[Nephrology in Sub-saharan Africa: Past, present, future].

Nephrology was a relatively poorly known specialty in sub-Saharan Africa until the early 1980s, because of low awareness and lack of access to diagnosis and renal replacement therapies. Nephrology has seen progress on the continent despite an unfavourable economic and geopolitical environment. With a prevalence of fewer than five nephrologists per million inhabitants, the training of nephrologists, now carried out on the continent, allowed to have more than 200 specialists trained in the last decade in French-speaking sub-Saharan Africa.

[Zenker´s diverticulum in a hemodialysis patient].

Zenker's diverticulum is a rare and generally benign condition. Its occurrence in a hemodialysis patient has therapeutic and prognostic implications and is a risk factor for mortality and morbidity due to its complications, such as protein-energy malnutrition and pneumonitis. We here report a case of Zenker's diverticulum diagnosed in a chronic haemodialysis patient.

Evaluation of blood pressure profile in chronic hemodialysis patients using two measurement methods: Home blood pressure measurement and conventional measurement.

The monitoring of hypertension (HTN) in dialysis is often delicate with potentially false measurements due to the white coat effect on the one hand and masked HTN (M-HTN) on the other hand. In this population, there is much controversy over the ideal moment for taking blood pressure (BP) and the target values. An answer to these questions is given by home BP measurement that can detect white coat HTN (WC-HTN) and M-HTN.

Continuous ambulatory peritoneal dialysis (CAPD) in children: a successful case for a bright future in a developing country.

The authors report the first case of successful peritoneal dialysis (PD) in a developing country performed about a 13-year-old adolescent followed-up for stage V chronic kidney disease (CKD) with anuria. After 3 months of hemodialysis, the parents opted for continuous ambulatory peritoneal dialysis (CAPD) as they wished to return home located 121km from Dakar. After PD catheter insertion, the plan proposed to the patient consisted 3-4 hours stasis of isotonic dialysate during the day and a night stasis of 8 hours of icodextrin for an injection volume of 1L per session.

Clinical efficacy of African traditional medicines in hypertension: A randomized controlled trial with Combretum micranthum and Hibiscus sabdariffa.

Medicinal plants are widely used as a first-line therapy for hypertension, often without comparative clinical data. A prospective, randomized controlled trial was conducted to assess efficacy of Combretum micranthum (kinkeliba) and Hibiscus sabdariffa (bissap), in the galenic form of capsules of plant powder, on blood pressure in adult patients with non-complicated hypertension ( > 140/90 mm Hg). One hundred and twenty five patients were randomly allocated into group 1 (kinkeliba leaves 190 mg × 2/day), or group 2 (bissap calyx 320 mg × 2/day), or group 3 (ramipril 5 mg /day) during four consecutive weeks.

Prevalence and risk factors of chronic kidney disease in an african semi-urban area: Results from a cross-sectional survey in Gueoul, Senegal.

Chronic kidney disease (CKD) is a public health priority worldwide; however, its prevalence and incidence are difficult to assess. In Africa, few studies have been conducted on the prevalence of CKD. This study sought to describe the epidemiological characteristics and profile of CKD, as well as the related risk factors in Guéoul, a semi-urban zone in Senegal.

[Idiopathic nephrotic syndrome (INS) in children in Dakar: about 40 cases].

Introduction: This study aimed to analyze the diagnostic, therapeutic, and evolutionary features of nephrosis in children in a pediatric department in Dakar.

Methods: The study was carried out in the Department of Pediatrics at the Aristide Le Dantec Hospital. We conducted a retrospective study over a period of 3 years from 1 January 2012 to 31 December 2014.

[Evaluation of cardiac complications among chronic hemodialysis in Dakar].

Introduction: Hemodialysis is the first extrarenal treatment method that allowed supporting patients in terminal chronic failure in Senegal since 1997. 25 years later, we conducted this study to determine the type and the prevalence of different cardiovascular complications and identify the main cardiovascular risk factors.

Methods: It is a retrospective study of 4 years.

Hemophagocytic Syndrome, an Uncommon Complication of Microscopic Polyangitis: A Case Report From Senegal.

Introduction: We reported a case of hemophagocytic syndrome complicating microscopic polyangitis presented by crescentic glomerulonephritis.

Case Presentation: A 22-year-old female patient originated from Dakar, Senegal presented with nephrotic syndrome and rapidly progressive glomerulonephritis. On physical examination, we noticed hyperchromic diffuse punctilious purpura skin lesions predominant on the trunk, the neck and the upper thigh.

Scleroderma renal crisis in tropical region: two senegalese cases.

Scleroderma renal crisis (SRC) is defined as the new onset of accelerated arterial hypertension and /or rapidly progressive oliguric renal failure during the course of systemic sclerosis. It is a rare but life-threatening complication. This formerly serious complication has got a considerable brighter outlook since the introduction of angiotensin converting enzyme inhibitors (ACE) however the mortality is still remaining high.

Erectile dysfunction in chronic hemodialysis patients in dakar: a cross-sectional study in 2012.

Background: Patients with chronic kidney disease (CKD) experience multiple complications including erectile dysfunction (ED). It involves more than 50% of patients on dialysis or transplant. In Africa, the true extent of ED in CKD is unknown although some studies have been done in this regard.

