Article Sidebar

Download
PDF

Main Article Content

Abstract

ABSTRACT
Background. Without a national renal registry in Cameroon, the burden and forms of renal disease in the North-West region of Cameroon is unknown. We aimed to describe the clinical pattern and outcome of renal and urinary tract admissions in the medical wards of the Bamenda Regional Hospital (BRH). Materials and methods. This was a retrospective analysis of records of patients hospitalized between January 1st, 2017 and December 31st, 2018, in the medical wards of the BRH. We excluded patients with incomplete files. Results. Out of the 2079 admissions, 274(13.2%) had renal and urinary tract disorders. In all, 75.5% (n= 207) were emergency admissions, 30.3% were referrals, with 92.7% (n=76) referred by general practitioners. Non-dialysed chronic kidney disease (CKD-ND) (40.9%), acute kidney injury (AKI) (27.4%), urinary tract infection (14.6%), dialysed chronic kidney disease (12.8%), nephrotic syndrome (2.2%) and renal colic (2.2%) were the renal syndromes seen. The need for dialysis was 57.3% in the AKI group and 67.8 % in the CKD-ND group, with less than 60% access rate. The overall mortality was 15.3% and the median length of hospital stay was 10 [IQR: 7 – 15] days. Conclusion. Renal and urinary tract diseases constitute a significant health burden in our community. The clinical pattern is dominated by CKD-ND and AKI secondary to preventable causes. Access to dialysis remains poor in those in need.


RÉSUMÉ
Introduction. En l’absence d’un registre national camerounais sur les maladies rénales, le fardeau que représente les maladies de l’appareil urinaire ainsi que leurs différentes présentations sur la population du Nord-Ouest Cameroun reste inconnue. Le but de notre travail était de décrire les différents aspects cliniques ainsi que le devenir de ces maladies parmi les admissions en médecine interne à l’Hôpital Régional de Bamenda. Matériels et Méthodes. Il s'agissait d'une analyse rétrospective des dossiers des patients hospitalisés entre le 1er janvier 2017 et le 31 décembre 2018, dans les services de médecine interne de l'Hôpital Régional de Bamenda. Nous avons exclu les patients dont les dossiers étaient incomplets. Résultats. Sur les 2079 admissions durant la période d’étude, 274 (13,2 %) presentaient des maladies rénales et des voies urinaires. Au total, 75,5% (n=207) de ces admissions rénales étaient des admissions d'urgence, 30,3% étaient des références avec 92,7% (n=76) d’elles réalisées par des médecins généralistes. Les maladies rénales chroniques non dialysées (MRC-ND) (40,9 %), les lésions rénales aiguës (LRA) (27,4 %), les infections des voies urinaires (14,6 %), les maladies rénales chroniques en dialyse (12,8 %), le syndrome néphrotique (2,2 %) et la colique néphrétique (2,2 %) étaient les syndromes rénaux observés. Le besoin de dialyse était de 57,3 % dans le groupe avec LRA et de 67,8 % dans le groupe MRC-ND, avec un taux d'accès inférieur à 60 %. La mortalité globale était de 15,3 % et la durée médiane d'hospitalisation était de 10 [EIQ : 7 – 15] jours. Conclusion. Les maladies rénales et des voies urinaires sont fréquentes en hospitalisation dans notre communauté. Leur présentation clinique est dominée par les MRC-ND et les LRA dues à des causes évitables. L'accès à la dialyse reste limité chez les personnes dans le besoin.

