Insuffisance rénale aïgue à COVID-19: à propos de 02 cas au Mali / Acute renal failure due to covid-19: about the two cases in Mali

Le rein est une des cibles de Covid-19.L'atteinte peut se présenter sous forme d'une insuffisance rénale aigue (5-35% des patients), d'une hématurie (30-40%) et/ou d'une protéinurie (40-65%). Nous rapportons deux cas d'insuffisance rénale aigue due au Covid-19 au Mali. Il s'agit d'une femme de 63 ans et d'un homme de 60 ans, de race noire et tous deux diabétiques. Les circonstances de découverte de l'insuffisance rénale ont été l'oligurie dans les deux cas et l'hématurie macroscopique totale dans le deuxième cas. Conclusion : Les atteintes rénales deviennent de plus de plus fréquentes au cours de l'infection à Covid-19. Nous suggérons de les rechercher systématiquement dès que le diagnostic de cette infection est posé.

Prevalence, pattern and determinants of urine abnormalities among school pupils in a semi-urban community

Background:Dipstickurinalysis is a semi-quantitative examination of the urine, whichcan be utilized as a screening and diagnostic tool in children. It is rapid, sensitive, easy to perform and affordable for the resource-poor environment.Objectives:Todescribe the pattern of urinalysis findings using urinary dipsticks and the determinants of urine abnormality among pupils in primary schools in a semi-urban area.Methods:Apparently healthy 387 pupils were recruited from 10 public and 5 private primary schools in IkenneLocal Government Area of Ogun State, Nigeriausing multi-stage and proportionate sampling techniques. Data on demography, nutritional status and urinary examination were obtained using Interviewer-administered questionnaires, clinical examination and dipstick urinalysis respectively. Results:Dipstick urinalysis revealed the following; urine pH and specific gravity were normal in 98.2% and 100.0% of the pupils respectively. Protein, leukocyteesterase, nitrite, bilirubin, urobilinogen, blood and ketones were detected in 18.1%, 15.8%, 14.2%, 3.3%, 2.1%, 0.8%, and 0.5% respectively. Glucose and ascorbic acid were generally absent in the urinesamples. Female gender significantlycontributed to the pattern of urinalysis(leukocyteesterase and nitrites).Proteinuria was most frequent among the underweight (38/70;54.3%). Urine abnormalities were more prevalent among pupils in public schools compared with private schools though not statistically significant, and not influenced by gender.Conclusion:Asymptomatic proteinuria and urinary tract infection are not uncommon among children. Female gender and socio-economic status play a role in the incidence of the conditions

Variation of urine parameters among diabetic patients: a cross-sectional study

BACKGROUND: Diabetic kidney disease is a common and severe microvascular complication of diabetes mellitus (DM). There are limited data regarding alteration of urine parameters other than proteinuria among DM patients. METHODS: Institution based cross-sectional study was conducted from February to May 2017 to assess alteration of urine parameters among DM patients at the University of Gondar Hospital, Northwest Ethiopia. A Systematic random sampling technique was used to recruit adult (≥18 years) diabetic participants. Data were collected after ethical requirements had been fulfilled. The degree of association between variables was evaluated through bivariable and multivariable logistic regression models. RESULTS: The majority (69.4%) of the study participants were type 2 DM patients. The prevalence of altered urine chemical parameters was 11.3% proteinuria, 4.5% ketonuria, 13.6% hematuria, 53.8% glucosuria, 24.9% leukocyturia and 1.7% positive for nitrite. Diastolic blood pressure and poor glycemic control were significantly associated with proteinuria. Male participants were 2.4 times more likely to have leukocyturia than female participants. The prevalence of abnormally increased microscopic findings was red blood cells 3.1%, white blood cells 12.5%, epithelial cells 27.5%, yeast cells 1.7%, bacteria 17.8%, casts 3.7% and crystals 29.2%. CONCLUSIONS: The prevalence of altered urine parameters among DM patients is found to be considerable. These increased prevalences of altered urine parameters are potential indicators for diabetic kidney disease

Chronic kidney disease screening: Results of the 2013 World Kidney Day activities conducted at the Jos University Teaching Hospital

