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Prevalence of Acute Renal Failure in the Intensive Care Unit of the CHU la Référence Nationale in Ndjamena

DOI: 10.4236/ojneph.2025.151008, PP. 82-89

Keywords: Acute Renal Failure, Resuscitation, CHU-RN, Chad

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Abstract:

Introduction: Acute renal failure (ARF) is a frequent clinico-biological syndrome in the intensive care unit. The aim of our study was to determine the prevalence of ARF in the general intensive care unit. Patients and Method: This was a cross-sectional study conducted over a period of 08 months in the intensive care unit of the CHU la Référence Nationale (CHU-RN) in N’Djamena. All patients presenting with ARF on admission were included. The clinical, biological and morphological characteristics of IR were studied. Data were analyzed using SPSS version 18.0 (Statistique Package for Social Sciences 18.0). Results: We recorded 206 ICU admissions, including 52 cases of acute renal failure, giving a prevalence of 25.2%. AKI accounted for 92.3%. The mean age of patients was 47 ± 17.1 years [19 - 86 years]. The sex ratio was 1.5. Functional signs were dominated by oligoanuria (84.6%) and disturbed consciousness (78.8%). Mean creatinemia was 125.2 mg/L [28.6 - 588.3 mg/L], mean uremia 2.3 g/L [0.7 - 6.0 g/L]. Ultrasonography was normal in 23.1%, showed dilation of the excretory tract on a single kidney in 1.9%, and stigmata of chronicity in 5.8%. According to the KDIGO classification of AKI, we found stage 3 in 53.9%. ARF was organic in 67.8%. Infectious causes accounted for 44.2%. Multivisceral failure syndrome was associated with ARF in 69.2%. Management was based on rehydration (82.7%), antibiotic therapy (53.8%), transfusion (42.3%), extrarenal purification (9.6%) and obstruction removal (3.8%). The outcome was favorable in 15.4% of cases, with recovery of renal function, and unfavorable in 84.6%, with 76.9% of deaths. The leading causes of death were multivisceral failure syndrome and AKI (p = 0.036). ICU stay was 4.4 days. Conclusion: Our study highlights the high mortality of ARF due to the multiplicity of causes, and calls for urgent measures to reduce its prevalence.

