TITLE:
Profile of Patients with Acute Renal Injury in N’Djamena: About 36 Cases
AUTHORS:
Guillaume Mahamat Abderraman, Hamat Ibrahim, Moussa Tondi Zeinabou Maiga, Tall Ahmed Lemrabott, Faye Maria, Kossi Akomola Sabi, Mahamat Youssouf, Cisse Mouhamadou Moustapha, Ka Elhaj Fary Ka, Niang Abdou, Diouf Boucar
KEYWORDS:
Acute Renal Injury, Hemodialysis, Epidemiology, Chad Component, Formatting, Style, Styling
JOURNAL NAME:
Open Journal of Nephrology,
Vol.7 No.1,
January
24,
2017
ABSTRACT: Introduction: The incidence of acute renal injury
(AKI) has increased in recent decades. Acute renal failure is defined by the
abrupt arrest (within hours or days) of the kidney excretory function. Oliguria
(urine output 24h) is
presented in about half of the cases. The circumstances of the occurrence of AKI
are multiple: surgical, traumatic, obstetric, medical, often obvious. Its
prognosis depends on the speed of management and the associated organ failure.
The objective of this study is to describe the profile of patients in emergency
hemodialysis at the Nephrology Unit of the National Reference General Hospital
(HGRN) in N’Djamena, Chad. Methods: This was a multicenter, descriptive study
in patients with acute renal failure place over a period of 12 months in the
emergency departments of the 2 hospitals in N’Djamena. Defined as carriers of
an AKI (RIFLE criteria), patients with: 1) Oliguria: urinary output 400 ml/24h ( 300 ml/24h; 2) Associated with an increase in serum
creatinine: serum creatinine × 3 or serum creatinine> 350 μmol/l or decrease
of GFR by 75%. Results: Of the 311 patients admitted, 36 cases met the
inclusion criteria, a frequency of 11.57%. The mean age was 34.46 years with
extremes ranging from 7 to 80 years. The female sex predominated with 52.80% as
sex ratio of 0.91. Isolated hypertension was noted with 38.88%. Dyspnea
accounted for 41.66% of patients admitted to emergency departments. In our
series, 50% of our patients had hyperthermia at admission. Oliguria was
observed in 41.70% of the cases. Edema accounted for 33.33% of cases. The AKI
with the “failure” criterion was 58.34%
(21/36), with the criterion “injury” 25% (9 cases) and the criterion “risk”
16.66 (6 cases). AKI were organic in 83.34% (30/36). It was noted that 14 patients, 38.8% had an infectious
syndrome. There were 6 patients who had (16.66%) an
obstructive AKI, 5 patients (13.88%) had eclampsia, 4 patients (11.12%) had
hepatocellular insufficiency, 3 patients (8.34% Cardiac, 2 patients (5.56%)
extracellular dehydration and 2 patients (5.56%) whose cause is indeterminate.
It was noted that 10 patients, as 27.7%, had fully recovered their renal
function after vascular filling and etiological treatment. Four (4) patients
with obstructive obstruction were referred to the urology department. There
were 22 patients who had benefited from the hemodialysis. 6 patients recovered
completely their renal function. We had recorded a number of deaths in our
study which was 44.44% (16/36). Septic shock was the most frequent cause of
death in 50% of cases. Conclusion: The incidence of AKI in our study was
11.57%. It affects a young population and despite the therapeutic progress, the
mortality remains high. The causes are multiple, entangled, dominated by
infectious syndrome and hypovolemia. Prevention seems to be the best
therapeutic option to avoid the installation or worsening of an AKI.