Mélanie Tia - Academia.edu (original) (raw)
Papers by Mélanie Tia
Néphrologie & Thérapeutique, 2022
The European Renal Association-European Dialysis and Transplant Association (ERA-EDTA)/European S... more The European Renal Association-European Dialysis and Transplant Association (ERA-EDTA)/European Society of Hypertension (ESH) recommends out-of-center blood pressure measurements, self-blood pressure measurement or ambulatory blood pressure measurement in dialysis patients. However, the feasibility of out-of-center blood pressure measurements in routine care is not known. The objective of our study was to quantify it as "a priori" i.e. the percentage of hemodialysis to whom out-of-center blood pressure measurements can be proposed and who accept it, as "a posteriori", i.e. the percentage of out-of-center blood pressure measurements made and valid. A systematic out-of-center blood pressure measurements program was implemented from April to October 2019 in our chronic hemodialysis structures. It was proposed to each dialysis patient to carry out after education, an self-blood pressure measurement (Omron M3®), from 2 measurements, to 1 to 2minutes interval, mornings...
Néphrologie & Thérapeutique, 2022
The European Renal Association-European Dialysis and Transplant Association (ERA-EDTA)/European S... more The European Renal Association-European Dialysis and Transplant Association (ERA-EDTA)/European Society of Hypertension (ESH) recommends out-of-center blood pressure measurements, self-blood pressure measurement or ambulatory blood pressure measurement in dialysis patients. However, the feasibility of out-of-center blood pressure measurements in routine care is not known. The objective of our study was to quantify it as "a priori" i.e. the percentage of hemodialysis to whom out-of-center blood pressure measurements can be proposed and who accept it, as "a posteriori", i.e. the percentage of out-of-center blood pressure measurements made and valid. A systematic out-of-center blood pressure measurements program was implemented from April to October 2019 in our chronic hemodialysis structures. It was proposed to each dialysis patient to carry out after education, an self-blood pressure measurement (Omron M3®), from 2 measurements, to 1 to 2minutes interval, mornings and evenings of 6days without dialysis (validity: 15 measures). Apart from arrhythmic patients, to all patients "not eligible" for self-blood pressure measurement (visually impaired, hemiplegic, neuropsychological disorders, language barrier), a 44-hour ambulatory blood pressure measurement (Microlife WatchBP 03®) was proposed separating 2 hemodialysis sessions; measures every 15minutes from 7 a.m. to 10 p.m. and 30minutes from 10 p.m. to 7 a.m. (validity: 40 measurements/day and 14/night). This is a study evaluating practices recommended for routine care in 18-year-old hemodialysis, having given their consent to the collection and analysis of the data. One hundred twenty nine patients were treated with chronic hemodialysis in our structures during the out-of-center blood pressure measurements campaign. Out-of-center blood pressure measurements could not be done in 21 patients (4 deceased, 2 transplanted and 4 absent before evaluation; 7 arrhythmics; 3 refusals and 1 multiple-disabled). Of these 108 patients (sex ratio 1.25; 69.3±13.5 years), 23 were ineligible for self-blood pressure measurement (visually impaired, neuro- and/or psychological disorders, language barrier). Due to 4 self-blood pressure measurement failures, the feasibility of the self-blood pressure measurement (n=81/129) is 62.8 % (CI95% 54.2-70.7). Of the 24 ambulatory blood pressure measurements performed (23 among those not eligible for self-blood pressure measurement and 1 failure of self-blood pressure measurement), 19 were valid. The "a posteriori" feasibility of out-of-center blood pressure measurements (n=100/129) is 77.5 % (CI95% 69.6-83.4). The feasibility of out-of-center blood pressure measurements in hemodialysis patients is good, making the application of the recommendations possible.
The Pan African Medical Journal, 2021
L´insuffisance rénale terminale nécessite un traitement de suppléance notamment l´hémodialyse. Av... more L´insuffisance rénale terminale nécessite un traitement de suppléance notamment l´hémodialyse. Avant l´initiation, le patient et son entourage reçoivent des informations sur la maladie rénale et les possibilités de traitement. Ce travail a pour objectif d´évaluer le niveau de connaissance ainsi que l´opinion de l´hémodialysé et de son entourage sur la maladie rénale chronique et les traitements de suppléances rénales. Il s´est agi d´une étude transversale descriptive qui s´est déroulée du 29 juillet au 19 août 2020 dans l´unité d´hémodialyse du CHU-SO. La population de notre étude était constituée de tous les patients hémodialysés de l´unité d´hémodialyse du CHU-SO et de leurs accompagnants qui ont donné leur consentement libre et éclairé. Les données ont été collectées de façon anonyme à partir d´un questionnaire. La saisie et l´analyse statistique des données ont été faites au moyen du logiciel Epi Info dans sa version 7.2.2.6. Quatre-vingt-et-un patients et 79 accompagnants ont é...
