Factors Associated with Non-Compliance among Patients with Chronic Kidney Disease at the Departmental University Hospital of Borgou and Alibori in Parakou (Benin)

Introduction: Therapeutic compliance in chronic kidney disease (CKD) represents a major challenge for the prevention of this condition, which is both a non-communicable disease (NCD) and a complication of other NCDs. Non-adherence to treatment (NOT) is a factor in the poor prognosis of CKD in developing countries, particularly in Benin. The aim of this study was to evaluate therapeutic compliance (TC) and determine the factors associated with non-compliance in patients with chronic kidney disease undergoing treatment at the Departmental University Hospital of Borgou and Alibori in Parakou (CHUD/B-A). Patients and Methods: This study was carried out in the Nephrology Department of CHUD/B-A. It was a cross-sectional, descriptive study with analytical aims that ran from December 25, 2022 to March 15, 2023 and covered data from 2017 to 2022. It involved 345 patient records meeting the diagnosis of CKD according to the KDIGO 2012 criteria. NOT was defined by a Girerd score evaluation greater than or equal to 3. Data processing and analysis were performed with R software version 4.3.0. Results: The mean age (SD) of patients was 50 years (±14.9). The prevalence of NOT was 57.1%. Potential predictors of non-adherence were: monthly revenue (p = 0.009), mode of admission (p = 0.001), phytotherapy (p = 0.040), traditional treatment (p = 0.049) and quantity of drugs (p = 0.042). Conclusion: Therapeutic compliance among chronic kidney patients still needs to be improved through awareness-raising sessions.

Morphological and Structural Study of Native Kidneys in Chronic Kidney Disease Patients on Dialysis Compared to Non-Dialysis Patients

Whether on dialysis or not, native kidneys in chronic kidney disease (CKD) patients undergo morphological and structural changes. Objective: To study native kidney morphometric and structural aspects in CKD patients on dialysis and non-dialysis patients. Methods: It was a descriptive, analytical, and cross-sectional study conducted from May to December 2018. The study enrolled CKD patients on dialysis or not followed at CNHU-HKM in Cotonou. Renal ultrasound was performed to locate cysts and uroscanner completed in the presence of atypical cysts. Through logistic regression, associated factors were determined. Results: The sample size was 240 patients, of which 151 (62.9%) were receiving dialysis and 89 (37.1%) non-dialysis patients. Male subjects were predominant (sex ratio = 1.5). The average size of the right kidney, expressed in mm in patients on dialysis was: pole-to-pole length = 78.56;width = 42.06;cortical thickness = 11.80;and the left kidney: pole-to-pole length = 79.76;width = 41.53;cortical thickness = 12.6. For non-dialysis patients, the following size was recorded for the right kidney: pole-to-pole length = 92.35;width = 47.61;cortical thickness = 15.64;and left kidney: length = 92.13;width = 47.82;cortical thickness = 15.43. Predictive factors for the occurrence of acquired renal cysts were: old age (p = 0.0001), dialysis (p < 0.001) and diabetic nephropathy (p = 0.0014). Conclusion: CKD patients on dialysis have small kidneys and are more likely to develop acquired renal cysts. There is a need to carry out an annual ultrasound screening for native kidneys in patients receiving dialysis.

Quality of Life of Chronic Haemodialytic Patients at Cotonou Teaching Hospital (BENIN)

Introduction: The objectives of this work were to assess haemodialytic patients’ quality of life (QoL) and to identify factors affecting this QoL. Patients and Methods: It was a three (03) month monocentric and transversal study (from October 24, 2011 to January 27, 2012) conducted in the haemodialysis unit at Hubert Koutoukou Maga Teaching Hospital (CNHU-HKM) in Cotonou. Patients included were residents of Benin, aged 18 years and above, chronic haemodialysis in this unit for over 3 months, and willfully gave their consent. Quality of life was evaluated using questionnaire on Kidney Disease Quality of Life Short-Form French version 1.2 (KDQoL-SF 36). Epidemiological data, nephropathy etiologies and purification parametres were recorded in patients files. Data statistical analysis was performed using SPSS software 11.5. Results: In total 131 patients were involved in the study. The average age was 50.27 ± 12.17 years with a sex ratio of 1.69. Nephroangiosclerosis was the 1st cause. Most patients 128 (97.71 %) received two haemodialysis sessions on weekly basis. The Average Overall Score (AOS) based respectively on SF 36 and KDQoL was 48.55 and 58.55. The average of both SF 36 and KDQoL AOS was 53.55. Factors affecting hemodialytic patients quality of life were vitality, limitations related to mental health and physical condition, burden of kidney disease, effect of the disease on daily life and occupational status. The study revealed that: Patients education level was correlated with vitality

