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Ailioaie O, Essig M, Levassort H. [Substitution treatments for chronic kidney disease in geriatrics: dialysis, transplantation and medical treatment without dialysis]. Soins Gerontol 2024; 29:14-20. [PMID: 38418067 DOI: 10.1016/j.sger.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
Kidney disease, whether acute or chronic, is a particularly common condition in the elderly, due to its main risk factors, the prevalence of which increases with age, and the fact that recovery from acute tubular damage is slower. Wherever possible, treatment of renal failure should be anticipated and discussed with the patient as part of a shared medical decision. Numerous treatment options are available to ensure maximum integration into the patient's life and care plan: renal transplantation for the most robust patients, hemodialysis in a care facility or at home, peritoneal dialysis at home, or medical treatment without dialysis. The choice of one of these treatments must leave the patient free to change his or her treatment modality at any time.
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Affiliation(s)
- Oana Ailioaie
- Service de néphrologie, Université Paris-Saclay, Site Ambroise-Paré, AP-HP, Boulogne-Billancourt, France
| | - Marie Essig
- Service de néphrologie, Université Paris-Saclay, Site Ambroise-Paré, AP-HP, Boulogne-Billancourt, France; Inserm UMRS 1018, Équipe épidémiologie clinique, Université Paris-Saclay, UVSQ, CESP, Villejuif, France
| | - Hélène Levassort
- Service de néphrologie, Université Paris-Saclay, Site Ambroise-Paré, AP-HP, Boulogne-Billancourt, France; Inserm UMRS 1018, Équipe épidémiologie clinique, Université Paris-Saclay, UVSQ, CESP, Villejuif, France; Service de gériatrie, Université Paris-Saclay, Site Ambroise-Paré, AP-HP, Boulogne-Billancourt, France.
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2
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Brahmbhatt S, Mikalachki A, Lawrence JA, Blackwell L, Bleah P, Khan Y, Tung TH, Austin K, Craig L, Clemens KK. Supporting Type 1 and Type 2 Diabetes Care in the Hemodialysis Unit: A Quality-improvement Initiative Throughout the COVID-19 Pandemic. Can J Diabetes 2024; 48:3-9.e7. [PMID: 37549869 DOI: 10.1016/j.jcjd.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/18/2023] [Accepted: 07/31/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE People living with diabetes mellitus (DM) and chronic kidney disease can have difficulty attending multiple appointments to receive DM care. We developed and studied the utility of a DM outreach program to offer in the hemodialysis (HD) unit. METHODS We conducted a quality improvement project in a satellite HD unit in London, Ontario, Canada, between August 1, 2019, and July 31, 2022. We assessed for baseline gaps in DM care among those with DM, performed root-cause analysis with key stakeholders to identify critical drivers of gaps, and conceptualized a certified diabetes educator-led outreach program to offer in the HD unit. We aimed to improve DM self-monitoring, hypo- and hyperglycemia, and DM-related screening. We used run and control charts to track outcome measures over time and modified our outreach program iteratively. RESULTS Fifty-eight persons with DM receiving HD participated in our program. Support spanned multiple waves of the COVID-19 pandemic. With 4 tests of change, we observed improvement in DM self-monitoring with a modest decline in self-reported hyperglycemia. There were no adverse consequences, and satisfaction with our program was high. CONCLUSIONS Although we did not meet all measures of success during the pandemic, outreach DM support in the HD unit appeared to improve self-monitoring and self-reported hyperglycemia. Similar programs could be modified and implemented in other centres.
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Affiliation(s)
- Shaily Brahmbhatt
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Amanda Mikalachki
- Primary Care Diabetes Support Program, St. Joseph's Health Care London, London, Ontario, Canada
| | - Julie Ann Lawrence
- Regional Renal Program, London Health Sciences Centre, London, Ontario, Canada
| | - Lindsay Blackwell
- Regional Renal Program, London Health Sciences Centre, London, Ontario, Canada
| | | | - Yumna Khan
- Lawson Health Research Institute, London, Ontario, Canada; Thames Valley Family Health Team, London, Ontario, Canada
| | - Tsan-Hua Tung
- Centre for Quality, Innovation and Patient Safety, Western University, London, Ontario, Canada
| | - Kathy Austin
- Regional Renal Program, London Health Sciences Centre, London, Ontario, Canada
| | - Laura Craig
- Regional Renal Program, London Health Sciences Centre, London, Ontario, Canada
| | - Kristin K Clemens
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Centre for Quality, Innovation and Patient Safety, Western University, London, Ontario, Canada; Division of Endocrinology and Metabolism, Western University, Department of Medicine, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; ICES, Ontario, Canada.
