<strong>Background:</strong> Obstructive nephropathies are a topical issue in urology and nephrology consultations, but no study has yet been conducted on the subject in our country. <strong>Objectiv...<strong>Background:</strong> Obstructive nephropathies are a topical issue in urology and nephrology consultations, but no study has yet been conducted on the subject in our country. <strong>Objective:</strong> Describe the epidemiological, clinical, therapeutic and evolutionary profile of obstructive nephropathies at the Sylvanus Olympio University hospital of Togo. <strong>Method:</strong> It was a descriptive and cross-sectional study with a collection of retrospective data over a period of 08 years (2012-2019) which focused on obstructive nephropathies in the Urology-Andrology, Nephrology and Internal Medicine departments at the medical clinic of CHU SO. The diagnosis of obstructive nephropathy is retained on the basis of radiological and medical imaging results. <strong>Results:</strong> The study population included 131 patients. The annual hospital frequency was 2.84 cases for 100 admissions. The mean age was 56.72 ± 17.76 years. These patients were mostly male (72.52%). The most frequent age group was 60 - 80 years. Common symptoms at presentation were loin pain (45.75%) and dysuria (25.95%). The average length of probable course of the disease before hospitalization was 636.94 ± 258.88 days (21 months). The etiologies of obstructive nephropathy were largely dominated by prostatic tumors in half of the cases (45.80%). Among these patients, 121 have presented renal failure (92.36%). The average serum creatinine at admission was 59.01 ± 21.56 mg/l. Of the 121 patients with obstructive nephropathy presenting renal failure, 54 (44.63%) had decreased their serum creatinine at the output of more than 25%. The open surgery (54.20%) was the main treatment. There was an improvement in kidney function in patients who had a shorter duration of disease progression and who did not have a history of loin pain, oliguria and that the etiologies of the disease were not tumors. Tumoral etiologies, the presence of a history of high blood pressure, oedema of the lower members, oliguria, and a longer duration of disease pr展开更多
Objectives: To determine the prevalence and risk factors of erectile dysfunction (ED) in men on hemodialysis in Togo. Methods: Prospective cross-sectional study, descriptive and analytical ranging from December 2015 t...Objectives: To determine the prevalence and risk factors of erectile dysfunction (ED) in men on hemodialysis in Togo. Methods: Prospective cross-sectional study, descriptive and analytical ranging from December 2015 to February 2016 in the hemodialysis unit of CHU SO, only dialysis center in the country. The evaluation of the ED was made through IIEF-5 questionnaire. Results: 39 men (67.2%) of 58 hemodialysis is a sex ratio M/F of 2.05. The average age was 43.5 years with extremes of 25 and 59 years. The majority of men had a profession in 19 cases (48.7%). The mean duration of dialysis was 30 months with a range of 4 months and 90 months. Initial glomerular nephropathy was in 19 cases (48.7%) and vascular in 14 cases (35.9%). 38 patients were hypertensive (97.4%) and 6 diabetic men (15.4%). The prevalence of ED was 74.3% (29 cases). ED score was less than 10 points in 14 cases (35.9%);01 case (2.6%) between 11 and 16 points;06 cases (15.4%) between 17 to 21 points;08 cases (20.5%) between 22 and 25 points;and 10 cases (25.6%) between 26 and 30 points. Age, profession and duration of dialysis were risk factors associated with ED (P 0.001). Conclusion: The prevalence of ED is very high in Togo.展开更多
Introduction: Emphysematous pyelonephritis (EPN) is a severe, life-threatening infection of the renal parenchyma. This condition is characterized by the production of intrarenal and perinephric gas. In the world, the ...Introduction: Emphysematous pyelonephritis (EPN) is a severe, life-threatening infection of the renal parenchyma. This condition is characterized by the production of intrarenal and perinephric gas. In the world, the EPN is currently limited to case series reported. No cases have been described in black Africa. Aims: Related a first case of EPN diagnosed and treated in the University Hospital Center Sylvanus Olympio of Lomé in Togo. Observation: A 40 years old woman, with antecedent of diabetes presented pyelonephritis emphysematous class 2. She was treated successfully with antibiotic alone without using percutaneous drainage or nephrectomy. Conclusion: As reported in every case series, it was a young diabetic patient with a clinical features of acute pyelonephritis which CT scan had helped lay the EPN class 2 diagnosed. The germ was Klebsiella pneumoniae. She was treated with adapted antibiotic alone.展开更多
