clove and Renal-Insufficiency--Chronic

Initiation of emergency dialysis is a critical situation responsible for high morbidity and mortality. This study describes the characteristics of emergency hemodialysis patients in a hospital in Madagascar.. It is a descriptive study over a period of 7 months, from September 1, 2018 to March 31, 2019, on emergency hemodialysis patients in the hemodialysis department of the University Hospital of Joseph Raseta Befelatanana, Antananarivo. Emergency hemodialysis was defined as dialysis performed immediately or within the first 48 hours of hospitalisation in a life-threatening situation.. Among 124 haemodialysis patients, 52 patients (41.93%) had started dialysis as an emergency. The mean age of patients was 50.5 years and the sex ratio (male/female) was 1.08. Hypertension (51.92%) and diabetes (34.61%) were the main comorbidities. Chronic kidney disease was found in 82.7%. The majority of patients were unprepared and had initiated dialysis with a central venous catheter. The most frequent indication was Kussmaul's breathing (32.6%) followed by anuria (28.84%). The mortality rate was 23.08% and the prognosis was influenced by their condition on arrival.. The predominance of chronic kidney disease and the absence of a permanent vascular approach can be explained by the late referral to nephrologists of patients with chronic kidney disease. Efforts need to be made to increase the proportion of scheduled dialysis patients with a permanent approach.. L’initiation de la dialyse en urgence est une situation critique responsable d’une morbi-mortalité élevée. Cette étude décrit les caractéristiques des patients hémodialysés en urgence dans un centre hospitalier de Madagascar.. Il s’agit d’une étude descriptive sur une période de sept mois, du 1er septembre 2018 au 31 mars 2019, portant sur les patients hémodialysés en urgence dans le service d’hémodialyse du centre hospitalier Joseph Raseta Befelatanana, Antananarivo. L’hémodialyse en urgence était définie par une dialyse réalisée dans l’immédiat ou dans les 48 premières heures d’hospitalisation devant une situation mettant en jeu le pronostic vital.. Parmi les 124 patients hémodialysés, 52 patients (41,93 %) avaient démarré la dialyse en urgence. L’âge moyen des patients était de 50,5 ans et le sex-ratio (hommes/femmes) était de 1,08. L’hypertension artérielle (51,92 %) et le diabète (34,61 %) étaient les principales comorbidités. L’insuffisance rénale chronique a été trouvée dans 82,7 %. La majorité des patients n’étaient pas préparés et avaient initié la dialyse avec un cathéter veineux central. L’indication la plus fréquente était la dyspnée de Kussmaul (32,6 %) suivie de l’anurie (28,84 %). Le taux de mortalité était de 23,08 % et le pronostic était influencé par l’état à l’arrivée.. La prédominance de l’insuffisance rénale chronique et l’absence d’abord vasculaire permanent peuvent s’expliquer par la référence tardive aux néphrologues des patients ayant une insuffisance rénale chronique. Des efforts doivent être faits pour augmenter la proportion de patients dialysés programmés avec une approche permanente.

Topics: Female; Hospitalization; Hospitals, University; Humans; Kidney Failure, Chronic; Madagascar; Male; Middle Aged; Renal Dialysis; Renal Insufficiency, Chronic

Chronic kidney disease is defined as an inability of the kidney to perform its normal functions and which persists beyond three months. Nowadays, the estimated glomerular filtration rate based on plasmatic creatinine level remains the gold standard to assess renal function. In Madagascar, we miss national data concerning the epidemiology of chronic kidney disease probably due to the complexity of carrying out the serum creatinine assays. The recent availability of creatinometer using a creatinine strip test with capillary creatinine facilitated the determination of the creatinine level in epidemiological study.. This simple technique allowed us to plan a pilot study in Antananarivo, the capital of Madagascar. The main objective was to assess the prevalence of chronic kidney disease determined from capillary creatinine level. The secondary objective was to determine the factors associated with chronic kidney disease in Madagascar. It is an analytical cross-sectional study over a period of three months. Chronic kidney disease is defined as a decrease of the glomerular filtration rate of capillary creatinine less than 60mL/min/1.73m. At the end of the study, 210 people were randomized for screening. The average age was 40 years old with 14.9 as standard deviation. The sex ratio (male/female) was 1.76. The prevalence of chronic kidney disease was 13.8% with extreme values of 9,1 and 18.5. With chronic kidney disease, high blood pressure (hypertension) and diabetes were found respectively in 41.3 and 17.2%. Chronic kidney disease affected mainly in 72.4% of population aged 25 to 54 years old.. This is the first study in Africa to screen chronic kidney disease using a creatinine strip test. This prevalence is relatively different compared to other African countries. The limits of the study are the absence of a subsequent control and/or double control of the creatinine, which definitively confirms the chronicity of kidney disease, the absence evaluation of the urinary sediments to determine proteinuria. Nevertheless, the results of our study can be used as data awaiting the results of a multicenter studies. To determine the national prevalence of chronic kidney disease, screening in the six provinces is currently in progress.

Topics: Adult; Creatinine; Cross-Sectional Studies; Female; Glomerular Filtration Rate; Humans; Madagascar; Male; Middle Aged; Pilot Projects; Prevalence; Renal Insufficiency, Chronic