Background: Hemodialysis is the most widely used renal replacement therapy in developing countries such as Cote d’Ivoire. Objective: To study the outcome of chronic hemodialysis patients in public centres in Abidjan ...Background: Hemodialysis is the most widely used renal replacement therapy in developing countries such as Cote d’Ivoire. Objective: To study the outcome of chronic hemodialysis patients in public centres in Abidjan using data from the Renal Registry of Cote d’Ivoire (2RCI). Method: This was a prospective analytical cohort study of End Stage Kidney Disease (ESKD) patients undergoing iterative hemodialysis in the network of public hemodialysis centres in Abidjan and who had been registered in the 2RCI register by September 2018. Results: Our study involved 363 cases out of 379 patients registered in the 2RCI registry database in 2018. The mean age of the patients was 47.3 ± 12.1 years, with a male predominance (sex ratio 1.97). In 70.24% of cases, they had no health insurance. The average duration of dialysis for our patients was 6.94 ± 4.1 years, with extremes of 2 and 28 years. This duration was less than 5 years in 44.3% of cases, between 6 and 10 years in 42.9% and more than 10 years in 12.6% of cases. The comorbidities found were hypertension in 95.6% of cases, diabetes in 7.8% and HIV in 4.6%. Anemia was found in 68% of cases and stroke in 8.6%. During the study period, 161 deaths were observed, representing a mortality rate of 44.35%. Acute lung oedema (29.8%), stroke (6.8%) and other cardiovascular diseases (19.3%) were the main causes of death. In multivariate analysis, factors such as age ≥ 65 years (HR = 3.66;CI 95% = 1.55 - 8.67;p = 0.003), “married/coupled” status (HR = 2.02;CI 95% = 1.24 - 3.31;p = 0.005) and normal weight at the start of dialysis (OR = 9.59, CI95% = 4.19 - 21.95;p = 0.001) were associated with the risk of death. Conclusion: Hemodialysis is performed in Abidjan on young patients. The mortality rate after three years of dialysis is very high. Hence the need to pursue the policy of decentralizing public centres and optimizing access to dialysis in terms of quality and quantity in order to improve patient survival.展开更多
Introduction: Cardio-renal syndrome (CRS) is a pathophysiological disorder of the heart and kidneys in which acute or chronic dysfunction of one organ can lead to acute or chronic dysfunction of the other. In Africa, ...Introduction: Cardio-renal syndrome (CRS) is a pathophysiological disorder of the heart and kidneys in which acute or chronic dysfunction of one organ can lead to acute or chronic dysfunction of the other. In Africa, particularly in C?te d’Ivoire, the incidence of cardio-renal syndrome is not precisely known. The aim of this study was to assess the frequency of CRS and to contribute to a better understanding of the condition in the medical department of the Abidjan Heart Institute. Materials and Methods: We conducted a prospective analytical study including all patients with heart failure hospitalised in the medicine department of the Abidjan Heart Institute from March to October 2020. Data were analysed using SPSS software version 22. Results: We included 111 patients in the study. The incidence of CRS was 64%, with a predominance of males (sex ratio 1.8). The mean age was 53 ± 15 years. Patients’ medical history was dominated by hypertension (56.8%), diabetes (15%), dyslipidaemia (18%), obesity (17.1%) and smoking (14.4%). The main causes of heart failure were dilated cardiomyopathy (22.8%) and ischaemic heart disease (21.4%). Symptomatology was mainly congestive heart failure (42.8%). Mean evaluated clearance (MDRD) was 39.9 ± 17.1 ml/min/m<sup>2</sup>. Doppler echocardiography showed a decrease in left ventricular ejection fraction in 74.3% of patients. Factors statistically associated with the occurrence of cardio-renal syndrome were: age > 60 years (p = 0.04), diabetes (p = 0.03), arterial hypertension (p = 0.001) and Hb Conclusion: The cardio-renal syndrome is a reality and marks an important point in the evolution of cardiac and renal diseases. It is highly frequent in the medical department of the Abidjan Heart Institute, as well as a high rate of CKD.展开更多
文摘Background: Hemodialysis is the most widely used renal replacement therapy in developing countries such as Cote d’Ivoire. Objective: To study the outcome of chronic hemodialysis patients in public centres in Abidjan using data from the Renal Registry of Cote d’Ivoire (2RCI). Method: This was a prospective analytical cohort study of End Stage Kidney Disease (ESKD) patients undergoing iterative hemodialysis in the network of public hemodialysis centres in Abidjan and who had been registered in the 2RCI register by September 2018. Results: Our study involved 363 cases out of 379 patients registered in the 2RCI registry database in 2018. The mean age of the patients was 47.3 ± 12.1 years, with a male predominance (sex ratio 1.97). In 70.24% of cases, they had no health insurance. The average duration of dialysis for our patients was 6.94 ± 4.1 years, with extremes of 2 and 28 years. This duration was less than 5 years in 44.3% of cases, between 6 and 10 years in 42.9% and more than 10 years in 12.6% of cases. The comorbidities found were hypertension in 95.6% of cases, diabetes in 7.8% and HIV in 4.6%. Anemia was found in 68% of cases and stroke in 8.6%. During the study period, 161 deaths were observed, representing a mortality rate of 44.35%. Acute lung oedema (29.8%), stroke (6.8%) and other cardiovascular diseases (19.3%) were the main causes of death. In multivariate analysis, factors such as age ≥ 65 years (HR = 3.66;CI 95% = 1.55 - 8.67;p = 0.003), “married/coupled” status (HR = 2.02;CI 95% = 1.24 - 3.31;p = 0.005) and normal weight at the start of dialysis (OR = 9.59, CI95% = 4.19 - 21.95;p = 0.001) were associated with the risk of death. Conclusion: Hemodialysis is performed in Abidjan on young patients. The mortality rate after three years of dialysis is very high. Hence the need to pursue the policy of decentralizing public centres and optimizing access to dialysis in terms of quality and quantity in order to improve patient survival.
文摘Introduction: Cardio-renal syndrome (CRS) is a pathophysiological disorder of the heart and kidneys in which acute or chronic dysfunction of one organ can lead to acute or chronic dysfunction of the other. In Africa, particularly in C?te d’Ivoire, the incidence of cardio-renal syndrome is not precisely known. The aim of this study was to assess the frequency of CRS and to contribute to a better understanding of the condition in the medical department of the Abidjan Heart Institute. Materials and Methods: We conducted a prospective analytical study including all patients with heart failure hospitalised in the medicine department of the Abidjan Heart Institute from March to October 2020. Data were analysed using SPSS software version 22. Results: We included 111 patients in the study. The incidence of CRS was 64%, with a predominance of males (sex ratio 1.8). The mean age was 53 ± 15 years. Patients’ medical history was dominated by hypertension (56.8%), diabetes (15%), dyslipidaemia (18%), obesity (17.1%) and smoking (14.4%). The main causes of heart failure were dilated cardiomyopathy (22.8%) and ischaemic heart disease (21.4%). Symptomatology was mainly congestive heart failure (42.8%). Mean evaluated clearance (MDRD) was 39.9 ± 17.1 ml/min/m<sup>2</sup>. Doppler echocardiography showed a decrease in left ventricular ejection fraction in 74.3% of patients. Factors statistically associated with the occurrence of cardio-renal syndrome were: age > 60 years (p = 0.04), diabetes (p = 0.03), arterial hypertension (p = 0.001) and Hb Conclusion: The cardio-renal syndrome is a reality and marks an important point in the evolution of cardiac and renal diseases. It is highly frequent in the medical department of the Abidjan Heart Institute, as well as a high rate of CKD.
