoxia (p < 0.001). Predictors of mortality were eGFR ≥ 60 mL/min/1.73 m2 with hypoxia (HR 2.05 [1.01-4.16], p = 0.048), eGFR < 60 mL/min/1.73 m2 without hypoxia (HR 3.20 [1.73-5.94], p < 0.001) and eGFR < 60 mL/min/1.73 m2 with hypoxia (HR 6.55 [3.63-11.84], p < 0.001). KD on admission and hypoxia are common in COVID-19. Its association with in-hospital mortality should encourage its use in the stratification of patients at risk of death. Influence of hypoxia could suggest a pattern of kidney-lung cross talk.

BACKGROUND:Sickle cell nephropathy remains a major contributor to morbidity in adults with Sickle Cell Disease (SCD), yet proximal tubular injury remains insufficiently characterized, particularly in African settings. Alpha-1 Microglobulin (A1M), a low-molecular-weight protein, may serve as a sensitive biomarker of proximal tubular dysfunction. METHODS:The authors conducted a multicentre observational cross-sectional study among 246 adults with stable SCD in Kinshasa, Democratic Republic of the Congo. Proximal tubulopathy was defined as A1M/Cr ≥ 20 mg/g. Measured Glomerular Filtration Rate (mGFR) was assessed by plasma iohexol clearance. Associations were evaluated using a pre-specified multivariable logistic regression model with multiple imputation for missing data. RESULTS:Proximal tubulopathy was present in 48% of participants. After adjustment, vaso-occlusive crises during the previous trimester (aOR = 1.96, 95% CI 1.14-3.35), leg ulcers (aOR = 2.11, 95% CI 1.16-3.82), and albuminuria (log-transformed UACR; aOR = 1.53, 95% CI 1.24-1.88) were independently associated with elevated A1M/Cr. Hydroxyurea use was associated with lower odds of proximal tubulopathy (aOR = 0.54, 95% CI 0.31-0.95). In a model adjusted for albuminuria, no independent associations were observed for markers of hemolysis or measured GFR, suggesting that the effects of these factors on tubular injury may be mediated through glomerular injury or are closely intertwined with it. Sensitivity analyses excluding albuminuria from the model (Tables S2-S5) did show associations with leg ulcer, recent VOC, and systolic blood pressure. CONCLUSIONS:Proximal tubular dysfunction is frequent among adults with SCD in this high-burden African setting and was independently associated with markers of disease severity and renal involvement.

Introduction:Sickle cell disease (SCD) carries a high risk of chronic kidney disease, necessitating accurate glomerular filtration rate (GFR) monitoring. This study evaluated the performance of creatinine-based (eGFRcrea), cystatin C-based (eGFRcys), and combined (eGFRcrea+cys) equations against directly measured GFR (mGFR). Methods:Clinically stable Congolese adults with SCD were recruited in 13 medical centers from Kinshasa. GFR was measured using iohexol plasma clearance. We compared the bias, precision, and accuracy of Chronic Kidney Disease Epidemiology (CKD-EPI) and European Kidney Function Consortium (EKFC) equations. Results:Among 207 patients included (24 [20;31] years and 58% of women), mean mGFR was 129 ± 38 ml/min/1.73 m2 with 41% of patients hyperfiltrating (mGFR >135 ml/min/1.73 m2). Among eGFRcrea equations, CKD-EPI was superior in hyperfiltrating patients, while EKFC performed better in normofiltrating patients. However, all eGFRcrea equations were suboptimal with only around 80% of estimated GFR (eGFR) results within 30% of mGFR. eGFRcys equations showed severe underestimation and poor accuracy. eGFRcrea+cys equations offered no clear added value. Conclusion:All eGFR equations were suboptimal in this young SCD population, with cystatin C performing particularly poorly. Given the limitations of current biomarkers, measuring GFR by a reference method remains the recommended standard. However, given the cost and logistical challenges of mGFR in low-income settings, relying on creatinine-based EKFC equation for normofiltrating patients and on creatinine based Chronic Kidney Disease Epidemiology Equation (CKD-EPIcrea) for hyperfiltrants appears to be a more feasible and pragmatic approach.