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3
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Galle AC, Radiguet A, Thibault C, Coutance V. [The benefits of home visits for patients on home hemodialysis]. Rev Infirm 2023; 72:32-33. [PMID: 37952992 DOI: 10.1016/j.revinf.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
The success of home hemodialysis depends on several criteria. On the one hand, the patient's willingness to be autonomous, his or her degree of understanding, the technical feasibility at home, and the presence of a third party. Secondly, the quality of initial training (which must respect the patient's rhythm) and follow-up at home. This is a true patient-caregiver partnership, based on trust. Home visits are part of this approach, and help maintain the link, as a team at Caen University Hospital can testify.
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Affiliation(s)
- Anne Céline Galle
- Centre universitaire des maladies rénales, CHU de Caen-Normandie, Avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France
| | - Anne Radiguet
- Centre universitaire des maladies rénales, CHU de Caen-Normandie, Avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France
| | - Catherine Thibault
- Centre universitaire des maladies rénales, CHU de Caen-Normandie, Avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France.
| | - Véronique Coutance
- Association normande pour la prise en charge de l'insuffisance rénale chronique par la dialyse, l'éducation des patients et la recherche (Anider), 11 avenue de Cambridge, 14200 Hérouville-Saint-Clair, France
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4
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Perrot A, Kassim D, Maurice E, Courivaud C. [Management of complications of renal failure in hemodialysis patients with IPA]. Soins 2023; 68:30-32. [PMID: 37419598 DOI: 10.1016/j.soin.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
The complications of renal failure are likely to have an impact on the quality of life of hemodialysis patients, which is why specific follow-ups are organized by the nephrologist. Advanced practice nurses (APNs) could take care of this alongside physicians. A survey conducted by the Santélys Bourgogne Franche-Comté association shows that professionals are in favor of working with APNs and that follow-up is carried out by medical and paramedical teams without standardized practices. The intervention of an RPN could improve coordination between the different actors.
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Affiliation(s)
- Amélie Perrot
- Santélys Bourgogne Franche-Comté, 4 rue de la Brot, 21850 Saint-Apollinaire, France.
| | - Delphine Kassim
- Service de néphrologie, Centre hospitalier universitaire de Besançon, 3 boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Elsa Maurice
- Santélys Bourgogne Franche-Comté, 4 rue de la Brot, 21850 Saint-Apollinaire, France
| | - Cécile Courivaud
- Service de néphrologie, Centre hospitalier universitaire de Besançon, 3 boulevard Alexandre-Fleming, 25030 Besançon cedex, France
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5
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Guillouët E. [Procedural simulation for nursing education]. Rev Infirm 2023; 72:19-20. [PMID: 36870768 DOI: 10.1016/j.revinf.2023.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Simulation is an educational tool that allows, in initial and continuing education, the acquisition of gestures and procedures. The management of the vascular approach concerning the arteriovenous fistula is not yet standardized. Thus, the standardization of the fistula puncture technique, approached through simulation, could be part of an approach to optimizing practices and continuous improvement of care.
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Affiliation(s)
- Erwan Guillouët
- CHU de Caen-Normandie, avenue de la Côte-de-Nacre, 14000 Caen cedex 9, France.
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6
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Gorsane I, Chermiti M, Mechri E, Elloumi Z. Evolutive profile of hemodialysis vascular accesses Hemodialysis accesses. Tunis Med 2022; 99:575-581. [PMID: 35244908 PMCID: PMC8772601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Arterio-venous fistula (AVF) is the first-choice vascular access for hemodialysis (HD). Hemodialysis catheter (KT) may be a temporary or permanent alternative. AIM To evaluate indications of KT and AVF and their predictive factors of complications. METHODS It's a retrospective multicentric study interesting KT and AVF in patients treated by hemodialysis, in the Kef Governorate in north-western Tunisia, during the period from 01/07/18 to 31/12/18. RESULTS We included 288 AVF and 148 KT that were created on 205 patients. The average age was 58.14 years, the sex ratio was 1.5. Hypertensive patients and diabetics represented respectively 83.9% and 27.3% of the population. Diabetic nephropathy was the most common (25.9%). For the KT, the main indication was the wait for AVF creation (68.9%). The overall incidence of immediate complications was 11.5%. Dysfunction was reported in 23.6% of cases with obesity and tunneled type of KT as contributing factors. KT infection was occuring in 39.2% of cases. It was promoted by prolonged duration of use and hemoglobin level < 8g/dl. The use of antiseptic lock reduced infections' risk (p=0.011). For AVF, the most common complications were thrombosis (36.2%), aneurysm (29.9%) and stenosis (22.6%). Survival rate was 60% at 2000 days. The AVF impairing factors were diabetes (p=0.05), obesity (p=0.05), anterior AVF creation (p=0.011), AVF grafts (p=0.016), and anticoagulant therapy (p=0.0001). Antiplatelet therapy improved AVF patency (p=0.02). CONCLUSION Much remained to be done to reduce KT complications, creation of AVF on time and prevention of their complications.
