RESUMO
Chronic kidney disease (CKD) is a major cause of morbidity and mortality worldwide, but few studies are available on CKD in Cote d'Ivoire. We aimed to assess the prevalence of CKD and identify its associated factors in the general population in Abidjan in 2016 in a cross-sectional study that included 1418 subjects. We did not receive laboratory data for 38 subjects, including serum creatinine data. Of the 1380 remaining subjects, 138 cases of CKD were included in the study (10% prevalence). We observed a female predominance (sex ratio = 0.81), and the mean age was 43.7 ± 14.5 years. Histories of hypertension (HTN) (29.7%) and diabetes (10.1%) were reported. The main clinical signs were high blood pressure (51.4%), obesity (21%), proteinuria (37.9%), and hematuria (37.4%). The glomerular filtration rate (GFR) was <60 mL/min in 8.2% of cases according to the Modification of Diet in Renal Disease equation, in 8.6% according to the CKD Epidemiology Collaboration equation, and in 12.6% according to the Cockroft-Gault (CG) equation. The other laboratory signs were hyperglycemia (51.4%), hypercholesterolemia (34.1%), and hyperlipidemia (21%). In the multivariate analysis, factors such as female sex (P = 0.013), age >55 years (P = 0.02), a history of HTN (P = 0.001), hypercholesterolemia (P = 0.010), and hyperlipidemia (P = 0.009) were associated with the risk of CKD. The prevalence of CKD was high in our study. The CG equation should not be used to estimate the GFR in the general population. Prevention involves managing modifiable risk factors.
Assuntos
Taxa de Filtração Glomerular , Insuficiência Renal Crônica , Humanos , Côte d'Ivoire/epidemiologia , Feminino , Estudos Transversais , Masculino , Prevalência , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/diagnóstico , Fatores de Risco , Pessoa de Meia-Idade , Adulto , Adulto Jovem , Hipertensão/epidemiologia , Idoso , Medição de RiscoRESUMO
Purple urine-bag syndrome is a rare condition that occurs in patients with indwelling urinary catheters carried over a long period and frequently associated with a urinary tract infection. It is characterized by the appearance of a violet coloration of the probe and/or the urine collection bag. We report the first case in West Africa that occurred in a 47-year-old woman in uremic encephalopathy and carrier of a urinary catheter, which presented a violet color of the tubing and urine-bag associated with a urinary tract infection. The outcome was favorable under antibiotic therapy. Many patients benefit from the installation of urinary catheters for various reasons and the occurrence of this syndrome should lead the medical team to systematically seek an underlying urinary tract infection to avoid if possible paraclinical assessments generally costly to our patients without medical coverage in our developing countries.
Assuntos
Infecções por Escherichia coli/diagnóstico , Cateteres Urinários/efeitos adversos , Infecções Urinárias/diagnóstico , Urina/microbiologia , Antibacterianos/uso terapêutico , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/tratamento farmacológico , Feminino , Humanos , Pessoa de Meia-Idade , Síndrome , Cateteres Urinários/microbiologia , Infecções Urinárias/tratamento farmacológicoRESUMO
AIM: To investigate the prognostic factors of acute kidney injury (AKI) in our daily practice. METHODS: We analyzed the cohort of patients hospitalized for AKI in the period from January 2010 to December 2015 in the Department of Internal Medicine, University Hospital of Treichville. Kaplan-Meier curves were built for survival analysis. Cox regression analysis was used to identify independent predictors of mortality. RESULTS: We collected 414 cases of AKI during the study period. The mean age was 48.3 ± 16.8 years. We observed a male predominance with a sex ratio (236/178) of 1.32. In multivariate analysis, the predictive factors of death were age ≥ 65 years (HR = 2.13; 95% CI = 1.28-3.55; P = 0.004), AKI stage 3 (HR = 1.69; 95%CI = 1.13-2.50; P = 0.009), haemoglobin <8 g/dL (HR = 2.91; 95% CI = 1.79-4.72; P = 0.0001), infection (HR = 1.85; 95% CI = 1.21-2.83; P = 0.004) and drug-induced AKI (HR = 3.23; 95% CI = 1.65-6.29; P = 0.001). Factors associated with incomplete recovery or non-recovery of renal function beyond 3 months were age ≥ 65 years (OR = 4.76; 95% CI = 1.85-12.50;P = 0.001), hypertension (OR = 2.17; 95% CI = 1.07-4.34; P = 0.03), haemoglobin <8 g/dL (OR = 6.66; 95% CI = 2.94-8.28; P < 0.001), AKI stage 3 (OR = 9.09; 95% CI = 4.54-16.66; P < 0.001) malignant hypertension (OR = 5; 95% CI = 1.67-7.27; P = 0.005) and cancer (OR = 4.69; 95% CI = 2.22-6.63; P = 0.001). CONCLUSION: The aetiologies are dominated by infections. The fatality rate is high and its risk factors are advanced age, low haemoglobin level, severe AKI, infection and drug intake. Prevention is essential.