Aim: Review of early postoperative deaths in the surgical intensive care unit at CHU-Kara. Introduction: Surgery, one of the means of treatment of diseases, also presents risks for the patient, including early postope...Aim: Review of early postoperative deaths in the surgical intensive care unit at CHU-Kara. Introduction: Surgery, one of the means of treatment of diseases, also presents risks for the patient, including early postoperative death linked to numerous risk factors. Methodology: This was a retrospective descriptive study conducted on the records of patients who died within 48 hours after surgery from November 1, 2019 to April 30, 2021. The study was conducted in the surgical intensive care unit and in the operating room. Results: Thirty-two early postoperative deaths or 2.22% out of 1442 operated with 30 deaths retained for the study. Male gender predominated (70%). The average age was 31.22 years. Farmers were more concerned (66.67%). The time to surgery was 1.6 days. ASA1 patients (40%) predominated followed by ASA IV (30%). 80% of patients were operated on as an emergency. Digestive pathologies 80% were more represented. General anaesthesia 86.66% was more practiced associating Propofol, Fentanyl, Ketamine and Atropine more frequently. The average duration of the procedures was 132.5 minutes. Intraoperative complications were associated with cardiac arrest and hemorrhage (33.34%). ASA class higher than 2, dirty surgery (46.67%), and delayed recovery (13.34%) were the incriminating risk factors. Death by hemodynamic shock and respiratory distress were the main causes 26.66%. Conclusion: Early postoperative mortality was high and involved all ages. Anesthesia and surgery, the low level of qualification of the intraoperative actors, the lesser intraoperative security;the association of anesthetic effects, the complexity of intraoperative lesions led to the increase of mortality. The combination of two or more factors was pejorative for the deaths.展开更多
Introduction: Hand hygiene (HH) is an effective way to fight infections in healthcare settings. The general purpose of our study was to explore the knowledge, attitudes and practices of health care providers on HH at ...Introduction: Hand hygiene (HH) is an effective way to fight infections in healthcare settings. The general purpose of our study was to explore the knowledge, attitudes and practices of health care providers on HH at Dapaong regional hospital (DRH). Methodology: This was a prospective, descriptive cross-sectional study conducted from March to June 2022 in the DRH wards. Data were collected using a questionnaire and observation grid. Results: 90 care providers were surveyed. Males and non-physician personnel predominated with 57.8%, and 94.4% respectively. The survey on staff’s knowledge reported: 31.1% of practitioners did not wash their hands on arrival and departure in services. 24% did not know the difference between simple hand washing (SHW) and hygienic hand washing (HHW). 23.3% did not know the type of soap to use for HHW. The caregivers did not know the type of hand washing (HW) required after a septic and non-septic procedure in respectively 41.6%, and 37.8%. They did not know that there are two types of hand antiseptics (45.4%), nor the amount of antiseptic for HW (78.9%). The survey on staff’s attitude regarding HW found that: 70% did not remove all jewels prior HW, and 51.1% did not know that wearing gloves cannot replace the HW. For HW Staff Practice: 62.2% did not wash their hands before treatment. 91.1% did not spread the soap on their hands and forearms after wetting them. 65.55% did not rinse hands from nails to elbows. Conclusion: The HH was poorly known, the attitude of the staff was dangerous in relation to the HH and the practice of HH was very inadequate at the RHC-Dapaong. As a result, there is a need to retrain staff to increase their capacity to prevent care-related infections and enhance patient safety in the hospital.展开更多
