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Saudi Journal of Kidney Diseases and Transplantation
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RENAL DATA FROM THE ASIA - AFRICA Table of Contents   
Year : 2003  |  Volume : 14  |  Issue : 2  |  Page : 212-214
Histopathological Profiles of Nephropathies in Senegal


Clinique Médicale 1, Centre Hospitalier Universitaire, A. Le Dantec, Dakar, Senegal

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   Abstract 

Few data from West Africa are available on the prevalence of the different kidney diseases. One hundred fifteen patients underwent renal biopsy in the nephrology department in Dakar from 1993 to 1998. Nephrotic syndrome was the main indication of biopsy (67%). The primary nephropathies were found in 69.5% of the patients, the secondary nephropathies in 23.5% and unclassified nephropathies in 7%. Of the primary nephropathies, focal segmental glomerulosclerosis was found in 47% of the patients followed by membranous glomerulopathy in 12.5%. Secondary nephropathies were dominated by lupus nephritis followed by tubulo-interstitial toxic nephritis, misnamed as "tropical nephropathy", due to the intake of local home remedies.

How to cite this article:
Abdou N, Boucar D, El Hadj Fary K A, Mouhamadou M, Abdoulaye L, Mamadou Mourtala K A, Saidou D, Abdoulaye P, Therese MD. Histopathological Profiles of Nephropathies in Senegal. Saudi J Kidney Dis Transpl 2003;14:212-4

How to cite this URL:
Abdou N, Boucar D, El Hadj Fary K A, Mouhamadou M, Abdoulaye L, Mamadou Mourtala K A, Saidou D, Abdoulaye P, Therese MD. Histopathological Profiles of Nephropathies in Senegal. Saudi J Kidney Dis Transpl [serial online] 2003 [cited 2019 Jul 15];14:212-4. Available from: http://www.sjkdt.org/text.asp?2003/14/2/212/33034

   Introduction Top


There are few data available on the renal pathology in black Africans. Nevertheless, nephropathies form an important sector in the practice of the medical department in Dakar. [1],[2] Chronic renal failure (CRF) repre­sents 7% of the admissions to the hospital; of them 16% are glomerulonephritis (GN) and the nephrotic syndrome (NS). [3],[4]

We report in this study the pathological aspects of the kidney diseases in our population.


   Patients and Methods Top


One hundred fifteen patients underwent kidney biopsy in the medical department of the university hospital center A. Le Dantec of Dakar, the unique nephrology unit in Senegal. We reviewed the medical records of the patients followed up in this unit from January 1993 to December 1998. There were 64 males and 51 females with a mean age of 28 years (range 5 to 60 years). Percu­taneous kidney biopsy was guided by ultrasonography. Renal tissue specimens were fixed in the Bouin fluid for light microsco­pic examination and in the Michel liquid for immunofluorescence procedure. All the specimens were sent to the pathology depart­ment of Necker's hospital in Paris- France, which later reported the results to our center.


   Results Top


There were 115 kidney biopsies available for analysis. The patients were from Senegal (n=108), Mauritania (n=4), Guinea (n=1), Mali (n=1), and Congo (n=1). The nephrotic syndrome was the main indication for biopsy (67%) followed by lupus erythema­tosus (13%) and glomerulonephropathy without NS (12%), [Table - 1]. There were no major complications after biopsy except transient gross hematuria in five cases.

The primary nephropathies (PN) were found in 80(69.5%) cases, secondary nephropathies in 27 (23.5%) and 8 (7%) cases could not be classified.

Focal segmental glomerulosclerosis (FSGS) represented 67% of the primary glomerulopa­thy in our series, and 47% of all the biop­sies; membranous glomerulopathy (MGN) ranked second, [Table - 2]. Extracapillary glomerulopathy superimposed FSGS in one case and mesangial proliferation in another.

The secondary nephropathies were asso­ciated with lupus nephritis in 55.5% of the cases, followed by tubulo-interstitial toxic nephritis secondary to the intake of home remedies (traditional drugs), [Table - 3].


   Discussion Top


Accurate pathological diagnosis of nephro­pathies is rarely made in our area because of insufficient technical means and late evaluation of the cases, which present usually with advanced renal failure; the previous studies from our region labeled the causes of CRF as unknown in 34 to 36% of the cases. [1],[3]

NS remains the main indication of kidney biopsy; it represented 80% of the indications in our region twenty years ago; [3] there were similar findings in other parts of the world. [5],[6],[7],[8] Moreover, the primary nephropathies were more common in our study than the previo­usly reported data from our region; [3] mostly due to the lack of immunofluorescence. Yahya [9] in United Emirates and Fatihi [10] in Morocco reported similar predominance of primary nephropathies in their series.

