Introduction: Hyperuricemia is defined as a level of serum uric acid greater than or equal to 70 mg/l (420 μmol/l) in men and 60 mg/l (360 μmol/l) in women. Several studies have shown that it is a risk factor or a f...Introduction: Hyperuricemia is defined as a level of serum uric acid greater than or equal to 70 mg/l (420 μmol/l) in men and 60 mg/l (360 μmol/l) in women. Several studies have shown that it is a risk factor or a factor of progression of chronic kidney disease. Recent experimental and epidemiological data correlate the association of hyperuricemia with chronic kidney disease (CKD), arterial hypertension and cardiovascular diseases, thus raising the question of the usefulness of therapeutics in the prevention of renal diseases. The objective of this study is to seek a link between chronic kidney disease and hyperuricemia. Materials and Methods: This is a descriptive and analytical study conducted at hemodialysis unit and cardiology service of General Hospital of National reference of N’Djamena (Chad) from 1th January to 1th October 2013 (10 months). We included all chronic kidney disease patients hospitalized in hemodialysis unit and cardiology service who presented associated hyperuricemia. Results: There were 712 CKD patients who were hospitalized. Among them, there were 108 patients who were included in the study and who had hyperuricemia as a prevalence of 15.20%. The average age of patients was 35.5 years and the sex ratio was 3/1. The age group between 40 to 60 years represented 54.6%. There were 41.7% of traders. Hypertensive patients accounted for 49.1%;association of diabetes and hypertension was noted in 12.90%. Renal insufficiency was moderate in 43.5% of patients. Hyperuricemia was present in more than 90% of patients. Profession, age, hematuria, proteinuria and hypertension were statistically positively related to hyperuricemia. Treatment consisted of prescribing allopurinol in 84% of patients. In more than 11% of patients the progression was unfavorable. Conclusion: The implication of hyperuricemia in chronic kidney disease has been proved in several recent studies. However, randomized studies at very long scales have to be carried out to conclude from its real impact on the prevention and treatment of chronic kidney disease.展开更多
Introduction: The incidence of acute renal injury (AKI) has increased in recent decades. Acute renal failure is defined by the abrupt arrest (within hours or days) of the kidney excretory function. Oliguria (urine out...Introduction: The incidence of acute renal injury (AKI) has increased in recent decades. Acute renal failure is defined by the abrupt arrest (within hours or days) of the kidney excretory function. Oliguria (urine output 24h) is presented in about half of the cases. The circumstances of the occurrence of AKI are multiple: surgical, traumatic, obstetric, medical, often obvious. Its prognosis depends on the speed of management and the associated organ failure. The objective of this study is to describe the profile of patients in emergency hemodialysis at the Nephrology Unit of the National Reference General Hospital (HGRN) in N’Djamena, Chad. Methods: This was a multicenter, descriptive study in patients with acute renal failure place over a period of 12 months in the emergency departments of the 2 hospitals in N’Djamena. Defined as carriers of an AKI (RIFLE criteria), patients with: 1) Oliguria: urinary output 400 ml/24h (<0.5 ml/kg/h in children) or anuria: urinary output 300 ml/24h;2) Associated with an increase in serum creatinine: serum creatinine × 3 or serum creatinine> 350 μmol/l or decrease of GFR by 75%. Results: Of the 311 patients admitted, 36 cases met the inclusion criteria, a frequency of 11.57%. The mean age was 34.46 years with extremes ranging from 7 to 80 years. The female sex predominated with 52.80% as sex ratio of 0.91. Isolated hypertension was noted with 38.88%. Dyspnea accounted for 41.66% of patients admitted to emergency departments. In our series, 50% of our patients had hyperthermia at admission. Oliguria was observed in 41.70% of the cases. Edema accounted for 33.33% of cases. The AKI with the “failure” criterion was 58.34% (21/36), with the criterion “injury” 25% (9 cases) and the criterion “risk” 16.66 (6 cases). AKI were organic in 83.34% (30/36). It was noted that 14 patients, 38.8% had an infectious syndrome. There were 6 patients who had (16.66%) an obstructive AKI, 5 patients (13.88%) had eclampsia, 4 patients (11.12%) had hepatocellular insufficiency, 3 patients (8.34% Cardiac, 2 patients (5.56%) extracellular dehydration and 2 patients (5.56%) whose cause is indeterminate. It was noted that 10 patients, as 27.7%, had fully recovered their renal function after vascular filling and etiological treatment. Four (4) patients with obstructive obstruction were referred to the urology department. There were 22 patients who had benefited from the hemodialysis. 6 patients recovered completely their renal function. We had recorded a number of deaths in our study which was 44.44% (16/36). Septic shock was the most frequent cause of death in 50% of cases. Conclusion: The incidence of AKI in our study was 11.57%. It affects a young population and despite the therapeutic progress, the mortality remains high. The causes are multiple, entangled, dominated by infectious syndrome and hypovolemia. Prevention seems to be the best therapeutic option to avoid the installation or worsening of an AKI.展开更多