Renal complications of sickle cell disease (SCD) often begin with tubular dysfunction (TD), yet this entity remains insufficiently recognized in African populations. Data from adults in Kinshasa are particularly scarce. We conducted a cross-sectional study between March 2023 and April 2024, enrolling 279 clinically stable adult SCD patients from 14 centers in Kinshasa. Tubulopathy was defined by the concomitant presence of three abnormalities: urinary α1-microglobulin-to-creatinine ratio (A1M/Cr) ≥20 mg/g, dipstick glucosuria ≥1+ with plasma glucose <126 mg/dL, and urine pH ≥5.5. Glomerular involvement was assessed by urinary albumin to creatinine ratio (UACR ≥30 mg/g). Measured GFR (mGFR) was obtained by iohexol clearance. Multivariable logistic regression was used to identify independent factors associated with tubulopathy. Tubulopathy was identified in 58 patients (20.8%). Compared with those without tubulopathy, affected patients had significantly higher median A1M/Cr (44.7 vs. 14.2 mg/g; p < 0.001) and UACR (22.1 vs. 10.7 mg/g; p = 0.007). They also displayed lower mean eGFR by CKD-EPIcrea+cys2021 (107.4 vs. 115.9 mL/min/1.73 m²; p = 0.031) and higher LDH levels (217.0 vs. 209.1 IU/L; p = 0.016). In multivariable analysis, independent predictors of tubulopathy included higher LDH (per 100 IU/L increase) (aOR 2.53, 95% CI 1.14-5.61), UACR ≥30 mg/g (aOR 1.94, 95% CI 1.18-5.18), while hydroxyurea use was independently associated with lower odds of tubulopathy (aOR 0.37, 95% CI 0.16-0.87). One in five stable adult SCD patients in Kinshasa presented with tubulopathy. This phenotype was associated with hemolysis, albuminuria, and lower eGFR, whereas hydroxyurea use was inversely associated with tubulopathy.

Albuminuria is an early marker of renal involvement in sickle cell disease (SCD) and is associated with progressive renal function decline. However, data on albuminuria in adults with SCD in sub-Saharan Africa remain limited. This study aimed to determine the prevalence of albuminuria and identify factors associated with albuminuria in adults with steady-state SCD in Kinshasa, Democratic Republic of the Congo. We conducted a multicenter cross-sectional study involving 279 adults (aged ≥ 18 years) with steady-state SCD. Albuminuria was assessed using the urinary albumin-to-creatinine ratio (UACR) and classified according to KDIGO categories. Glomerular filtration rate (GFR) was directly measured by plasma iohexol clearance. Cardiac function was evaluated by Doppler echocardiography, and arterial stiffness was assessed using pulse wave velocity (PWV). Multivariable linear and logistic regression analyses were performed to identify factors associated with albuminuria. The overall prevalence of albuminuria was 29.1

Background and Objectives: On-line hemodiafiltration (OL-HDF) has been proposed as an alternative to conventional hemodialysis (HD) for patients with end-stage chronic kidney disease (CKD). Randomized controlled trials suggest that OL-HDF may reduce mortality, particularly when the convection volume (CV) exceeds 23 L/1.73 m2 per session. However, achieving this target depends on local practices and may be limited to selected populations. The CONVINCE trial reported a 97% success rate using a structured optimization protocol, but its applicability to unselected real-world populations remains uncertain. This study aimed to evaluate the incidence of high CV in OL-HDF among unselected patients managed under routine conditions with a standardized optimization protocol. Methods and Materials: This prospective cohort study (May–October 2024) included 67 unselected incident and prevalent patients undergoing HD or HDF in a hospital-based dialysis center. All patients were switched to post-dilution OL-HDF following the CONVINCE optimization protocol, which involved stepwise increases in blood flow, adjustment of filtration fraction, and optimization of session duration. Results: The mean age was 68.8 ± 14.9 years; 56.7% were male. Blood flow increased from 283 to 338 mL/min (p < 0.001), and the use of dialyzers > 2 m2 increased from 36% to 68% (p < 0.003). Kt/V improved from 1.22 to 1.6 (p < 0.01). CV increased by ~2 L from M1 onward and was sustained through M6, correlating positively with blood flow, session duration, and Kt/V (all p < 0.01). Conclusions: Stepwise optimization protocol enabled sustained achievement of high CV (23.5 L/session) in 62.3% of patients, improving dialysis adequacy.