Saudi Journal of Kidney Diseases and Transplantation, 2016
Kidney transplantation from living kidney donors (LKDs) because of its good results represents a ... more Kidney transplantation from living kidney donors (LKDs) because of its good results represents a good option for the treatment of patients with the end-stage renal disease. Kidney donation is a relatively safe procedure according to several studies. We conducted this cross-sectional study in order to describe the demographic, clinical, and renal outcome of LKD in Côte d'Ivoire. From March to November 2014, LKD residing in Côte d'Ivoire at the time of investigation and having donated the kidney more than one year ago were considered for the study. They were evaluated through a questionnaire. Of the 29 LKD listed in Côte d'Ivoire, only 14 responded to the questionnaire. The mean age at donation was 43.29 ± 9.12 years (27-59) and 10 of the LKD were women. Eight were related to the recipients, and the remaining were spouses. Laparoscopic nephrectomy was performed in nine LKD. The left kidney was harvested in ten cases. The main motivation for donation in all donors was the desire to save a life. At the time of the survey, the average duration after the donation was 4.57 ± 2.56 years (1-8). Only five donors had a regular nephrological follow-up. Hypertension was observed in one donor, seven had significant proteinuria, and six had glomerular filtration rate <60 mL/min but >30 mL/min. Significantly higher proteinuria was noted in donors under 45 years as compared to those over 45 years (0.43 ± 0.17 g/24 h vs. 0.22 ± 0.03 g/24 h, P = 0.01). Our study suggests that renal disease in LKD in Côte d'Ivoire is low after a mean follow-up period of four years. A donor registry is essential to ensure better follow-up of donors in order to detect potential adverse effects of kidney donation in the medium as well as in the long-term.
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2011
Chronic renal failure (CRF) represents the major cause of mortality in the nephrology unit in Ivo... more Chronic renal failure (CRF) represents the major cause of mortality in the nephrology unit in Ivory Coast because the means for appropriate management are lacking. The present study was performed to investigate the risk factors for CRF so that strategies for prevention could be elaborated. A case-control study was performed prospectively at the Yopougon Teaching Hospital in Abidjan from January 2006 to December 2006. Factors known to cause CRF were investigated in patients and controls. Their prevalence rates were compared with the general population. A total of 280 patients and 113 controls were recruited. The mean age of the patients was 37.88 ± 13.33 years and that of the controls was 41.5 ± 9.72 years. Both genders were equally represented. The main causes of CRF were chronic glomerulonephritis (47.48%), with HIV infection accounting for 15% of them, and essential hypertension (HTA) (25%). Essential HTA represented the only factor which, if untreated, inevitably leads to CRF. Th...
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2008
This study was conducted in order to identify the failure rate of the first arterio-venous fistul... more This study was conducted in order to identify the failure rate of the first arterio-venous fistula (AVF) in patients starting hemodialysis (HD) with a central venous catheter (CVC) and to search for factors responsible for this failure. A retrospective study was conducted on 85 patients on chronic HD in Abidjan, from March 15 th to April 15 th , 2007. Factors that could potentially influence the failure of the first AVF were collected. Statistical analysis was used for comparison between groups. Among the study subjects, 7.14% had AVF at the start of their dialysis as against 92.86% who had CVC. About 50% of the patients starting dialysis with CVC failed to have an AVF created within 90 days of commencing dialysis. The number of catheters inserted was significantly higher in patients with failed first AVF as compared to their counterparts (49.29 % versus 30.77%) (p< 0.001). Similarly, the number of attempts at AVF creation, within 90 days of starting HD, was significantly higher ...
Néphrologie & thérapeutique, 2007
The source of living kidney donors in the general population remains underused. The present study... more The source of living kidney donors in the general population remains underused. The present study aims at assessing the prevalence and the characteristics of potential living kidney donors in Ivory Coast in a view of a project of kidney transplantation in French Black Africa. A survey was undertaken in Abidjan from 30 June to 7 July 2006. Nine hundred (and) sixty-two subjects living in the capital and aged between 19 and 64 years old were randomly chosen using data from the 1998 population census. Subjects were asked their age, gender, nationality, marital status, information on kidney graft and renal failure, and their willingness to donate kidney to a relative or friend for transplantation purpose. Seventy per cent of the population study appeared favourable to kidney donation. Potentials living kidney donors have displayed following characteristics: age inferior to 26 years old [OR=2.08, P<0.02, 95%CI: 1.10-3.92]; Ivorians national [OR=2.72, P<0.002, 95% CI 1.42-5.21]; havi...
Néphrologie & Thérapeutique, 2015
Les infections virales sont des complications fré quentes de la transplantation. Les polyomavirus... more Les infections virales sont des complications fré quentes de la transplantation. Les polyomavirus sont les virus qui dé terminent le plus fré quemment des atteintes ré nales et, dans une moindre mesure, les herpè s virus. Ces derniè res anné es, une né phropathie à adé novirus a fait l'objet de plusieurs cas cliniques publié s dans la litté rature. Si dans les pays riches, ces affections sont relativement bé nignes mais sources de morbidité importante chez le transplanté ré nal, l'avenir de ces patients dans les pays à ressources limité es reste mal connu. Nous rapportons le premier cas d'un transplanté ré nal d'Afrique noire, survenu au tout dé but d'un projet pilote de greffe ré nale. Il s'agit d'un homme âgé de 54 ans, qui a pré senté une cystite hé morragique fé brile environ 1 mois aprè s la greffe ré nale. Le diagnostic d'adé novirus a é té suspecté devant des tableaux de conjonctivite et de gastroenté rite à ré pé tition avant la greffe ré nale, et apporté par la PCR adé novirus ré alisé e dans le sang. La conjonction de mesures conservatoires avec une ré duction de l'immunosuppression ont permis d'amender l'hé maturie. Nous avons discuté le cas de ce patient au regard de l'é pidé miologie, du diagnostic, du traitement, de l'é volution et du pronostic de l'infection à adé novirus chez le transplanté ré nal. Une revue de la litté rature de ces 15 derniè res anné es a parallè lement é té effectué e pour faire le point sur cette affection é mergente. ß 2015 Association Socié té de né phrologie. Publié par Elsevier Masson SAS. Tous droits ré servé s.