Introduction: The practice of spinal anesthesia in pediatric surgery is declining, especially in countries with limited means. What about in our context? Objective: To evaluate the practice of spinal anesthesia in ped...Introduction: The practice of spinal anesthesia in pediatric surgery is declining, especially in countries with limited means. What about in our context? Objective: To evaluate the practice of spinal anesthesia in pediatric surgery in Togo. Framework and method of study: This was a prospective study from November 2017 to May 2018 in pediatric surgery at CHU SO de Lomé, in the operating room and hospital ward of CHU Kara. The surgical, anesthesiological and evolutionary aspects of the patients were analyzed. Results: Sixty children were selected for the study who had an indication for sub-umbilical surgery. The male sex was predominant (73.3%). 47 (78.30%) patients were operated on for scheduled surgery. Hernia repair was the most performed surgical intervention (43.30%). The mean duration of the surgery was 78 ± 35.9 minutes. Most of the patients were ASA 1 (98.30%). The local anesthetic used was 0.5% isobaric Bupivacaine. Fentanyl was the predominant adjuvant (55%). The most widely used lumbar puncture needle was 25 Gauge with 75 millimeters in length (63.30%). Diazepam was the most widely used sedative (50%). The predominant spinal anesthesia protocol was spinal anesthesia alone (60%). Only one patient had hypotension (1.70%). Conclusion: The fairly satisfactory pediatric spinal anesthesia in Togo remains poorly performed. Its promotion involves the training of anesthesia practitioners and the strengthening of the technical platform.展开更多
Background: Coronavirus disease mortality is high in people with chronic kidney disease. Method: we present the characteristics and factors associated with mortality of patients hospitalized for Covid-19 and with chro...Background: Coronavirus disease mortality is high in people with chronic kidney disease. Method: we present the characteristics and factors associated with mortality of patients hospitalized for Covid-19 and with chronic kidney disease in a descriptive and analytical cross-sectional study of CKD patients admitted to the Lomé Commune Regional Hospital Center (CHR-LC) from March 2020 to August 2021. Results: A total of 127 patients met our inclusion criteria. We found a mortality rate of 48.8% in Lomé (Togo). Factors associated with this mortality in our study were severity of Covid-19 (p Conclusion: Mortality is very high in CKD patients with Covid-19.展开更多
Background: Acute kidney injury (AKI) is one of the increasingly described complications of coronavirus infection. Objectives: To identify factors associated with death in patients with acute kidney injury (AKI) durin...Background: Acute kidney injury (AKI) is one of the increasingly described complications of coronavirus infection. Objectives: To identify factors associated with death in patients with acute kidney injury (AKI) during Coronavirus disease (COVID-19) in Abidjan, C?te d’Ivoire. Material and Method: This was a monocentric retrospective analytical study of all patients over 18 years of age with AKI during COVID-19 at the Farah Polyclinic in Abidjan, C?te d’Ivoire. AKI was defined and ranked according to Kidney Disease Improving Global Outcomes (KDIGO) 2012. The data were collected from the medical record and processed using RStudio. Results: Forty-three cases were collected. The average age was 58.5 12 years. The sex ratio (M/F) was 4.4. The main comorbidities were high blood pressure (60.4%) and diabetes (37.2%). AKI was at KDIGO stage 3 in 58%, KDIGO 2 in 21% and KDIGO 1 in 21%. The diagnosis of acute tubular necrosis was retained in 44.2% of patients followed by acute functional kidney injury in 32.6%. Hemodialysis was initiated in 48.8% of cases. The main indication of dialysis was anuria (46.6%). In total, 55.8% of patients died. Factors associated with death were KDIGO stage (p = 0.049), and invasive ventilation (p Conclusion: Mortality is high in patients with AKI during COVID-19 infection.展开更多
<strong>Context:</strong> The coexistence in the same patient of a mixed connectivitis or Sharp’s syndrome is a rare eventuality. <strong>Objective:</strong> To underline the presence of this ...<strong>Context:</strong> The coexistence in the same patient of a mixed connectivitis or Sharp’s syndrome is a rare eventuality. <strong>Objective:</strong> To underline the presence of this mixed connectivitis in our practice, whose prevalence remains unknown, particularly in Africa and more precisely in Mali. <strong>Case Presentations:</strong> We report two cases of Sharp’s syndrome in a 48-year-old man and a 40-year-old woman with impaired renal function. The picture achieved associated massive proteinuria, hypoalbuminemia, moderate renal failure and edematous syndrome in men. In women, the picture was associated with accelerated to malignant hypertension and severe renal failure. There were no osteoarticular manifestations and the diagnosis of Sharp’s syndrome was based on the presence of high levels of antibodies to U1RNP. Therapeutic management has been that of predominantly associated connective tissue disease (systemic lupus erythematosus). <strong>Conclusion:</strong> Mixed connectivitis or Sharp’s syndrome is increasingly recognized as a separate entity thanks to advances in molecular biology. Its prevalence is low in sub-Saharan African countries with renal disease that manifests itself as proteinuria or nephrotic syndrome associated with microscopic hematuria, renal failure, and hypertension. This renal impairment is more likely to occur in severe forms of the disease.展开更多