Article Details

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to Cite
Tatang Mambap, A. ., Ngum, S. C. ., Teuwafeu, D. G. ., & Ashuntantang, G. E. . (2021). Clinical Spectrum and Outcome of Renal and Urine Tract Disease among Medical Admissions at the Bamenda Regional Hospital-Cameroon: A 2-Years Review: Renal and urine tract diseases in Bamenda. HEALTH SCIENCES AND DISEASE, 22(11). https://doi.org/10.5281/hsd.v22i11.3080
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. Van Rensburg BWJ, Van Staden AM, Rossouw GJ, Joubert G. The profile of adult nephrology patients admitted to the renal unit of the universitas tertiary hospital in bloemfontein, South Africa from 1997 to 2006. Nephrol Dial Transplant [Internet]. 2010 Mar [cited 2021 Jun 28];25(3):820–4. Available from: https://pubmed.ncbi.nlm.nih.gov/19875380/
  2. Naicker S. End-stage renal disease in sub-Saharan and South Africa. In: Kidney International, Supplement [Internet]. Blackwell Publishing Inc.; 2003 [cited 2020 Dec 6]. p. S119–22. Available from: http://www.kidney-international.org/article/S0085253815491975/fulltext
  3. Lameire NH, Bagga A, Cruz D, De Maeseneer J, Endre Z, Kellum JA, et al. Acute kidney injury: An increasing global concern [Internet]. Vol. 382, The Lancet. Elsevier B.V.; 2013 [cited 2021 Jun 7]. p. 170–9. Available from: https://pubmed.ncbi.nlm.nih.gov/23727171/
  4. Raimann JG, Riella MC, Levin NW. International Society of Nephrology’s 0by25 initiative (zero preventable deaths from acute kidney injury by 2025): Focus on diagnosis of acute kidney injury in low-income countries. Clin Kidney J [Internet]. 2018 Feb 1 [cited 2021 Jun 7];11(1):12–9. Available from: https://pubmed.ncbi.nlm.nih.gov/29423195/
  5. McCullough PA, Shaw AD, Haase M, Bouchard J, Waikar SS, Siew ED, et al. Diagnosis of acute kidney injury using functional and injury biomarkers: Workgroup statements from the tenth acute dialysis quality initiative consensus conference [Internet]. Vol. 182, Contributions to Nephrology. Contrib Nephrol; 2013 [cited 2021 Jun 7]. p. 13–29. Available from: https://pubmed.ncbi.nlm.nih.gov/23689653/
  6. Hobson C, Ozrazgat-Baslanti T, Kuxhausen A, Thottakkara P, Efron PA, Moore FA, et al. Cost and mortality associated with postoperative acute kidney injury. Ann Surg [Internet]. 2015 Jun 1 [cited 2021 Jun 7];261(6):1207–14. Available from: https://pubmed.ncbi.nlm.nih.gov/24887982/
  7. Aseneh JB, Kemah BLA, Mabouna S, Njang ME, Ekane DSM, Agbor VN. Chronic kidney disease in Cameroon: A scoping review [Internet]. Vol. 21, BMC Nephrology. BioMed Central Ltd; 2020 [cited 2021 Jun 7]. p. 1–11. Available from: https://doi.org/10.1186/s12882-020-02072-5
  8. Suckling R, Gallagher H. Chronic kidney disease, diabetes mellitus and cardiovascular disease: Risks and commonalities. J Ren Care [Internet]. 2012 Feb [cited 2021 Jun 7];38(SUPPL. 1):4–11. Available from: https://pubmed.ncbi.nlm.nih.gov/22348359/
  9. Essue BM, Laba T-L, Knaul F, Chu A, Minh H Van, Nguyen TKP, et al. Economic Burden of Chronic Ill Health and Injuries for Households in Low- and Middle-Income Countries. In: Disease Control Priorities, Third Edition (Volume 9): Improving Health and Reducing Poverty [Internet]. The World Bank; 2017 [cited 2021 Jun 7]. p. 121–43. Available from: https://pubmed.ncbi.nlm.nih.gov/30212160/
  10. Ogiator M, Okopi J, Idikwu I, Ogiator A. Spectrum of Renal Diseases in Benue State University Teaching Hospital Makurdi, Nigeria. J Adv Med Pharm Sci. 2017 Jan 10;12(2):1–7.
  11. Wachukwu CM, Emem-Chioma PC, Wokoma FS, Oko-Jaja RI. Pattern and outcome of renal admissions at the University of Port Harcourt Teaching Hospital, Nigeria: A 4 years review [Internet]. Vol. 15, Annals of African Medicine. Medknow Publications; 2016 [cited 2020 Dec 6]. p. 63–8. Available from: /pmc/articles/PMC5402825/?report=abstract