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Affiliation(s)
- Imen Gorsane
- 1- Hôpital Charles Nicolle / faculté de médecine de Tunis
| | | | - Eya Mechri
- 2- Hôpital du Kef / faculté de médecine de Tunis
| | - Zied Elloumi
- 2- Hôpital du Kef / faculté de médecine de Tunis
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Sivarajahkumar S, So M, Morris AM, Lok C, Bell CM, Battistella M. Patterns of Antimicrobial Use in an Outpatient Hemodialysis Unit. Can J Hosp Pharm 2022; 75:15-20. [PMID: 34987258 PMCID: PMC8677003 DOI: 10.4212/cjhp.v75i1.3250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Patients receiving hemodialysis (HD) are at high risk of infections, including those caused by multidrug-resistant organisms. Given that antimicrobial exposure is a major risk factor for the emergence of these resistant organisms, minimizing inappropriate use is imperative. To optimize use, it is important to understand patterns of antimicrobial prescribing in this setting. OBJECTIVES To measure antimicrobial use and to describe prescribing patterns among patients receiving outpatient HD. METHODS A retrospective observational case series study was performed in an outpatient HD unit from February to April 2017. Adults for whom at least 1 antimicrobial was prescribed were included. The primary outcome was total antimicrobial days of therapy (DOT) per 1000 patient-days. Secondary outcomes were the characteristics of the antimicrobial prescriptions, in terms of antimicrobial class, indication, purpose, route, and prescriber group. RESULTS Antimicrobials were prescribed for 53 (16%) of the 330 patients treated in the HD unit during the study period; the total number of prescriptions was 75. Antimicrobial use was 27.5 DOTs/1000 patient-days. Fluoroquinolones were the most frequently prescribed type of antimicrobial (n = 17, 23%), whereas the second most frequently prescribed were first-generation cephalosporins (n = 16, 21%). The most common indication was skin or soft-tissue infection (n = 14, 19%), followed by bloodstream infection (n = 13, 17%). Of the 75 antimicrobials, 48 (64%) were prescribed for empiric therapy, 19 (25%) for targeted therapy, and 8 (11%) for prophylaxis. Two-thirds of the antimicrobials prescribed (n = 50, 67%) were oral medications, and most (n = 72, 96%) were ordered by hospital prescribers. CONCLUSIONS Antimicrobial use was common in this study setting, with 1 in 6 HD patients receiving this type of medication. The findings of this study create opportunities to standardize antimicrobial prescribing at the local level for common infections that occur in patients receiving outpatient HD.
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Affiliation(s)
- Sylvia Sivarajahkumar
- , HBSc, BScPhm, is with the University Health Network and the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
| | - Miranda So
- , BScPhm, PharmD, is with the University Health Network and the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
| | - Andrew M Morris
- , MD, FRCPC, SM(Epi), is with the University Health Network, the Sinai Health System, and the Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Charmaine Lok
- , MD, FRCPC, MSc, is with the University Health Network and the Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Chaim M Bell
- , MD, FRCPC, PhD, is with the University Health Network, the Sinai Health System, and the Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Marisa Battistella
- , BScPhm, PharmD, is with the University Health Network and the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
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8
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Guillouët S, Thibault C. [Reception of patients with chronic renal failure, COVID-19]. Rev Infirm 2021; 70:41-42. [PMID: 34024584 DOI: 10.1016/j.revinf.2021.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The renal disease center of the university hospital of Caen Normandy (14) is dedicated to the ambulatory care of patients with chronic renal disease, including those treated by dialysis or transplanted. These are fragile patients and, for many of them, coming to the center is inevitable for their care. Faced with the COVID-19 pandemic, the care teams have shown a great capacity to adapt, even to be creative, in order to welcome and care for them in optimal safety conditions.
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Affiliation(s)
- Sonia Guillouët
- Centre universitaire des maladies rénales, CHU de Caen Normandie, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France.
| | - Catherine Thibault
- Centre universitaire des maladies rénales, CHU de Caen Normandie, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France
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9
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Legoupil M, Vieilly S. [Training and follow-up of the dialysis patient at home]. Rev Infirm 2021; 70:26-27. [PMID: 33608091 DOI: 10.1016/j.revinf.2020.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Regardless of the home dialysis technique, training of the patient or caregivers is necessary. Formalized over several weeks, this is carried out by an expert nursing team. The patient must acquire the skills and knowledge to be able to dialyse effectively at home, in optimal conditions of safety.
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Affiliation(s)
- Mathilde Legoupil
- Aurad Aquitaine, 2, allée des Demoiselles, 33171 Gradignan cedex, France.
| | - Sandra Vieilly
- Service de dialyse péritonéale, CHU Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France
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10
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Abstract
Home dialysis is an effective and safe care strategy that promotes patients' quality of life. At the collective level, it responds to the medico-economic challenges of the French healthcare system. Although it has few contraindications, it remains under-used in France. Its implementation requires early information for patients and their families, as well as the organisation of personalised follow-up by a dedicated and trained team.