Background: Chronic kidney disease (CKD) is on the rise globally due to the increase in prevalence of common risk factors. Screening for CKD risk factors is important for early detection and institution of measures to retard its progression. This study aimed to determine the markers of CKD and its risk factors in a selected population.Methods: A cross sectional study of 510 individuals who were recruited during the 2013 world kidney day activities. History, clinical examination as well as the collection of urine and blood samples was performed on each participant to determine the presence of CKD and its risk factors. CKD markers were defined as the presence of proteinuria and or an estimated glomerular filtration rate (eGFR) of < 60ml/min.Results: The mean age of the participants was 39±11 years with majority of them being females (64.7%). Hypertension was present in 256 (50.2%) while diabetes mellitus was seen in 27 (5.29%). Forty three individuals (8.4%) had proteinuria while the prevalence of CKD markers was 10.5%. Only age, (OR =1.03; 95% CI: 1.01-1.06) was found to be a factor independently associated with the development of CKD. Conclusion: Though the prevalence of the traditional risk factors for CKD was high, only age was found to be independently associated with CKD markers.Screening exercise is encouraged for the early detection of CKD markers with a view to mitigating their impact

Screening for chronic kidney disease and its risk factors in Oghara, Nigeria: a World Kidney Day 2014 report

Background: The risk factors associated with CKD such as hypertension, diabetes and obesity remain prevalent globally, resulting in a high prevalence of CKD especially in developing countries. Screening for CKD and its' risk factors is recommended for high-risk population. This study aimed to determine the prevalence and risk factors of CKD in a semiurban community in Nigeria.Methods: A cross-sectional survey was conducted in the teaching hospital premises at Oghara, after a world kidney day (WKD) health awareness campaign was undertaken in the community. A total of 135 subjects were interviewed and the following measurements were performed: blood pressure, body mass index, blood glucose, dipstick urinalysis, serum creatinine and estimation of glomerular filtration rate (GFR) using CKDEPI.Results: Mean age was 40 ± 13 years and 69.6% of participants were young. Male to female ratio was 1:4. The prevalence of proteinuria was 4.4% while 10.7% of all subjects had CKD (GFR <60ml/min). Although 11.1% of participants were known hypertensives only 6.7% had high blood pressure on screening. Other risk factors identified were Diabetes mellitus (10.3%), family of history of hypertension (14.1%), family of history of diabetes (9.6%), family of history CKD (1.5%) and obesity (11.9%). Proteinuria, diabetes and family history of hypertension were significantly associated with CKD.Conclusions: CKD and its risk factors are common in the population.Dipstick proteinuria remains a useful and significant indicator of CKD.Community screening for the risk factors of CKD in developing countries is realistic and should be encouraged as a public health priority

Early pregnancy plasminogen activator inhibitor-1 levels in Nigerian women and its relationship with preeclampsia

Aim: This study compared early plasma levels of plasminogen activator inhibitor-1 (PAI-1) in normal pregnancy and preeclampsia and determined its relationship with disease severity. Subjects and Methods: This was a prospective cohort study of 195 normotensive, aproteinuric pregnant women without prior history of gestational hypertension. The women were attending the Antenatal Clinic at The Lagos University Teaching Hospital and were within 24 weeks gestation at recruitment. The outcome measures were PAI-1, systolic blood pressure (SBP), diastolic blood pressure (DBP), and significant proteinuria. The endpoint of the study was the development of preeclampsia. The diagnosis of preeclampsia was made by the attending Obstetrician. The data were analyzed using the IBM SPSS statistical software. Statistical significance was set at P < 0.05. Results: First trimester PAI-1 levels were significantly higher in the women who later developed preeclampsia compared to those who had a normal pregnancy (P < 0.0001). In these group of women who later developed preeclampsia, PAI-1 had an inverse relationship with gestational age (r = 0.878) whereas in normal pregnancy, PAI-1 and gestational age had a direct relationship (r = 0.017). Second trimester systolic and DBP values were also significantly higher in the women who later developed preeclampsia compared to normal pregnancy, P = 0.007 and 0.004, respectively. There was, however, no correlation between PAI-1 values and SBP, DBP and proteinuria in the women who developed preeclampsia. Conclusion: Plasma levels of PAI-1 are increased early in pregnancies complicated by preeclampsia, but the lack of correlation of this marker with disease severity may limit its clinical utility

