Saudi Journal of Kidney Diseases and Transplantation

LETTER TO THE EDITOR
Year
: 2016  |  Volume : 27  |  Issue : 5  |  Page : 1073--1075

Risk factors for chronic kidney disease among patients admitted to the medical wards in Conakry


ML Kaba1, M Camara1, M Béavogui2, AO Bah1, D Fousény1, ML Kourouma1, A Camara1, A. A. S. Diallo3, YI Touré1,  
1 Department of Nephrology, Donka National Hospital, Conakry, Guinea
2 Department of Cardiology, Donka National Hospital, Conakry, Guinea
3 Department of Internal Medicine, Donka National Hospital, Conakry, Guinea

Correspondence Address:
Dr. M L Kaba
Department of Nephrology, Donka National Hospital, Conakry
Guinea




How to cite this article:
Kaba M L, Camara M, Béavogui M, Bah A O, Fousény D, Kourouma M L, Camara A, Diallo A, Touré Y I. Risk factors for chronic kidney disease among patients admitted to the medical wards in Conakry.Saudi J Kidney Dis Transpl 2016;27:1073-1075


How to cite this URL:
Kaba M L, Camara M, Béavogui M, Bah A O, Fousény D, Kourouma M L, Camara A, Diallo A, Touré Y I. Risk factors for chronic kidney disease among patients admitted to the medical wards in Conakry. Saudi J Kidney Dis Transpl [serial online] 2016 [cited 2020 Nov 30 ];27:1073-1075
Available from: https://www.sjkdt.org/text.asp?2016/27/5/1073/190916


Full Text

To the Editor,

Chronic kidney disease (CKD) is defined by the presence for more than three months of markers of kidney damage and/or a decrease in the glomerular filtration rate (GFR) below 60 mL/min/1.73 m 2 . [1]

The CKD has an increasing incidence worldwide. Its precise prevalence is not formally established in Sub-Saharan Africa.

The treatment of CKD at an early stage reduces the risk of cardiovascular disease and stroke. This risk is increased relative to the general population when the creatinine clearance is below 90 mL/min. [2]

In Guinea, the prevalence of CKD in the Nephrology Department in Conakry increased from 41% (2001-2005) to 60% (2006-2010). [3],[4]

The reality during this decade was a late discovery of the disease, as almost 60% of cases were handled at the end stage, among them, only 8-20% had access to renal replacement therapy. [4]

The aim of our study was to detect the prevalence, risk factors, etiology, and stages of the CKD in the hospitalized patients.

The Internal Medicine Department at Donka National Hospital is the setting of our work. This was a prospective study over a threemonth period (November 1, 2011, to January 31, 2012) to detect for CKD among all hospitalized patients. The markers of kidney damage sought were proteinuria, hematuria, pyuria, renal morphological abnormalities, and estimate GFR (eGFR) ≤60 mL/min. [5],[6]

We recorded age, gender, risk factors for CKD, clinical type of kidney disease, and stage of CKD. Risk factors for CKD sought were high blood pressure (HBP), age over 60 years, diabetes mellitus, episode of acute renal failure (ARF), heart disease, obesity, and high cholesterol level. eGFR was calculated using the simplified formula of MDRD (modification of diet in renal disease).

We classified the cause of CKD according to the following criteria:

Chronic glomerulonephritis: Presence of proteinuria ≥1.5 g/L with or without microscopic hematuriaHypertensive nephropathy: Presence of proteinuria ≤1 g/L in the setting of longstanding hypertension with a cardiac echo showing left ventricular hypertrophy and ocular examination showing hypertensive retinopathyDiabetic nephropathy: Presence of proteinuria and diabetic retinopathyChronic interstitial nephropathy: Absence of proteinuria with persistent sterile leukocyturia.

Dialysis patients were excluded from the study.

The patients were informed, and their free consent was obtained for inclusion.

Out of 185 hospitalized patients, 61 (33%) had CKD, of whom 35 (57%) were male with a mean age of 56 ± 19 years. The distribution of the CKD by age is shown in [Table 1].{Table 1}

The main risk factors for CKD encountered were: HBP (52%), age >60 years (41%), diabetes mellitus (18%), previous ARF (18%), and heart disease (7%) [Table 2].{Table 2}

The mean serum creatinine was 144 ± 80 μmol/L and the mean eGFR was 62 ± 29 mL/ min. Proteinuria was ≥5 g/L in 42% of cases, 2 g/L in 27% of cases, and <1 g/L in 32%. The causes of CKD were hypertension (43%), glomerulonephritis (26%), diabetes (10%), and interstitial nephropathy (8%) [Table 3].{Table 3}

CKD was in Stage 1 in 21% of cases, Stage 2 in 31%, in Stage 3 in 33%, and in Stage 4 in 15% [Figure 1]. The treatment of nephrology yielded significant clinical improvement in 52 cases (85%) and four cases of death were recorded (7%).{Figure 1}

Gender predominance of CKD in reports from Guinea was found to be in women by Okpechi et al [7] and in men according to Ouattara et al and Loos-Ayav et al. [8],[9]

The average age was 56 years in our study and 53 years in Senegal. [10]

