[Chronic renal failure and hemodialysis in Lomé: are patients on haemodialysis and their entourage well informed?] / Insuffisance rénale chronique et hémodialyse à Lomé: l´hémodialysé et son entourage sont-ils bien informés?

End stage renal failure requires substitution therapy, including hemodialysis. Before initiation, patients and their entourage receive information on renal disease and treatment options. The purpose of this study is to assess the level of knowledge as well as the opinion of patients on haemodialysis and of their entourage on chronic kidney disease and substitution therapies. We conducted a cross-sectional descriptive study in the Department of Haemodialysis at the Sylvanus Olympio University Hospital (CHU-SO) from 29 July to 19 August 2020. The study population was composed by all the haemodialysis patients in the Department of Haemodialysis at the CHU-SO and by their accompanying persons who gave their free and informed consent. Anonymous survey was used to collect data. Data collection and statistical analysis were carried out using the Epi Info software 7.2.2.6. Eighty-one patients and 79 accompanying persons were interviewed. The average ages of patients and their accompanying persons were 49.7 years ± 13.5 and 39,6years ± 13.2 respectively. All patients knew their disease and 94% of accompanying persons were informed about their parents' disease. Hemodialysis was considered very expensive by 95.1% of patients. Patients stated that improved quality of life was the most known benefit of hemodialysis (80.2%) while 15% also thought that renal transplantation was equally effective. The majority of accompanying persons (85%) stated that hemodialysis was the best treatment. Haemodialysis education program for patients and their accompanying persons is essential to better overall management of haemodialysis patients.

[Iatrogenic disease in the elderly: about two cases of tricyclics-induced renal failure]. / Iatrogénie médicamenteuse chez la personne âgée: à propos de deux cas d'insuffisance rénale favorisée par les tricycliques.

Prostatic hyperplasia is a common condition in people over the age of 50 and its incidence increases with age. It gives particular cause for concern when it is symptomatic. Drugs with potential adverse effects on lower urinary tract can induce symptoms. Among those, anticholinergic drugs causing primary or secondary effects, such as tricyclics, are often associated with symptoms. These are contraindicated in patients with subvesical obstruction because they can induce or worsen urinary symptoms and complications resulting from them. Renal failure having health and economic consequences on elderly subjects Who often suffer from multiple disorders is the most severe complication. We report two cases of tricyclics-related adverse effects on the urinary tract in patients with prostatic hyperplasia ranging between 80 and 92 years. Given the lack of semiologic signs, imaging techniques and bladder TC scan enabled etiological diagnosis allowing adequate management. Study results justify a systematic performace of rectal examination, bladder CT scan or even ultrasound in any elderly with acute renal failure or with a worsening of chronic renal failure based on the frequency of prostatic pathologies and polypharmacy in this age.

[Tuberculosis among chronic hemodialysis patients in Togo: Report of 10 cases]. / Tuberculose chez les patients hémodialysés chroniques au Togo : à propos de 10 observations.

GOALS: To determine the frequency of tuberculosis among hemodialysis patients in Togo, specify its different localizations and identify its diagnostic and therapeutic difficulties. PATIENTS AND METHODS: This was a retrospective study over a period of 5 years (2010-2015). It includes the records of periodic hemodialysis patients in the Nephrology Department of the Sylvanus-Olympio University Teaching Hospital in Lomé. The diagnosis of tuberculosis was selected on the basis of clinical and laboratory data. The specific treatment has involved the association of 4 antituberculosis, which was adapted to the renal function. RESULTS: Of 91 chronic hemodialysis patients treated in Hospital Sylvanus-Olympio hemodialysis center, 10 cases (10.9%) of tuberculosis were diagnosed. The mean age was 37.3±12.8 years, and the sex ratio was 1.5. The median time to onset of tuberculosis after initiation of hemodialysis was 16.8±9 months. Extrapulmonary sites are found in 100% of cases (5 had both peritoneal and pleural localization, only 5 had pleural localization). The tuberculin skin test was positive in 4 patients (40%). The search for Mycobacterium tuberculosis was unsuccessful in all types of samples. Tuberculosis treatment was generally tolerated. Two patients (20%) had died during treatment. CONCLUSION: Tuberculosis is relatively common in hemodialysis patients. Diagnosis is difficult and may be based on the therapeutic trial.

[Depression in patients on chronic hemodialysis at the Sylvanus Olympio University Hospital of Lomé (Togo)]. / Hémodialyse chronique et dépression au Centre Hospitalier Universitaire Sylvanus Olympio de Lomé (Togo).

INTRODUCTION: The aim of our study was to estimate the prevalence of depression and to investigate its associated risk factors in patients with chronic renal failure on hemodialysis. METHODS: We conducted a descriptive cross-sectional study in the hemodialysis unit of the Division of Nephrology at the University Hospital of Sylvanus Olympio Lomé (Togo) from 1 January 2014 to 31 December 2014. Self-evaluation Scale as calibrated using the Beck Depression Inventory in his simplified version was our screening tool. RESULTS: During the study period, 88 patients were enrolled of whom 61.4% were men with a sex ratio of 1.6. The average age was 38.80 ± 13.24 years ranging from 12 to 66 years. The majority of patients (90.9%) were workers. Arterial hypertension was the most common somatic comorbidity (45.4%) recorded. Forty-six patients (52.3%) had hemodialysis duration between 1-4 years; 68.2% of patients had depression; 47.7% of depressed patients had severe depression. The occurrence of the depression is significantly related to the hemodialysis length (p= 0,008). CONCLUSION: The management of chronic hemodialysis patient should be multidisciplinary including nephrologist and psychiatrist.