Pattern and outcome of renal diseases in hospitalized children in Tikur Anbessa specialized teaching hospital, Addis Ababa, Ethiopia

Background: Renal diseases are major causes of morbidity and mortality in pediatric practice. Pediatric patients with renal disease, especially younger ones may present with nonspecific signs and symptoms unrelated to the urinary tract. Unexplained fever or failure to thrive may be the only manifestation. Most children with renal diseases in our hospital arrive very late either because of inadequate health awareness among the parents or failure of recognizing the symptoms of renal diseases at a lower health care level. This review will highlight the symptoms of renal diseases at presentation and outcomes of treatment in children in a major referral hospital.Methods: A cross-sectional retrospective chart review was done over a period of 3 years (June, 2012 to May, 2015) in 381 admitted children (Birth-17 years) at Tikur Anbessa Specialized Teaching Hospital in Addis Ababa, Ethiopia.Results: Out of 14521 pediatric ward admissions in the study period, kidney diseases accounted for 473 admissions in 381 children, accounting for 3.3% of all admissions. The three most common renal diseases observed were congenital anomalies of the kidney and urinary tract (CAKUT) seen in 127 children (26.8%), followed by nephrotic syndrome in 80 children 16.9% and acute glomerulonephritis in 58 children (12.2%). Other renal diseases observed were urinary tract infection 8.0%, urolithiasis 6.7%, Wilm's tumor 6.3%, acute kidney injury 4.2% and chronic kidney disease 4.0%. Other less frequently detected diseases were bladder exstrophy, lupus nephritis, Henock shonlein Purpura nephritis and prune-belly syndrome.Out of 381 children 207 (54.3%) recovered normal renal function, 20(5.2%) remained with proteinuria, 13(3.4%) progressed to chronic kidney disease and 11(2.9%) died. Sixty one nephrotic children (76.3%) achieved remission but 17 children (21.3%) remained with proteinuria; one steroid resistant child died of end stage renal disease. Ten children (2.6%) with different renal diseases were lost to follow-up and 5 (1.3%) discharged against medical advice.Conclusions: This data reflects that many of the renal diseases are preventable or potentially curable. Therefore, improvement of pediatric renal services and training of health workers would help in early detection and treatment of these conditions leading to reduction in their morbidity and mortality

Awareness of Blood Pressure Status; Undiagnosed Hypertension and Proteinuria among Adults in Umuahia; South-East Nigeria

Background: Hypertension and proteinuria are risk factors for cardiovascular disease. They are also important risk factors for further deterioration of renal function in chronic kidney disease (CKD) irrespective of the cause of CKD. Both are asymptomatic at early stages and can only be detected during medical consultation for a related or unrelated illness. Materials and Methods: This was a cross-sectional study carried out to assess awareness of blood pressure (BP) status among adults in a semi-urban community in Southern Nigeria. The magnitude of undiagnosed hypertension and proteinuria in the community was also assessed. BP measurement was by standardized method while proteinuria was detected by use of urinary dipstick. Data was analyzed using SPSS version 21.0. Results: A total of 389 people were recruited. There were 223 (57.3) males and 116 (42.7) females. Only 104 (26.7) were aware of their BP status before the study. Awareness was higher in females but did not differ significantly among the different age groups; educational status or occupations. Hypertension was newly diagnosed in 105 (27) of the participants while proteinuria was diagnosed in 47 (12.1). Proteinuria and overweight were higher among participants with prehypertension than other BP categories. Conclusions: The study revealed a low level of awareness of BP status and a high prevalence of undiagnosed hypertension and proteinuria in the community. Concerted efforts are needed to improve the awareness of BP and other risk factors for cardiovascular and kidney diseases

A descriptive retrospective study on children with newly diagnosed nephrotic syndrome presented to Tripoli Children Hospital during the period between Jan. to Dec. 2014

