High failure rate of first arterio-venous fistula in patients starting hemodialysis treatment: a report from the Ivory Coast.

This study was conducted in order to identify the failure rate of the first arterio-venous fistula (AVF) in patients starting hemodialysis (HD) with a central venous catheter (CVC) and to search for factors responsible for this failure. A retrospective study was conducted on 85 patients on chronic HD in Abidjan, from March 15 th to April 15 th , 2007. Factors that could potentially influence the failure of the first AVF were collected. Statistical analysis was used for comparison between groups. Among the study subjects, 7.14% had AVF at the start of their dialysis as against 92.86% who had CVC. About 50% of the patients starting dialysis with CVC failed to have an AVF created within 90 days of commencing dialysis. The number of catheters inserted was significantly higher in patients with failed first AVF as compared to their counterparts (49.29 % versus 30.77%) (p< 0.001). Similarly, the number of attempts at AVF creation, within 90 days of starting HD, was significantly higher in patients with failed first AVF (81.48% versus 18.52%) (p< 0.001). Multivariate analysis did not reveal any specific factor(s) that influenced the failure rate of the first AVF. Our study suggests that a very small number of patients in Ivory Coast started dialysis with an AVF. The failure rate of the first AVF in patients starting dialysis on CVC is about 50%.

[Characteristics of potential living kidney donors in Ivory Coast: a survey prior to a project of kidney transplantation in French Black Africa]. / Typologie des potentiels donneurs vivants de rein en Côte-d'Ivoire: une enquête prélude à un projet de greffe de rein en Afrique noire francophone.

The source of living kidney donors in the general population remains underused. The present study aims at assessing the prevalence and the characteristics of potential living kidney donors in Ivory Coast in a view of a project of kidney transplantation in French Black Africa. A survey was undertaken in Abidjan from 30 June to 7 July 2006. Nine hundred (and) sixty-two subjects living in the capital and aged between 19 and 64 years old were randomly chosen using data from the 1998 population census. Subjects were asked their age, gender, nationality, marital status, information on kidney graft and renal failure, and their willingness to donate kidney to a relative or friend for transplantation purpose. Seventy per cent of the population study appeared favourable to kidney donation. Potentials living kidney donors have displayed following characteristics: age inferior to 26 years old [OR=2.08, P<0.02, 95%CI: 1.10-3.92]; Ivorians national [OR=2.72, P<0.002, 95% CI 1.42-5.21]; having heard of kidney transplantation (OR=1.89, P<0.047, 95% CI 1-3.54]); the death of a relative or friend from renal failure [OR=1.82, P<0.002, 95% CI 1.25 2.67]. Being married adversely affect kidney donation [OR=0.52, P<0.0002, 95% CI 0.34-0.79]. Potentials living kidney donors are in great number in Ivory Coast, who had specific characteristics.