Néphrologie & Thérapeutique, 2007
Reçu le 2 août 2006 ; accepté le 26 décembre 2006 MOTS CLÉS Afrique noire ; Donneurs vivants de r... more Reçu le 2 août 2006 ; accepté le 26 décembre 2006 MOTS CLÉS Afrique noire ; Donneurs vivants de rein ; Greffe de rein ; Typologie Résumé Il existe en général dans la population un pool important de donneurs vivants potentiels de rein, mais sous utilisé. La présente étude a pour objectif d'apprécier pour la première fois dans une population d'Afrique noire francophone la proportion de donneurs potentiels en prélude à un projet de greffe rénale. Une enquête a été réalisée du 30 juin au 7 juillet 2006 à Abidjan (Côte-d'Ivoire). Neuf cent soixante-deux personnes âgées de 19 à 64 ans ont été tirées au sort à partir de la population générale issue du recensement de 1998. Ces personnes ont été interrogées sur la base d'un questionnaire pour identifier les caractéristiques des personnes qui étaient plus favorables au don de rein. Soixante-dix pour cent de la population sont favorables à la donation de rein. Les caractéristiques suivantes sont apparues essentielles pour le don de rein : sujets de moins de 26 ans [OR = 2,08 p < 0,02, IC 95 % : 1,10-3,92] ; être de nationalité ivoirienne [OR = 2,72, p < 0,002, IC 95 % : 1,42-5,21] ; avoir un proche décédé d'insuffisance rénale [OR = 1,82, p < 0,002, IC 95 % : 1,25-2,67] ; avoir entendu parler de greffe [OR = 1,89, p < 0,047, IC 95 % : 1-3,54]. Les sujets mariés sont deux fois moins favorables au don de rein que les célibataires [OR = 0,52, p < 0,0002, IC 95 % : 0,34-0,79]. Il existe donc aussi en Côte-d'Ivoire un pool important de donneurs potentiels qui présentent des caractéristiques spécifiques.
Annals of Ibadan Postgraduate Medicine, 2010
Chronic renal failure (CRF) occurring in sickle cell disease has a dismal outcome. The systematic... more Chronic renal failure (CRF) occurring in sickle cell disease has a dismal outcome. The systematic screening for microalbuminuria represents the touchstone to prevent CRF in patients with diabetes mellitus. Microalbuminuria has also been demonstrated in patients with sickle cell disease. Whether this has the same prognostic significance as it does in diabetes mellitus has never been clearly stated. The purpose of the present study was to determine the prevalence of microalbuminuria and to establish the clinical significance of microalbuminuria in patients with sickle cell disease. Patients with sickle cell disease of both sexes and all ages were consecutively recruited at the haematology outpatient clinic of the Yopougon Teaching Hospital, Abidjan, Ivory Coast. in a prospective study from July to September 2004. In each patient characteristics such as age, gender, ethnic group, weight, height, blood pressure, type of haemoglobinopathy , glomerular filtration rate, complications related to the disease and current treatment were collected. Microalbuminuria was assessed in all the patients. Statistical analysis was performed to identify factors related to microalbuminuria. The prevalence of microalbuminuria was 17.3% in our study population. Glomerular filtration rate was significantly lower in the microalbuminuric group than in the normoalbuminuric group both on univariate analysis (p<0.01) and on multivariate analysis (OR=1.074) CI 95% [1.020 1.136]) (p<0.01). Height was significantly lower in the microalbuminuric group than in the normoalbuminuric group both on univariate analysis (p=0.05) and on multivariate analysis (OR=1.029 CI 95% [1.003 1.056])(p<0.05). Anaemia was more prevalent in the microalbuminuric group than in the normoalbuminuric group(p<0.05) on univariate analysis but not on multivariate analysis. No relationship has been found between microabuminuria and age, as well as with disease duration and body mass index. Microalbuminuria in sickle cell disease patients represents a feature of more advanced disease as it is significantly related to low glomerular filtration rate. The high prevalence of anaemia in the microalbuminuric patients corroborates the depressed renal function. The role of short height in the promotion of microalbuminuria is unclear.
