The profile of patients with obstructive uropathy in Cameroon: case of the Douala General Hospital

Halle, Marie Patrice; Toukep, Linda Njonkam; Nzuobontane, Samuel Ekane; Ebana, Hermine Fouda; Ekane, Gregory Halle; Priso, E Belley

doi:10.11604/pamj.2016.23.67.8170

Cited by 12 publications

(15 citation statements)

References 18 publications

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“…13 Other causes also noted in our study were urethral strictures, prostate cancer, posterior urethral valve, ureteric ligation from total abdominal hysterectomy and pelvi-ureteric junction obstruction, as reported in the previous studies. 10,12,14,15 We also found a case of urethral stenosis in a female child similar to that reported from Port Harcourt. 16 Urinary diversion was done in 25% of our patients which is lower than 100% and 45% reported by the previous studies.…”

Section: Discussionsupporting

confidence: 83%

“…The commonest presentations in our patients were lower urinary tract symptoms, haematuria, flank pain, urinary tract infection, hypertension, and anuria, which are in agreement with other studies. 10,12 The commonest aetiological factors in our study, in order of frequency, were bladder carcinoma, BPH, ureteric stones, and schistosomal lower ureteric obstruction. This is contrary to the findings in the previous studies including those from West Africa where BPH and urolithiasis were the commonest causes.…”

Section: Discussionmentioning

confidence: 68%

“…There was a higher male-to-female ratio in our study than in the other studies. 8,10 The difference in male-tofemale ratio in this series may be due to higher prevalence of urinary schistosomiasis from greater exposure of men to the parasites during farming and fishing activities.…”

Section: Discussionmentioning

confidence: 81%

“…This is contrary to the findings in the previous studies including those from West Africa where BPH and urolithiasis were the commonest causes. 2,10,11 This is due to the fact that bladder cancer is the commonest male malignancy in Sokoto, Nigeria as a consequence of high prevalence of urinary schistosomiasis. 13 Other causes also noted in our study were urethral strictures, prostate cancer, posterior urethral valve, ureteric ligation from total abdominal hysterectomy and pelvi-ureteric junction obstruction, as reported in the previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…16 Urinary diversion was done in 25% of our patients which is lower than 100% and 45% reported by the previous studies. 10,14 In a study done in Maiduguri, North East, Nigeria, all the patients with renal impairment had urinary diversion or dialysis before definitive treatment. 14 Emergency dialysis was required in 57% of our patients, which was higher than 23% and 41% reported by previous studies.…”

Section: Discussionmentioning

confidence: 99%

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Management of obstructive nephropathy in a tertiary hospital in North West Nigeria: A five-year review

Muhammad¹,

Abdulwahab-Ahmed²,

Agwu³

et al. 2018

East. Cent. Afr. J. Surg.

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Background: Obstructive nephropathy is managed initially with urinary diversion and possibly haemodialysis before definitive therapy. This study was aimed at determining the pattern of presentation, aetiology and management options of obstructive nephropathy in our practice. Methods: This was a five-year retrospective study of the patients managed for obstructive nephropathy at our facility from January 2011-December 2015. Data were collected via a pro forma and analysed using SPSS version 20.0.Results: There were 106 patients managed for obstructive nephropathy with a mean age of 48.3 ± 17. 4 years and age range of 4 months to 85 years. The male: female ratio was 10:1. The most common causes of obstructive nephropathy were bladder cancer (49.1%), benign prostatic hyperplasia (BPH, 22.6%), bilateral ureteric stone (5.7%) (22.6%), nephrostomy (2.8%) and dialysis (10.4%) were the initial treatments. Chemoradiation was done for the patients with bladder cancer and 17.9% of the patients had operative interventions, which included ureteroneocystostomy, open prostatectomy or transurethral resection of the prostate, and ureteroscopy + lithotripsy. Fifty-two patients (49.1%) died while awaiting dialysis and four patients (3.8%) developed end-stage renal disease. and bilateral schistosomal lower ureteric obstruction (4.7%). Urethral or suprapubic catheterisation Conclusions: Bladder carcinomas, BPH, ureteric obstruction are the commonest causes of obstructive nephropathy in our practice. The initial treatment includes urinary diversion and or dialysis before definitive treatment.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Management of obstructive nephropathy in a tertiary hospital in North West Nigeria: A five-year review

Muhammad¹,

Abdulwahab-Ahmed²,

Agwu³

et al. 2018

East. Cent. Afr. J. Surg.