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Affiliation(s)
- Emmanuelle Hecquet
- Service de néphrologie, bâtiment de médecine,CH Dieppe, avenue Pasteur, 76200 Dieppe, France.
| | - Amélie Lecoq
- Service de néphrologie, bâtiment de médecine,CH Dieppe, avenue Pasteur, 76200 Dieppe, France
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11
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Valle Flores JA, Fariño Cortéz JE, Mayner Tresol GA, Perozo Romero J, Blasco Carlos M, Nestares T. Oral supplementation with omega-3 fatty acids and inflammation markers in patients with chronic kidney disease in hemodialysis. Appl Physiol Nutr Metab 2020; 45:805-811. [PMID: 31935118 DOI: 10.1139/apnm-2019-0729] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Chronic kidney disease (CKD) is an increasingly common public health problem that increases the risk of death because of cardiovascular complications by 2-3 times compared with the general population. This research concerns a prospective, randomized, double-blind study in patients with CKD undergoing hemodialysis. The participants were assigned to 1 of 2 groups: the study group (group A; 46 patients) received 4 capsules (2.4 g) of omega-3 fatty acids daily during the 12-week intervention, while patients in the control group (group B; 47 patients) received 4 capsules of paraffin oil. The patients' general characteristics, nutritional indicators, renal disease markers and inflammatory markers (C-reactive protein, interleukin (IL)-6, IL-10, and tumour necrosis factor alpha (TNF-α)) were evaluated. No differences were found between the general characteristics of the patients (P < 0.05), and no differences were shown in the nutritional indicators and markers of kidney disease (P < 0.05). Patients in group A showed significant decreases in levels of C-reactive protein, IL-6, TNF-α, and the IL-10/IL-6 ratio after 12 weeks of supplementation (P < 0.05). Patients in group B did not show any significant changes in concentrations of inflammatory markers during the intervention (P < 0.05). In conclusion, oral supplementation with omega-3 fatty acids produces a significant decrease in the concentrations of inflammation markers in patients with chronic kidney disease on hemodialysis. Novelty Oral supplementation with omega-3 fatty acids produced significant decreases in the concentrations of inflammation markers. This supplementation could be given to patients with uremic syndrome and coronary heart disease to reduce cardiovascular risk.
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Affiliation(s)
- José A Valle Flores
- Nutrition and Food Science Program, University of Granada, Spain.,Nutrition and Dietetics, Faculty of Medical Sciences, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador, 150950
| | - Juan E Fariño Cortéz
- Carrera de Enfermería, Facultad de Ciencias Sociales y de la Salud, Universidad Estatal de Santa Elena, Santa Elena, Ecuador, 241702
| | - Gabriel A Mayner Tresol
- Carrera de Medicina, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador, 150950
| | - Juan Perozo Romero
- Servicio de Nefrología, Hospital Central Dr. Urquinaona, Facultad de Medicina, Universidad de Zulia, Maracaibo, Venezuela, 4001
| | - Miquel Blasco Carlos
- Instituto de Investigación e Innovación de Salud Integral, Universidad Católica de Santiago de Guayaquil, Avenue Carlos Julio Arosemena Tola, Guayaquil, Ecuador.,Escuela de Nutrición y Dietética, Universidad Espíritu Santo-Ecuador, Avenue Samborondón, Guayaquil, Ecuador
| | - Teresa Nestares
- Department of Physiology, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain, 18010
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Coulibaly M, Samké M, Fofana AS, Coulibaly SB, Sy S, Yattara H, Diallo D, Fongoro S. [Mortality in the hemodialysis unit of the Gavardo hospital in sebenikoro]. Mali Med 2020; 35:12-14. [PMID: 37978731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Chronic kidney disease (CKD)is a serious public health problem in Africa with regard to mortality associated with it. According to global hospital data, CKD is involved in 4-22% of deaths in tropical Africa. In Mali, epidemiological studies are infrequent.Thus, this work is under taken with the objective of studying the epidemiological aspects and the factors associated with the mortality of hemodialysis patients in the hemodialysis unit of the Mali Gavardo Hospital (HMG) in Sébenikoro. METHOD We conducted a descriptive retrospective cross-sectionalstudy of the hemodialysis unit of the HMG in Sébenikoro. Data were collected over a 12-month period from January to December 2017. Included were records of all hemodialysis patients for chronic renal failure who died, of either sex and anyage. RESULTS A total of 52 patients were dialysed during the study period among whom 12 died or a mortality rate of 23%. The average age of the patients was 59.16 years with extremes of 39 and 71 years. Patients aged 60 and over accounted for 58.3% of cases. There was a male predominance with a sex ratio M / F: 2. In terms of chronic diseases, 83.3% of patients were hypertensive, 50% diabetic, and 16.66% hadhepatitis C. Compared to the initial nephropathies : glomerular nephropathy: 58.3%, vascular nephropathy: 25.0%, undetermined nephropathy: 16.7%. For the management of anemia, 100% ofour patients received EPO and iron injection. Regarding the management of hemodialysis, 83.3% had an AVF as a vascular approach and 16.7% had a central venous catheter as a vascular approach. The patients were all regular at their hemodialysis session with a rhythm of two sessions of 04H of time per session and per week. The causes of death were dominated by cardiovascular pathologies: 5 cases, 41.7%, infectious diseases: 4 cases, 33.3%, indeterminate pathologies: 3 cases or 25%. Deaths occurred in 58.3% of cases before one year of dialysis and 41.7% after one year of hemodialysis treatment. CONCLUSION The mortality rate of hemodialysis patients is high in Mali, especially in the HMG of Sébénikoro. Cardiovascular causes have an important role in the mortality of hemodialysis patients, but other causes such as infections are not to be over looked.
