[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.

[Renal involvement during monoclonal gammopathies at the teaching hospital of Yopougon in Abidjan, from 2000 to 2016]. / Manifestations Renales des Gammapathies Monoclonales au CHU de Yopougon de 2000 a 2016 : Etude Retrospective D'Une Serie de 42 cas.

BACKGROUND: Renal involvement is common during monoclonal gammopathies and their occurrence impacts the survival of the patients. Our objective was to describe the renal features during monoclonal gammopathies from 2004 to 2016 at the University Hospital of Yopougon in Abidjan. METHODS: Renal failure was defined as blood creatinine level > 20 mg/L and/or proteinuria > 500 mg/24 hours. RESULTS: We identified 42 cases of monoclonal gammopathiesincluding multiple myeloma (n=40) and monoclonal gammopathy of underdetermined significance (n=2). The rate of renal impairment was 57% (n=24) including tubular disease (n=20)and glomerular nephropathy (n=3). Two patients (one with cast nephropathy and another with Randall's disease) performed renal biopsy. The factors associated with renal impairment were mainly hyperuricemia (n=24)and hypercalcemia (n=23). Three cases were treated by hemodialysis. There were 6 (14.3%) deaths among patients with renal impairment. CONCLUSION: Tubular injury was common among patients with monoclonal gammopathy. It was associated with hypercalcemia and Hyperuricemia.

CONTEXTE: Les atteintes rénales sont fréquentes au cours des gammapathies monoclonales (GM) et leur persistance impacte la survie des patients. Notre objectif était de décrire ces atteintes observées de 2004 à 2016 au CHU de Yopougon à Abidjan. MÉTHODES: L'atteinte rénale était définie par une créatinine > 20 mg/l et ou une protéinurie > 500 mg/24 heures. RÉSULTATS: Nous avons recensé 42 cas de GM dont 40 cas de myélome multiple et 2 cas de gammapathie monoclonale de signification indéterminée. La fréquence de l'atteinte rénale était de 57% (n=24). Il s'agissait de 3 cas de néphropathie glomérulaires et 20 cas d'atteintes tubulaires. Deux patients ont bénéficié d'une ponction biopsie rénale et c'était un cas de tubulopathie myélomateuse, et un cas de maladie de Randall. Les facteurs favorisant l'atteinte rénale étaient dominée par l'hypercalcémie (23 cas) et l'hyperuricémie (24 cas). Trois cas ont été traités par hémodialyse conventionnelle. Il y eu 6 (14,3%) décès parmi les patients ayant l'atteinte rénale. CONCLUSION: l'atteinte tubulaire est plus fréquente au cours de la gammapathie monoclonale. Elle est favorisée par la prise de toxiques traditionnels, l'hypercalcémie et l'hyperuricémie.

[Purple urine-bag syndrome: A case report]. / Le syndrome de la poche à urines violette : à propos d'un cas.

Purple urine-bag syndrome is a rare condition that occurs in patients with indwelling urinary catheters carried over a long period and frequently associated with a urinary tract infection. It is characterized by the appearance of a violet coloration of the probe and/or the urine collection bag. We report the first case in West Africa that occurred in a 47-year-old woman in uremic encephalopathy and carrier of a urinary catheter, which presented a violet color of the tubing and urine-bag associated with a urinary tract infection. The outcome was favorable under antibiotic therapy. Many patients benefit from the installation of urinary catheters for various reasons and the occurrence of this syndrome should lead the medical team to systematically seek an underlying urinary tract infection to avoid if possible paraclinical assessments generally costly to our patients without medical coverage in our developing countries.

Outcomes of acute kidney injury in a department of internal medicine in ABIDJAN (cote D'IVOIRE).

AIM: To investigate the prognostic factors of acute kidney injury (AKI) in our daily practice. METHODS: We analyzed the cohort of patients hospitalized for AKI in the period from January 2010 to December 2015 in the Department of Internal Medicine, University Hospital of Treichville. Kaplan-Meier curves were built for survival analysis. Cox regression analysis was used to identify independent predictors of mortality. RESULTS: We collected 414 cases of AKI during the study period. The mean age was 48.3 ± 16.8 years. We observed a male predominance with a sex ratio (236/178) of 1.32. In multivariate analysis, the predictive factors of death were age ≥ 65 years (HR = 2.13; 95% CI = 1.28-3.55; P = 0.004), AKI stage 3 (HR = 1.69; 95%CI = 1.13-2.50; P = 0.009), haemoglobin <8 g/dL (HR = 2.91; 95% CI = 1.79-4.72; P = 0.0001), infection (HR = 1.85; 95% CI = 1.21-2.83; P = 0.004) and drug-induced AKI (HR = 3.23; 95% CI = 1.65-6.29; P = 0.001). Factors associated with incomplete recovery or non-recovery of renal function beyond 3 months were age ≥ 65 years (OR = 4.76; 95% CI = 1.85-12.50;P = 0.001), hypertension (OR = 2.17; 95% CI = 1.07-4.34; P = 0.03), haemoglobin <8 g/dL (OR = 6.66; 95% CI = 2.94-8.28; P < 0.001), AKI stage 3 (OR = 9.09; 95% CI = 4.54-16.66; P < 0.001) malignant hypertension (OR = 5; 95% CI = 1.67-7.27; P = 0.005) and cancer (OR = 4.69; 95% CI = 2.22-6.63; P = 0.001). CONCLUSION: The aetiologies are dominated by infections. The fatality rate is high and its risk factors are advanced age, low haemoglobin level, severe AKI, infection and drug intake. Prevention is essential.