Context: Acute kidney injury (AKI) in intensive care unit (ICU) is common and associated with very high mortality. In Togo, a tropical country with limited resources and only one nephrology department in the north, ac...Context: Acute kidney injury (AKI) in intensive care unit (ICU) is common and associated with very high mortality. In Togo, a tropical country with limited resources and only one nephrology department in the north, acute kidney injury seems to be a real tragedy with high mortality. Aims: to determine risk factors for mortality in acute kidney injury in the intensive care units. Methods and Material: We made a multicentric cross sectional study during 6 months in the four referral centers in northern Togo. Univariate and multivariate logistic regression was used to identify factors associated with mortality. Data were analyzed using RStudio 2023.04.1. Results: A total of 12.6% of patients admitted to intensive care had presented with AKI. The mean age was 49.6 ± 17.9. The sex ratio (M/F) was 2.1. Community-acquired AKI was in the majority (67.7%). Oligo anuria was the most frequent functional sign (38.4%). In our series, 81.6% of patients were in KDIGO stages 2 to 3. AKI was organic in 56.2% of cases. Mortality was 44.3%. In multivariate analysis, the main factors predictive of death were: respiratory distress (OR = 2.36;p Conclusions: Acute kidney injury in intensive care is common in northern Togo, and mortality is high. Identification of associated factors should help anticipate prognosis.展开更多
Introduction: The frequent late-stage diagnosis of chronic kidney disease (CKD) constrains the treatment choices for nephrologists. Renal biopsy (RB) is crucial for accurately identifying renal lesions. This key nephr...Introduction: The frequent late-stage diagnosis of chronic kidney disease (CKD) constrains the treatment choices for nephrologists. Renal biopsy (RB) is crucial for accurately identifying renal lesions. This key nephrological procedure, however, is invasive and not without potential complications. The purpose of this study was to evaluate the indications, frequency, and histological lesion profiles of renal biopsies in Togo. Materials and Methods: We conducted a descriptive cross-sectional study encompassing all renal biopsies performed in Togo from the inception of nephrology services to the present. Data were compiled from the medical records of the patients. Results: From 2015 to 2023, 68 high-quality renal biopsies were executed in Togo. The patients had an average age of 30.6 years, with a predominance of males (69.1%). The most common indication was nephrotic syndrome, accounting for 66.2% of cases. Histologically, glomerulopathies were predominant, representing 61.8% of lesions, followed by vascular nephropathies (25%) and tubulointerstitial nephropathies (13.2%). The most frequently observed primary glomerulopathy was focal segmental glomerulosclerosis (FSGS). Gross hematuria was the sole complication, occurring in 1.4% of the cases. Conclusion: RB is an evolving practice in Togo. Glomerulopathies are the most commonly observed lesions. The histological categorization of renal lesions is vital for clinicians in their diagnostic reasoning and approach.展开更多
文摘<strong>Background:</strong> Obstructive nephropathies are a topical issue in urology and nephrology consultations, but no study has yet been conducted on the subject in our country. <strong>Objective:</strong> Describe the epidemiological, clinical, therapeutic and evolutionary profile of obstructive nephropathies at the Sylvanus Olympio University hospital of Togo. <strong>Method:</strong> It was a descriptive and cross-sectional study with a collection of retrospective data over a period of 08 years (2012-2019) which focused on obstructive nephropathies in the Urology-Andrology, Nephrology and Internal Medicine departments at the medical clinic of CHU SO. The diagnosis of obstructive nephropathy is retained on the basis of radiological and medical imaging results. <strong>Results:</strong> The study population included 131 patients. The annual hospital frequency was 2.84 cases for 100 admissions. The mean age was 56.72 ± 17.76 years. These patients were mostly male (72.52%). The most frequent age group was 60 - 80 years. Common symptoms at presentation were loin pain (45.75%) and dysuria (25.95%). The average length of probable course of the disease before hospitalization was 636.94 ± 