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Affiliation(s)
| | - M Samké
- Hopital Fousséyni Daou de Kayes
| | - A S Fofana
- Centre Hospitalier Universitaire du Point G
| | | | - S Sy
- Centre Hospitalier Universitaire du Point G
| | - H Yattara
- Centre Hospitalier Universitaire du Point G
| | - D Diallo
- Centre Hospitalier Universitaire du Point G
| | - S Fongoro
- Centre Hospitalier Universitaire du Point G
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13
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Abstract
Haemodialysis is the most frequently used renal replacement therapy for chronic kidney disease. Much progress has been made in this field since the invention of this technique. The nurse nevertheless continues to play an essential role. Kidney transplantation is gradually becoming the first-line treatment, the aim of dialysis being to prepare patients for this procedure.
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Affiliation(s)
- Philippe Brunet
- Service de néphrologie, hôpital de la Conception, AP-HM, Aix-Marseille université, 147, boulevard Baille, 13005 Marseille, France.
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14
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Georgatzakou HT, Tzounakas VL, Kriebardis AG, Velentzas AD, Kokkalis AC, Antonelou MH, Papassideri IS. Short-term effects of hemodiafiltration versus conventional hemodialysis on erythrocyte performance. Can J Physiol Pharmacol 2017; 96:249-257. [PMID: 28854342 DOI: 10.1139/cjpp-2017-0285] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Hemodiafiltration (HDF) is a renal replacement therapy that is based on the principles of diffusion and convection for the elimination of uremic toxins. A significant and increasing number of end-stage renal disease (ESRD) patients are treated with HDF, even in the absence of definite and conclusive survival and anemia treatment data. However, its effects on red blood cell (RBC) physiological features have not been examined in depth. In this study, ESRD patients under regular HDF or conventional hemodialysis (cHD) treatment were examined for RBC-related parameters, including anemia, hemolysis, cell shape, redox status, removal signaling, membrane protein composition, and microvesiculation, in repeated paired measurements accomplished before and right after each dialysis session. The HDF group was characterized by better redox potential and suppressed exovesiculation of blood cells compared with the cHD group pre-dialysis. However, HDF was associated with a temporary but acute, oxidative-stress-driven increase in hemolysis, RBC removal signaling, and stomatocytosis, probably associated with the effective clearance of dialyzable natural antioxidant components, including uric acid, from the uremic plasma. The nature of these adverse short-term effects of HDF on post-dialysis plasma and RBCs strongly suggests the use of a parallel antioxidant therapy during the HDF session.
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Affiliation(s)
- Hara T Georgatzakou
- a Department of Biology, Section of Cell Biology & Biophysics, School of Science, National and Kapodistrian University of Athens (NKUA), Greece
| | - Vassilis L Tzounakas
- a Department of Biology, Section of Cell Biology & Biophysics, School of Science, National and Kapodistrian University of Athens (NKUA), Greece
| | - Anastasios G Kriebardis
- b Department of Medical Laboratories, Faculty of Health and Caring Professions, Technological and Educational Institute (TEI) of Athens, Greece
| | - Athanassios D Velentzas
- a Department of Biology, Section of Cell Biology & Biophysics, School of Science, National and Kapodistrian University of Athens (NKUA), Greece
| | | | - Marianna H Antonelou
- a Department of Biology, Section of Cell Biology & Biophysics, School of Science, National and Kapodistrian University of Athens (NKUA), Greece
| | - Issidora S Papassideri
- a Department of Biology, Section of Cell Biology & Biophysics, School of Science, National and Kapodistrian University of Athens (NKUA), Greece
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15
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Laprugne-Garcia É, Gardes S. [The infection risk assessment visit in haemodialysis, a new tool]. Soins 2017; 62:17-19. [PMID: 28342461 DOI: 10.1016/j.soin.2017.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Haemodialysis is a speciality with a high risk of infection, due in part to the frailty of the patients (immunosuppressed, high prevalence of carriers of multi-drug resistant bacteria), as well as to the invasive procedures carried out (inserting central venous catheters, using these catheters and arteriovenous fistulas). The infection risk assessment visit in haemodialysis is a tool which contributes to the safety of care.