The prevalence of CKD was estimated to be 141 patients per million inhabitants in Iraq. [11] In this study, the main causes of CKD were diabetes mellitus (33%), hypertension (23%), obstructive nephropathy (17%), unspecified nephropathy (14%), chronic pyelonephritis (5%), polycystic renal disease (4%), and glomerulonephritis (4%). HBP was the most common risk factor, and this was confirmed by Sabi et al [12] and by Diouf et al. [10]

The common prevalence of vascular nephropathy of nephroangiosclerosis type was observed by Osafo et al. in Ghana, [13] Kaba et al in Guinea, [14] and Sabi et al in Togo. [12]

In 1990, Diallo et al [15] reported in Côte d'Ivoire, a CKD hospital incidence of 5.8%. Among the patients, 61% were <45-year-old, the socioeconomic status was modest in 92% of them. The causes were chronic glomerulonephritis in 49% and nephroangiosclerosis in 25%. The dialysis treatment was performed in only 5% of patients with end-stage kidney failure.

According to Arogundade et al, [16] in SubSaharan Africa, CKD affects more young adult patients. The main causes are HBP and glomerular nephropathy of infectious origin. Morbidity and mortality are high because of the limited access to renal replacement therapy.

Moderate or severe CKD is more common than ESRD in the general population. This was demonstrated in our study and by several authors. [12],[13],[17],[18]

CKD is common and significant in internal medicine affecting nearly one-third of patients. Early detection in populations at risk could significantly change the mediumand longterm renal prognosis.

Conflict of interest: None declared.

References

1Frimat L, Loos-Ayav C, Briançon S, Kessler M. Epidemiology of chronic kidney diseases. EMC Néphrologie 2005;2(4):139-157.
2Jungers P, Joly D, Man Nguyen K, Legendre C. The Chronic kidney diseases: prevention and Treatment. 3rd éd. M S Flammarion; Paris, 2004 (5-6).
3Diallo OS. Epidemiological and Etiological profile of chronic kidney diseases in nephrology department of donka hospital in conakry, Doctoral thesis in Medicine FMPOS UC, Conakry; 2007.
4Mba KJ. Management of The cardiac insufficiency to chronic renal failure and hypertension in Conakry, Doctoral thesis in Medicine FMPOS UC; 2011.
5Froissart M, Moranne O and Nephrotest group: Evaluation of the progress and the bio markers of the chronic renal disease. Flammarion médecine-sciences -actualités néphrologiques, 2008, (www.medecine.flammarion.com).
6ANAES/guidelines: the diagnosis of the chronic kidney diseases at the adult; in September, 2002. http://www.has-sante.fr
7Okpechi I, Swanepoel C, Duffield M and al: Patterns of renal disease in Cape Town South Africa: a 10-year review of a single-centre renal biopsy database. Nephrol Dial Transplant 2011;26:1853-61.
8Ouattara B, Kra O, Yao H, Kadjo K, Kodjo NE. Characteristics of chronic renal failure in black adult patients hospitalized in the Internal Medicine department of Treichville University Hospital. Nephrol Ther 2011;7(7):531-4.
9Loos-Ayav C, Briançon S, Frimat L, André JL, Kessler M; Pour le Comité de Pilotage EPIRAN. Incidence of chronic kidney disease in general population, EPIRAN study. Nephrol Ther 2009;5 Suppl 4:S250-5.
10Diouf B, Niang A, Ka EH, Badiane M, Moreira Diop T. Chronical renal failure in one Dakar Hospital Department. Dakar Med 2003;48:185-8.
11Awad SM. Chronic renal failure in Al-Anbar of Iraq. Saudi J Kidney Dis Transpl 2011;22: 1280-4.
12Sabi KA, Gnionsahe DA, Amedegnato D. Chronic kidney failure in Togo: clinical, laboratory, and etiological aspects. Med Trop (Mars) 2011;71:74-6.
13Osafo C, Mate-Kole M, Affram K, Adu D. Prevalence of chronic kidney disease in hypertensive patients in Ghana. Ren Fail 2011;33: 388-92.
14Kaba ML, Balde MD, Bah AO, Diallo A, Beavogui, Condé M, Toure YI: Evaluation of the kidney damage during the hypertension at the adult in Conakry.Méd Afr Noire 2008;55: 185-8.
15Diallo AD, Niamkey E, Beda Yao B. Chronic renal insufficiency in Côte d′Ivoire: Study of 800 hospital cases. Bull Soc Pathol Exot 1997; 90:346-8.
16Arogundade FA, Barsoum RS. CKD prevention in Sub-Saharan Africa: a call for governmental, nongovernmental, and community support. Am J Kidney Dis 2008;51:515-23.
17Le Goaziou MF, Zerbib Y, Chopin Gheorghiev C. Chronic renal failure in patients aged more than 50 years in general practice: An epidemiological survey among a sample of 1034 patients. Presse Med 2007;36(12 Pt 1): 1766-8.
18Sumaili EK, Nseka NM, Lepira FB, et al. Screening for proteinuria and chronic kidney disease risk factors in Kinshasa: a World Kidney Day 2007 study. Nephron Clin Pract. 2008;110(4):c220-8.