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Incidence, characteristics and prognosis of acute kidney injury in Cameroon: a prospective study at the Douala General Hospital

et al. 2017

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Objective: There are limited data on AKI in sub-Saharan Africa. We aim to determine the incidence, characteristics and prognosis of AKI in Cameroon.Patients and methods: A prospective study including all consenting acute admissions in the internal medicine and the ICU of a tertiary referral hospital in Cameroon from January 2015 to June 2016. Serum creatinine assay was done on admission, days 2 and 7 to diagnose AKI. For patients with AKI, serum creatinine was done on discharge, days 30, 60 and 90. AKI was defined according to the modified KDIGO 2012 criteria as an increase or decrease in serum creatinine of 3 mg/l or greater, or an increase of 50% or more from the reference value obtained at admission or the known baseline value. AKI severity was graded using KDIGO2012 criteria. Outcome measures were renal recovery, mortality and causes of death. Renal recovery was complete if serum creatinine between the first 90 days was less than baseline or reference, partial if less than diagnosis but not baseline or reference, no-recovery if creatinine did not decrease or if the patient remained on dialysis.Results: Of the 2402 patients included, 536 developed AKI giving a global incidence of 22.3% and annual incidence of 15 per 100 patients-years. Of the 536 patients with AKI, 43.3% were at stage 3, 54.7% were males, median age was 56 years. Pre-renal AKI (61.4%) and acute tubular necrosis (28.9%) were the most frequent forms. Main etiologies were sepsis (50.4%) and volume depletion (31.6%). Renal outcome was unknown in 34% of patients. Of the 354 patients with known renal function at 3 months, 84.2% recovered completely, 14.7% partially and 1.1% progressed to CKD. Global mortality rate was 36.9% mainly due to sepsis.Conclusions: AKI is frequent in our setting, mainly due to sepsis and hypovolemia. It carries a poor prognosis.

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Epidemiological, Clinical, and Evolutionary Aspects of Severe Obstructive Acute Renal Failure Requiring Dialysis in the Nephrology Department of the University Hospital of Brazzaville

GH,

et al. 2024

Int J Nephrol Kidney Fail

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Introduction: Obstructive anuria represents a medical and surgical emergency, sometimes necessitating immediate extrarenal replacement therapy. Our study aims to delineate the profile of hemodialyzed patients with obstructive acute renal failure (OARF), detailing indications for hemodialysis and observing the course of the condition. Patients and Methods: This retrospective study covers the period from 2019 to 2022, encompassing all patients with OARF requiring emergency dialysis at the Nephrology Department of the University Hospital of Brazzaville. Data analysis was performed using EPI Info software version 3.3.2 (CDC, Atlanta, USA). Results: The study involved 39 patients, with 69.23% being male. The average age was 58.10 years, and oliguria was the primary presenting symptom (82%). Tumoral obstruction accounted for 76%, while lithiasic obstruction constituted 14%. Two cases of retroperitoneal fibrosis were observed (2.8%). Neoplastic origins included prostate, bladder, cervical, and rectal cancers in 46.67%, 33.33%, 16.67%, and 3.33% of cases, respectively. Indications for hemodialysis were poorly tolerated uremia, acidosis, hyperkalemia, and pulmonary edema in 79.1%, 38.57%, 19.49%, and 13.21% of cases, respectively. The mortality rate was 25.64%. Conclusion: The reliance on hemodialysis in obstructive anuria underscores a delay in patient management. Emergency treatment revolves around urinary tract drainage, followed by addressing the underlying cause. Prevention hinges on early and adequate management of various causal pathologies.

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The profile of patients with obstructive uropathy in Cameroon: case of the Douala General Hospital

Cited by 12 publications

References 18 publications

Management of obstructive nephropathy in a tertiary hospital in North West Nigeria: A five-year review

Management of obstructive nephropathy in a tertiary hospital in North West Nigeria: A five-year review

Incidence, characteristics and prognosis of acute kidney injury in Cameroon: a prospective study at the Douala General Hospital

Epidemiological, Clinical, and Evolutionary Aspects of Severe Obstructive Acute Renal Failure Requiring Dialysis in the Nephrology Department of the University Hospital of Brazzaville

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