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Affiliation(s)
- Élisabeth Laprugne-Garcia
- CClin Sud-Est - Hôpital Henry-Gabrielle, Villa Alice, 20, route de Vourles, 69230 Saint-Genis Laval, France.
| | - Sophie Gardes
- Hygiène épidémiologie infectiovigilance prévention, groupement hospitalier Sud centre hospitalier Lyon Sud (HCL), pavillon 3B 1(er), chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
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16
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Coulibaly N, Coulibaly SP, Coulibaly M, Tounkara AA, Sanogo MS, Diallo D, Djiguiba K, Yattara H, Fongoro S. [Depression To The Chronic Hemodialysis Of the University Hospital OF Point G (Bamako-Mali)]. Mali Med 2017; 32:1-6. [PMID: 30079642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Determine prevalence of the depression in a population of patients chronic hemodialysis. Look for the associated sociodemographic, clinical and biological factors. METHOD It was a transverse study. She concerned the at least 18-years-old patients, followed in the center of Hemodialysis of the CHU at the rate of 2 - 3 sessions a week. The patients having agreed, were in dialysis at least for 3 months and benefited from an individual interview through an index card of investigation based of Hamilton's scale French version in 17 items. RESULTS On a sample of 107 patients, the average age was 43, 24 ± 14 years old with extremes between 20 and 75 years. The average duration in dialysis was of ±40, 37 36, 5 months with extremes between 4 and 144 months. Prevalence of the depression was 88 %. The depression was light in 78, 5 %, moderated in 6,5% and severe in 3 %. The anemia was present at 94 patient's among whom 76 had a light depression. CONCLUSION We observed that prevalence of the depression remains high to the chronic hemodialysis.
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Affiliation(s)
- N Coulibaly
- Service de néphrologie et d'hémodialyse du Centre Hospitalier Universitaire du Point G
| | - S P Coulibaly
- service de psychiatrie du CHU du Point G (Bamako-Mali); 2. Service d'anatomie -cytologie- pathologie du CHU du Point G (Bamako-Mali)
| | - M Coulibaly
- Service de néphrologie et d'hémodialyse du Centre Hospitalier Universitaire du Point G
| | - A A Tounkara
- Service de néphrologie et d'hémodialyse du Centre Hospitalier Universitaire du Point G
| | | | - D Diallo
- Service de néphrologie et d'hémodialyse du Centre Hospitalier Universitaire du Point G
| | | | | | - S Fongoro
- Service de néphrologie et d'hémodialyse du Centre Hospitalier Universitaire du Point G
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17
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Tosic Dragovic J, Popovic J, Djuric P, Jankovic A, Bulatovic A, Barovic M, Pravica V, Marinkovic J, Dimkovic N. Relative risk for cardiovascular morbidity in hemodialysis patients regarding gene polymorphism for IL-10, IL-6, and TNF. Can J Physiol Pharmacol 2016; 94:1106-1109. [PMID: 27580171 DOI: 10.1139/cjpp-2015-0569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Uremia-related inflammation is prone to be a key factor to explain high cardiovascular morbidity in hemodialysis patients. Genetic susceptibility may be of importance, including IL-10, IL-6, and TNF. The aim was to analyze IL-10, IL-6, and TNF gene polymorphisms in a group of hemodialysis patients and to correlate the findings with cardiovascular morbidity. This study included 169 patients on regular hemodialysis at Zvezdara University Medical Center. Gene polymorphisms for IL-10, IL-6 and TNF were determined using PCR. These findings were correlated with the cardiovascular morbidity data from patient histories. Heterozygots for IL-10 gene showed significantly lower incidence of cardiovascular events (p = 0.05) and twice lower risk for development of myocardial infarction, but experienced twice higher risk for left ventricular hypertrophy. Regarding TNF gene polymorphism, patients with A allele had 1.5-fold higher risk for cerebrovascular accident and cardiovascular events and 2-fold higher risk for hypertension and peripheral vascular disease. Patients with G allele of IL-6 gene experienced 1.5-fold higher risks for cerebrovascular accident. We need studies with larger number of patients for definitive conclusion about the influence of gene polymorphisms on cardiovascular morbidity in hemodialysis patients and its importance in everyday clinical practice.
