The clinical pattern of renal diseases in the nephrology in-patient unit of the Yaounde General Hospital in Cameroon: a five-year audit

Abstract

IntroductionKidney diseases are a growing worldwide problem and one of the major public health threats. We analyzed the spectrum of kidney diseases seen over a five-year period in the nephrology in-patient unit of the Yaounde general hospital.MethodsThis was a retrospective analysis of 225 medical records of patients admitted from January 2005 to December 2009 in the unit with a discharge diagnosis of kidney and urinary tract diseases. The first hospitalization was considered for patients admitted several times for the same disease. Socio-demographic and clinical patient data were recorded.ResultsThe patients mean age was 44.8±16 years with 135 (60%) males and 211 (93.8%) emergency admissions. All 139 (61.8%) patients with chronic kidney disease (CKD) had chronic renal failure. Acute kidney injury (AKI) (28%), nephrotic syndrome (7.6%), renal colic (1.3%) and acute pyelonephritis (1.3%) were other patterns observed. Chronic glomerulonephritis (25.9%), hypertension (22.3%) and diabetes (20.1%) were the main etiological factors of CKD. All AKI patients were in stage RIFLE-F. AKI was secondary to parenchymal (58.7%), functional (25.4%) and obstructive (15.9%) etiologies. Black water fever (36.4%), sepsis (22.7%), drugs (18.2%), eclampsia (13.6%) and herbal concoctions (9.1%) were the etiologies of acute tubular necrosis while enterocolitis (56.2%), heart failure (31.3%) and digestive hemorrhage (12.5%) were the etiologies of functional AKI.ConclusionThe clinical pattern of renal diseases is dominated by advanced CKD and AKI secondary to preventable causes. This study suggests a need for an array of actions including sensitization, continuous medical education and strengthening of the health system.

Spectrum and Clinical Characteristics of Renal Diseases in Ghanaian Adults: A 13-Year Retrospective Study

“…A Cameroonian retrospective study observed hypertension as the overall highest cause of renal conditions which is in line with our study [9]. Also, both studies recorded hypertension as the main cause of CKD; however, sepsis was the main cause of AKI in our study whiles hypertension was the main cause of AKI in their study.…”

“…e variations may be due to difference in the population setting, as well as sampling technique. At par with a study in Cameroon (61.8%), majority of our study participants (70%) had CKD; both studies employed a retrospective study design; however, the percentages vary because of the difference in our sample sizes [9]. Previous studies among renal disease patients have identified a wide range of presentations.…”

“…Chronic kidney disease is thought to be prevalent in sub-Saharan Africa and is a major public health concern [8]. Types of renal disease presentation include acute kidney injury (AKI), chronic renal failure (CRF), and nephrotic syndrome [9]. e etiology of renal diseases usually includes renovascular diseases (including hypertension), analgesic nephropathy, nephrolithiasis, reflux nephropathy and lithium-related CKD, and diabetic nephropathy [10].…”

Traditional Medications Mixed with Ethylene Glycol in a Nigerian Patient on Hemodialysis

“…In many instances, this nephrotoxicity is dose-dependent, and this underscores the additional importance of also understanding the mode by which people consume Traditional medicines because people with CKD may be particularly vulnerable to these effects. In the case of Aloe vera, which can cause acute tubular necrosis and acute interstitial nephritis in addition to chronic renal insufficiency, the nephrotoxicity is substantially higher with the larger doses ingested by boiling and drinking the plant [18]. Many edible plants have been associated with chronic kidney injury.…”

“…In most African countries, CKD and ESRD are very common in young adults in their economically productive years. The clinical pattern of disease is characterized by advanced CKD and acute kidney injuries secondary to preventable causes [18].…”