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Congress Proceedings CONGRESS PROCEEDINGS Abstracts of the joint AFRAN, AFPNA and SOCANEPH Congress held in Yaoundé, Cameroon, 14-18 March 2017 Pages Adult nephrology - English abstracts 58 Adult nephrology - French abstracts 157 Paediatric nephrology - English abstracts 187 Paediatric nephrology - French abstracts 199 Volume 20, No 1, 2017 Post-partum acute kidney injury : experience of the nephrology department of the university hospital Ibn Sina Abouzoubair Afaf, Moussokoro Kone Hadja, Belmokadem Salma, Hacib Sara, Benamar Loubna, Bayahia Rabia, Bouattar Tarik, Ouzeddoun Naima Nephrology department Ibn Sina Hospital, Rabat, Morocco . Objective : The aim of our study was to evaluate the clinical and biological characteristics, the etiological profile and the prognosis of post-partum acute kidney injury (AKI) and to identify risk factors associated with fetal death and poor renal prognosis. Materials and methods:This was a 15 years retrospective study conducted in the Nephrology-Dialysis department of the university hospital Ibn Sina, Rabat. We reviewed medical records of patients with a diagnosis of post-partum AKI to identify the causes therapeutic methods used. We defined a favorable outcome complete renal recovery with a live babyand adverse outcome as dthe absence of renal recovery and/or maternal death and /or fetal loss. Results:We collected 37 cases of postpartum AKF. The average age was 30.2 +/- 7.4 years. The average length of gestation was 38.8 +/- 1.3 weeks of amenorrhea. Pre- natal care was effective in 75% of cases. Childbirth was medicalized in 92 % of cases and 75% were vaginal deliveries High blood pressure, oedema and oligoanuria were the main clinical features.The mean serum creatinine at 54 +/- 30 mg/l. All patients were in stage Fof RIFLE classification and the main causes of AKI were: pre-eclampsia-eclampsia (56.8%), hemorrhagic shock (37.8%) and sepsis (18.9%). Renal biopsy was carried out in 18.9% of cases. Hemodialysis was required in 59.5% with pulmonary edema and electrolyte disorders constituiting the main indications. Renal recovery was complete in 56.8% of cases, partial recovery in 13.5% and 16.2% had end-stage.There were 2 cases of maternal death and 3 cases of maternal blindness.Fetal mortality was 48.7%. Risk factors for poor renal outcomes were: AKI RIFLE stage L or E, cortical necrosis and fetal death. Preeclampsia, hemorrhagic shock and classes L and E RIFLE were associated with fœtal deaths. Conclusion: Our study highlights the need for close monitoring of pregnancy and a systematic and regular screening for infections, proteinuria and hypertension. Acute kidney injury following invitro fertilization; an uncommon complication of a rapidly growing assisted reproductive technique in Nigeria- case report Chimezie Okwuonu1, Nnabuike Ojiegbe2, Chuku Abali3 1Department of Internal Medicine, Federal Medical Centre, UmuahiaAbia State, Nigeria. 2Department of Obstetrics and Gynaecology, Federal Medical Centre, Umuahia, Abia State Nigeria. 3Department of Ophthalmology, Federal Medical Centre, UmuahiaAbia State Nigeria Objective: The objective of this report is to highlight an unusual but possible occurrence of AKI during a rapidly growing assisted reproductive procedure, and its successful management. Methodology: A 22 year old lady who was an oocyte donor in an IVF procedure. She was not hypertensive or diabetic and had no family or past medical history of renal disease. She had stimulation of the ovaries with gonadotrophins and succesful harvest of the oocyte. Two days later she developed abdominal distension and breathlessness and was found to have low blood pressure and ascites. Abdominal ultrasound showed ascites and massive ovarian cystic enlargement. The kidney function test showed an increase in serum creatinine from baseline 0.8mg/dl to 1.7mg/dl. She was successfully managed with albumin infusion and vassopressor agents. Conclusion: Acute kidney injury can occur in a wide range of medical specialties. Clinical vigilance will improve outcome. 58 Acute kidney injury in elderly patients in saint-louis: a restrospective study in 2015 1Diallo.I.MB, 2Dia Diatou2, 1Seck Sidy ¹ Service de Néphrologie et Hémodialyse, CHR Saint-Louis, 2 Service de Médecine interne, CHR Saint-Louis. Objective: The aim of which is to determine the epidemiological, clinical, biological, therapeutic and prognostic profile in this particular population. Patients and Methods: In a prospective study, we included patients aged ≥60 years, hospitalized in nephrology department at Saint-Louis Regional Hospital, from March 1st 2015 to August 31st 2015. Acute kidney injury (AKI) was defined according to the Kidney Disease Improving Global Outcomes [2] criteria: The data collected was entered and analyzed with MSEXCEL 2010. Results: Prevalence of AKI in the elderly was 29,5%. The mean age was 70.9 years [60-88 years] and the age group 60-70 was more represented (50%). The sex ratio was 3.5. Fifty percent had a history of hypertension. The dominant functional signs were dyspnea and disorders