258.88 days (21 months). The etiologies of obstructive nephropathy were largely dominated by prostatic tumors in half of the cases (45.80%). Among these patients, 121 have presented renal failure (92.36%). The average serum creatinine at admission was 59.01 ± 21.56 mg/l. Of the 121 patients with obstructive nephropathy presenting renal failure, 54 (44.63%) had decreased their serum creatinine at the output of more than 25%. The open surgery (54.20%) was the main treatment. There was an improvement in kidney function in patients who had a shorter duration of disease progression and who did not have a history of loin pain, oliguria and that the etiologies of the disease were not tumors. Tumoral etiologies, the presence of a history of high blood pressure, oedema of the lower members, oliguria, and a longer duration of disease pr
文摘Objectives: To determine the prevalence and risk factors of erectile dysfunction (ED) in men on hemodialysis in Togo. Methods: Prospective cross-sectional study, descriptive and analytical ranging from December 2015 to February 2016 in the hemodialysis unit of CHU SO, only dialysis center in the country. The evaluation of the ED was made through IIEF-5 questionnaire. Results: 39 men (67.2%) of 58 hemodialysis is a sex ratio M/F of 2.05. The average age was 43.5 years with extremes of 25 and 59 years. The majority of men had a profession in 19 cases (48.7%). The mean duration of dialysis was 30 months with a range of 4 months and 90 months. Initial glomerular nephropathy was in 19 cases (48.7%) and vascular in 14 cases (35.9%). 38 patients were hypertensive (97.4%) and 6 diabetic men (15.4%). The prevalence of ED was 74.3% (29 cases). ED score was less than 10 points in 14 cases (35.9%);01 case (2.6%) between 11 and 16 points;06 cases (15.4%) between 17 to 21 points;08 cases (20.5%) between 22 and 25 points;and 10 cases (25.6%) between 26 and 30 points. Age, profession and duration of dialysis were risk factors associated with ED (P 0.001). Conclusion: The prevalence of ED is very high in Togo.
文摘Introduction: Emphysematous pyelonephritis (EPN) is a severe, life-threatening infection of the renal parenchyma. This condition is characterized by the production of intrarenal and perinephric gas. In the world, the EPN is currently limited to case series reported. No cases have been described in black Africa. Aims: Related a first case of EPN diagnosed and treated in the University Hospital Center Sylvanus Olympio of Lomé in Togo. Observation: A 40 years old woman, with antecedent of diabetes presented pyelonephritis emphysematous class 2. She was treated successfully with antibiotic alone without using percutaneous drainage or nephrectomy. Conclusion: As reported in every case series, it was a young diabetic patient with a clinical features of acute pyelonephritis which CT scan had helped lay the EPN class 2 diagnosed. The germ was Klebsiella pneumoniae. She was treated with adapted antibiotic alone.
文摘Aim: Review of early postoperative deaths in the surgical intensive care unit at CHU-Kara. Introduction: Surgery, one of the means of treatment of diseases, also presents risks for the patient, including early postoperative death linked to numerous risk factors. Methodology: This was a retrospective descriptive study conducted on the records of patients who died within 48 hours after surgery from November 1, 2019 to April 30, 2021. The study was conducted in the surgical intensive care unit and in the operating room. Results: Thirty-two early postoperative deaths or 2.22% out of 1442 operated with 30 deaths retained for the study. Male gender predominated (70%). The average age was 31.22 years. Farmers were more concerned (66.67%). The time to surgery was 1.6 days. ASA1 patients (40%) predominated followed by ASA IV (30%). 80% of patients were operated on as an emergency. Digestive pathologies 80% were more represented. General anaesthesia 86.66% was more practiced associating Propofol, Fentanyl, Ketamine and Atropine more frequently. The average duration of the procedures was 132.5 minutes. Intraoperative complications were associated with cardiac arrest and hemorrhage (33.34%). ASA class higher than 2, dirty surgery (46.67%), and delayed recovery (13.34%) were the incriminating risk factors. Death by hemodynamic shock and respiratory distress were the main causes 26.66%. Conclusion: Early postoperative mortality was high and involved all ages. Anesthesia and surgery, the low level of qualification of the intraoperative actors, the lesser intraoperative security;the association of anesthetic effects, the complexity of intraoperative lesions led to the increase of mortality. The combination of two or more factors was pejorative for the deaths.
