Little is known about the challenges of routine renal replacement therapy in Sub-Saharan Africa. We investigated the fatal and nonfatal acute hemodialysis (HD) complications in patients with end-stage renal disease (ESRD) in two main dialysis centers in Cameroon. 1000 consecutive HD sessions incurred over a 4-month period by 129 patients (96 men, 74%) with ESRD, receiving two weekly HD sessions of 4 hours each, were considered. Personal and clinical profiles before, during, and within 24 hours after HD sessions were used to diagnose complications. Participants were aged 7 to 80 years (mean 46 years). In all, 452 acute complications were recorded in 411 (41%) of the 1000 HD sessions. Of the 11 types of complications, hypotension (25%), muscular cramps (22%), hypertensive crisis (14%), pruritus (10%), and fever (7%) were the most frequent. Three hundred and six complications (67.7%) occurred during understaffed nighttime. The vascular access was the main bleeding site with 64%. Being diabetic and ultrafiltration rate >1000 mL/h were associated with hypotension and muscle cramps. The shorter duration in dialysis was associated with the risk of bleeding and the disequilibrium syndrome while longer duration was associated with muscle cramps. Four deaths (three from bleeding and one from disequilibrium syndrome) occurred, all during nighttime. Nearly half of dialysis sessions in these settings are associated with acute complications, some of which are fatal. Those complications occurred mostly during understaffed periods. Urgent strategies are needed to quickly solve the human capital crisis in the health care sector.
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http://dx.doi.org/10.1111/j.1542-4758.2012.00692.x | DOI Listing |
Int J Nephrol
December 2024
Department of Cell and Developmental Biology, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel.
Thrombotic microangiopathy is a severe complication of renal transplantation. Little is known about risk factors, incidence of autoantibodies against complement components, and prognosis. Clinical and laboratory data were retrospectively collected for 13 patients diagnosed with post-transplant thrombotic microangiopathy (PT-TMA) in 2011-2018.
View Article and Find Full Text PDFInt J Nephrol
December 2024
Department of Parasitology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka.
The outcome of acute kidney injury (AKI) depends on causes, patient factors and care received. We studied the causes, complications and 90-day outcomes of patients with AKI at a tertiary referral centre in Sri Lanka. Patients aged 18 years or older with AKI referred to nephrology services were analysed retrospectively.
View Article and Find Full Text PDFAm J Case Rep
January 2025
Department of Urology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, Guangdong, China.
BACKGROUND Transplant lithiasis may be rare but poses significant risk to the renal graft function of the recipient. Immediate management is necessitated upon first detection, to prevent further complications. CASE REPORT We report 2 cases of transplant lithiasis that were not treated immediately upon first detection.
View Article and Find Full Text PDFPLoS One
December 2024
Department of Medicine, Division of Nephrology and Hypertension, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, NY, United States of America.
Acute kidney injury (AKI) incidence after neurosurgical operations has been reported as 10-14%. The literature regarding the incidence of nosocomial acute kidney disease (AKD) following neurosurgery is scarce. This retrospective, single-center, observational study aimed to assess the impact of different anaesthetics on development of postoperative AKI and persistent AKD in neurosurgical patients.
View Article and Find Full Text PDFCan J Kidney Health Dis
December 2024
Division of Nephrology, McGill University, Montreal, QC, Canada.
Rationale: Infection-related glomerulonephritis (IRGN) is an immune-mediated glomerulonephritis caused by extra-renal infectious diseases. There has been an important shift in epidemiology in recent years, with a significant proportion of adults affected. The incidence of IRGN is higher amongst Indigenous populations and especially in those with multiple comorbidities.
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