of consciousness (27.8%). Mean serum creatinine level was 60.3 mg /l [15 - 148.6mg / l] and mean blood urea was 1.03 g / l [0.63 g / l - 1.92 g / l]. Anemia was present in 50% of cases, with an average Hb level of 9.9 g/dl. Patients were classified according to the classification of RIFLE: class R (Risk) was 16.70%, class I (Injury) 27.80%, class F (Failure) 55.60%. AKI was functional in (61.1%), obstructive in (27.8%) and organic in (11.1%). The following measures were instituted: Rehydration in (55.6%), antibiotic therapy in (50%). The progression was favorable in (61.1%), with a recovery of the renal function: mean serum creatinine at the outlet was 11.35mg / l. Hospitalization duration varied from 3 to 18 days. The evolution was unfavorable in (38.9%), including a partial recovery in (11.1%). Mean serum creatinine in the partial recovery ranged from [18.16 to 23.65 mg / l]. The average hospital stay was between 6 and 21 days. However, we deplored 5 deaths (27.8%). The causes of death in our patients were cardiac arrest, probably related to a history of cardiovascular disease, a stroke, a tumor of the uterus, a case of sepsis, a case of severe malaria. Conclusion: AKI is common among seniors in the Saint-Louis Regional Hospital. Early diagnosis and management is necessary to reduce morbidity and mortality responsible for poor prognosis. Key words: acute kidney injury, elderly, prevalence, Saint-Louis. The prevalence and predictors of Acute kidney injury in women with complicated pregnancies in tertiary Obstetrics Units in Yaounde, Cameroon Gloria Ashuntantang1, Sandra Jessica Njiki Kouatchou2, Agnes esiene1, Alex Tatang Mambap1, Francois kaze2, Pascale Foumane1 1Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon, 2Institut Supérieur des Sciences de la Sante, Bangangte, Cameroon. Objective: The aim of this study was to determine the prevalence and predictors of AKI in women with complicated pregnancies. Methods: We conducted a cross-sectional study from April 6 to September 6, 2015 in 2 Obstetrics units of Yaounde. All consenting pregnant or post-partum women with complicated pregnancy were enrolled. Patients with a prior diagnosis of chronic kidney disease were excluded. Complications of pregnancy considered were: post abortum/puerperal sepsis, preeclampsia/eclampsia(PEE), and pregnancy-related hemorrhage. We measured serum creatinine on identification of the complication, at 48 hours, and on day 7. AKI was defined using the modified KDIGO criteria. We used logistic regression modelling to identify associated factors. A p value<0.05 was considered statistically significant. We obtained approval from the ethics board of the hospitals involved. Results: A total of 173 women, mean age of 28.04 ± 6.74 years and parity of 2.0 ± 1.7 were enrolled.5.2% were HIV positive and 1.7% known hypertensives.72.8% of participants were in the 3rd trimester or post-partum period and 46.2 % had done the minimum recommended prenatal consultations. Third trimester/postpartum hemorrhage (n= 84), PEE (n= 72), sepsis (n= 22), and clandestine abortions(n=16) were the main risk factors of AKI. The prevalence of AKI was 38.2 % (n=66), with 27% in AKI stage 3. PEE, puerperal/post- abortum sepsis, and postpartum hemorrhage were the main etiologies of AKI. Sepsis (p = 0.000), HELLP syndrome (p = 0.000), blood pressure ≥140 / 90 mmHg (p = 0.038), and delay in management of pregnancy complication ( p = 0.020 were risk factors of AKI identified. Conclusion: AKI is frequent among women with complicated pregnancies in our setting. Early recognition and treatment of risk factors may reduce this burden. 59 Clinical and biological profile of patients with malaria induced acute kidney injury at the Buea hemodialysis center Ronald Gobina1, Kegni Serge2, Gloria Ashuntantang1, Francois Kaze1, Aristide Nono3, MaimounaMahamat3, Cecile Ngo Makang1 1Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1. 2Buea Regional Hemodialysis Center. 3Yaounde General Hospital Objective: To assess the clinical and biological profile of patients with Malaria Induced Acute Kidney Injury Methods: This retrospective cross-sectional descriptive study covered a period from November 2011 to September 2014. We included all patients seen with acute kidney injury plus a positive thick blood film for plasmodium or suggestive symptoms and a positive rapid diagnostic test at presentation at the Buea Regional Hemodialysis Center. We describe their clinical and biological findings. The study was approved by the ethical board of the SW regional delegation for public health. Results: A total of 13 patients were seen with acute kidney injury attributed to malaria. 5 (38.46%) were male. The mean age was 38.69 ± 19.5 years. The most common symptoms at presentation included fever (100%), asthenia (100%), headaches (84.62%) and joint pains (84.62%). During the course of follow-up, the most common systems involved were musculoskeletal (84.62%), hematologic (76.92%), genitourinary (76.92%), gastrointestinal (69.23%), neurologic (38.46), and respiratory (23.08%).
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