[Etiological and evolving profile of renal disability of children in hospital in Togo]. / Profil étiologique et évolutif de l'insuffisance rénale de l'enfant en milieu hospitalier au Togo.

OBJECTIVE: To determine the etiological and evolutionary profile of renal failure of chidren in Togo. METHODS: This is a cross-sectional study over the period of 12 months (2016-2017) including children aged 1 to 18 years hospitalized in the pediatric ward of Sylvanus Olympio university teaching hospital of Lome (Togo) for renal failure. RESULTS: Of 2374 patients hospitalized in our unit, 58 (2.4%) had renal failure. The mean age was 8.17±4 years with a sex ratio of 1.32. The average consultation time was 11.9 days. The mean duration of hospitalization was 12.7±7.7 days. Thirty-seven patients (63.8%) were referred from a peripheral center. Thirty-seven children out of 58 (63.1%) were oligoanuric. Renal failure was acute in 94.8% and chronic in 5.2%. Anemia was found in 84.4% of children. The main etiologies found were severe malaria (63.8%), glomerulonephritis (10.3%) and nephrotic syndrome (10.3%). Thirteen children (22.4%) benefited from dialysis sessions. The evolution was favorable in 79.3% of the cases. CONCLUSION: The renal failure of child is relatively common in our daily practice. The low socio-economic level and the lack of adapted equipment make the care difficult.

[Falls among hemodialysis patients: Incidence and risk factors]. / Chutes chez l'hémodialysé : incidence et facteurs de risque.

Falls and mineral and bones disorders are both implicated in the occurrence of pathological fractures in patients undergoing chronic dialysis. However, data on falls among this population are rare. We carried out a prospective study during four weeks and included 70 patients on chronic hemodialysis with the main objectives being to evaluate the incidence of falls and factors related to it. At the end of the four weeks, 16 patients (22.86%) fell at least once, with a total of 17 falls during 4 weeks, giving an incidence of 3.2 falls per patient/year. The mean age was 40 ± 16 years. Five patients (31.2%) had a past history of pathological fractures. Ten patients (62.5%) presented intra- and post-dialysis hypotension, six (37.5%) was diagnosed of gait disorders and two (12.5%) had sensory deficit of the lower limbs. Six patients (37.5%) presented frailty. Hypotension (P=0.004), frailty (P=0.047) and sensory deficit (P=0.049) were significantly associated with the occurrence of falls. The incidence of falls is relatively high in our hemodialysis patients and real risk factors exist. Hence, it is important to implement programs for falls prevention to reduce their incidence and impact.

[Changing c.106delG (p.Ala36fs*6) loss syndrome associated with congenital Finnish type: first case diagnosed in Togo]. / Mutation c.106delG (p.Ala36fs*6) associée au syndrome néphrotique congénital type finlandais : premier cas diagnostiqué au Togo.

OBJECTIVE: To report the first case of congenital nephrotic syndrome of the Finnish type (SNCF) in Togo associated with a new mutation of NPHS1. OBSERVATION: Our study focused on a female infant of 10months, born premature at 34weeks 6days, followed from birth to pure SNC discovered the 10th day of life. Monitoring and pregnancy outcome unremarkable. It is the third in a family of three children, the first two are killed in a similar table but not explored before 1year of age. The diagnosis is confirmed by the SNCF genetic study NPHS1 gene encoding nephrin performed in our patient and her parents showed a double mutation of which c.[106delG]+[2728T>C] and p. at the nucleotide level. [Ala36fs*6]+[Ser91OPro] at the protein level inherited from each parent. The change was made to the 10th month of death in life after sepsis in a third of cortico-resistance. CONCLUSION: The SNCF, autosomal recessive disease early, which remains a serious diagnosis, is genetic. This new mutation could she explained the severity of the SNCF in this family?