Assuntos
Injúria Renal Aguda/terapia , Departamentos Hospitalares , Medicina Interna , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/mortalidade , Injúria Renal Aguda/fisiopatologia , Adulto , Côte d'Ivoire/epidemiologia , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Admissão do Paciente , Estudos Prospectivos , Recuperação de Função Fisiológica , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: Acute kidney injury (AKI) is commonly associated with HIV infection. OBJECTIVES: To describe the profile of AKI in HIV infected versus non-infected persons. PATIENTS AND METHODS: This is a prospective study that was carried out during the study period from January 2010 to December 2015 in the department of nephrology-internal medicine D of Treichville University Hospital (Côte d'Ivoire). RESULTS: The prevalence of HIV infection was 35.2% in the population of AKI. The average age of patients was 42±18 years in the HIV positive group against 51±18 years in the HIV negative group (P=0.0001). Etiologies were infections in 65.1% in the HIV positive group against 38.8% in the HIV negative group (P=0.0001) and water loss in 24.7% in the HIV positive group against 7.8% in the HIV negative group (P=0.0001). Factors such as the AIDS stage (P=0.002), severe sepsis (P=0.002) and acute pyelonephritis (P=0.001) were associated with mortality in HIV positive patients against severe anemia (P=0.0001) and severe sepsis (P=0.0001) in the HIV-negative group. CONCLUSION: HIV positive patients are younger with a female predominance. The mortality rate is identical in both groups.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Injúria Renal Aguda/epidemiologia , Soronegatividade para HIV , Soropositividade para HIV/epidemiologia , Hospedeiro Imunocomprometido , Medicina Interna/estatística & dados numéricos , Infecções Oportunistas Relacionadas com a AIDS/complicações , Infecções Oportunistas Relacionadas com a AIDS/mortalidade , Injúria Renal Aguda/complicações , Injúria Renal Aguda/mortalidade , Adulto , Idoso , Côte d'Ivoire/epidemiologia , Feminino , Soropositividade para HIV/complicações , Soropositividade para HIV/mortalidade , Hospitais Universitários/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fatores de RiscoRESUMO
UNLABELLED: Infectious diseases are frequent in chronic dialysis patients. Our study had for objective to describe the prevalence and the clinical presentation of tuberculosis in the chronic dialysis patient. This observational study was conducted over a period of 21 months in chronically hemodialyzed patients. RESULTS: Among 118 patients chronically dialysed and during the study period, seven (5.9%) presented tuberculosis. An average lag time of 13,7 months was observed between the beginning of the dialysis and the appearance of the signs of tuberculosis, and of 10,4 weeks between the first signs and the beginning of treatment. Extrapulmonary localization was observed in six cases among seven peritoneal involvements. CONCLUSION: Extrapulmonary localisation is a characteristic of tuberculosis in the chronic dialysis patients. Systematic screening of tuberculosis is recommended in order to start chemotherapy without any delay.