文摘Introduction: Hand hygiene (HH) is an effective way to fight infections in healthcare settings. The general purpose of our study was to explore the knowledge, attitudes and practices of health care providers on HH at Dapaong regional hospital (DRH). Methodology: This was a prospective, descriptive cross-sectional study conducted from March to June 2022 in the DRH wards. Data were collected using a questionnaire and observation grid. Results: 90 care providers were surveyed. Males and non-physician personnel predominated with 57.8%, and 94.4% respectively. The survey on staff’s knowledge reported: 31.1% of practitioners did not wash their hands on arrival and departure in services. 24% did not know the difference between simple hand washing (SHW) and hygienic hand washing (HHW). 23.3% did not know the type of soap to use for HHW. The caregivers did not know the type of hand washing (HW) required after a septic and non-septic procedure in respectively 41.6%, and 37.8%. They did not know that there are two types of hand antiseptics (45.4%), nor the amount of antiseptic for HW (78.9%). The survey on staff’s attitude regarding HW found that: 70% did not remove all jewels prior HW, and 51.1% did not know that wearing gloves cannot replace the HW. For HW Staff Practice: 62.2% did not wash their hands before treatment. 91.1% did not spread the soap on their hands and forearms after wetting them. 65.55% did not rinse hands from nails to elbows. Conclusion: The HH was poorly known, the attitude of the staff was dangerous in relation to the HH and the practice of HH was very inadequate at the RHC-Dapaong. As a result, there is a need to retrain staff to increase their capacity to prevent care-related infections and enhance patient safety in the hospital.
文摘Introduction: The practice of spinal anesthesia in pediatric surgery is declining, especially in countries with limited means. What about in our context? Objective: To evaluate the practice of spinal anesthesia in pediatric surgery in Togo. Framework and method of study: This was a prospective study from November 2017 to May 2018 in pediatric surgery at CHU SO de Lomé, in the operating room and hospital ward of CHU Kara. The surgical, anesthesiological and evolutionary aspects of the patients were analyzed. Results: Sixty children were selected for the study who had an indication for sub-umbilical surgery. The male sex was predominant (73.3%). 47 (78.30%) patients were operated on for scheduled surgery. Hernia repair was the most performed surgical intervention (43.30%). The mean duration of the surgery was 78 ± 35.9 minutes. Most of the patients were ASA 1 (98.30%). The local anesthetic used was 0.5% isobaric Bupivacaine. Fentanyl was the predominant adjuvant (55%). The most widely used lumbar puncture needle was 25 Gauge with 75 millimeters in length (63.30%). Diazepam was the most widely used sedative (50%). The predominant spinal anesthesia protocol was spinal anesthesia alone (60%). Only one patient had hypotension (1.70%). Conclusion: The fairly satisfactory pediatric spinal anesthesia in Togo remains poorly performed. Its promotion involves the training of anesthesia practitioners and the strengthening of the technical platform.
文摘Background: Coronavirus disease mortality is high in people with chronic kidney disease. Method: we present the characteristics and factors associated with mortality of patients hospitalized for Covid-19 and with chronic kidney disease in a descriptive and analytical cross-sectional study of CKD patients admitted to the Lomé Commune Regional Hospital Center (CHR-LC) from March 2020 to August 2021. Results: A total of 127 patients met our inclusion criteria. We found a mortality rate of 48.8% in Lomé (Togo). Factors associated with this mortality in our study were severity of Covid-19 (p Conclusion: Mortality is very high in CKD patients with Covid-19.
文摘Background: Acute kidney injury (AKI) is one of the increasingly described complications of coronavirus infection. Objectives: To identify factors associated with death in patients with acute kidney injury (AKI) during Coronavirus disease (COVID-19) in Abidjan, C?te d’Ivoire. Material and Method: This was a monocentric retrospective analytical study of all patients over 18 years of age with AKI during COVID-19 at the Farah Polyclinic in Abidjan, C?te d’Ivoire. AKI was defined and ranked according to Kidney Disease Improving Global Outcomes (KDIGO) 2012. The data were collected from the medical record and processed using RStudio. Results: Forty-three cases were collected. The average age was 58.5 12 years. The sex ratio (M/F) was 4.4. The main comorbidities were high blood pressure (60.4%) and diabetes (37.2%). AKI was at KDIGO stage 3 in 58%, KDIGO 2 in 21% and KDIGO 1 in 21%. The diagnosis of acute tubular necrosis was retained in 44.2% of patients followed by acute functional kidney injury in 32.6%. Hemodialysis was initiated in 48.8% of cases. The main indication of dialysis was anuria (46.6%). In total, 55.8% of patients died. Factors associated with death were KDIGO stage (p = 0.049), and invasive ventilation (p Conclusion: Mortality is high in patients with AKI during COVID-19 infection.