Néphrologie & Thérapeutique, 2014
L'incidence de l'hypertension arté rielle non contrôlé e (HTA+) au cours de la maladie ré nale ch... more L'incidence de l'hypertension arté rielle non contrôlé e (HTA+) au cours de la maladie ré nale chronique (MRC) en né phrologie peut reflé ter l'efficacité ou non de la prise en charge en amont de cette affection. L'objectif de cette é tude é tait d'identifier les facteurs associé s à une HTA+ lors de la MRC afin de proposer une straté gie de pré vention. Une é tude ré trospective de 479 patients incidents admis en service de né phrologie a é té ré alisé e de janvier à dé cembre 2012. Parmi les patients, 62 % avaient une MRC HTA+. Ils é taient vus à un stade tardif. La pression arté rielle systolique (PAS) é tait de 166,5 AE 32 mmHg et la pression arté rielle diastolique (PAD) de 96 AE 27,3 mmHg. L'âge moyen é tait de 48,2 AE 14,6 anné es. Les sujets MRC HTA+ é taient significativement plus âgé s (50,3 AE 15 anné es contre 46,9 AE 14,3 anné es ; p < 0,01). Le dé bit de filtration glomé rulaire (DFG) moyen é tait de 17,4 AE 17,1 mL/min, identique entre les groupes (17,4 AE 17,6 mL/min MRC HTA+ et 17,5 AE 16,3 mL/min MRC HTA-; p < 0,9). La consommation d'alcool é tait notable chez les MRC HTA+ (37,2 % MRC HTA+ versus 27,6 % MRC HTA-; p < 0,09). Les sujets qui prenaient un antihypertenseur é taient en nombre significativement plus important chez les MRC HTA-(22 % MRC HTA+ et 41,1 % MRC HTA-; p < 0,0001). Les facteurs associé s à une MRC HTA+ é taient un traitement antihypertenseur et la consommation d'alcool. La pression arté rielle é tait similaire pour les né phropathies hypertensives (HTN+) et non hypertensives (HTN-) (173,0 AE 26,9 mmHg versus 174,7 AE 33,7 mmHg ; p = 0,75). Mais la fonction ré nale est non significativement meilleure dans les HTN+ (16,9 AE 17,7 mL/min et 20,95 AE 18,5 mL/min ; p < 0,1). Les anté cé dents d'HTA et l'âge sont positivement associé s à l'HTA+ des HTN+. Les anté cé dents de diabè te et un stade MRC sont né gativement associé s à l'HTA+HTN+. ß 2014 Association Socié té de né phrologie. Publié par Elsevier Masson SAS. Tous droits ré servé s.
Open Journal of Nephrology
Immunopathologia Persa
Quality of life and life span have considerably increased in human immunodeficiency virus (HIV) p... more Quality of life and life span have considerably increased in human immunodeficiency virus (HIV) patients over the past years owing to the highly effective antiretroviral therapy. Consequently, the number of patients with end-stage renal disease (ESRD) has increased in dialysis centers. Several teams in the United States as well as in Europe have therefore proposed renal transplantation to this group of patients with encouraging results. From March 2015 to February 2016, four kidney transplantations have been conducted in the very first kidney transplantation program ever in French speaking black Africa. Three male and one female with a mean age of 50.75 years have been transplanted. One of them was HIV-2 positive. Before kidney transplantation, patients have exhibited diverse highly active antiretroviral therapy (HAART) regimen. They all have undetectable viremia and the mean value of the CD4 count was 454.5 cells/µL. Raltegravir, an integrase inhibitor, has systematically been added to the baseline HAART therapy at least 30 days before transplantation. Immunosuppression comprised basiliximab as induction therapy, tacrolimus, sodium mycophenolate and steroids. After a mean time of six months, all the patients are alive with a mean serum creatinine of 1.425±0.263mg/dl, and a mean proteinuria of 0.55±0.29 g/d. We present these results in full, and discuss them according to data retrieved from the literature. The conditions of access of human immunodeficiency virus positive patients to renal transplantation, the immunosuppression and the antiretroviral regimen, graft and patient survival have all been discussed accordingly.
Open Journal of Nephrology
Background: Kidney Transplantation is the best treatment for patients in end stage renal disease.... more Background: Kidney Transplantation is the best treatment for patients in end stage renal disease. It's a new therapeutic approach for such patients in Cote d'Ivoire which is expected to develop. Aim: Determine the adherence factors affecting kidney transplant recipient among patients on maintenance haemodialysis in Cote d'Ivoire and point out possible obstacles to the development of this new practice in the country. Patients and Methods: This was a cross-sectional study carried out from May to June 2016 in the Haemodialysis Centres of Abidjan. Any patient aged ≥18 years, on haemodialysis for at least 6 months, who signed the inform consent were subjected to a questionnaire. None of the respondents had been transplanted. The subjects addressed in the document were sociocultural status, opinion related to kidney transplantation and willingness to be transplanted or not and the reasons. A statistical analysis was performed to determine factors associated with kidney transplantation desire. Results: We included 295 (71.53% males) patients, with a mean age of 44.53 ± 12.09 years. Among this population, 36.61% had a higher level of education, 70.85% were Christians, 66.44% lived with partners, 56.61% had no income and 74.92% were treated in Public Health Centres. The median duration on dialysis was 34 months. A total of 287 (97.29%) patients had already heard of kidney transplantation among which 149 (51.94%) for the first time after initiation of haemodialysis. There was 231 (78.31%) patients willing to be transplanted with only 91 (39.39%) of them having a potential living donors. The main motivations were the desire to stop dialysis (52.38%) and the search for a better quality of life (41.13%). Among the 64 (21.
African Journal of Nephrology
Some biomarkers have been developed to estimate the glomerular filtration rate (GFR) and detect d... more Some biomarkers have been developed to estimate the glomerular filtration rate (GFR) and detect declining kidney function. However, there is still a lack of simple tools to detect trends in renal function over time, when the GFR is normal or high [3]. Cystatin C is a lowmolecular weight endogenous protein, produced at a steady rate by nucleated cells and eliminated from the
Journal of Infectious Diseases, 2016
Various hantaviruses have been discovered in unconventional hosts (shrews and bats) in Africa. Up... more Various hantaviruses have been discovered in unconventional hosts (shrews and bats) in Africa. Up to now, it was unknown whether these viruses pose a threat for human health. In this study, using newly established serological assays, we demonstrated evidence of shrew-borne hantavirus infections in humans from Côte d'Ivoire and Gabon.