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Affiliation(s)
- J Tosic Dragovic
- a Clinical Department for Renal Diseases, Zvezdara University Medical Center, Dimitrija Tucovica 161, 11000 Belgrade, Serbia
| | - J Popovic
- a Clinical Department for Renal Diseases, Zvezdara University Medical Center, Dimitrija Tucovica 161, 11000 Belgrade, Serbia
| | - P Djuric
- a Clinical Department for Renal Diseases, Zvezdara University Medical Center, Dimitrija Tucovica 161, 11000 Belgrade, Serbia
| | - A Jankovic
- a Clinical Department for Renal Diseases, Zvezdara University Medical Center, Dimitrija Tucovica 161, 11000 Belgrade, Serbia
| | - A Bulatovic
- a Clinical Department for Renal Diseases, Zvezdara University Medical Center, Dimitrija Tucovica 161, 11000 Belgrade, Serbia
| | - M Barovic
- b Medical Faculty, Belgrade University, Dr Subotica 9, 11000 Belgrade, Serbia
| | - V Pravica
- b Medical Faculty, Belgrade University, Dr Subotica 9, 11000 Belgrade, Serbia
| | - J Marinkovic
- b Medical Faculty, Belgrade University, Dr Subotica 9, 11000 Belgrade, Serbia
| | - N Dimkovic
- a Clinical Department for Renal Diseases, Zvezdara University Medical Center, Dimitrija Tucovica 161, 11000 Belgrade, Serbia.,b Medical Faculty, Belgrade University, Dr Subotica 9, 11000 Belgrade, Serbia
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18
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Chaput H. ["I believe that dialysis has improved my health status"]. Soins Gerontol 2016:30-1. [PMID: 26805645 DOI: 10.1016/j.sger.2015.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
For JM, dialysis is not a battle but a life contract which requires a time of adaptation both on a physical as well as an organisational level. After a few months of treatment, he describes here in simple terms how he feels about this new and unknown world, one which he is getting to grips with little by little thanks to the confidence he has in the professionals surrounding with him.
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Affiliation(s)
- Hélène Chaput
- Centre d'action sociale de la ville de Paris, 30 rue des Baudemons, 94320 Thiais, France.
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19
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Loubert C. [Hemodialysis, sociological analysis of caregivers and patients]. Soins Gerontol 2016; 21:22-24. [PMID: 26805643 DOI: 10.1016/j.sger.2015.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The trajectory of elderly patients undergoing haemodialysis is different from that of younger patients. A detailed description of these trajectories has resulted in the identification of certain characteristics inherent to the elderly. A study suggests moving beyond the perceptual knowledge of the professional in order to objectify the factors influencing these interpersonal relationships.
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Affiliation(s)
- Christine Loubert
- Institut de formation aux métiers de la santé, Centre hospitalier J. Bernard, avenue Desandrouin, 59300 Valenciennes, France.
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20
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Grangier JP. [Peritoneal dialysis today and tomorrow]. Soins Gerontol 2016; 21:14-17. [PMID: 26805641 DOI: 10.1016/j.sger.2015.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Peritoneal dialysis was first used in the 1980s. Less well-known than haemodialysis, it represents an important treatment option for elderly patients at home.
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21
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Chir A, Sanson F, Vilaine E. [The support of the elderly person on hemodialysis]. Soins Gerontol 2016; 21:18-21. [PMID: 26805642 DOI: 10.1016/j.sger.2015.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The ageing of the population is associated with an increase in the incidence of chronic renal failure. Management of the condition must be adapted to the specificities linked to ageing. With end-stage renal failure, haemodialysis is a substitution technique offered under certain conditions. The central role of the caregivers is to support and guide the elderly person along their care pathway. Faced with a reduced life expectancy, the aim of all concerned is to strike a balance between an effective treatment and quality of life.
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Affiliation(s)
- Anne Chir
- Service de néphrologie et hémodialyse, centre hospitalo-universitaire Ambroise-Paré (AP-HP), 9 avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France; Université de Versailles Saint-Quentin-en-Yvelines, UFR des sciences de la santé Simone-Veil, 2 avenue de la source de la Bièvre, 78180 Montigny-le-Bretonneux, France.
