Evaluation des complications cardiaques chez les hémodialysés chroniques de Dakar

Introduction: L'évaluation cardiovasculaire est essentielle en hémodialyse périodique car les affections cardiovasculaires sont la première cause de mortalité chez les hémodialysés chroniques. Nous avons conduit cette étude afin de déterminer la prévalence et le type des différentes complications cardiovasculaires et d'identifier les principaux facteurs de risque cardiovasculaire. Méthodes: Il s'agissait d'une étude rétrospective de 4 ans portant sur les dossiers de patients traités au moins 6 mois en hémodialyse et ayant des explorations cardio-vasculaires comportant une radiographie du thorax de face, un électrocardiogramme et une échographie cardiaque. Les données épidémiologiques, cliniques, paracliniques, les aspects évolutifs des complications cardiaques ont été recueillies pour chaque patient retenu. Résultats: Trente huit dossiers de patients ont été inclus dans cette étude. L'âge moyen était de 52 ans ± 12,85 et le sex-ratio H/F de 1,53. Les complications cardiovasculaires étaient dominées par l'hypertrophie ventriculaire gauche (71,05 %), la maladie coronaire (34,21%), l'insuffisance cardiaque congestive (18,42%), Calcifications vasculaires (5,78 %), les troubles du rythme (7.89%), les fuites valvulaires mitrales (44,73%), tricuspidiennes (42,10%) et les accidents vasculaires cérébraux hémorragiques (5,26%). L'incidence moyenne de l'HVG était de 81% chez les patients hypertendus. Au cours de cette étude, 27 patients avaient poursuivi l'hémodialyse et 11 étaient décédés dont 6 de causes cardiovasculaires (54,55%). Conclusion: L'hémodialyse est une technique d'épuration qui expose les patients à de multiples complications cardiovasculaires.Pan African Medical Journal 2016; 23: 4

Décentralisation De La Dialyse Au Sénégal : Expérience D’1 An Du Centre De Tambacounda A l’Est Du Pays

Hemodialysis has made numerous and significant progress in recent decades resulting in life expectancy increase (thirty or forty years). The aim of our study was to assess the treatment of acute and chronic hemodialysis in the reference center of Tambacounda. Patients and methods: This was a prospective study over a one-year period (April 2013 to March 2014) in the hemodialysis center of the regional hospital of Tambacounda, 450km away from Dakar. The study focused on epidemiological, clinical, paraclinical and scalable data. Results: Fifty-nine patients were involved in the study. The sex ratio was 0.85 (32F/ 27M). The mean age was 41.3 years [12-72 years old]. Nineteen patients were on dialysis treatment for acute renal failure (ARF) (32.2%) and 40 were chronic hemodialysis patients (67.79%). Fifty patients were under emergency dialysis (84.7%) including 17 in intensive care (28.8%). Most chronic hemodialysis patients had 3 sessions per week (98.3%). Only 9 patients were monitored in nephrology prior to dialysis (22%). Thirty-two patients had a femoral double-lumen catheter (54.23%), 6 patients used ordinary double- lumen jugular catheters (10.17%) and 3 received tunneled jugular catheters (5.09%). Eighteen patients had functional arteriovenous (AV) fistula (18.51%). The mean hemoglobin was 7 g/dl. Only 11 patients had erythropoietin-based therapy. In acute renal impairment there were 8 deaths (42.10%), whereas in chronic renal failure the fatality rate was 18.8% (n = 9). Conclusion: Our study has demonstrated the benefits of decentralizing dialysis treatment in the provinces. However there is a need to implement the accompanying measures, such as the availability of some essential medicines for all hemodialysis patients, and equipment of intensive care units

Les Facteurs Associés Aux Calcifications Valvulaires Du Cœur Et Ou Des Gros Troncs Artériels Chez Les Hémodialysés