Néphrologie & Thérapeutique, 2015
Néphrologie & Thérapeutique, 2022
The European Renal Association-European Dialysis and Transplant Association (ERA-EDTA)/European S... more The European Renal Association-European Dialysis and Transplant Association (ERA-EDTA)/European Society of Hypertension (ESH) recommends out-of-center blood pressure measurements, self-blood pressure measurement or ambulatory blood pressure measurement in dialysis patients. However, the feasibility of out-of-center blood pressure measurements in routine care is not known. The objective of our study was to quantify it as "a priori" i.e. the percentage of hemodialysis to whom out-of-center blood pressure measurements can be proposed and who accept it, as "a posteriori", i.e. the percentage of out-of-center blood pressure measurements made and valid. A systematic out-of-center blood pressure measurements program was implemented from April to October 2019 in our chronic hemodialysis structures. It was proposed to each dialysis patient to carry out after education, an self-blood pressure measurement (Omron M3®), from 2 measurements, to 1 to 2minutes interval, mornings...
Néphrologie & Thérapeutique, 2022
The European Renal Association-European Dialysis and Transplant Association (ERA-EDTA)/European S... more The European Renal Association-European Dialysis and Transplant Association (ERA-EDTA)/European Society of Hypertension (ESH) recommends out-of-center blood pressure measurements, self-blood pressure measurement or ambulatory blood pressure measurement in dialysis patients. However, the feasibility of out-of-center blood pressure measurements in routine care is not known. The objective of our study was to quantify it as "a priori" i.e. the percentage of hemodialysis to whom out-of-center blood pressure measurements can be proposed and who accept it, as "a posteriori", i.e. the percentage of out-of-center blood pressure measurements made and valid. A systematic out-of-center blood pressure measurements program was implemented from April to October 2019 in our chronic hemodialysis structures. It was proposed to each dialysis patient to carry out after education, an self-blood pressure measurement (Omron M3®), from 2 measurements, to 1 to 2minutes interval, mornings and evenings of 6days without dialysis (validity: 15 measures). Apart from arrhythmic patients, to all patients "not eligible" for self-blood pressure measurement (visually impaired, hemiplegic, neuropsychological disorders, language barrier), a 44-hour ambulatory blood pressure measurement (Microlife WatchBP 03®) was proposed separating 2 hemodialysis sessions; measures every 15minutes from 7 a.m. to 10 p.m. and 30minutes from 10 p.m. to 7 a.m. (validity: 40 measurements/day and 14/night). This is a study evaluating practices recommended for routine care in 18-year-old hemodialysis, having given their consent to the collection and analysis of the data. One hundred twenty nine patients were treated with chronic hemodialysis in our structures during the out-of-center blood pressure measurements campaign. Out-of-center blood pressure measurements could not be done in 21 patients (4 deceased, 2 transplanted and 4 absent before evaluation; 7 arrhythmics; 3 refusals and 1 multiple-disabled). Of these 108 patients (sex ratio 1.25; 69.3±13.5 years), 23 were ineligible for self-blood pressure measurement (visually impaired, neuro- and/or psychological disorders, language barrier). Due to 4 self-blood pressure measurement failures, the feasibility of the self-blood pressure measurement (n=81/129) is 62.8 % (CI95% 54.2-70.7). Of the 24 ambulatory blood pressure measurements performed (23 among those not eligible for self-blood pressure measurement and 1 failure of self-blood pressure measurement), 19 were valid. The "a posteriori" feasibility of out-of-center blood pressure measurements (n=100/129) is 77.5 % (CI95% 69.6-83.4). The feasibility of out-of-center blood pressure measurements in hemodialysis patients is good, making the application of the recommendations possible.
The Pan African Medical Journal, 2021
L´insuffisance rénale terminale nécessite un traitement de suppléance notamment l´hémodialyse. Av... more L´insuffisance rénale terminale nécessite un traitement de suppléance notamment l´hémodialyse. Avant l´initiation, le patient et son entourage reçoivent des informations sur la maladie rénale et les possibilités de traitement. Ce travail a pour objectif d´évaluer le niveau de connaissance ainsi que l´opinion de l´hémodialysé et de son entourage sur la maladie rénale chronique et les traitements de suppléances rénales. Il s´est agi d´une étude transversale descriptive qui s´est déroulée du 29 juillet au 19 août 2020 dans l´unité d´hémodialyse du CHU-SO. La population de notre étude était constituée de tous les patients hémodialysés de l´unité d´hémodialyse du CHU-SO et de leurs accompagnants qui ont donné leur consentement libre et éclairé. Les données ont été collectées de façon anonyme à partir d´un questionnaire. La saisie et l´analyse statistique des données ont été faites au moyen du logiciel Epi Info dans sa version 7.2.2.6. Quatre-vingt-et-un patients et 79 accompagnants ont é...
