First Emergency Hemodialysis Session at the Nephrology Department of the Teaching Hospital of Yopougon: about 146 Cases

Context: Due to the late referral of the pads to the nephrologist and the lack of medical follow-up, many patients are admitted with complications from kidney disease requiring the urgent start of hemodialysis sessions.Purpose: Study the profile of emergency hemodialysis patients in order to ease their management.Methods: This was a retrospective, descriptive and analytical study carried out at the Nephrology Department of the Teaching Hospital of Yopougon from January 1st to December 31st, 2016.This study included all patients who had received a first session of hemodialysis in an emergency context.Results: We collected 146 patients with an average age of 39.80 ± 14.55 years and a sex ratio of 0.6 for men.Before admission, patients were known as hypertensives (63.9%), followed by CKD (23.9%) and HIV-infected (8.2%).The main clinical signs were hypertension (64.3%), edema (44.5%) and coma (30.1%).Anemia was observed in 97.2% of cases and it was less than 8 g/dl in 57.5%.Kidney failure was chronic in 75.3% and acute in 24.6%.Chronic nephropathies were glomerular (54.1%), vascular (20.5%).The main indications for hemodialysis were encephalopathy (33.5%), severe uremia (28%), acute pulmonary edema (19.8%), persistent anuria (11.6%) and hyperkalemia (5.4%).The vascular approach was a catheter in 97.2% (femoral site in 53.4% and jugular in 43.8% and arteriovenous fistula in 2.7%).Death was observed in 17.8%.In univariate analysis, age > 65 years (p = 0.04), coma (p = 0.004) and acute kidney failure (p = 0.02) were associated with the risk of death, and in multivariate analysis, only coma (p = 0.024, OR = 5.88) seemed to be associated with mortality risk for our patients.Conclusion: Hemodialysis in an emergency situation is a common practice in the Teaching Hospital of Yopougon and mainly concerns patients with CKD.