Pilot experience in senegal with peritoneal dialysis for end-stage renal disease.

Unlabelled: ♦

Introduction: Peritoneal dialysis (PD) is occasionally used in western sub-Saharan Africa to treat patients with end-stage renal disease (ESRD). The present study is a retrospective review of the initial six years' experience with PD for ESRD therapy in Senegal, a West African country with a population of over 12 million. ♦

Material And Methods: Single-center retrospective cohort study of patients treated with PD between March 2004 and December 2010.

A New PKD-1 Mutation Discovered in a Black African Woman With Autosomal Polycystic Kidney Disease.

Autosomal polycystic kidney disease (ADPKD) is a genetic disorder with two causal PKD-1 and PKD-2. Genetic studies have demonstrated an important allelic variability between patients but few data are known about genetic variants in African populations. We report a new mutation found in a 41-year old women with mild chronic kidney disease secondary to ADPKD.

[Perception of kidney donation in Senegal and potential donors].

Introduction: The objective of this study was to explore the potential for kidney donation in the Senegalese population, as a prelude to a proposed kidney transplant from living donors.

Method: A survey of cross type, and descriptive analysis was conducted from June 15 to September 15, 2010 in Dakar (Senegal). A two-stage sampling was done.

Distribution of volumes of individual glomeruli in kidneys at autopsy: association with physical and clinical characteristics and with ethnic group.

We have demonstrated considerable variability in the volumes of different glomeruli in given individuals (individual glomerular volume: IGV) in a stereologic study of kidneys at forensic autopsy performed to investigate sudden or unexpected death in people without manifest kidney disease. We review some important associations of IGV by subject characteristics and by ethnic groups. IGVs were measured by the Cavalieri method in 30 glomeruli in each of 111 adult males who belonged to 4 ethnic groups, i.

Human nephron number: implications for health and disease.

Several studies have shown that total nephron (glomerular) number varies widely in normal human kidneys. Whereas the studies agree that average nephron number is approximately 900,000 to 1 million per kidney, numbers for individual kidneys range from approximately 200,000 to >2.5 million.

The burden of erectile dysfunction in dialysis patients in Senegal.

Erectile dysfunction (ED) is very common in dialysis patients because of organic and psychological risk factors. It has a negative impact on patients' quality of life. In Senegal, ED is assumed to be frequent in the general adult population but its prevalence in dialysis patients is unknown.

Current indication of plasma exchanges in nephrology: a systematic review.

Therapeutic plasma exchange (TPE) has been firstly performed with centrifugation devices used in blood banking procedures. Nowadays, TPE is increasingly performed in intensive care units using hemodiafiltration generators that ensure better efficiency and simplicity. However, prescription for the different medical pathologies depends on weak evidence-based recommendations, and is often guided by the clinician's own experience.

Glomerular number and size variability and risk for kidney disease.

Purpose Of Review: This review discusses current understandings of variability in glomerular number and size, and the implications for renal health.

Recent Findings: The quantitative microanatomy of the normal human kidney varies widely. Of greatest significance, total nephron number varies at least 13-fold, and several genes and environmental factors that regulate human nephron endowment have been identified.

A comparison of nephron number, glomerular volume and kidney weight in Senegalese Africans and African Americans.

Background: Low nephron number is determined in utero and is a proposed risk for essential hypertension. Glomerular volume is inversely correlated with nephron number, and genetic and environmental factors that determine nephron number are thought to determine glomerular volume. This study compared total glomerular (nephron) number (N(glom)), mean glomerular volume (V(glom)) and kidney weight in two geographically separated black populations with significant common genetic ancestry.

Patterns of autosomal dominant polycystic kidney diseases in black Africans.

Autosomal dominant polycystic kidney disease (ADPKD) is not well described in black Africans while some data suggesting the disease is exceptional in this race. A retrospective study of patients with ADPKD followed in nephrology department of a teaching hospital in Dakar (January 1, 1995 to December 31, 2005) was therefore undertaken. Prevalence of ADPKD was one in 250.

Associations between age, body size and nephron number with individual glomerular volumes in urban West African males.

Background: Glomerulomegaly has been associated with an increased risk of renal disease. Few reports have investigated the heterogeneity of glomerular size within kidneys and associated risk factors. This study measured the individual glomerular volume (IGV) of 720 non-sclerotic glomeruli in kidneys of adult West African males, and investigated associations of IGV with age, total glomerular (nephron) number and body surface area (BSA).

Collapsing glomerulopathy and haemophagocytic syndrome related to malaria: a case report.

Authors report a 37-year-old Senegalese woman with no known history of nephropathy who was admitted for fever related to malaria, severe acute renal failure requiring dialysis with nephrotic syndrome. Biological examinations and bone marrow aspiration showed hemophagocytic syndrome. A kidney biopsy found a 'collapsing glomerulopathy' (CG).

[Adherence to therapy in sub-Saharan non-dialysed patients with chronic kidney diseases].

Background: Poor adherence to medication regimens accounts for substantial morbidity, mortality and increased health care costs in developing countries. The aim of this study is to assess adherence to therapy in patients with chronic kidney diseases and to identify the major barriers to adherence.

Patients And Method: A prospective study of non-dialysed patients with chronic kidney diseases followed during three months.