Saudi Journal of Kidney Diseases and Transplantation, 2016
Kidney transplantation from living kidney donors (LKDs) because of its good results represents a ... more Kidney transplantation from living kidney donors (LKDs) because of its good results represents a good option for the treatment of patients with the end-stage renal disease. Kidney donation is a relatively safe procedure according to several studies. We conducted this cross-sectional study in order to describe the demographic, clinical, and renal outcome of LKD in Côte d'Ivoire. From March to November 2014, LKD residing in Côte d'Ivoire at the time of investigation and having donated the kidney more than one year ago were considered for the study. They were evaluated through a questionnaire. Of the 29 LKD listed in Côte d'Ivoire, only 14 responded to the questionnaire. The mean age at donation was 43.29 ± 9.12 years (27-59) and 10 of the LKD were women. Eight were related to the recipients, and the remaining were spouses. Laparoscopic nephrectomy was performed in nine LKD. The left kidney was harvested in ten cases. The main motivation for donation in all donors was the desire to save a life. At the time of the survey, the average duration after the donation was 4.57 ± 2.56 years (1-8). Only five donors had a regular nephrological follow-up. Hypertension was observed in one donor, seven had significant proteinuria, and six had glomerular filtration rate <60 mL/min but >30 mL/min. Significantly higher proteinuria was noted in donors under 45 years as compared to those over 45 years (0.43 ± 0.17 g/24 h vs. 0.22 ± 0.03 g/24 h, P = 0.01). Our study suggests that renal disease in LKD in Côte d'Ivoire is low after a mean follow-up period of four years. A donor registry is essential to ensure better follow-up of donors in order to detect potential adverse effects of kidney donation in the medium as well as in the long-term.
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2011
Chronic renal failure (CRF) represents the major cause of mortality in the nephrology unit in Ivo... more Chronic renal failure (CRF) represents the major cause of mortality in the nephrology unit in Ivory Coast because the means for appropriate management are lacking. The present study was performed to investigate the risk factors for CRF so that strategies for prevention could be elaborated. A case-control study was performed prospectively at the Yopougon Teaching Hospital in Abidjan from January 2006 to December 2006. Factors known to cause CRF were investigated in patients and controls. Their prevalence rates were compared with the general population. A total of 280 patients and 113 controls were recruited. The mean age of the patients was 37.88 ± 13.33 years and that of the controls was 41.5 ± 9.72 years. Both genders were equally represented. The main causes of CRF were chronic glomerulonephritis (47.48%), with HIV infection accounting for 15% of them, and essential hypertension (HTA) (25%). Essential HTA represented the only factor which, if untreated, inevitably leads to CRF. Th...
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2008
This study was conducted in order to identify the failure rate of the first arterio-venous fistul... more This study was conducted in order to identify the failure rate of the first arterio-venous fistula (AVF) in patients starting hemodialysis (HD) with a central venous catheter (CVC) and to search for factors responsible for this failure. A retrospective study was conducted on 85 patients on chronic HD in Abidjan, from March 15 th to April 15 th , 2007. Factors that could potentially influence the failure of the first AVF were collected. Statistical analysis was used for comparison between groups. Among the study subjects, 7.14% had AVF at the start of their dialysis as against 92.86% who had CVC. About 50% of the patients starting dialysis with CVC failed to have an AVF created within 90 days of commencing dialysis. The number of catheters inserted was significantly higher in patients with failed first AVF as compared to their counterparts (49.29 % versus 30.77%) (p< 0.001). Similarly, the number of attempts at AVF creation, within 90 days of starting HD, was significantly higher ...
Néphrologie & thérapeutique, 2007
The source of living kidney donors in the general population remains underused. The present study... more The source of living kidney donors in the general population remains underused. The present study aims at assessing the prevalence and the characteristics of potential living kidney donors in Ivory Coast in a view of a project of kidney transplantation in French Black Africa. A survey was undertaken in Abidjan from 30 June to 7 July 2006. Nine hundred (and) sixty-two subjects living in the capital and aged between 19 and 64 years old were randomly chosen using data from the 1998 population census. Subjects were asked their age, gender, nationality, marital status, information on kidney graft and renal failure, and their willingness to donate kidney to a relative or friend for transplantation purpose. Seventy per cent of the population study appeared favourable to kidney donation. Potentials living kidney donors have displayed following characteristics: age inferior to 26 years old [OR=2.08, P<0.02, 95%CI: 1.10-3.92]; Ivorians national [OR=2.72, P<0.002, 95% CI 1.42-5.21]; havi...
Néphrologie & Thérapeutique, 2015
Les infections virales sont des complications fré quentes de la transplantation. Les polyomavirus... more Les infections virales sont des complications fré quentes de la transplantation. Les polyomavirus sont les virus qui dé terminent le plus fré quemment des atteintes ré nales et, dans une moindre mesure, les herpè s virus. Ces derniè res anné es, une né phropathie à adé novirus a fait l'objet de plusieurs cas cliniques publié s dans la litté rature. Si dans les pays riches, ces affections sont relativement bé nignes mais sources de morbidité importante chez le transplanté ré nal, l'avenir de ces patients dans les pays à ressources limité es reste mal connu. Nous rapportons le premier cas d'un transplanté ré nal d'Afrique noire, survenu au tout dé but d'un projet pilote de greffe ré nale. Il s'agit d'un homme âgé de 54 ans, qui a pré senté une cystite hé morragique fé brile environ 1 mois aprè s la greffe ré nale. Le diagnostic d'adé novirus a é té suspecté devant des tableaux de conjonctivite et de gastroenté rite à ré pé tition avant la greffe ré nale, et apporté par la PCR adé novirus ré alisé e dans le sang. La conjonction de mesures conservatoires avec une ré duction de l'immunosuppression ont permis d'amender l'hé maturie. Nous avons discuté le cas de ce patient au regard de l'é pidé miologie, du diagnostic, du traitement, de l'é volution et du pronostic de l'infection à adé novirus chez le transplanté ré nal. Une revue de la litté rature de ces 15 derniè res anné es a parallè lement é té effectué e pour faire le point sur cette affection é mergente. ß 2015 Association Socié té de né phrologie. Publié par Elsevier Masson SAS. Tous droits ré servé s.