Chronic kidney disease is a major complication of sickle cell disease (SCD), but early kidney injury frequently occurs despite preserved or increased glomerular filtration rate (GFR), potentially limiting the usefulness of conventional kidney failure prediction tools. We evaluated whether the Kidney Failure Risk Equation (KFRE) adequately reflects renal vulnerability in adults with SCD. In this multicenter cross-sectional study conducted in Kinshasa, Democratic Republic of the Congo, 241 adults with stable SCD underwent iohexol-measured GFR (mGFR) and albuminuria assessment. Renal risk was classified according to KDIGO criteria. The KFRE was calculated overall and in participants with CKD stage ≥3. Multivariable logistic regression identified factors independently associated with moderate-to-high renal risk. Overall, 35.7% of participants had moderate-to-high KDIGO renal risk. Despite this burden of renal risk, KFRE estimates remained very low overall and increased only in participants with CKD stage ≥3 (median risk: 5.98% at 2 years and 10.14% at 5 years). Increased renal risk was independently associated with vaso-occlusive crises (aOR 2.80, p = 0.012), leg ulcers (aOR 1.90, p = 0.030), stroke (aOR 2.66, p = 0.035), elevated LDH >220 U/L (aOR 3.19, p = 0.006), CRP ≥6 mg/L (aOR 3.04, p = 0.024), AST >40 IU/L (aOR 2.60, p = 0.002), and tricuspid regurgitant velocity ≥2.5 m/s (aOR 1.81, p = 0.041). More than one-third of adults with SCD had moderate-to-high renal risk despite preserved GFR. The discordance between KDIGO renal risk and KFRE estimates suggests that KFRE may underestimate early renal vulnerability in SCD. Measured GFR combined with albuminuria may improve early renal risk stratification and warrants prospective validation.

Pulmonary hypertension is a severe complication of sickle cell disease (SCD) and is associated with increased morbidity and mortality. Elevated tricuspid regurgitation velocity (TRV) assessed by echocardiography is commonly used as a screening marker to estimate the risk of pulmonary hypertension in adults with SCD. The objective of this study was to determine the prevalence of elevated TRV and to identify factors associated with elevated TRV in adults with sickle cell disease compared with HbAA clinical controls in Kinshasa. We conducted a comparative cross-sectional study between January 2024 and January 2025 including 71 adults with SCD in steady state (SCD excluding HbSC) and 71 HbAA clinical controls, individually matched by age (± 5 years) and sex. Participants were recruited independently of TRV status. Sociodemographic, clinical, biological, and echocardiographic data were collected. Transthoracic Doppler echocardiography was performed and TRV was measured from multiple ac in the absence of right heart catheterization to assess PH, with the highest value retained. Elevated TRV was defined as TRV ≥ 2.9 m/s. Logistic regression analyses were used to identify factors independently associated with elevated TRV. The mean age was 31.8 ± 5.8 years in the SCD group and 32.8 ± 5.6 years in controls. The overall prevalence of elevated TRV was 10.6

Background Albuminuria is an early marker of glomerular injury in sickle cell disease (SCD) and predicts progressive renal impairment. Data on albuminuria among adults with SCD in sub-Saharan Africa remain limited. This study aimed to determine the prevalence of albuminuria and identify associated factors in adults with steady-state SCD in Kinshasa, Democratic Republic of Congo. Methods We conducted a multicenter cross-sectional study including 279 adults (≥ 18 years) with steady-state SCD. Albuminuria was assessed using the urinary albumin-to-creatinine ratio (UACR) and categorized according to KDIGO criteria. Glomerular filtration rate (GFR) was measured by plasma iohexol clearance. Cardiac function was evaluated by Doppler echocardiography, and arterial stiffness was assessed using pulse wave velocity (PWV). Multivariate linear and logistic regression analyses were performed to identify independent determinants of albuminuria. Results The overall prevalence of albuminuria was 29.1%, including 21.5% grade A2 and 7.5% grade A3. Albuminuria was associated with elevated systolic blood pressure (SBP), lactate dehydrogenase (LDH), PWV, increased cardiac output, and reduced systemic vascular resistance (SVR). In multivariate analysis, urinary α-1 microglobulin ≥ 12 mg/L (aOR 3.01, 95% CI 1.80–4.02), recent vaso-occlusive crisis (aOR 2.71, 95% CI 1.22–4.21), LDH > 246 IU/L (aOR 3.57, 95% CI 2.40–6.13), and SVR < 700 dyn·s/cm⁵ (aOR 1.91, 95% CI 1.51–7.15) remained independently associated with albuminuria. Conclusions Nearly one-third of adults with steady-state SCD had albuminuria. Hemolysis, tubular injury, recent vaso-occlusive events, and vascular dysfunction were key determinants, highlighting the interplay between glomerular hyperfiltration and systemic vasculopathy. Longitudinal studies are warranted to assess persistence and progression of renal involvement.

