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RÉSUMÉ
Objectif. Décrire les aspects cliniques, biologiques et évolutifs des patients hospitalisés pour Insuffisance rénale aigue (IRA) et ayant été mis en hémodialyse. Méthodes. Il s’agissait d’une étude de cohorte de patients hospitalisés au service de Néphrologie- Médecine Interne D du CHU de Treichville; réalisée sur une période de 02 ans d’Octobre 2016 à Septembre 2018. Résultats. Nous avons colligé 84 cas d’IRA hémodialysée durant la période d’étude. L’âge moyen était de 42,6±15,5 ans avec une prédominance masculine (sex-ratio=2,23). Les patients étaient majoritairement référés pour altération de la fonction rénale (38%). Ils étaient admis pour perte de connaissance(23,8%), diarrhée-vomissements (14,3%). Les facteurs de risque tels que l’hypertension artérielle(23,8%), le VIH (11,9%) et le diabète(7,1%) ont été retrouvés. L’atteinte rénale était parenchymateuse (92,9%) et obstructive(7,1%). Les principales étiologies étaient infectieuses (42,8%) et toxiques (38%). La dialyse a été indiquée devant une urémie sévère(73,7%) et une anurie de plus de 24h (36,8%). Le nombre moyen de séance était de 3. L’évolution était favorable dans 73,8% des cas avec une récupération totale de la fonction rénale dans 40,5%. La présence de diabète était associée au risque de décès chez nos patients (OR=2,30; IC95%=1,73-7,20; p=0,03). Les facteurs tels que l’obstruction des voies urinaires(OR=1,77; IC95%=1,45-2,15; p=0,03), et la présence de diabète (OR=0,56; IC95%=0,46-0,68; p=0,03) étaient associés à la non-récupération de la fonction rénale. Conclusion. La mortalité chez les hémodialysés pour IRA reste élevée. Les étiologies sont dominées par les infections et les causes toxiques. La présence de diabète impacte le pronostic des patients.
ABSTRACT
Aim. To describe the clinical, biological and evolutionary aspects of patients hospitalized for acute kidney injury (AKI) and having undergone hemodialysis sessions. Methods. This was a cohort study of hospitalized patients in the Department of Nephrology-Internal Medicine D of the Teaching Hospital of Treichville carried over a period of 02 years from October 2016 to September 2018. Results. We collected 84 cases of hemodialysis AKI during the study period. The mean age was 42.6 ± 15.5 years with a male predominance (sex ratio = 2.23). The majority of patients were referred for impaired kidney function (38%). They were admitted for loss of consciousness (23.8%), diarrhea and vomiting (14.3%). Risk factors such as high blood pressure (23.8%), HIV (11.9%) and diabetes (7.1%) were found. Kidney damage was parenchymal (92.9%) and obstructive (7.1%). The main diseases were infectious (42.8%) and toxic (38%). Dialysis was performed for severe uremia (73.7%) and anuria of more than 24 hours (36.8%). The average number of sessions was 3. The evolution was favorable in 73.8% of the cases with a total recovery of the renal function in 40.5%. Being diabetic was associated with the risk of death in our patients (OR = 2.30, 95% CI = 1.73-7.20, p = 0.03). Factors such as urinary tract obstruction (OR = 1.77, 95% CI = 1.45-2.15, p = 0.03), and presence of diabetes (OR = 0.56, 95% CI) 0.46-0.68, p = 0.03) were associated with recovery of renal function. Conclusion. Mortality in hemodialysis for AKI remains high. The main causes were dominated by infections and toxic causes. The presence of diabetes impacts the prognosis of patients.

Keywords

Acute Kidney injury, hemodialysis, infection, toxic Insuffisance rénale aigue, hémodialyse, infection, toxique.

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Guei, M. C., Sery Patrick, D. ., Monlet Cyr, G. ., Sanogo, S. ., Affi Jean, A. A. ., Assa, O. ., & Hubert, Y. K. . (2021). Insuffisance Rénale Aigue et Hémodialyse : Aspects Cliniques, Biologiques et Évolutifs au Service de Néphrologie-Médecine Interne D du CHU de Treichville. HEALTH SCIENCES AND DISEASE, 22(10). https://doi.org/10.5281/hsd.v22i10.2963
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