Néphrologie & Thérapeutique, 2007
Reçu le 2 août 2006 ; accepté le 26 décembre 2006 MOTS CLÉS Afrique noire ; Donneurs vivants de r... more Reçu le 2 août 2006 ; accepté le 26 décembre 2006 MOTS CLÉS Afrique noire ; Donneurs vivants de rein ; Greffe de rein ; Typologie Résumé Il existe en général dans la population un pool important de donneurs vivants potentiels de rein, mais sous utilisé. La présente étude a pour objectif d'apprécier pour la première fois dans une population d'Afrique noire francophone la proportion de donneurs potentiels en prélude à un projet de greffe rénale. Une enquête a été réalisée du 30 juin au 7 juillet 2006 à Abidjan (Côte-d'Ivoire). Neuf cent soixante-deux personnes âgées de 19 à 64 ans ont été tirées au sort à partir de la population générale issue du recensement de 1998. Ces personnes ont été interrogées sur la base d'un questionnaire pour identifier les caractéristiques des personnes qui étaient plus favorables au don de rein. Soixante-dix pour cent de la population sont favorables à la donation de rein. Les caractéristiques suivantes sont apparues essentielles pour le don de rein : sujets de moins de 26 ans [OR = 2,08 p < 0,02, IC 95 % : 1,10-3,92] ; être de nationalité ivoirienne [OR = 2,72, p < 0,002, IC 95 % : 1,42-5,21] ; avoir un proche décédé d'insuffisance rénale [OR = 1,82, p < 0,002, IC 95 % : 1,25-2,67] ; avoir entendu parler de greffe [OR = 1,89, p < 0,047, IC 95 % : 1-3,54]. Les sujets mariés sont deux fois moins favorables au don de rein que les célibataires [OR = 0,52, p < 0,0002, IC 95 % : 0,34-0,79]. Il existe donc aussi en Côte-d'Ivoire un pool important de donneurs potentiels qui présentent des caractéristiques spécifiques.
Annals of Ibadan Postgraduate Medicine, 2010
Chronic renal failure (CRF) occurring in sickle cell disease has a dismal outcome. The systematic... more Chronic renal failure (CRF) occurring in sickle cell disease has a dismal outcome. The systematic screening for microalbuminuria represents the touchstone to prevent CRF in patients with diabetes mellitus. Microalbuminuria has also been demonstrated in patients with sickle cell disease. Whether this has the same prognostic significance as it does in diabetes mellitus has never been clearly stated. The purpose of the present study was to determine the prevalence of microalbuminuria and to establish the clinical significance of microalbuminuria in patients with sickle cell disease. Patients with sickle cell disease of both sexes and all ages were consecutively recruited at the haematology outpatient clinic of the Yopougon Teaching Hospital, Abidjan, Ivory Coast. in a prospective study from July to September 2004. In each patient characteristics such as age, gender, ethnic group, weight, height, blood pressure, type of haemoglobinopathy , glomerular filtration rate, complications related to the disease and current treatment were collected. Microalbuminuria was assessed in all the patients. Statistical analysis was performed to identify factors related to microalbuminuria. The prevalence of microalbuminuria was 17.3% in our study population. Glomerular filtration rate was significantly lower in the microalbuminuric group than in the normoalbuminuric group both on univariate analysis (p<0.01) and on multivariate analysis (OR=1.074) CI 95% [1.020 1.136]) (p<0.01). Height was significantly lower in the microalbuminuric group than in the normoalbuminuric group both on univariate analysis (p=0.05) and on multivariate analysis (OR=1.029 CI 95% [1.003 1.056])(p<0.05). Anaemia was more prevalent in the microalbuminuric group than in the normoalbuminuric group(p<0.05) on univariate analysis but not on multivariate analysis. No relationship has been found between microabuminuria and age, as well as with disease duration and body mass index. Microalbuminuria in sickle cell disease patients represents a feature of more advanced disease as it is significantly related to low glomerular filtration rate. The high prevalence of anaemia in the microalbuminuric patients corroborates the depressed renal function. The role of short height in the promotion of microalbuminuria is unclear.