  12. Ngwogu K, Onwuchekwa U, … AN-IJ of, 2015 U. Incidence, pattern and outcome of renal admissions at the Abia State University Teaching Hospital, Aba: A five year review. ajol.info [Internet]. 2015 [cited 2020 Dec 6];4(4). Available from: https://www.ajol.info/index.php/ijbair/article/view/133181
  13. Etyang AO, Scott JAG. Medical causes of admissions to hospital among adults in Africa: A systematic review and 2003. Glob Health Action [Internet]. 2013 [cited 2021 Jun 7];6(1). Available from: https://pubmed.ncbi.nlm.nih.gov/23336616/
  14. Kaze FF, Ekokobe FE, Halle MP, Fouda H, Menanga AP, Ashuntantang G. The clinical pattern of renal diseases in the nephrology in-patient unit of the Yaounde General Hospital in Cameroon: A five-year audit. Pan Afr Med J [Internet]. 2015 Aug 26 [cited 2020 Dec 6];21. Available from: https://pubmed.ncbi.nlm.nih.gov/26421100/
  15. Ghimire M, Vaidya S, Upadhyay HP. Clinicodemographic profile of kidney diseases in a tertiary hospitaof central nepal, chitwan: A descriptive cross-sectional study. J Nepal Med Assoc [Internet]. 2020 Jul 1 [cited 2021 Mar 4];58(227):459–64. Available from: https://pubmed.ncbi.nlm.nih.gov/32827005/
  16. Okyere P, Okyere I, Ephraim RKD, Attakorah J, Osafo C, Arhin B, et al. Spectrum and Clinical Characteristics of Renal Diseases in Ghanaian Adults: A 13-Year Retrospective Study. Int J Nephrol [Internet]. 2020 [cited 2021 Mar 4];2020. Available from: https://pubmed.ncbi.nlm.nih.gov/32328308/
  17. Naicker S. End-stage renal disease in Sub-Saharan Africa. Kidney Int Suppl. 2013 May 1;3(2):161–3.
  18. Madala ND, Thusi GP, Assounga AGH, Naicker S. Characteristics of South African patients presenting with kidney disease in rural KwaZulu-Natal: A cross sectional study. BMC Nephrol [Internet]. 2014 Apr 14 [cited 2021 Jun 14];15(1). Available from: https://pubmed.ncbi.nlm.nih.gov/24731300/
  19. Feest TG, Mistry CD, Grimes DS, Mallick NP. Incidence of advanced chronic renal failure and the need for end stage renal replacement treatment. Br Med J [Internet]. 1990 [cited 2021 Jun 19];301(6757):897–900. Available from: https://pubmed.ncbi.nlm.nih.gov/2261533/
  20. Muiru AN, Charlebois ED, Balzer LB, Kwarisiima D, Elly A, Black D, et al. The epidemiology of chronic kidney disease (CKD) in rural East Africa: A population-based study. PLoS One [Internet]. 2020 [cited 2021 Sep 13];15(3):e0229649. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0229649
  21. Patrice HM, Pascal KA, François KF, Hilaire D, Solange DM, Gloria AE, et al. Markers and risk factors for chronic kidney disease in sub-Saharan Africans: baseline levels and 12-month trajectories in newly referred patients in Cameroon. BMC Nephrol 2020 211 [Internet]. 2020 Mar 18 [cited 2021 Sep 13];21(1):1–11. Available from: https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-020-01760-6
  22. Halle MPE, Kengne AP, Ashuntantang G. Referral of patients with kidney impairment for specialist care in developing country of sub-saharan Africa. Ren Fail [Internet]. 2009 [cited 2021 Jun 28];31(5):341–8. Available from: https://pubmed.ncbi.nlm.nih.gov/19839832/
  23. Kazmi WH, Obrador GT, Khan SS, Pereira BJG, Kausz AT. Late nephrology referral and mortality among patients with end-stage renal disease: A propensity score analysis. Nephrol Dial Transplant [Internet]. 2004 Jun [cited 2021 Jun 28];19(7):1808–14. Available from: https://pubmed.ncbi.nlm.nih.gov/15199194/
  24. Parameswaran S, Geda SB, Rathi M, Kohli H, Gupta K, Sakhuja V, et al. Referral pattern of patients with end-stage renal disease at a public sector hospital and its impact on outcome. undefined. 2011;