Despite current interest in creatinine-based equations for estimating glomerular filtration rate, the evaluation of creatinine reference intervals remains relevant. The present study aimed to establish such reference intervals from a healthy Congolese adult population and to investigate the determinants of serum creatinine. This study was based on post-hoc data of previous epidemiology studies conducted in the general population of Kinshasa. Serum Creatinine measurement was performed with the Roche Cobas (Roche Diagnostics, Mannheim, Germany) enzymatic method calibrated to Isotope Dilution Mass Spectrometry (IDMS) traceable. The creatinine values being not normally distributed, the median values and interquartile range and the 2.5th and 97.5th percentiles were considered. Serum creatinine determinants were investigated by a generalized linear model (GLM). A value of p < 0.05 was the threshold of statistical significance. Of 2,504 Congolese adults screened, 506 (males, 67.7

Albuminuria, which depends on multiple factors, is common in patients with sickle cell disease and can progress to chronic kidney disease. In this study, we investigated the frequency and determinants of albuminuria according to sickle cell disease genotype. This multicentre cross-sectional analytical study of adults with stable sickle cell disease was conducted in Kinshasa. Genotypes were categorised as follows: homozygous, HbSS; heterozygous, HbAS; albuminuria, urinary albumin/creatinine ratio (mg/g): grade A1, < 30; grade A2:30–300; or grade A3, > 300. In total, 247 patients with sickle cell disease were included: 205 homozygous and 42 heterozygous. Albuminuria was prevalent in 50.5

Context and objective. Lupus nephropathy (LN) is a common complication of systemic lupus erythematosus (SLE), which is life-threatening for patients. The objective of the present study was to describe survival and investigate predictors of mortality in patients with LN. Methods. This was an analytical study of historical cohort conducted in seven hospitals in Kinshasa from January 2013 to December 2023. The primary outcome was mortality at 24 months. Survival curves were produced using the Kaplan Meier method and their comparisons using the Log Rank test. Cox regression was used to determine mortality predictors. Results. Fifty-five patients with LN, all biopsied, were included. Their average age was 35.1 ± 11.2 years, with a preponderance of women (96.4%) and of average socio-economic level (67.3%). Edematous syndrome, polyarthralgia, hypertension and nephrotic syndrome were present in 87.3%, 58.1%, 52.7% and 36.4% respectively. The histological class IV lesion was the most common (40.0%). The therapeutic combination of corticosteroid-plaquénil was the most used (41.8%). Total remission was observed in 56.4% of cases. Mortality was 25.5%, with a median survival of 22 months. Predictors of mortality were pericarditis (HRa=7, p=0.019) and low socio-economic level (HRa=4, p=0.022). Conclusion. LN is associated with high mortality in the study settings, favored by the low socio-economic level and the percarditis.Received: November 26th, 2024Accepted: April 1st, 2025

OBJECTIVES:The aim of this study was to determine kidney outcomes and associated factors in COVID-19 patients discharged from intensive care unit (ICU) in an African setting. METHODS:In a prospective observational single-center cohort study, we compared the rate of decline in eGFRcr and the incidence of CKD between COVID-19 patients with and without AKI after discharge from ICU. Kidney function decline (KFD) and chronic kidney disease (CKD) during 2 years of follow-up were defined as eGFR decline ≥ 30% and eGFR less than 60 mL/min/1.73 m2 and/or the presence of proteinuria, respectively. The association between COVID-19-associated AKI (COVID-AKI) and eGFR decline after hospital discharge was assessed using mixed-effects models. Logistic regression and Cox regression were used to define factors associated with KFD and CKD. RESULTS:The incidence of KFD and CKD at two years of follow-up was 23% and 0.73 per 100 patient months (P-M), respectively. Patients with COVID-AKI had a greater decline in eGFR (-11.09 mL/min/1.73 m2/year [95% CI, -3.65 to-1.02]; p ˂0.001) and CKD incidence (3.11 per 100 P-M vs 0.18 per 100 P-M, p = 0.003) in the fully adjusted model controlling for comorbidities and peak creatinine level. AKI was associated with KFD (aOR: 3.46 [2.40-5.24], p = 0.001) and CKD (aHR: 3.37 [2.35-5.41], p = 0.003). CONCLUSION:KFD and CKD are common in COVID-19 survivors. AKI was associated with both KFD and CKD after ICU discharge. Kidney care after COVID-19 needs to be organized in the context of AKI.

