ஜர்னல் ஆஃப் நெப்ராலஜி & தெரபியூட்டிக்ஸ்

The kidney, ureter, and bladder cancers have different cellular ancestries and thus constitute separate clinical entities. Most frequently, tumours of the renal parenchyma are referred to as kidney cancer in general. 90% of all renal malignancies are renal cell carcinomas (RCC), which are by far the most common type of kidney cancer. Urothelial carcinoma (UC; formerly known as transitional cell carcinoma) predominates in cancers of the renal pelvis, ureter, and bladder, which are a significant cause of morbidity and mortality.

Background: Renal biopsy (RB) is a significant advance in the management of kidney disease. In sub-Saharan Africa, few studies were conducted. The objective of our work was to evaluate the indications of RB, to determine the epidemiological and histological characteristics of nephropathies diagnosed in sub-Saharan Africa.

Materials and Methods: We conducted a retrospective and descriptive study on RBs examined between January 2015 and December 2019, at the Pathological Anatomy and Cytology Departments of Cocody-Abidjan and Bouaké Teaching Hospitals. RBs came from four African countries (Côte d'Ivoire, Togo, Guinea-Conakry and Burkina Faso). Optical microscopy and/or direct immunofluorescence techniques were used. Included in this study were RBs containing epidemiological, clinical, biological and anatomic pathological data (optical microscopy and/or direct immunofluorescence). The parameters studied were: indication of RB, epidemiological and clinical profile, proteinuria and histology.

Results: Over the study period, we collected 179 RBs, or 35.8 RBs/year. The mean age of patients was 32.9 13.8 years (extremes of 11 and 70 years). The sex ratio (M/F) was 1.03. Nephrotic syndrome was the main indication (64.2%, n=115) followed by persistent acute kidney disease (7.8%, n=14), rapidly progressive glomerulonephritis (7.3%, n=13), nephrotic syndrome with chronic kidney disease (6.1%, n=11), isolated chronic kidney disease (5.6%, n=10) and other indications (8.9, n=16). Glomerular nephropathy (GN) was observed in 97.8% (n=175) and tubulointerstitial disease (TID) in 2.2% (n=4). Focal segmental glomerulosclerosis (FSGS) (34.6%, n=62), nephrotangiosclerosis (10.6%, n=19), extramembranous GN (10%, n=18), post-infectious GN (8.9%, n=16), lupus GN (7.3%, n=13) were the main nephropathies.

Conclusion: The Renal biopsy is a crucial gesture for the diagnosis of nephropathy. Focal segmental glomerulosclerosis is the main nosology. The establishment of a kidney registry would allow a better knowledge and management of kidney pathologies in sub-Saharan Africa.

Background: Chronic kidney disease is a global public health problem in terms of prevalence, the cost of management and its mortality. Despite the high cost of hemodialysis facilities, many public units are being created to meet the ever-increasing demand of kidney disease patients in Ivory Coast. The aim of our study was to describe the epidemiological profile of patients treated by chronic hemodialysis in a public unit in an Ivorian city.

Methods: It was a retrospective study of record of chronic hemodialysis patients for at least 3 months during the period from November 2014 to December 2020.

Results: The mean age was 41.5 years with a sex ratio of 1.5. The dialysis started as an emergency with 85.9% of patients, on a temporary catheter in 78.4%. The average duration on dialysis was 28.08 months. Mortality rate was 26.67%. Factors associated with death were a nonhigher level of education (0.01), chronic heart failure (0.001), the presence of a temporary catheter (0.05), uncontrolled blood pressure (0.0001), a severe anemia (0.0001), the absence of the use of erythropoietin (0.004), the absence of diuretic (0.02) and a less than one year duration on dialysis (0.00012).

Conclusion: The patients treated in this dialysis unit were young. Mortality was high. We recommend the inclusion of dialysis care for chronic kidney disease patients in the universal healthcare coverage of Ivory Coast.