References

[1]  Aniort, J., Deteix, P., Souweine, B., et al. (2019) Epidémiologie de l’insuffisance rénale aigue. Néphrologie & Thérapeutique, 15, 63-69.
[2]  Hoste, E.A.J., Bagshaw, S.M., Bellomo, R., Cely, C.M., Colman, R., Cruz, D.N., et al. (2015) Epidemiology of Acute Kidney Injury in Critically Ill Patients: The Multinational AKI-EPI Study. Intensive Care Medicine, 41, 1411-1423.
https://doi.org/10.1007/s00134-015-3934-7
[3]  Uchino, S. (2005) Acute Renal Failure in Critically Ill Patients: A Multinational, Multicenter Study. Journal of the American Medical Association, 294, 813-818.
https://doi.org/10.1001/jama.294.7.813
[4]  Ostermann, M. and Chang, R. (2008) Correlation between the AKI Classification and Outcome. Critical Care, 12, Article No. R144.
https://doi.org/10.1186/cc7123
[5]  The Kidney Disease Improving Global Outcomes (KDIGO) Working Group (2012) KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney International, 2, 1-138.
[6]  Klouche, K., Sandapa, D., Barrau, H. and Jonquet, O. (2010) Insuffisance rénale aiguë en réanimation—Prévention et traitement. Réanimation, 20, 552-559.
https://doi.org/10.1007/s13546-010-0030-4
[7]  Valette, X., Terzi, N. and du Cheyron, D. (2010) Quelle définition pour l’insuffisance rénale aiguë en réanimation? Réanimation, 19, 431-440.
https://doi.org/10.1016/j.reaurg.2010.04.006
[8]  Gaudry, S., Zucman, N. and Dreyfuss, D. (2015) Critères de début et d’arrêt de l’épuration extrarénale en réanimation. Réanimation, 24, 400-405.
https://doi.org/10.1007/s13546-015-1028-8
[9]  Imane, A.O. (2017) Prise en charge de l’insuffisance rénale aiguë en milieu de réanimation à l’hôpital militaire Avicenne de Marrakech. Université Gadi Ayyad.
[10]  Brivet, F.G., Kleinknecht, D.J., Loirat, P. and Landais, P.J.M. (1996) Acute Renal Failure in Intensive Care Units—Causes, Outcome, and Prognostic Factors of Hospital Mortality. Critical Care Medicine, 24, 192-198.
https://doi.org/10.1097/00003246-199602000-00003
[11]  Groeneveld, A.B.J., Tran, D.D., van der Meulen, J., Nauta, J.J.P. and Thijs, L. (1991) Acute Renal Failure in the Medical Intensive Care Unit: Predisposing, Complicating Factors and Outcome. Nephron, 59, 602-610.
https://doi.org/10.1159/000186651
[12]  Kerzaz, R. (2017) Insuffisance rénale aigue en réanimation et perioperatoire: Serie prospective de 42 cas. Université Sidi Mohammed Ben Abdellah.
[13]  Borni-Duval, C., Krummel, T., Bazin, D. and Hannedouche, T. (2011) Épidémiologie et pronostic de l’insuffisance rénale aiguë aux soins intensifs de néphrologie. Néphrologie & Thérapeutique, 7, 298-299.
https://doi.org/10.1016/j.nephro.2011.07.083
[14]  Mehta, R.L., Bouchard, J., Soroko, S.B., Ikizler, T.A., Paganini, E.P., Chertow, G.M., et al. (2010) Sepsis as a Cause and Consequence of Acute Kidney Injury: Program to Improve Care in Acute Renal Disease. Intensive Care Medicine, 37, 241-248.
https://doi.org/10.1007/s00134-010-2089-9
[15]  Lamine, T. (2014) Insuffisance rénale aigue en réanimation: Facteurs étiologiques et pronostiques. Université des sciences, des techniques et des technologies de Bamako.
https://www.bibliosante.ml/handle/123456789/5136
[16]  Coulibaly, G., Lengani, H.Y.A., Sondo, K.A., Konvolbo, H.P., Diendéré, É.A., Nitiéma, I.J., et al. (2020) Épidémiologie de l’insuffisance rénale aiguë au cours de la dengue dans la ville de Ouagadougou. Néphrologie & Thérapeutique, 16, 27-32.
https://doi.org/10.1016/j.nephro.2019.04.002
[17]  Guerin, C., Girard, R., Selli, J., Perdrix, J. And Ayzac, L. (2000) Initial versus Delayed Acute Renal Failure in the Intensive Care Unit. American Journal of Respiratory and Critical Care Medicine, 161, 872-879.
https://doi.org/10.1164/ajrccm.161.3.9809066
[18]  Payen, D. and Berton, C. (2005) Insuffisance rénale aiguë: Épidémiologie, incidence et facteurs de risque. Annales Françaises dAnesthésie et de Réanimation, 24, 134-139.
https://doi.org/10.1016/j.annfar.2004.11.017
[19]  Benouaz, S., Toudert, K., Batouche, D.D., Benouaz, N.A., Meghraoui, H. and Mentouri, Z. (2017) Profil épidémiologique et facteurs pronostiques de l’insuffisance rénale aiguë en réanimation. Néphrologie & Thérapeutique, 13, 401.
https://doi.org/10.1016/j.nephro.2017.08.313
[20]  Cruz, D.N., Bolgan, I., Perazella, M.A., Bonello, M., de Cal, M., Corradi, V., et al. (2007) North East Italian Prospective Hospital Renal Outcome Survey on Acute Kidney Injury (NEiPHROS-AKI). Clinical Journal of the American Society of Nephrology, 2, 418-425.
https://doi.org/10.2215/cjn.03361006
[21]  Metnitz, P.G.H., Krenn, C.G., Steltzer, H., Lang, T., Ploder, J., Lenz, K., et al. (2002) Effect of Acute Renal Failure Requiring Renal Replacement Therapy on Outcome in Critically Ill Patients. Critical Care Medicine, 30, 2051-2058.
https://doi.org/10.1097/00003246-200209000-00016
[22]  Bagshaw, S.M., George, C. and Bellomo, R. (2007) Changes in the Incidence and Outcome for Early Acute Kidney Injury in a Cohort of Australian Intensive Care Units. Critical Care, 11, R68.
https://doi.org/10.1186/cc5949

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