Context and Objective. Anemia is a very common complication of chronic kidney failure. Its causes are multiple, notably erythropoietin (EPO) deficiency. The objectives of this study were to determine the prevalence of EPO resistance, identify associated factors, and assess their impact on mortality.Methods. This was a single-center retrospective cohort study including patients undergoing hemodialysis for at least three months and weekly treated with EPO. EPO resistance index (ERI) was defined according to KDIGO criteria as a requirement of ≥300 IU/kg/week of EPO. The Kaplan-Meier method was used to describe survival curves of patients. Multivariate logistic and Cox regression models were used to identify factors associated with ERI and predictors of mortality, respectively. Results. A total of 185 hemodialysis patient records (mean age: 70.7 ± 14 years, male sex: 62.4%) were analyzed. The mean hemoglobin level was 10.7 ± 0.8 g/dL, with normocytic values of 92.8 ± 6.4 fL. The cumulative incidence of ERI was 30.3%. Independent factors associated with ERI included hypoalbuminemia, while male gender was found to be protective. ERI 3, age ≥60 years, and hypoalbuminemia emerged as independent predictors of mortality, increasing the risk by factors of 2.1, 3.1, and 2.2, respectively (p < 0.05). Conclusion. EPO resistance is highly prevalent, particularly in cases of hypoalbuminemia, which negatively impacts the survival of chronic hemodialysis patients. Patients with ERI 3, female gender, and malnutrition require special attention. Received: February 6th, 2025Accepted: April 25th, 2025 https://dx.doi.org/10.4314/aamed.v18i3.2

Introduction Glomerular hyperfiltration is highly frequent, theoretically dependent on cardiac output, low systemic vascular resistance and hemolysis markers. In sickle cell disease (SCD), hyperfiltration is an extremely common phenomenon and occurred in young and early adult patients. Despite the fact that the glomerular hyperfiltration is known as the early manifestations of sickle cell nephropathy, its burden among adult sickle cell disease in sub-Saharan is poor studied. This study aimed to determine the prevalence and associated factors of hyperfiltrationMethods This was an analytical multicentric cross-sectional study involving stable adult sickle cell patients in Kinshasa, recruited between March and October 2023. Parameters of interest encompasses demographic, clinical, biological, echocardiographic and pulse wave measurement data. Hyperfiltration was defined using the CDK-EPI equation based on cystatin C; eGFR >130 for women and >140 ml/min/1.73m2 for men. We used multivariate logistic regression analysis to search determinants of glomerular hyperfiltration.Results Two hundred and fourty six (246) patients with SCD were enrolled. The prevalence of hyperfiltration was 20.7%. In multiple logistic regression analysis, hyperfiltration status was independently associated with age (< 25 years) [3.57 (1.78-7.49); p = 0.027)], female sex [4.36 (2.55-5.62); p = 0.031), CRP (< 6 mg/l) [0.77 (0.61-0.97); p = 0.028)], central systolic pressure (< 100 mmHg) and central diastolic pressure (< 60 mmHg) [0.86(0.74-0.98), p = 0.028)], [(0.83 (0.71-0.98); p = 0.032)].Conclusion One out of five SS adults exhibits hyperfiltration, which is associated with young age and female sex, whereas low CRP and blood pressure were negative risk factors.

Introduction: Several scores are used to assess prognosis in intensive care units (ICU). The Tropical Intensive Care Score (tropICS) has been proposed as an alternative in low income countries. Our objective was to assess the performance of tropICS in a few ICUs in Kinshasa. Methods: This was a multicenter cohort over the period 01/03 to 04/02/2021. The performance of "tropICS" was evaluated by analysis of the area under the ROC curve and calibration with the Lemeshow-Hosmer test. Results: A total of 249 patients with a mean age of 54 years with a sex ratio of 1.9 men to 1 woman were selected in four ICUs in Kinshasa. Medical (89%), surgical (8%) and traumatic (3%) conditions were the causes of admissions, with an average length of stay of 4 (2 to 7) days. The death rate was 38.2%. After analysis of the ROC curve, a tropICS value ≥ 3.8 predicted mortality with a sensitivity of 92.6%, a specificity of 77.9%, good discrimination with an area under the ROC curve of 0.85 (CI 0.80 - 0.90) and a poor calibration of with p < 0.05. Conclusion: tropICS is a simple and powerful tool for identifying high-risk patients and can be used in ICUs in Kinshasa.

