Emergency Hemodialysis at the Fousseyni Daou Hospital in Kayes, Mali

Résumé fourni par la source

Introduction: Emergency hemodialysis (EH) is a frequent occurrence in sub-Saharan Africa and is associated with high mortality. The aim of this study was to describe the epidemio-clinical profile of emergency hemodialysis patients at the Fousseyni Daou Hospital in Kayes, Mali. Methodology: This was a descriptive study with retrospective data collection carried out on patients undergoing emergency hemodialysis for the first time at the hemodialysis unit of the Kayes Hospital from July 24, 2023 to July 24, 2024. Results: During the study period, 110 patients underwent emergency hemodialysis, with a mean age of 44.63 ± 18.02 years. Females accounted for 54.5%. A history of high blood pressure (HBP) was found in 71.8% of cases. Functional signs were dominated by physical asthenia and vomiting in 92.7% and 83.6% of cases respectively. On physical assessment, 21.8% of patients showed pericardial friction on auscultation. Eighty-nine patients (80.9%) were in chronic kidney disease (CKD) versus 21 cases (19.1%) of severe acute kidney injury (AKI) KDIGO stage 3. Patients had a mean hemoglobin level of 7.08 ± 2.01 g/dl. Initial nephropathy in CKD patients was dominated by malignant hypertension in 38 cases (42.7%). Urgent indications for hemodialysis were uremic syndrome with encephalopathy or coma (70%), anuria lasting more than 48 hours with severe renal failure (11.8%), acute lung edema (7.1%), uremic pericarditis (6.4%) and severe hyperkalemia (4.5%). The outcome was favorable in 71 patients (64.3%) versus 24 cases of death (21.8%) and 15 cases of abandonment of care against medical advice (13.6%). We noted total recovery of renal function in 16 patients (14.5%) out of 21 with AKI, versus 4 cases (3.6%) of partial recovery. The risk of mortality was mainly associated with uraemic coma and severe azotemia (urea > 30 mmol/l) at the time of dialysis initiation (P Conclusion: Emergency hemodialysis is a frequent situation associated with high mortality at Kayes Hospital. Promoting the geographical accessibility of hemodialysis and ensuring its management is the key to better patient survival.

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