Cardio-Renal Syndrome: Frequency and Associated Factors in the Abidjan Heart Institute’s Medical Department

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/m2. 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.

Chronic Kidney Disease (CKD) in Patients Living with HIV under Antiretroviral Treatment: Prevalence and Risk Factors

CKD is one of the major complications when infected by HIV. The surveillance of CKD indicators and control of its determinants in the HIV-infected population in our African communities is essential. This was a descriptive and analytical cross-sectional study of people living with HIV received at the Ambulatory Treatment Center (ATC) at Infectious Diseases department of Sylvanus Olympio University Hospital (CHU-SO). The study period was 6 months—from January 1, 2018 to June 30, 2018—CKD was defined by a clearance below 60 ml/min/1.73 m2 for at least 3 months. A total of 117 patients were enrolled during the study period. The average age of patients for trial treatment was between 9.49 and 42.0 7 years. The duration of follow-up for antiretroviral treatment was ±3.22 to ±5.64 years. The female gender was predominant (70.09%) with a sex ratio (M/F) of 0.43. Most of people living with HIV were mostly classified at clinical stage 2 (31.03%) and 3 (31.90%) of WHO at initiation of HAART. The main CD4 rate was 223.30 ± 143.764 at initiation of HAART and 462.58 ± 202.723 at the time of the study. The majority of patients were placed in a fixed combination of Tenofovir/Lamivudine/Efavirenz in a proportion of 81.20% cases. CKD was found in 13 patients—that is 11.11% of patients. Univariate analysis shows that age greater than 45 years plus (p = 0.017) and pathological proteinuria (p = 0.021) were associated with CKD. In multivariate analysis, only ages (p = 0.045) and pathological proteinuria (p = 0.035) were significantly associated with CKD. The prevalence of CKD in HIV-infected patients is significant in Togo. The occurrence of proteinuria is linked to the delay in taking antiretroviral therapy.