[Growth in steroid-responsive nephrotic syndrome in Cote d'Ivoire]. / La croissance staturale des enfants ayant un syndrome néphrotique cortico-sensible en Côte d'Ivoire.

We realized one of the first observational studies in sub-Saharan Africa whose aim was to analyze the growth in steroid-responsive nephrotic syndrome. This was a retrospective study, involving 30 children followed for nephrotic syndrome in pediatric nephrology unit of the University Hospital of Yopougon (Abidjan) from 28.02.2005 to 19.12.2010. Each child was followed for two years and we are interested in demographic characteristics and the evolution of size. At the end of our study, it appears that: the mean age was 89.33 ± 43.41 months (7.44 years) with a sex ratio of 3,28. At the end of the two years of follow-up, patients had received a median dose of steroids 6151 ± 3832 mg/m(2), 9111 ± 1376 mg/m(2) and 8664 ± 5379 mg/m(2), respectively, for a relapse or no, two and at least three relapses. Fourteen patients had received vitamin D therapy and calcium. At the end of follow-up, four children had growth retardation. An average gain in Z-score was noted at the end of follow-up in girls and boys respectively +0.06 and +0.36. The growth retardation observed in our study was not associated with different growth periods (P=0.116), gender (P=0.548) and the mean Z-scores observed at the end of follow-up was not significantly different between the sexes (P=0.26). Growth retardation observed was not related to the cumulative dose administered (P=0.15), number of relapse (P=1.000).

Acute peritoneal dialysis in African pediatric area experience of pediatric nephrology unit of Yopougon University Hospital (Abidjan, Côte d'Ivoire).

INTRODUCTION: Acute kidney injury (AKI) is a diagnostic emergency threatening patients in a major way. Pediatric renal extra purification methods are limited in African countries due to the nonavailability of resources. Peritoneal dialysis (PD) seems to be the modality that is the most practiced for children with acute renal failure (ARF). METHODOLOGY: We conducted a retrospective study on 5 years of records of children from 1 month to 15 years who have suffered an ARF and benefited from PD while being treated at the pediatric nephrology unit of the Chu of Yopougon. ARF is defined as the condition that exists when the serum creatinine level is high or equal to 200 µmol/l outside any underlying uropathies. RESULTS: Out of the hospitalized 88 children for AKI, 33 were on PD. Twenty-two children have been on dialysis while 9 children had to discontinue treatment due to financial problems. The sex ratio was 0.46 and the average age was 8.1. The etiologies of the AKI were predominantly glomerular diseases (45%), malaria (31.8%), and secondary interstitial nephritis of toxic origin. The indications of the PD are anuria (31%), hyperkalemia (18%), acute edema of lung (13%), and hyperuremia (13%). Eight children had automated peritoneal dialysis, 02 children underwent manual PD, and 9 children had both methods of treatment. We recorded 31 mechanical complications and 10 infections. While 8 children died, 10 recovered from AKI. CONCLUSION: Trained surgical medical personnel and favorable economic statuses of patients are the factors that will determine the success of PD in our country.