Acute Renal Failure during Progressive Systemic Sclerosis in the Regional University Teaching Hospital of Brest-La Cavale Blanche (France)

Systemic scleroderma is a rare disease in which visceral manifestations occur, particularly peripheral vascular, digestive, cardiopulmonary and renal. It is pathology with a predilection for women. The present clinical case is that of a man with the renal complications of scleroderma and the difficulties of the treatment even in the developed countries like France. In the present case, the management of this disease required a high dose of corticosteroid therapy and extra-renal purification. Early detection of complications through a minimal clinical examination supplemented with paraclinic tests has proved necessary.

Hemodialysis patients’ satisfaction and associated factors in National Teaching Hospital Hemodialysis Center, Cotonou (Benin)

Background: Patients’ satisfaction is a relevant component in assessing healthcare services. The objective of this study was to study the level of satisfaction of chronic hemodialysis patients and the associated factors in Cotonou CNHU-HKM dialysis center. Patients and Methods: It was a cross-sectional, descriptive and analytical study conducted by administering a questionnaire on days off dialysis. It was carried out from 1st November 2015 to 1st January 2016 in CNHU-HKM Nephrology University Clinic of Cotonou. Hemodialysis patients aged 18 years and above having given their informed consent were included in the study. Patients’ recruitment was comprehensive. Likert scale was used in assessing the level of satisfaction with 4 as “very satisfied” and 1 for “very dissatisfied”. Satisfaction was evaluated on the basis of Ware dimensions. The threshold for satisfaction was 50. Outcomes: Overall, 377 patients were included in the study. Respondents’ mean age was 51.5 ± 13.3 years with 1.37 as sex ratio. Arteriovenous fistula was used for 80.1% of hemodialysis patients. 77.7% of the patients underwent dialysis twice a week while 45.9% were administered a four-hour dialysis. The overall average proportion of “satisfied” was 76.5%. The level of satisfaction was 52% for healthcare environment, 61% for service delivery, 73.9% for healthcare accessibility, 76.1% for healthcare structure, 77.5% for healthcare management, 90.3% for quality of healthcare, 88.3% for interpersonal relationship and 93.2% for efficiency and continuum of healthcare. Factors associated with satisfaction included age (p = 0.02), vascular access (p = 0.04) and urea reduction ratio (p = 0.01). In addition, the degree of satisfaction of hemodialysis patients was not statistically associated with sex, marital status, educational level, history of the disease, age of dialysis, number of sessions per week, and duration per session. Conclusion: The overall level of hemodialysis patients’ satisfaction is above average. There is a need to particularly focus on healthcare environment, so as to better improve the level of satisfaction.

Epidemiology of Anemia at the Internal Medicine Department in Borgou Departmental Hospital Center(DHC)in Parakou(Benin)

Objective: To describe clinical and biological characteristics of anemia in the Internal Medicine department of Borgou Departmental Hospital Center (DHC). Methods: This was a transversal and descriptive study for an analytic purpose. All patients hospitalized in the Internal Medicine department of Borgou DHC who had a hemogram for their care were included in the study. Anemia was defined as a hemoglobin level lower than 12 g/dL for men and lower than 11.5 g/dL for women. Results: Frequency of anemia was 61.8% (76 of 123 patients). Anemia was moderate in 47.4% of the cases and severe in 27.6% of the cases. Basing on the mean corpuscular volume, microcytic anemia accounted for 36.8%, anemia was normocytic in 46.1% and macrocytic in 17.1% of cases. According to the mean corpuscular hemoglobin concentration, normochromic anemia accounted for 81.6% of the series and hypochromic in 18.4%. The most common pathologies found in anemic patients came from digestive origin (17%), the renal causes were also found in 17% of the cases. Cardiac pathologies were responsible for anemia in 13% of cases. Malaria and pulmonary pathologies were responsible for anemia in respectively 12% and 9%. The main factors associated with anemia were young age (young adult) and neurological pathologies. Conclusion: Anemia hospital prevalence is very high in the Internal Medicine Department of Borgou DHC. Awareness of populations and practitioners for the early management of various pathologies which provide anemia could improve this presentation.