Risk of obstructive sleep apnea among senegalese dialysis patients.

Obstructive sleep apnea syndrome (OSAS) is a common condition in patients undergoing chronic dialysis and is associated with increased cardiovascular morbidity and mortality. This study aimed to determine the prevalence and risk factors of OSAS in Senegalese dialysis patients. In a cross-sectional study including 128 patients (75 men and 53 women) dialyzed since ≥6 months in four dialysis units. Data were collected during the dialysis session in the units. OSAS was assessed with the Berlin Questionnaire. Factors associated with OSAS risk were identified by multivariate logistic regression. The mean age of patients was 46.8 ± 16.9 ¥16-85 years). OSAS was found in 53 patients (overall prevalence of 41.4%) with predominance among individuals aged ≥50 years (52.6%). Hypertension and diabetes were more frequent in patients with OSAS, while the prevalence of obesity and sedentary was not different. The majority of patients were not aware of their disease before the survey, and none was treated. After multivariate regression analysis, age >50 years [odds ratio (OR) = 1.09, P = 0.02], neck circumference >45 cm (OR= 1.25, P= 0.03), and daytime hypersomnia (OR = 1.18, P= 0.02) were significantly associated with OSAS. This study showed that OSAS is frequent among Senegalese dialysis patients but is usually under-diagnosed. Older age, excessive daytime sleepiness, and neck circumference are the main associated factors.

Trends in hepatitis C infection among hemodialysis patients in Senegal: results of a decade of prevention.

Chronic kidney disease is an emerging public health issue in Africa. At end-stage renal disease (ESRD), patients need hemodialysis (HD), which may expose them to blood transmitted infections, such as the hepatitis C virus (HCV). Sub-Saharan Africa has the highest HCV prevalence in the world, but data on HD patients is scarce and shows an exceptionally high rate in Senegal. To assess the efficacy of preventive measures in reducing HCV infection among dialysis patients, we retrospectively conducted a cross-sectional study in three Senegalese HD centers, including all HD patients who performed HCV serology between 1 st and 31 st August 2011. The demographical, clinical, and biological data were collected for each patient. We included 106 patients with a mean age of 43.4±15.8 years (range from 18 to 80 years), with 52.8% males. HD vintage was 60.5±15 months (range from six to 206 months). The main causes of kidney disease included nephrosclerosis (36%) and diabetes (24%). The prevalence of HCV was 5.6%, with one patient co-infected with the hepatitis B virus. After adjusting for age and sex, HD vintage was the only risk factor for HCV infection, while nutritional status and the number of blood transfusions did not significantly correlate with HCV infection. We conclude that during the past decade, the prevalence of HCV infection in HD patients living in Senegal has declined considerably, mainly because of improved transfusion measures and better clinical practice in the HD centers. Such efforts should be maintained and reinforced to reduce the seroprevalence of HCV infection.

Erectile dysfunction in chronic hemodialysis patients in dakar: a cross-sectional study in 2012.

BACKGROUND: Patients with chronic kidney disease (CKD) experience multiple complications including erectile dysfunction (ED). It involves more than 50% of patients on dialysis or transplant. In Africa, the true extent of ED in CKD is unknown although some studies have been done in this regard. OBJECTIVES: This study aimed to determine the prevalence and identify risk factors of ED in patients on hemodialysis. PATIENTS AND METHODS: This cross-sectional multicenter study was conducted from January 2, 2012 through April 30, 2012 in four hemodialysis centers in Dakar. We included all patients on chronic hemodialysis who aged ≥ 18 years old and freely consented to participate in the study. Sociodemographic, clinical, and hemodialysis data were collected through a questionnaire. Erectile function was assessed by a short version of International Index of Erectile Function (IIEF-5). RESULTS: Among a target of 80 patients, 73 met the inclusion criteria and were included in this study. Mean dialysis vintage was 27.3 months (range, 1-156). Their mean age was 53.81 ± 12.52 years, with a higher proportion of age group of 50 to 69 years old. Fifty-six patients were married (37 monogamous and 19 polygamous) and six were singles. Overall prevalence of ED was 84.9% and it was severe in 14 patients (19.2%). Hypertension and diabetes were the most frequent etiologies and antihypertensive treatment was used in 95.5%. The main factors associated with ED were age > 50 years old and polygamy. CONCLUSIONS: ED is a common problem among patients on hemodialysis in Dakar with a high prevalence. Aging and diabetes represent most common causes. More efforts are needed for its early detection, prevention, and multidisciplinary management.

Mineral and bone disease in black african hemodialysis patients: a report from senegal.

BACKGROUND: Chronic kidney disease related mineral and bone disease (CKD-MBD) is a worldwide challenge in hemodialysis patients. In Senegal, number of dialysis patients is growing but few data are available about their bone disorders. OBJECTIVES: To describe patterns of CKD-MBD in Senegalese dialysis patients. PATIENTS AND METHODS: We performed a cross-sectional study including patients from three dialysis centres in Senegal. Diagnosis of different types of CKD-MBD relied on clinical, biological and radiological data collected from medical records in dialysis. RESULTS: We included 118 patients and 79 of them presented CKD-BMD (prevalence of was 66.9 %). Mean age of CKD-MBD patients was 47.8 ± 15.7 years (16-81 years) and sex-ratio (Male/Female) was 1.15. Secondary hyperparathyroidism was the most frequent disorder (57 patients) followed by adynamic bone disease (21 patients) and osteomalacia (1 patients). The main clinical manifestations were bone pain (17.5% of cases), pruritus (36.8% of cases) and pathological fractures (2.5% of cases). Bone biopsy was not available. Valvular and peripheral vascular calcification were present in 24.5% and 21.2% of patients respectively. Management of CKD-MBD included optimization of dialysis, calcium bicarbonate, sevelamer, vitamin D analogues and calcimimetics. The NKF/DOQI recommended levels of serum calcium, phosphate and parathormone PTH were not achieved in one third of patients. Six patients presented major cardiovascular events during their dialysis period. CONCLUSIONS: CKD-MBD are frequent in Senegalese hemodialysis patients and they are dominated by high turn-over disease. Clinical and biological manifestations are unspecific and accurate diagnoses are often difficult in absence of histomorphometry. Treatment is suboptimal for many patients in a context of limited resources.