Introduction: Le but de l’étude était de déterminer la prévalence ainsi que les principaux facteurs de risque associés au développement des calcifications valvulaires du cœur et/ou d’au moins un gros tronc artériel chez les hémodialysés. Patients et méthodes: Etaient inclus les patients qui avaient présenté à l’échodoppler cardiaque une calcification valvulaire du cœur et ou d’au moins un gros tronc artériel. Les variables suivantes avaient été étudiées : épidémiologiques, cliniques et paracliniques. Résultats: Sur 54 patients hémodialysés, 51 avaient été explorés parmi lesquels 39 présentaient des calcifications cardio-vasculaires. Les femmes étaient les plus touchées 66.67 % avec un sex- ratio de ½. Les calcifications valvulaires représentaient 64.1% et les calcifications vasculaires 76.9%. Les atteintes univalvulaires représentaient 68% suivies des atteintes bivalvulaires 24% et trivalvulaires 8%. Les calcifications des artères fémorales étaient les plus fréquemment rencontrées 63.3% suivies des artères iliaques 53.3 %. Conclusion: Les calcifications cardiovasculaires sont fréquentes chez les hémodialysés. Les principaux facteurs de risque liés à la survenue des calcifications étaient : l’hypocalcémie, l’hypo et l’hypercholestérolémie à LDL, l’hyper cholestérolémie totale et le taux sanguin de PTHi augmenté. La correction de ces troubles pourrait prévenir la survenue des calcifications.   Introduction: The purpose of the study was to determine the prevalence and key risk factors associated with the development of valve calcifications of the heart and/or at least one large arterial trunk in hemodialysis. Patients and methods: Patients who had presented with cardiac echodoppler a valve calcification of the heart and or at least one large arterial trunk were included. The following variables had been studied: epidemiological, clinical and paraclinical. Results: Of 54 hemodialysis patients, 51 were explored, 39 of whom had cardiovascular calcifications. Women were the most affected 66.67% with a sex ratio of ½. Valvular calcifications represented 64.1% and vascular calcifications 76.9%. Univalvular involvement accounted for 68% followed by bivalvular involvement 24% and trivalvular involvement 8%. Calcifications of the femoral arteries were the most frequently encountered 63.3% followed by the iliac arteries 53.3%. Conclusion: Cardiovascular calcifications are common in hemodialysis patients. The main risk factors related to the onset of calcifications were: hypocalcemia, hypo and hyperlolesterolemia with LDL, hyper hyper cholesterolemia and increased blood PTHi levels. The correction of these disorders would be a way to prevent the occurrence of calcifications

Prevalence and risk factors of chronic kidney disease in an african semi-urban area: Results from a cross-sectional survey in Gueoul, Senegal

Chronic kidney disease (CKD) is a public health priority worldwide; however, its prevalence and incidence are difficult to assess. In Africa, few studies have been conducted on the prevalence of CKD. This study sought to describe the epidemiological characteristics and profile of CKD, as well as the related risk factors in Guéoul, a semi-urban zone in Senegal. An observational, cross-sectional, and descriptive study was conducted in Guéoul city in Senegal from November 1, 2012, to December 10, 2012, according to the WHO STEPS approach. People older than 35 years living in Guéoul city were included in the study. Cardiovascular and renal disease risk factor screening was conducted for this population. Data were analyzed using the 3.5.1 version of Epi Info software. The significance level was a P <0.05. One thousand four hundred and eleven participants with a mean age of 48 ± 12.68 years and a sex ratio of 0.34 were included in the study (359 men/1052 women). The prevalence of renal disease was 36.5%. Sixty-eight people showed proteinuria greater than two cross with urinary dipsticks. Two hundred and six people had a glomerular filtration rate <60 mL/min, and among them, 201 were in stage III, two in stage IV, and three in stage V according to the modification of diet in renal disease formula. Ninety-eight participants had morphological abnormalities. Cardiovascular risk factors found among participants with renal disease were obesity (25.2%), hypertension (55.5%), diabetes (2.3%), and renal and metabolic syndrome (32.43%). Those that statistically significantly correlated with renal disease were obesity (P = 0.0001), hypertension (P = 0.0001), and diabetes (P = 0.021). This study assessed the extent of renal disease in the population of Guéoul city. Being aware of the prevalence of CKD in the general population of Senegal is mandatory for defining appropriate strategies for the management of these risk factors and progression of renal diseases

Particularities of COVID-19 infection in chronic hemodialysis patients in Sub-Saharan Africa: experience from Senegal (West Africa)

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appeared in December 2019 in China and has rapidly become a major global health concern. Patients with end-stage renal disease receiving dialysis treatment are very exposed to the SARS-CoV-2 during their frequent visits to healthcare facilities and immune induced by uremia. The aim of our work was to describe the particularity of COVID-19 infection in hemodialysis patients in sub-Saharan Africa and in Ziguinchor, south of Senegal, particularly. To do this, we conducted a monocentric prospective study over a period of 16 months at the Ziguinchor hemodialysis center and compared our results to a study that focuses on the seroprevalence of SARS-CoV-2 in chronic hemodialysis patients. We found a low prevalence of COVID-19 infection while the majority of our patients were in contact with the virus