文摘<strong>Context:</strong> The coexistence in the same patient of a mixed connectivitis or Sharp’s syndrome is a rare eventuality. <strong>Objective:</strong> To underline the presence of this mixed connectivitis in our practice, whose prevalence remains unknown, particularly in Africa and more precisely in Mali. <strong>Case Presentations:</strong> We report two cases of Sharp’s syndrome in a 48-year-old man and a 40-year-old woman with impaired renal function. The picture achieved associated massive proteinuria, hypoalbuminemia, moderate renal failure and edematous syndrome in men. In women, the picture was associated with accelerated to malignant hypertension and severe renal failure. There were no osteoarticular manifestations and the diagnosis of Sharp’s syndrome was based on the presence of high levels of antibodies to U1RNP. Therapeutic management has been that of predominantly associated connective tissue disease (systemic lupus erythematosus). <strong>Conclusion:</strong> Mixed connectivitis or Sharp’s syndrome is increasingly recognized as a separate entity thanks to advances in molecular biology. Its prevalence is low in sub-Saharan African countries with renal disease that manifests itself as proteinuria or nephrotic syndrome associated with microscopic hematuria, renal failure, and hypertension. This renal impairment is more likely to occur in severe forms of the disease.
文摘Context: Acute kidney injury (AKI) in intensive care unit (ICU) is common and associated with very high mortality. In Togo, a tropical country with limited resources and only one nephrology department in the north, acute kidney injury seems to be a real tragedy with high mortality. Aims: to determine risk factors for mortality in acute kidney injury in the intensive care units. Methods and Material: We made a multicentric cross sectional study during 6 months in the four referral centers in northern Togo. Univariate and multivariate logistic regression was used to identify factors associated with mortality. Data were analyzed using RStudio 2023.04.1. Results: A total of 12.6% of patients admitted to intensive care had presented with AKI. The mean age was 49.6 ± 17.9. The sex ratio (M/F) was 2.1. Community-acquired AKI was in the majority (67.7%). Oligo anuria was the most frequent functional sign (38.4%). In our series, 81.6% of patients were in KDIGO stages 2 to 3. AKI was organic in 56.2% of cases. Mortality was 44.3%. In multivariate analysis, the main factors predictive of death were: respiratory distress (OR = 2.36;p Conclusions: Acute kidney injury in intensive care is common in northern Togo, and mortality is high. Identification of associated factors should help anticipate prognosis.
文摘Introduction: The frequent late-stage diagnosis of chronic kidney disease (CKD) constrains the treatment choices for nephrologists. Renal biopsy (RB) is crucial for accurately identifying renal lesions. This key nephrological procedure, however, is invasive and not without potential complications. The purpose of this study was to evaluate the indications, frequency, and histological lesion profiles of renal biopsies in Togo. Materials and Methods: We conducted a descriptive cross-sectional study encompassing all renal biopsies performed in Togo from the inception of nephrology services to the present. Data were compiled from the medical records of the patients. Results: From 2015 to 2023, 68 high-quality renal biopsies were executed in Togo. The patients had an average age of 30.6 years, with a predominance of males (69.1%). The most common indication was nephrotic syndrome, accounting for 66.2% of cases. Histologically, glomerulopathies were predominant, representing 61.8% of lesions, followed by vascular nephropathies (25%) and tubulointerstitial nephropathies (13.2%). The most frequently observed primary glomerulopathy was focal segmental glomerulosclerosis (FSGS). Gross hematuria was the sole complication, occurring in 1.4% of the cases. Conclusion: RB is an evolving practice in Togo. Glomerulopathies are the most commonly observed lesions. The histological categorization of renal lesions is vital for clinicians in their diagnostic reasoning and approach.