文摘Introduction: Hyperuricemia is defined as a level of serum uric acid greater than or equal to 70 mg/l (420 μmol/l) in men and 60 mg/l (360 μmol/l) in women. Several studies have shown that it is a risk factor or a factor of progression of chronic kidney disease. Recent experimental and epidemiological data correlate the association of hyperuricemia with chronic kidney disease (CKD), arterial hypertension and cardiovascular diseases, thus raising the question of the usefulness of therapeutics in the prevention of renal diseases. The objective of this study is to seek a link between chronic kidney disease and hyperuricemia. Materials and Methods: This is a descriptive and analytical study conducted at hemodialysis unit and cardiology service of General Hospital of National reference of N’Djamena (Chad) from 1th January to 1th October 2013 (10 months). We included all chronic kidney disease patients hospitalized in hemodialysis unit and cardiology service who presented associated hyperuricemia. Results: There were 712 CKD patients who were hospitalized. Among them, there were 108 patients who were included in the study and who had hyperuricemia as a prevalence of 15.20%. The average age of patients was 35.5 years and the sex ratio was 3/1. The age group between 40 to 60 years represented 54.6%. There were 41.7% of traders. Hypertensive patients accounted for 49.1%;association of diabetes and hypertension was noted in 12.90%. Renal insufficiency was moderate in 43.5% of patients. Hyperuricemia was present in more than 90% of patients. Profession, age, hematuria, proteinuria and hypertension were statistically positively related to hyperuricemia. Treatment consisted of prescribing allopurinol in 84% of patients. In more than 11% of patients the progression was unfavorable. Conclusion: The implication of hyperuricemia in chronic kidney disease has been proved in several recent studies. However, randomized studies at very long scales have to be carried out to conclude from its real impact on the prevention and treatment of chronic kidney disease.
文摘Introduction: The incidence of acute renal injury (AKI) has increased in recent decades. Acute renal failure is defined by the abrupt arrest (within hours or days) of the kidney excretory function. Oliguria (urine output 24h) is presented in about half of the cases. The circumstances of the occurrence of AKI are multiple: surgical, traumatic, obstetric, medical, often obvious. Its prognosis depends on the speed of management and the associated organ failure. The objective of this study is to describe the profile of patients in emergency hemodialysis at the Nephrology Unit of the National Reference General Hospital (HGRN) in N’Djamena, Chad. Methods: This was a multicenter, descriptive study in patients with acute renal failure place over a period of 12 months in the emergency departments of the 2 hospitals in N’Djamena. Defined as carriers of an AKI (RIFLE criteria), patients with: 1) Oliguria: urinary output 400 ml/24h (<0.5 ml/kg/h in children) or anuria: urinary output 300 ml/24h;2) Associated with an increase in serum creatinine: serum creatinine × 3 or serum creatinine> 350 μmol/l or decrease of GFR by 75%. Results: Of the 311 patients admitted, 36 cases met the inclusion criteria, a frequency of 11.57%. The mean age was 34.46 years with extremes ranging from 7 to 80 years. The female sex predominated with 52.80% as sex ratio of 0.91. Isolated hypertension was noted with 38.88%. Dyspnea accounted for 41.66% of patients admitted to emergency departments. In our series, 50% of our patients had hyperthermia at admission. Oliguria was observed in 41.70% of the cases. Edema accounted for 33.33% of cases. The AKI with the “failure” criterion was 58.34% (21/36), with the criterion “injury” 25% (9 cases) and the criterion “risk” 16.66 (6 cases). AKI were organic in 83.34% (30/36). It was noted that 14 patients, 38.8% had an infectious syndrome. There were 6 patients who had (16.66%) an obstructive AKI, 5 patients (13.88%) had eclampsia, 4 patients (11.12%) had hepatocellular insufficiency, 3 patients (8.34% Cardiac, 2 patients (5.56%) extracellular dehydration and 2 patients (5.56%) whose cause is indeterminate. It was noted that 10 patients, as 27.7%, had fully recovered their renal function after vascular filling and etiological treatment. Four (4) patients with obstructive obstruction were referred to the urology department. There were 22 patients who had benefited from the hemodialysis. 6 patients recovered completely their renal function. We had recorded a number of deaths in our study which was 44.44% (16/36). Septic shock was the most frequent cause of death in 50% of cases. Conclusion: The incidence of AKI in our study was 11.57%. It affects a young population and despite the therapeutic progress, the mortality remains high. The causes are multiple, entangled, dominated by infectious syndrome and hypovolemia. Prevention seems to be the best therapeutic option to avoid the installation or worsening of an AKI.