Introduction: Nephrotic syndrome is a clinical picture characterized by severe proteinuria, hypoalbuminemia, edema and hypercholesterolemia. A retrospective study was carried out in order to describe disease pattern in newly diagnosed nephrotic syndrome of children admitted to Tripoli children hospital during the year 2014.Methods: The medical data of 56 patients aged between 1 year and 11 years diagnosed with idiopathic nephrotic syndrome were analysed using SPSS software. The data included gender differences, sensitivity to steroid therapy, relapses during six months of follow up and the effect of variable factors such as family history, hypertension, hematuria, serum urea on the degree of relapse.Results: Out of 56 patients with newly diagnosed nephrotic syndrome (NS), 60.7% were boys and 39.3% were girls, with a mean age 4.2±2.2 years. Age was related significantly to the response to steroid therapy, where 79.5% of patients aged between 2-8 years (group 1) had steroid sensitive nephrotic syndrome (SSNS) compared with only 41.7% of patients aged less than 2 years or more than 8 years (group 2) (P<0.001). Although girls relapsed more than boys (70.5% versus 57.1%) during six months of therapy, this difference was not statistically significant. Similarly, no other factors measured such as family history of NS, hypertension, hematuria, serum complement and urea had any effect on the percentage of relapse in patients with newly diagnosed NS. Conclusion: NS is one of the commonest reasons for admission to nephrology ward. It is more common in boys than girls. The age at presentation related significantly to the response to steroidal therapy. Regarding relapses, girls seems to relapse more frequent than boys and relapses was seen more in age group 1 than group 2, however, these differences were not significant. Other factors studied seems to have no effect on the relapse rate of children with newly diagnosed NS

Increased Levels of Pancreatic Enzymes in Sickle Cell Anemia and the Effect of Proteinuria

Background/Objective: Sickle cell disease (SCD) is the most common hemoglobinopathy in Nigeria; and the condition can affect any part of the body including the pancreas. The study seeks to evaluate the levels of pancreatic enzymes in blood and urine of SCD patients in steady clinical state; and the effect of proteinuria on the enzyme levels as proteinuria was previously reported in SCD subjects. Materials and Methods: Urine and plasma amylase; serum lipase; and proteinuria were determined in 150 subjects comprising 100 SCD patients and 50 age/sex matched apparently healthy subjects with normal hemoglobin using commercially available reagent test kits. Results: Urine amylase (P = 0.029); serum amylase (P 0.001); lipase (P

La proteinurie chez l'hypertendu dans le service de cardiologie du CHU Gabriel Toure

Objectif. Ce travail visait a decrire les aspects epidemiologiques; cliniques et biologiques de la proteinurie chez l'hypertendu avec une augmentation de la creatininemie dans le service de cardiologie du CHU Gabriel TOURE de Bamako. Patients et methodes. L'etude etait transversale et descriptive allant du 1er Janvier au 31 Decembre 2007 dans le service de cardiologie du CHU Gabriel TOURE. Resultats. Au total 114 sujets ont etes inclus; dont 60 hommes et 54 femmes; en moyenne ages de 57 ans; le sex ratio etait de 1;11. Dans la population d'hypertendus; l'IRC debutante a moderee avait une frequence de 12;9 (114/880). Les patients ages de moins de 60 ans etaient plus nombreux avec une frequence de 61;5. La proteinurie etait retrouvee chez 37/114 patients en insuffisance renale chronique soit 32;5. La frequence de la proteinurie dans la population generale d'hypertendus etait 4;2 (37/880).L'atteinte renale marquee par la micro albuminurie etait predominante par rapport a la macro albuminurie : 25;5 contre 7. La dyspnee (38;6) et les cephalees (36;8) etaient les principales manifestations de l'HTA. L'echographie renale etait anormale dans 14;1 avec une predominance du stade 0 (76); les stades 1 et 2 representaient chacun 7. Conclusion. La proteinurie est une anomalie biologique frequemment associee a l'HTA. Sa recherche s'impose lorsqu'une atteinte renale est associee a l'HTA. Sa decouverte au cours de l'HTA change considerablement la strategie de prise en charge de cette affection