| | - Fabienne Sanson
- Service de néphrologie et hémodialyse, centre hospitalo-universitaire Ambroise-Paré (AP-HP), 9 avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France; Université de Versailles Saint-Quentin-en-Yvelines, UFR des sciences de la santé Simone-Veil, 2 avenue de la source de la Bièvre, 78180 Montigny-le-Bretonneux, France
| | - Eve Vilaine
- Service de néphrologie et hémodialyse, centre hospitalo-universitaire Ambroise-Paré (AP-HP), 9 avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France; Université de Versailles Saint-Quentin-en-Yvelines, UFR des sciences de la santé Simone-Veil, 2 avenue de la source de la Bièvre, 78180 Montigny-le-Bretonneux, France
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22
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Karimi I, Benabdellah N, Bentata Y, Haddiya I. [Elderly patients on chronic hemodialysis: experience of a Moroccan hospital]. Pan Afr Med J 2013; 15:25. [PMID: 24009801 PMCID: PMC3758857 DOI: 10.11604/pamj.2013.15.25.2278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 01/01/2013] [Indexed: 11/18/2022] Open
Abstract
De plus en plus de patients âgés sont pris en charge en hémodialyse chronique. L'augmentation de l'incidence de la maladie rénale chronique, du diabète et l'amélioration de la survie cardio-vasculaire expliquent en grande partie ce constat. Les conséquences de la prise en charge de ces patients âgés en en hémodialyse chronique sont multiples. Elles sont dominées par les comorbidités et les troubles d'autonomie. Le but de notre étude est de décrire le profil épidémiologique et clinique des patients âgés traités par HDC dans notre centre. Nous avons réalisé une étude transversale, en Novembre 2011, incluant tous les patients hémodialysés chroniques de l'Hôpital Al Farabi d'Oujda, dans la région de l'Oriental Marocain. Nous avons analysé chez les patients âgés de 65 ans et plus les paramètres démographiques, clinico-biologiques et dialytiques. L'analyse statistique est réalisée par le logiciel SPSS 17,0. Parmi 94 patients hémodialysés chroniques actuellement pris en charge dans notre centre, 31patients sont âgés de 65 ans et plus (32,9%). La néphropathie causale était diabétique dans 6,4% des cas, vasculaire dans 19,35% des cas, et glomérulaire dans 20% des cas. Les comorbidités sont observées chez 65% de ces patients. 29% de patients avaient une comorbidité cardiovasculaire, 55% étaient hypertendus, alors que 6,4% avaient des troubles cognitifs. Les sujets âgés en hémodialyse chronique représentent une population de patients fragiles. Ils nécessitent une surveillance particulière et régulière afin de prévenir certaines complications propres au sujet âgé et améliorer ainsi leur qualité de vie.
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Affiliation(s)
- Ilham Karimi
- Service de Néphrologie-Dialyse, Hôpital Al farabi, Université Mohamed Premier, Faculté de médecine et de pharmacie, Oujda, Maroc
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23
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Hassimi L, Bako H, Boubacar A, Toure AI. [Arterial hypertension in chronic hemodialysis patients at the National Hospital of Niamey Lamordé]. Mali Med 2013; 28:44-49. [PMID: 30049154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A prospective study was conducted at the department of the National Hospital in Niamey, Niger Lamordé over a period of 12 months (from January 1 to December 31, 2009) on 99 patients on chronic hemodialysis. The purpose of this study was to analyze the epidemiological, clinical, paraclinical and therapeutic aspects of arterial hypertension in this population. The average age was 37 years (range 17 to 65) , the prevalence of arterial hypertension was 61.61 %. The most common functional signs are headache, present in 29.50 % of patients, dizziness in 24.59% and phosphenes in 18.03% of them. Low arterial hypertension was found in 21.32%, mild for 44.26% of patients and severe in 34.42%, tachycardia in 21.31% and heart murmur in 19.67% of them. The dominant etiologies of chronic renal failure in this series remain the chronic glomerulonephritis in 62.30% of cases and the nephroangiosclerosis in 36.06 % of the cases. Cardiomegaly is found in more than half of the patients, the atrial and ventricular hypertrophy in 39.34% and repolarization disorders in 19.67% of them. The systolic and diastolic blood pressure in patients have been standardized in 26.22% under dialysis alone, dialysis plus inhibitor of angiotensin conversion enzyme alone 44.26%, or associated with a calcium channel blocker with 21.33%, and in 8.19% of them arterial hypertension resisted. At the end of this study, there is a high prevalence of arterial hypertension with cardiac resonance in patients on chronic hemodialysis, and its mechanism appears to be natural or volo-dependent, renin-dépendant or both.
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Affiliation(s)
- Larabou Hassimi
- Faculté des Sciences de la Santé Niamey - Niger
- Service de Néphrologie Hémodialyse de l'Hôpital National de Lamordé
| | - Harouna Bako
- Faculté des Sciences de la Santé Niamey - Niger
- Service de Cardiologie Département de Spécialités Médicales de l'Hôpital National de Niamey
| | - Amadou Boubacar
- Service de Néphrologie Hémodialyse de l'Hôpital National de Lamordé
| | - A Ibrahim Toure
- Faculté des Sciences de la Santé Niamey - Niger
- Service de Médecine Interne et de Cardiologie de l'Hôpital National de Lamordé
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24
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El Bouazzaoui A, Darkaoui A, Houari N, Attaraf K, Bouabdellah Y, Labib S, Harandou M. [Iatrogenic ileal perforation: complication of exceptional mechanical hemodialysis catheter placement at the femoral site ]. Pan Afr Med J 2010; 5:24. [PMID: 21293751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Accepted: 06/27/2010] [Indexed: 11/25/2022] Open
Abstract
Le cathétérisme veineux fémoral est d’indication fréquente et de réalisation le plus souvent aisée et rapide. Thrombose et infection sont les complications les plus couramment rapportées. La perforation iatrogène d’une anse digestive par le trocart de ponction lors de la mise en place d’un cathéter d’hémodialyse au niveau du site fémoral est une complication mécanique inhabituelle. Nous en rapportons un cas jamais décrit, à notre connaissance, dans la littérature médicale.
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