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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 : 2007  |  Volume : 18  |  Issue : 1  |  Page : 114-116
Prevalence of Acquired Cystic disease in Black Africans on Hemodialysis in West Africa


Service of Nephrology, University Teaching Hospital of Yopougon, Abidjan, West Africa (Cote d'Ivoire)

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   Abstract 

Acquired cystic kidney disease (ACKD) is a late manifestation of end-stage renal disease. To determine the prevalence of ACKD in black African patients on chronic hemodialysis in West Africa, we examined by ultrasonography the native kidneys of 83 patients from February to August 2002. ACKD was present in 26 patients, with estimated prevalence of 31% that was higher in males. There were 20 (77%) ACKD patients with a duration on dialysis of more than five years. The associated clinical manifestations were lumbar pain (58%), hematuria (23%) and urinary tract infection (23%). No case of renal cancer was detected during this study. We conclude that the prevalence of ACKD and its complications in black African patients on chronic hemodialysis in West Africa is high. We recommend that renal ultrasonography should be performed routinely in patients on hemodialysis for more than 5 years.

Keywords: Chronic Renal Failure, Acquired Cystic Kidney Disease, Hemodialysis

How to cite this article:
Gnionsahe D A, Lagou D A, Tia W M. Prevalence of Acquired Cystic disease in Black Africans on Hemodialysis in West Africa. Saudi J Kidney Dis Transpl 2007;18:114-6

How to cite this URL:
Gnionsahe D A, Lagou D A, Tia W M. Prevalence of Acquired Cystic disease in Black Africans on Hemodialysis in West Africa. Saudi J Kidney Dis Transpl [serial online] 2007 [cited 2019 Nov 13];18:114-6. Available from: http://www.sjkdt.org/text.asp?2007/18/1/114/31858

   Introduction Top


Hemodialysis has improved and prolonged the survival rate of patients suffering from chronic renal failure. Chronic hemodialysis has recently been introduced to Sub-Saharan Africa.

Acquired cystic kidney disease (ACKD) is a late complication of end-stage renal disease. In 1977, Dunnil et al were the first to describe ACKD in dialysis patients. [1] ACKD can manifest as hematuria, intracystic hemorrhages or infection, and cancer.

We aim in this study to determine the prevalence of ACKD within the population of black African patients on hemodialysis in West Africa.


   Patients and Methods Top


We examined by ultrasonography the native kidneys of 83 black African patients on chronic hemodialysis at Abidjan University Hospital from February to August 2002. The ultrasonography apparatus had two low­frequency catheters (MADISON S.A. 600, 3,5 MHz). The patients were examined in different clinical positions: dorsal decubitus, lateral decubitus and prone. The diagnostic criterion of ACKD was the presence of 5 cysts or more in the kidneys bilaterally. The patients with a polycystic kidney disease or unilateral cysts were excluded. All ultra­sonographies were performed by the same operator. The duration of hemodialysis, lumbar pain, hematuria, infection and renal tumor were investigated.


   Results Top


Out of 83 explored patients, 26 were shown to have. ACKD (21 males, 5 females), with estimated prevalence of 31% and a male: female ratio of 4:2. There were 20 (77%) ACKD patients with a duration on dialysis of more than five years. The causes of renal disease in the ACKD group included hyper­tension (65%), glomerulonephropathy (26%), chronic interstitial nephropathy (3%), and diabetes (3%). The associated clinical manifestations were lumbar pain (58%), hematuria (23%) and urinary tract infection (23%). No case of renal cancer was detected during this study.


   Discussion Top


The prevalence of ACKD in our study probably underestimates the real prevalence of ACKD because of the low sensitivity of the used technique. The prevalence of ACKD reported by other studies ranges from 59-90% in the studies that used computed tomography, autopsy or nephrectomy samples. [2],[3],[4],[5],[6],[7] More­ over, Matson and Cohen reported a higher prevalence in black American patients. [8] These authors found no significant difference of prevalence according to gender. However, Malloffre et al., like us, reported a higher frequency of ACKD in male patients. [7]

The majority of authors have noted that the prevalence of ACKD was higher with the longer duration on dialysis. [2],[3],[8],[9] The results of our study were similar since 77% of the ACKD patients were on hemodialysis longer than 5 years.

ACKD can develop regardless of the etiology of kidney failure. [3],[4],[5],[9] The results of our study revealed similar observations. The most frequent clinical manifestations in our ACKD patients were lumbar pain, hematuria and urinary tract infection. We did not detect any case associated with ACKD of renal cancer, which was reported by others. [8],[10]

We conclude that the prevalence of ACKD and its complications in black African patients on chronic hemodialysis in West Africa is high. We recommend that renal ultrasonography should be performed routinely in black African patients on hemodialysis for more than 5 years.

 
   References Top

1.Dunnill MS, Millard PR, Oliver D. Acquired cystic disease of the kidneys; a hazard of long-term intermittent maintenance haemodialysis. J Clin Pathol 1977;30: 868-77.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Grantham JJ, Levine E. Acquired cystic disease: replacing one kidney disease with another. Kidney Int 1985;28:99-105.  Back to cited text no. 2  [PUBMED]  
3.Grantham JJ. Acquired cystic kidney disease. Kidney Int 1991;40:143-52.  Back to cited text no. 3  [PUBMED]  
4.Jabour BA, Ralls PW, Tang WW, et al. Acquired cystic disease of the kidney, computed tomography and ultrasono­graphy appraisal in patients on peritoneal and hemodialysis. Invest Radiol 1987;22:728-32.  Back to cited text no. 4  [PUBMED]  
5.Katz A, Sombolos K, Oreopoulos DG. Acquired cystic disease of the kidney in association with chronic ambulatory peritoneal dialysis. Am J Kidney Dis 1987; 9 (5):426-9.  Back to cited text no. 5    
6.Kutcher R, Amodio JB, Rosemblatt R. Uremic renal cystic disease: value of sonographic screening. Radiology 1983, 147: 833-5.  Back to cited text no. 6    
7.Mallofre C, Almirall J, Campistol JM, Andrew J, Cardesa A, and Revert L. Acquired renal cystic disease in HD: a study of 82 nephrectomies in Young patients. Clin Nephrol 1992;37:297-302.  Back to cited text no. 7    
8.Matson M A, Cohen EP. Acquired cystic kidney disease: occurrence, prevalence and renal cancers. Medicine 1990;69:217-26.  Back to cited text no. 8    
9.Thomson BJ, Jenkins DA, Allaw PL, Elton RA, Winney RJ. Acquired cystic disease of the kidney in patients with end-stage chronic renal failure: A study of prevalence and aetiology. Nephrol Dial Transplant 1986; 1:38-43.  Back to cited text no. 9    
10.Traong ID, Krishnan B, Cao JT, Barrios R, Suki WN. Renal neoplasm in acquired cystic kidney disease. Am J Kidney Dis 1995;26:1-12.  Back to cited text no. 10    

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Correspondence Address:
D A Gnionsahe
Service de Nephrologie, CHU de Yopougon, 21 BP 1632 Abidjan 21 Cote d’Ivoire

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PMID: 17237903

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This article has been cited by
1 Evaluation of acquired cystic kidney disease in patients on hemodialysis with ultrasonography
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Iranian Journal of Kidney Diseases. 2010; 4(3): 223-226
[Pubmed]



 

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    Abstract
    Introduction
    Patients and Methods
    Results
    Discussion
    References
 

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