Assessment of renal function in malaria patients in Minna, North Central Nigeria

Establishment of prevalence of malaria-associated renal impairment in Nigeria is important for proper prognosis and management of malaria and its associated complications. Using biuret method for protein estimation; alkaline picrate-slot method for creatinine and urea estimation; and flame photometry and titrimetric method for electrolytes estimation; selected kidney function parameters which included proteinuria; serum levels of urea; creatinine and electrolytes were determined in 169 malaria patients and in 58 individuals without malaria. Data obtained were analyzed using one-way analysis of variance to compare variation among malaria patients and individuals without malaria; Duncan multiple range test to compare variation among means; and correlation matrix to evaluate correlation between the parameters measured. Proteinuria in malaria cases differed significantly (p 0.05) from individuals without malaria; and a positive correlation existed between proteinuria and parasitaemia. There was no significant difference (p0.05) in the creatinine levels of malaria patients and those without malaria. It is concluded that there is a form of renal impairment associated with malaria infection in Minna irrespective of age and sex

Protéinurie et syndrome néphrotique de l'adulte dans le service de néphrologie de l'unité d'hémodialyse de l'hôpital du Point G :à propos de 65 cas

Le syndrome néphrotique est une affection assez fréquente dans le monde en général et dans les pays sous-développés en particulier, lié au bas niveau socio-économique. En Afrique, en particulier au Mali, plusieurs facteurs interviennent dans la pathogénie de la maladie modifiant son aspect caricatural. Nous avons réalisé une étude rétrospective portant sur un échantillon de 65 patients âgés de 15 à 63 ans. L'objectif était d'étudier la protéinurie au cours du syndrome néphrotique de l'adulte, afin de déterminer les aspects quantitatifs, les signes cliniques et biologiques associés et les aspects thérapeutiques. Il ressort que la protéinurie était supérieure à 3g/24h dans 70,76% des cas, comprise entre 1 et 3 g/24 h dans 21,54% des cas et entre 0,5 et 1g/24h dans 7,69% des cas. Les signes cliniques étaient plus fréquents chez les patients présentant une protéinurie supérieure à 3g/24h. Quant aux signes biologiques, ils étaient diversement observés selon le taux de protéinurie. Le traitement spécifique de la protéinurie a consisté en une corticothérapie, utilisée dans 93,85% des cas, seule ou associée aux IEC et aux immunosuppresseurs. Le traitement non spécifique a fait appel aux IEC dans 6,15% des cas

Etude de la prevalence de la proteinurie et de la glycosurie chez les jeunes recrues de la classe 2000-2A de l'armee Ivoirienne: a propos de 1979 cas

OBJECTIF: Connaitre la prevalence de la proteinurie et de la glycosurie chez les recrues des forces armees nationales de cote d'ivoire (FANCI) de janvier 2003.MATERIELS ET METHODES : Notre travail est une etude descriptive transversale qui a porte sur 1979 recrues. Cette etude a consiste au depistage de la proteinurie et de la glycosurie par des bandelettes reactives de type URICHECK sur les differents lieux d'entrainement.RESULTATS*Au plan sociodemographique:-la moyenne d'age des enroles est 24;62 ans avec des extremes de 18 et 34 ans.-le groupe ethnique majoritaire est le groupe KWA (42;54pour_cent); suivi du groupe KROU (38;75pour_cent).-la plupart des appeles travaillent dans le secteur informel (53;57pour_cent); s'ils ne sont pas chomeurs (29;10pour_cent) ou eleves et etudiants (17;33pour_cent).*Au plan clinique-L'indice de Pignet qui mesure la robustesse des appeles a permis d'exempter 161 enroles.-l'indice de masses corporelles IMC a permis de detecter 5;6pour_cent des sujets ayant un surpoids et 0;61pour_cent d'obeses.-la hernie ombilicale a ete revelee dans 0;8pour_cent des cas.*Au plan biologique :La proteinurie :-la proteinurie globale a ete trouvee dans 3;3pour_cent alors que la proteinurie significative superieure a une croix etait de 0;45pour_cent-cette proteinurie est independante de l'age; du groupe ethnique de la region d'origine; de l'activite professionnelle; de l'indice de masses corporelles et de l'indice de Pignet-ces chiffres sont nettement en dessous de ceux de Konan qui a trouve 4;5pour_cent de proteinuries significatives sur un effectif de 1000 enfants ages de 10 a 18 ans.La glycosurie :-la prevalence de la glycosurie globale est de 1;5pour_cent.-la frequence de la glycosurie potentiellement pathologique (deux croix et plus) etait de 0;25pour_cent.-cette glycosurie est independante de l'age; du groupe ethnique; de la region d'origine; de l'activite professionnelle; de l'indice de masse corporelle et de l'indice de Pignet.CONCLUSION : Le couple glycosurie; proteinurie dont la recherche est indispensable dans les criteres d'enrolement en Cote d'ivoire; gagnerait a etre analysee dans des conditions optimales pour une interpretation plus objective