  25. Marie Patrice H, Joiven N, Hermine F, Jean Yves B, Folefack François K, Enow Gloria A. Factors associated with late presentation of patients with chronic kidney disease in nephrology consultation in Cameroon-a descriptive cross-sectional study. Ren Fail [Internet]. 2019 Jan 1 [cited 2021 Jun 14];41(1):384–92. Available from: /pmc/articles/PMC6534206/
  26. Adejumo O, Akinbodewa A, Okaka E, Alli O, Ibukun I. Chronic kidney disease in Nigeria: Late presentation is still the norm. Niger Med J [Internet]. 2016 [cited 2021 Jun 28];57(3):185. Available from: https://www.nigeriamedj.com/article.asp?issn=0300-1652;year=2016;volume=57;issue=3;spage=185;epage=189;aulast=Adejumo
  27. Marie Patrice H, Joiven N, Hermine F, Jean Yves B, Folefack François K, Enow Gloria A. Factors associated with late presentation of patients with chronic kidney disease in nephrology consultation in Cameroon-a descriptive cross-sectional study. Ren Fail [Internet]. 2019 Jan 1 [cited 2021 Jun 22];41(1):384–92. Available from: /pmc/articles/PMC6534206/
  28. Ogunmola O, Oladosu O. Pattern and outcome of admissions in the medical wards of a tertiary health center in a rural community of Ekiti state, Nigeria. Ann Afr Med [Internet]. 2014 Dec 1 [cited 2020 Dec 6];13(4):195. Available from: http://www.annalsafrmed.org/text.asp?2014/13/4/195/142291
  29. Halle MP, Takongue C, Kengne AP, Kaze FF, Ngu KB. Epidemiological profile of patients with end stage renal disease in a referral hospital in Cameroon Epidemiology and Health Outcomes. BMC Nephrol [Internet]. 2015 Apr 21 [cited 2021 Jun 14];16(1). Available from: https://pubmed.ncbi.nlm.nih.gov/25896605/
  30. Halle MPE, Chipekam NM, Beyiha G, Fouda H, Coulibaly A, Hentchoya R, et al. Incidence, characteristics and prognosis of acute kidney injury in Cameroon: a prospective study at the Douala General Hospital. Ren Fail [Internet]. 2018 Nov 1 [cited 2021 Mar 6];40(1):30–7. Available from: /pmc/articles/PMC6014289/
  31. Halle MP, Ashuntantang G, Kaze FF, Takongue C, Kengne AP. Fatal outcomes among patients on maintenance haemodialysis in sub-Saharan Africa: a 10-year audit from the Douala General Hospital in Cameroon. BMC Nephrol [Internet]. 2016 Nov 3 [cited 2021 Mar 16];17(1):1–9. Available from: http://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-016-0377-5
  32. Kaze FF, Ekokobe FE, Halle MP, Fouda H, Menanga AP, Ashuntantang G. The clinical pattern of renal diseases in the nephrology in-patient unit of the Yaounde General Hospital in Cameroon: A five-year audit. Pan Afr Med J. 2015 Aug 26;21.
  33. Fouda H, Ashuntantang G. The Epidemiology of Acute Kidney Injury in a Tertiary Hospital in Cameroon: A 13 Months Review. J Nephrol Ther. 2016;6(3).
  34. Olowu WA, Niang A, Osafo C, Ashuntantang G, Arogundade FA, Porter J, et al. Outcomes of acute kidney injury in children and adults in sub-Saharan Africa: A systematic review. Lancet Glob Heal [Internet]. 2016 Apr 1 [cited 2020 Dec 6];4(4):e242–50. Available from: https://pubmed.ncbi.nlm.nih.gov/27013312/
  35. Ashuntantang G, Osafo C, Olowu WA, Arogundade F, Niang A, Porter J, et al. Outcomes in adults and children with end-stage kidney disease requiring dialysis in sub-Saharan Africa: a systematic review. Lancet Glob Heal [Internet]. 2017 Apr 1 [cited 2021 Jun 19];5(4):e408–17. Available from: www.thelancet.com/lancetgh
  36. Paul G, Gautam PL, Mahajan RK, Gautam N, Ragavaiah S. Patients leaving against medical advice–A national survey. Indian J Crit Care Med [Internet]. 2019 Mar 1 [cited 2021 Jun 27];23(3):143–8. Available from: /pmc/articles/PMC6487628/

Most read articles by the same author(s)