FSGS was found in 67% of the patients in our study; similar to the previous studies from the region. [4],[11] the prevalence of FSGS is estimated to be from 10 to 23% in the white race. [8],[12]

On the other hand, IgA nephropathy, which is one of the most common PN in Europe [13],[14] is very rare in Dakar; it formed only 2% of all the nephropathies in our study.

Another unique feature of the glomerulo­pathies in our study is the toxic nephropa­thy due to the intake of the home remedies (traditional drugs), which was a common finding. It was associated with changes that ranged from alterations of podocytes to hyalin deposits and fibrosis in the glomeruli. Nevertheless, we believe that the frequency of this misnamed "tropical nephropathy" is probably underestimated on the account of the prevalent use of the traditional drugs in our area.

 
   References Top

1.Diouf B, Ka EF, Niang A, Diouf ML, Mbengue M, Diop TM. Etiologies des insuffisances renales chroniques dans un service de medecine interne a Dakar. Dakar Med 2000;45:62-5.  Back to cited text no. 1  [PUBMED]  
2.Toure YI, Abdallahi M, Diop B. The place of nephrology in morbidity in an internal medicines department for black African adults in Dakar. (7379 cases). Dakar Med 1984;29:213-20.  Back to cited text no. 2    
3.Diop B, Toure YI. Causes of chronic renal insufficiency in an adult internal medicines service in Dakar. Dakar Med 1983; 28: 563-70.  Back to cited text no. 3  [PUBMED]  
4.Diop B, Toure YI, Mannicacci M. Histological aspects of nephrotic syndrome in adult Black Africans in the internal medicine service at Dakar (33 cases). Dakar Med 1980;3:213-21.  Back to cited text no. 4    
5.Yoshimoto M, Fujisawa S, Sudo M. Percutaneous renal biopsy well-visualized by orthogonal ultrasound application using linear scanning. Clin Nephrol 1988;30: 106-10.  Back to cited text no. 5  [PUBMED]  
6.Ghnaimat M, Akash N, El-Lozi M. Kidney biopsy in Jordan: complications and histo­pathological findings. Saudi J Kidney Dis Transplant 1999;10:152-6.  Back to cited text no. 6    
7.Haas M, Spargo BH, Conventry S. Increasing incidence of focal segmental glomerulosclerosis among adults nephro­pathies: a 20-years renal biopsy study. Am J Kidney Dis 1995;26:740-50.  Back to cited text no. 7    
8.Howie AJ, Lee SJ, Green NJ, et al. Different clinicopathological types of segmental sclerosing glomerular lesions in adults. Nephrol Dial Transplant 1993;8:590-9.  Back to cited text no. 8  [PUBMED]  [FULLTEXT]
9.Yahya TM, Pingle A, Boobes Y, Pingle S. Analysis of 490 kidney biopsies: data from the United Arab Emirates renal diseases registry. J Nephrol 1998;11:148-50.  Back to cited text no. 9  [PUBMED]  [FULLTEXT]
10.Fatihi E, Niang A, Hachim K, et al. Les glomerulopathies du sujet age au Maroc. Sem Hop 1998;74:1290-93.  Back to cited text no. 10    
11.Pakasa M, Mangani N, Dikassa L. Focal and segmental glomerulosclerosis in nephrotic syndrome: a new profile of adult nephrotic syndrome in Zaire. Mod Pathol 1993;6:125-8.  Back to cited text no. 11  [PUBMED]  
12.Korbet SM, Genchi MR, Borok RZ, Schwartz MM. The racial prevalence of glomerular lesions in nephrotic adults. Am J Kidney Dis 1996;27;647-51.  Back to cited text no. 12    
13.Parrish AE. Complications of percu taneous renal biopsy: a review of 37 years experience. Clin Nephrol 1992;38:135-41.  Back to cited text no. 13  [PUBMED]  
14.Stratta P, Segoloni PG, Canavese C, et al. Incidence of biopsy proven primary glome­rulonephritis in an Italian province.Am J Kidney Dis 1996;27:631-9.  Back to cited text no. 14    

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Correspondence Address:
Niang Abdou
BP 6548 Dakar Etoile
Senegal
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PMID: 18209451

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