The treatment of chronic hepatitis C virus (HCV) infection in chronic hemodialysis patients remains an issue of great concern for nephrologists. In 2008 the kidney disease improving global outcomes working group suggested the use of pegylated interferon in end stage kidney disease patients treated by dialysis. Since then, series and some clinical trials on different direct-acting antiviral agents have shown better efficacy and tolerance than interferon-based regimens. Data on the efficacy, tolerance and the right dose of sofosbuvir in this population are still unclear. We report a case of chronic HCV genotype 1b infection in a 47-year-old patient on maintenance hemodialysis successfully treated by a combination of sofosbuvir and ledipasvir for 12 weeks. Evolution was marked by the complete regression of the hepatic cytolysis, a complete and sustained virologic response with HCV viral load undetectable for a 24 months follow-up period. No adverse reaction was found. The treatment of HCV genotype 1 or 4 infection in patients on maintenance hemodialysis is possible with sofosbuvir based regimens with a good efficacy/safety ratio in the absence of current recommended drugs for patients with eGFR<30ml/min/1.73m 2 . The prescription of sofosbuvir should be encouraged amongst this population in this setting.

was 21% at 10 years and according to the Karnofsky index, most of our patients require ongoing help and frequent medical care. The average duration of dialysis was 47.3 months (2-192 months). 44 patients (81%) had a rhythm of 3 sessions per week, while the remaining 19% were dialyzed twice a week with an average duration of the session of 3.7 hours. Most of our patients (82%) had an arteriovenous fistula (AVF), 5 patients (9.4%) were dialyzed via a femoral valve and 5 patients via a jugular catheter. Most of our patients were anemic with an average hemoglobin level of 8.9 g / dl, hypocalcemia was present in 23 patients (43.3%), hyperphosphatemia in 16 patients (30.1%) and secondary hyperparathyroidism in 22 patients (41.5%). The main complications in hemodialysis were stroke in 3 patients (5.6%), pericarditis in 4 patients (7.5%) and coronary insufficiency in 8 patients (15.1%). Regarding cognitive disorders, 2 patients (3.7%) had dementia, 6 patients (11.3%) had depression, 11 patients (20.7%) had anxiety, and 32 patients (60.3%) had insomnia. Two cases of death were noted whose etiology was a rupture of a false aneurysm in one patient and wet gangrene in the other patient. Conclusions: The elderly are a population of frail patients with high comorbidity and autonomic disorders. Chronic hemodialysis treatment is a heavy treatment that requires regular monitoring to avoid particular complications of the elderly.Introduction: Current literature suggests the arteriovenous fistula (AVF) to be the preferred type of vascular access for hemodialysis. However, AVFs have significant and potentially deleterious effects on cardiac functions particularly in the setting of preexisting heart disease. The aim of this study is to compare the clinical and echocardiographic evolution after creation of a proximal AVF and a radial AVF. Methods: We conducted a retrospective descriptive study including all chronic hemodialysis patients through AVF. Group 1 (G1) included patients with proximal AVF and group 2 (G2) patients with radial AVF. Data collected included demographics, Clinical Status, vascular access type, and metabolic parameters. Data were entered and analyzed using SPSS software. Chi-squared test with a level of significance of 0.05 was used for the qualitative variables. Results: Twenty-four patients were collected in G1 and the average age was 55 years. G2 included 13 patients with a mean age of 44 years. Systolic blood pressure decreased after AVF creation in both groups (G1: 62.5%, G2: 45%, NS). A dyspnea was noted in 70% of cases of G1 and 38.4% of cases of G2 (NS). The interventricular septum was thickened in 20.8% of cases of G1 and 38.4% of G2 (NS). Left ventricular (LV) dilatation was observed in both groups with LV diastolic telegram diameter increase of 58% in G1 versus 10% in G2 (p ¼ 0.04). A decrease in LV ejection fraction was found in 62.5% in G1 and 46.1% in G2 (p ¼ 0.066). The major cardiac complications in G1 were acute coronary syndrome in 5 patients and atrial fibrillation in 4 cases after an average of...

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Goal: Evaluate the importance and reasons of non-infectious complications of non-tunneled central venous catheterization in our hemodialysis unit. Patients and methods: The study, a prospective type, was conducted in the department of nephrology and hemodialysis of Yalgado Ouedraogo University Hospital Center (YO-UHC) in Ouagadougou, Burkina Faso, from 15 February to 30 June 2015. Patients in whom a new central venous catheter (CVC) was inserted during the study period were included. Catheterization-related complications were noted. Results: During the study period, 156 CVCs (9 per week) were placed in femoral (56.4%), internal jugular (40.4%) or subclavian vein (3.2%). There were 114 patients (59.7% of men and 40.3% of women), average age 41.8 ± 17.1 years, low socioeconomic level in 64% of cases. At least a non-infectious complication was observed in 67 cases representing 42.9%. They were: puncture failure (40%), arterial puncture (12.2%), puncture of the thoracic duct (1.3%), pneumothorax (1.3%), bleeding related to the catheter insertion (5.8%), hematoma (1.3%), opposite direction (0.6%), dysfunction of the CVC (10.3%), femoralthrombophlebitis (3.2%). Conclusion: Non-infectious complications of non-tunneled central venous catheterization in our hemodialysis unit were frequent and sometimes severe. Their common denominator was the absence of ultrasound guidance. Our study reaffirms the need for equipping with Doppler ultrasound in our hemodialysis units, even in de-* Corresponding author. G. Coulibaly et al. 2 veloping countries, for better security of the patient during central venous catheterization.

Goal: The goal is to evaluate infections associated with central venous catheters of hemodialysis (CRI) in hemodialysis patients in Ouagadougou. Patients and methods: The study was cross-sectional, from February 15th to June 30th, 2015. It was conducted in Ouagadougou (Burkina Faso). We included patients with a new central venous catheter (CVC) inserted in the hemodialysis unit. The timeout for making an arteriovenous fistula (AVF) for chronic hemodialysis in Ouagadougou may exceed six months. The CVCs used at the time of the study were made of polyurethane and non-tunneled. Sociodemographic, clinical and paraclinical data were collected and analyzed. Results: During the study period, 156 CVCs were installed in 114 patients, and the average age was 41.8 ± 17.1 years. A CRI occurred on 39 CVCs for a rate of 9.5/1000 days-catheter. The frequency of CRI was 28.4%, 20.6% and 20% respectively in femoral, jugular, and subclavian veins. The culture of the tip of the catheter was done in 21 cases. Fifteen germs have been identified: eight cases of Gram-positive cocci (53.3%) and seven cases of Gram-negative bacilli (46.7%). It was essentially staphylococci (eight cases). In univariate analysis, a period of use of the CVC in chronic hemodialysis over 10 days was significantly (p = 0.01; r = 2.91) associated with the catheter-related infection (CRI). Conclusion: The impact of the CRI was very high in our series. The associated factor in the univariate analysis was the long period of use of the CVC. The most diligent production of AVFs at the YO-UHC would contribute to a significant reduction of the CRI.