1. Renal Unit, Kinshasa University Hospital (KUH), University of Kinshasa, PO BOX 121 Kin XI, The Democratic Republic of the Congo aCorrespondence: Ernest Kiswaya Sumaili, MD, Ph D, Email: [email protected], [email protected] This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Dans la maladie rénale chronique (MRC), la carence martiale (CM) représente l’une des causes de l’anémie et contribue à la résistance à l’action de l’érythropoïétine (EPO). L’objectif était d’en déterminer la fréquence et les facteurs associés chez les patients avec MRC non dialysés en consultations ambulatoires de néphrologie. Étude transversale incluant les patients MRC aux stades 3–5 non dialysés, suivis dans 6 hôpitaux de Kinshasa. L’anémie était définie par un taux Hb < 13 g% (homme) et < 12 g% (femme) et ou sous EPO et ou traitement à base du fer. La CM fonctionnelle était définie par une ferritinémie ≥ 100 μg/L et un CST < 20 % et la CM absolue par une ferritinémie < 100 μg/L et un CST < 20 %. Les déterminants de la CM globale ont été recherchés par la régression logistique multivariée. Au total, 93 patients ont été enrôlés (68 % hommes ; âge moyen 59 ± 15 ans ; 47,3 % MRC stade 3 vs 24,7 % stade 4 et 28 % stade 5 ; 6 % recevaient EPO et 15 % un traitement martial). Soixante-quinze patients (80,6 %) avaient l’anémie. La CM globale était observée chez 44,2 % des patients ; 55,8 % en carence absolue et 44,2 % en carence fonctionnelle. En l’absence d’anémie, les fréquences respectives de la CM absolue et fonctionnelle étaient de 12,5 % et 5,3 % vs 87,5 % et 94,7 % en cas d’anémie (p = 0,034). Les principaux facteurs indépendants associés à la CM globale étaient le stade 5 MRC (ORa 5,34 IC 95 % [1,78–16,0]) et la dénutrition (ORa 2,58 [1,14–4,59]). La fréquence de la CM dans la MRC est élevée. Une prise en charge de la dénutrition et de la MRC au stade 5 améliorerait la qualité de vie de ces patients.

Despite rhabdomyolysis is known as a potential etiology of Acute kidney injury in SARS-COV-2 patients, the burden of rhabdomyolysis in COVID-19 hospitalized patients is scarce. The objective of the present study was to assess the prevalence and risk factors of rhabdomyolysis in SARS-COVID-2 patients.

L’hypovitaminose D contribue à la surmortalité en hémodialyse (HD). L’objectif de l’étude était d’en déterminer la fréquence et les déterminants chez les patients suivis à Kinshasa. Étude menée entre 2018 et 2019 dans 6 centres d’HD. Hormis la 25-OH (D), les autres paramètres étaient : calcémie ionisée, phosphatémie, PTHi, hémogramme, CRP, lipidogramme et modalités du traitement en HD. L’hypovitaminose D était définie par une insuffisance si taux de 25-OH (D) entre 20, 29 pg/ml et une carence si < 20 pg/ml. Les déterminants de l’hypovitaminose D étaient recherchés par la régression logistique ; la variation de la 25-OH (D) vs PTHi était évaluée par le coefficient de Pearson. Un total de 251 patients inclus (72,5 % hommes ; âge 56 ± 14 ans ; durée médiane de suivi en HD = 5 mois ; 60 % sous association calcium + vitamine D native ; 29 % sous bain Ca 1,5 et 71 % sous bain Ca 1,75). La fréquence de l’hypovitaminose D était de 79,7 % (insuffisance = 32,3 % et carence = 47,4 %) avec comme déterminants en analyse multivariée : hyperphosphatémie (ORa 2,0 ; IC 95 % [1,0–5,0]), anémie (ORa 3,9 [1,2–12,7]), utilisation des dialyseurs à basse perméabilité (ORa :2,2 [1,1–4,2]) et sexe masculin (OR 2,7[1,4–5,2]). Les déterminants en analyse univariée étaient : obésité (OR 2,5 [1,0–6,2]), bain Ca 1,5 vs 1,75(OR 2,2 [1,2–4,2]) et technique HD vs HDF (OR 2,2 [1,2–4,2]). Le coefficient r entre la 25-OH (D) et la PTHi était de –0,166 avec p = 0,008. L’hypovitaminose D est très fréquente parmi les patients suivis en HD chronique à Kinshasa. Une optimisation du traitement et une action ciblée sur les facteurs de risque permettrait de la corriger pour prévenir les complications osseuses et cardiovasculaires dans cette sous-population.