Etude de la prevalence de la proteinure chez les femmes gestantes a Abidjan

La recherche systematique d'une proteinurie au cours du bilan prenatal; permet de detecter precocement les anomalies de la fonction renale. Dans le but de souligner l'importance de cet examen nous avons realise une etude prospective transversale sur une periode de 6 mois; (1er Fevrier au 31 juillet 2000) dans 6 maternites peripheriques d'Abidjan. L'objectif de ce travail etait de determiner la prevalence de la proteinurie chez les femmes gestantes afin d'evaluer le risque de developpement d'une nephropathie dans cette population. Dans notre etude nous avons trouver une prevalence de 6;15 pour cent; soit 544 cas de proteinurie sur 8836 gestantes recues en consultation prenatales. Nous avons etudie les caracteres epidemiologiques cliniques; biologiques et les antecedents pathologiques des gestantes proteinuriques. Nos resultats etaient les suivants : les gestantes proteinuriques etaient pour la plupart des paucipares (75;73 pour cent) avec un niveau socio economique bas (54;77 pour cent sans emploi) ; 55;88 pour cent des gestantes avaient un age inferieur ou egal a 25 ans ; la majorite des proteinuries a ete detectee au 2e trimestre (50 pour cent) et au 3e trimestre (36;06 pour cent) de la grossesse ; 8 1;80 pour cent des gestantes etaient supposees sans antecedent ; 57;37 pour cent des gestantes ne presentaient aucun signe clinique (HTA-OMI). La fonction renale a ete appreciee par le dosage de la creatinine. Sur 119 dosages demandes; seulement 24 dosages ont ete effectues. Les taux etaient eleves chez 3 gestante. (?14 mg par l). Devant ces resultats; il apparait essentiel de : souligner le caractere pronostic de la proteinurie d'autant plus qu'elle est retrouve a une frequence elevee dans les syndromes vasculo-renaux de la grossesse ; souligner son importance chez toute femme gestante meme apparemment saines ; l'explorer correctement afin de reduire le risque renal a court et a long terme dans cette population de femmes gestantes

Determination de faibles quantites de proteines par une methode soustractive au rouge ponceau S : apllication au dosage des proteines urinaires

Les auteurs decrivent une methode simple; sensible et reproductible de determination des proteines totales dans les milieux biologiques a faibles concentrations proteiques. Il s'agit d'une methode de soustraction comme colorant le Rouge Ponceau S

A propos de l'atteinte renale chez l'enfant drepanocytaire

Dans la prise en charge des enfants souffrant d'anemie SS; nous avons observe divers types d'atteinte renale. Cette atteinte s'est traduite par l'hematurie; la proteinurie avec ou sans syndrome nephrotique; l'hyperuricemie et l'insuffisance renale

Corrélations cliniques entre rétinopathie et proteinurie chez le diabétique

Au Congo; les etudes concernant le diabete et ses complications ne sont pas nombreuses. Cette etude realisee en collaboration avec les nephrologues; ophtalmologistes et diabetologues se propose de rapporter les correlations cliniques entre retinopathie et proteinurie chez le diabetique. Pour atteindre cet objectif general; l'auteur s'est fixe des objectifs specifiques a savoir evaluer le risque d'atteinte retinienne au cours du diabete; evaluer la frequence de la proteinurie afin de faire une approche de la nephropathie chez le diabetique et montrer l'existence ou non d'un parallelisme entre les atteintes renales et retiniennes au cours du diabete