Néphrologie & Thérapeutique, 2014
L'incidence de l'hypertension arté rielle non contrôlé e (HTA+) au cours de la maladie ré nale ch... more L'incidence de l'hypertension arté rielle non contrôlé e (HTA+) au cours de la maladie ré nale chronique (MRC) en né phrologie peut reflé ter l'efficacité ou non de la prise en charge en amont de cette affection. L'objectif de cette é tude é tait d'identifier les facteurs associé s à une HTA+ lors de la MRC afin de proposer une straté gie de pré vention. Une é tude ré trospective de 479 patients incidents admis en service de né phrologie a é té ré alisé e de janvier à dé cembre 2012. Parmi les patients, 62 % avaient une MRC HTA+. Ils é taient vus à un stade tardif. La pression arté rielle systolique (PAS) é tait de 166,5 AE 32 mmHg et la pression arté rielle diastolique (PAD) de 96 AE 27,3 mmHg. L'âge moyen é tait de 48,2 AE 14,6 anné es. Les sujets MRC HTA+ é taient significativement plus âgé s (50,3 AE 15 anné es contre 46,9 AE 14,3 anné es ; p < 0,01). Le dé bit de filtration glomé rulaire (DFG) moyen é tait de 17,4 AE 17,1 mL/min, identique entre les groupes (17,4 AE 17,6 mL/min MRC HTA+ et 17,5 AE 16,3 mL/min MRC HTA-; p < 0,9). La consommation d'alcool é tait notable chez les MRC HTA+ (37,2 % MRC HTA+ versus 27,6 % MRC HTA-; p < 0,09). Les sujets qui prenaient un antihypertenseur é taient en nombre significativement plus important chez les MRC HTA-(22 % MRC HTA+ et 41,1 % MRC HTA-; p < 0,0001). Les facteurs associé s à une MRC HTA+ é taient un traitement antihypertenseur et la consommation d'alcool. La pression arté rielle é tait similaire pour les né phropathies hypertensives (HTN+) et non hypertensives (HTN-) (173,0 AE 26,9 mmHg versus 174,7 AE 33,7 mmHg ; p = 0,75). Mais la fonction ré nale est non significativement meilleure dans les HTN+ (16,9 AE 17,7 mL/min et 20,95 AE 18,5 mL/min ; p < 0,1). Les anté cé dents d'HTA et l'âge sont positivement associé s à l'HTA+ des HTN+. Les anté cé dents de diabè te et un stade MRC sont né gativement associé s à l'HTA+HTN+. ß 2014 Association Socié té de né phrologie. Publié par Elsevier Masson SAS. Tous droits ré servé s.
Open Journal of Nephrology
Immunopathologia Persa
Quality of life and life span have considerably increased in human immunodeficiency virus (HIV) p... more Quality of life and life span have considerably increased in human immunodeficiency virus (HIV) patients over the past years owing to the highly effective antiretroviral therapy. Consequently, the number of patients with end-stage renal disease (ESRD) has increased in dialysis centers. Several teams in the United States as well as in Europe have therefore proposed renal transplantation to this group of patients with encouraging results. From March 2015 to February 2016, four kidney transplantations have been conducted in the very first kidney transplantation program ever in French speaking black Africa. Three male and one female with a mean age of 50.75 years have been transplanted. One of them was HIV-2 positive. Before kidney transplantation, patients have exhibited diverse highly active antiretroviral therapy (HAART) regimen. They all have undetectable viremia and the mean value of the CD4 count was 454.5 cells/µL. Raltegravir, an integrase inhibitor, has systematically been added to the baseline HAART therapy at least 30 days before transplantation. Immunosuppression comprised basiliximab as induction therapy, tacrolimus, sodium mycophenolate and steroids. After a mean time of six months, all the patients are alive with a mean serum creatinine of 1.425±0.263mg/dl, and a mean proteinuria of 0.55±0.29 g/d. We present these results in full, and discuss them according to data retrieved from the literature. The conditions of access of human immunodeficiency virus positive patients to renal transplantation, the immunosuppression and the antiretroviral regimen, graft and patient survival have all been discussed accordingly.
Open Journal of Nephrology
Background: Kidney Transplantation is the best treatment for patients in end stage renal disease.... more Background: Kidney Transplantation is the best treatment for patients in end stage renal disease. It's a new therapeutic approach for such patients in Cote d'Ivoire which is expected to develop. Aim: Determine the adherence factors affecting kidney transplant recipient among patients on maintenance haemodialysis in Cote d'Ivoire and point out possible obstacles to the development of this new practice in the country. Patients and Methods: This was a cross-sectional study carried out from May to June 2016 in the Haemodialysis Centres of Abidjan. Any patient aged ≥18 years, on haemodialysis for at least 6 months, who signed the inform consent were subjected to a questionnaire. None of the respondents had been transplanted. The subjects addressed in the document were sociocultural status, opinion related to kidney transplantation and willingness to be transplanted or not and the reasons. A statistical analysis was performed to determine factors associated with kidney transplantation desire. Results: We included 295 (71.53% males) patients, with a mean age of 44.53 ± 12.09 years. Among this population, 36.61% had a higher level of education, 70.85% were Christians, 66.44% lived with partners, 56.61% had no income and 74.92% were treated in Public Health Centres. The median duration on dialysis was 34 months. A total of 287 (97.29%) patients had already heard of kidney transplantation among which 149 (51.94%) for the first time after initiation of haemodialysis. There was 231 (78.31%) patients willing to be transplanted with only 91 (39.39%) of them having a potential living donors. The main motivations were the desire to stop dialysis (52.38%) and the search for a better quality of life (41.13%). Among the 64 (21.
African Journal of Nephrology
Some biomarkers have been developed to estimate the glomerular filtration rate (GFR) and detect d... more Some biomarkers have been developed to estimate the glomerular filtration rate (GFR) and detect declining kidney function. However, there is still a lack of simple tools to detect trends in renal function over time, when the GFR is normal or high [3]. Cystatin C is a lowmolecular weight endogenous protein, produced at a steady rate by nucleated cells and eliminated from the
Journal of Infectious Diseases, 2016
Various hantaviruses have been discovered in unconventional hosts (shrews and bats) in Africa. Up... more Various hantaviruses have been discovered in unconventional hosts (shrews and bats) in Africa. Up to now, it was unknown whether these viruses pose a threat for human health. In this study, using newly established serological assays, we demonstrated evidence of shrew-borne hantavirus infections in humans from Côte d'Ivoire and Gabon.
Néphrologie & Thérapeutique, 2015