[Renal dimensions in the Nephrology Department of Befelatanana Hospital, Antananarivo]. / Dimensions rénales en Service de Néphrologie Clinique, Befelatanana, Antananarivo.

The knowledge of normale renal sizes specific for each individual and for any ethnicity, allows diagnostic and therapeutic medical decision. For a low-income country such as Madagascar, ultrasound is an ideal tool for this purpose. This study aims to collect data on renal dimensions and to seek the correlation between these data and the demographic and anthropometric parameters in Malagasies. This is a retrospective study of 200 non-diabetic patients without chronic kidney disease, spanning 3 years, conducted in the Nephrology Department of Befelatanana Hospital, Antananarivo. The average age of our patients was 45 ±16 years, with a sex-ratio of 0,9. On average, the dimensions (length x width x thickness) were 98 mm × 42 mm × 30 mm for right kidney, 99 mm × 45 mm × 31 mm for the left kidney. We found a significant difference between the right and left kidney in length (p<0.00001) and width (p = 0.03). A significant relationship was also found between renal length and age (p = 0.0016 and p = 0.04 respectively for the right kidney and the left kidney). No significant relationship was found between renal dimensions and size and patients weight. Despite its limitations, our study would provide important supports for clinical practice as well as for further studies.

[A retrospective study on the incidence of chronic renal failure in the Department of Internal Medicine and Nephrology at University Hospital of Antananarivo (the capital city of Madagascar)]. / Une étude rétrospective sur l'incidence de l'insuffisance rénale chronique dans le service de Médecine Interne et Néphrologie du Centre Hospitalier Universitaire d'Antananarivo.

Chronic renal failure is a global public health problem. In developed countries, this disease occurs mainly in the elderly, but in Africa it rather affects active young subjects. This disease need for expensive treatments in a low income country, because of its costs. Our aim is to describe the epidemiology of new cases of chronic renal failure in Madagascar. This is a retrospective, descriptive study of 239 patients with chronic renal failure over a 3 year period, starting from 1 January 2007 to 31 December 2009, in the Department of Internal Medicine and Nephrology at University Hospital of Antananarivo. The incidence was 8.51% among patients hospitalized in the Department. The average age of patients was 45.4 years with extremes of 16 and 82 years and a sex ratio 1,46. The main antecedent was arterial hypertension (59.8%). Chronic renal failure was terminal in 75.31% of the cases (n=180). The causes of chronic renal failure were dominated by chronic glomerulonephritis (40.1%), nephroangiosclerosis (35.5%). Hemodialysis was performed in 3 patients (1.26%), no patient was scheduled for a renal transplantation. Mortality rate in the Department was 28.87%. Chronic renal failure is a debilitating disease with a dreadful prognosis which affects young patients in Madagascar. Its treatment remains inaccessible to the majority of patients. The focus must be mainly on prevention, especially on early effective management of infections, arterial hypertension and diabetes to reduce its negative impacts on the community and public health. The project on renal transplantation: living donor, effective and less expensive treatment compared to hemodialysis could also be a good solution for these Malagasy young subjects.