[Chronic renal failure's profile in hemodialysis at the Edith Lucie Bongo Ondimba General Hospital]. / Profil epidemiologique des patients en hemodialyse a l'Hopital General Edith Lucie Bongo Ondimba.

INTRODUCTION: Our objective was to evaluate the management of chronic renal failure in hemodialysis at the Edith Lucie Bongo Ondimba General Hospital (HGELBO). MATERIALS AND METHODS: This was a cross-sectional and analytical study over a 10-month period from March 1, 2018 to December 31, 2018. This included all patients aged 16 and over whohad at least one treatment session hemodialysis during the study period. The sociodemographic, clinical, biological, therapeutic and evolutionaryparameters of the patients werenoted. And data entry wasdoneusing Excel 2013 and EPI Infos version 3 software with a p <0.05 consideredstatisticallysignificant. RESULTS: The number of patients hospitalized for chronic and acute renal failurein 10 months was 101 patients, of whom 97 received hemodialysis treatment. The sex ratio was 1.4 with 59% males. The meanagewas 49.19 ± 28.4 years. The most affected intervalisbetween 50 and 59 years old with 19 patients or 29.68%. The patients came from Brazzaville in 60.93%. The first indication of hemodialysis wasuremiapoorlytoleratedin 81, 25% of cases. Diabeticnephropathywas the leading cause of CKD in hemodialysis. Meanserumcreatinine at initiation of hemodialysis was128.5 ± 75.12 mg / l. The incidence of HIV in hemodialysis is 6.4%, those of hepatitis B and C are 1.25% respectively. There were 54 patients (84.37%) whobenefited from femoralcatheter placement at baseline. We have so far 7 deaths out of 64 patients. CONCLUSION: This center of hemodialysis contributes to the improvement of the management of the renal insufficiency in the stage of hemodialysis. The assessment of this work reveals strong and weak points and we are consideringother work, more hemodialysis stations and itwould be interesting to do some work on the prevalence of renal disease in the Republic of Congo.

INTRODUCTION: Notre étude avait pour objectif d'évaluer la prise en charge des insuffisants rénaux chroniques en hémodialyse à l'Hôpital Général Edith Lucie Bongo Ondimba (HGELBO). MATÉRIELS ET MÉTHODES: Il s'agissait d'une étude transversale et analytique sur une période de dix mois s'étendant du 1er mars 2018 au 31 decembre 2018. Étaient inclus tous lespatients âgés de 16 ans ou plus, ayant bénéficié d'au moins une séance d'hémodialyse durant la période de l'étude. Les paramètres sociodémographique, clinique, biologique, thérapeutique et évolutif des patients ont été relevés. Et la saisie des données a été réalisée en utilisant les logiciels Excel 2013 et EPI Infos version 3 avec un p <0,05 considérée comme statistiquement significative. RÉSULTATS: Le nombre de patients hospitalisés pour insuffisance rénale chronique et aigue en 10 mois a été de 101 patients parmi lesquels 97 ont bénéficié du traitement d'hémodialyse. Le sex ratio a été de 1,4 avec 59 % de sexe masculin. L'âge moyen a été de 49,19 ± 28,4 ans. L'intervalle le plus touché est compris entre 50 et 59 ans avec 19 patients soit 29,68%. Les patients venaient de Brazzaville dans 60,93%. La première indication d'hémodialyse a été l'urémie mal tolérée dans 81, 25% des cas. La néphropathie diabétique a été la première cause de l'IRC en hémodialyse.La moyenne dela créatininémie à l'initiation de l'hémodialyse a été de128,5±75,12 mg/l. L'incidence du VIH en hémodialyse est de 6,4%, celles des hépatites B et C sont de 1,25% respectivement. Il y a 54 patients soit 84,37 % qui ont bénéficié de la pose cathéter fémoral à l'inclusion. Nous avons à ce jour 7 décès sur 64 patients. CONCLUSION: Ce centre d'hémodialyse contribue à l'amélioration de la prise en charge des insuffisants rénaux en stade d'hémodialyse. L'évaluation de ce travail révèle des points fort et faible et nous envisageons d'autres travaux, plus des postes d'hémodialyse et il serait intéressant de faire un travail sur la prévalence de la maladie renale en République du Congo.

[Nephrotic syndrome complicated by chylous ascites in a girl of 2 years and 8 months old]. / Syndrome néphrotique compliqué d'ascite chyleuse chez une fillette de 2 ans et 8 mois.

We report on a case of nephrotic syndrome with focal and segmental hyalinosis complicated by chylous ascites in a girl of 2 years and 8 months old. This pure nephrotic syndrome in its early stage was initially treated with intensive steroid treatment at 2mg/kg/day orally for 2 months, followed by a bolus of methylprednisolone. The persistence of proteinuria meant corticosteroid resistance. Renal biopsy then revealed focal and segmental hyalinosis. A recurrence of the edema-ascites syndrome was associated with macroscopic hematuria. Blood pressure and serum creatinine remained normal. Protidemia decreased to 28g/L, with severe hypoalbuminemia at 7g/L. The ascites puncture brought 1 L of aseptic and milky fluid, containing 0.22g/L of proteins, 20 IU/L of amylase, and 331g/L of total lipids. The treatment protocol included a hyperprotein diet, prednisone at 0.5mg/kg/day, cyclophosphamide at 2.5mg/kg/day for 1 month, then once every 2 days for 3 months, and repeated ascites punctures. After 12 ascites punctures performed every 15 days, a polyuric episode occurred and the ascites disappeared. Proteinuria persisted at a nephrotic rate up to the 14th month, without impairment in kidney filtration function, and completely disappeared at the 20th month. After 5 years of follow-up, proteinuria remains undetectable and the physical exam is normal. The occurrence of chylous ascites during the nephrotic syndrome is a rare event. The formation of bowel lymphangiectasia, caused by a slowdown in venous return due to the pressure exerted by ascites, is probably the predominant mechanism.

[Enuresis in children with sickle cell disease]. / L'énurésie chez l'enfant drépanocytaire.

POPULATIONS AND METHODS: In order to analyze epidemiological and clinical characteristics of enuresis in children with sickle cell disease, and identify risk and aetiological factors, 987 subjects (aged 5-20 years) took part in a cross-sectional study. These children were divided into two groups: group 1 consisted of 456 homozygous children with sickle cell disease (haemoglobin SS), while group 2 consisted of 531 normal children. These groups were paired according to age and sex. RESULTS: The prevalence of enuresis was 50.9% in group 1 and 16.4% in group 2, and was significantly higher (P < 0.05) in the girls. The frequency decreased significantly between the ages of 5-20. At age 16, frequency of enuretic children with sickle cell disease remained statistically greater (15.9% vs. 8.0%). The frequency of wet nights was higher (P < 0.05) in group 1. In addition, anaemia crisis and painful crisis were related to prevalence of enuresis. There was a significant (P < 0.01) negative correlation between haemoglobin F percentage and prevalence of enuresis. CONCLUSION: Enuresis is frequent in children with sickle cell disease and its intensity is linked to severity of disease.