Insuffisance Rénale Aigue Post-Opératoire Au Centre Hospitalier Universitaire Et Départemental Du Borgou : Fréquence Et Facteurs De Risques Associés

Abstract

Introduction: Acute renal failure (ARF) post-operative is a specific form of acute deficiencies causing multiple declining factors. Objective: This survey aims to study the incidence and risk factors associated with acute renal failure (ARF) in post-operative surgical intensive care units to University Hospital of Borgou (UH-B): during 2015. Patients and Methods this study is a cross sectional, descriptive and analytical ones with the prospective data collection from March 1st to European Scientific Journal November 2016 edition vol.12, No.33 ISSN: 1857 -7881 (Print) e -ISSN 1857 189 August 31th, 2015. The research has involved all patients admitted to the operating room for surgery and motherhood whatever reason and then transferred respectively to the intensive care areas at UH-B. The postoperative ARF has been investigated inner patients following inclusion criteria and classification according to RIFLE score. The socio-demographic, clinical and biological variables monitoring, even support and evolution are experimented. A questionnaire is designed for data collection. Data are analyzed by Epi-Info means with 5% of significance level. Results: 130 patients are registered. The mean age is 27.68 ± 12.87 years. The sex ratio is 0.66. The frequency of post-operative ARF reaches 12.31%. The associated risk factors are: hypertension (p = 0.0018), diabetes (p = 0.002), heart failure (p = 0.0104), severe sepsis (p = 0.006) hypovolemic shock (p = 0.002), ASA class ≥ 3 (p = 0.0014), preeclampsia-eclampsia (p = 0.012), the Altémier class classification ≥ 3 (p = 0.0164), a pathological urinary sediment like a proteinuria (p=0.006), haematuria (p= 0.001) and nitrituria (p=0.007). Consequently, three (03) subjects out of sixteen (16) have died (18.75%). Conclusion:The post-operative ARF is a reality in University Hospital Borgou , with a higher mortality rate. Thus, the prevention strategy is the best treatment through the screening and monitoring promotion towards risk factors. er Mars au 31 Août 2015. Tous les patients opérés (de la chirurgie et de la maternité) et transférés dans les secteurs de la réanimation chirurgicale étaient concernés. Le score de RIFLE a permis de diagnostiquer l'IRA post opératoire. Les variables socio démographiques, clinico-biologiques celles de prise en charge de suivi et d'évolution ont été étudiées. Un questionnaire a été établi pour la collecte des données. Les données collectées ont été analysées avec le logiciel Epi-Info 7.1.1.14 avec un seuil de significativité de 5%. Résultats : Au total, 130 patients ont été enregistrés. L'âge moyen était de 27,68 ± 12,87 ans. La sex-ratio était de 0,66. La fréquence de l'IRA post European Scientific Journal November 2016 edition vol.12, No.33 ISSN: 1857 -7881 (Print) e -ISSN 1857 190 opératoire était de 12,31%. Les facteurs de risque associés étaient : l'hypertension artérielle (p=0,0018),le diabète (p=0,002), l'insuffisance cardiaque(p=0,0104), le sepsis sévère(p=0,006), l' état de choc hypovolémique(p=0,002), la classe ASA ≥3 (p=0,0014), l...

Prevalence, Characteristics and Outcome of Post-Operative Acute Kidney Injury in Cameroon: A Prospective Study in Three Hospitals in Douala

“…Kidney outcome was known on day 7 in 30 patients and we noted 66.6% of total recovery, 23.3% partial recovery and 10% no recovery. This result was close to that of Ahoui et al in Benin who found that kidney recovery was total in 56.25% of patients, partial in 37.5% and absent in 6.25% [17]. That result was in agreement with the literature which mainly reports a total recovery of kidney function when the causes of AKI are rapidly identified and corrected [10,21,37].…”

“…AKI stage 1 was also the most frequent (55.7%). Several studies reported similar results in developed and developing countries [17,33,35]. However, L Sadaoui et al in Morocco found AKI stage 3 most frequently (33.3%) and acute tubular necrosis as the main type [36].…”

“…Low technical platform, high frequency of emergently pathology in our study like bone fracture and peritonitis that occur hemodynamic instability can explain these results. Ahoui et al in Benin found similar results with a mortality rate of 18.75% [17]. However, higher mortality rate were reported by Gordon et al in England (40 -60% ) and Tien-Jyun Chang in China (45.1%) mainly due to cardiogenic shock or multiple organ failure [33,38].…”

“…Similar data were reported in SSA countries where infectious disease are more prevalent [29,30] . Emergency surgery is considered as risk factor for AKI [17,31,32].. However, most western studies incriminate cardiovascular surgery as the first cause of postoperative AKI [5,33,34].…”

“…In Asia, the incidence ranges from 7.1% to 39% [6,15]. Sub-Saharan Africa alone is home to over 85% of global AKI cases with post-operative AKI accounting for 13 to 28% of cases; It is associated with a high mortality rate estimated at 32% well above the worldwide mortality of 23.9% [16,17], a longer hospital stays, high risk of nosocomial infections, high cost of care, a and 10-fold increase risk of progression to CKD [18][19][20].…”