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J Nephropathol. 2015;4(4): 127-133.
doi: 10.12860/jnp.2015.24
PMID: 26457260
PMCID: PMC4596297
Scopus ID: 84943645633
  Abstract View: 2839
  PDF Download: 1260

Original Article

Epidemiology of chronic kidney diseases in the Republic of Guinea; future dialysis needs

Alpha Oumar Bah 1*, Cisse Lamine 1, Mamadou Cellou Balde 1, Mamadou Lamine Yaya Bah 1, Lionel Rostaing 2,3

1 Nephrology Unit, Donka National Hospital, Conakry, Republic of Guinea
2 Department of Nephrology and Organ Transplantation, CHU Rangueil, TSA 50032, Université Paul Sabatier, Toulouse, France
3 INSERM U563, IFR–BMT, CHU Purpan, Toulouse, France
*Corresponding Author: *Corresponding author: Bah Alpha Oumar, Service de Néphrologie, CHU Donka, Conakry, République de Guinée. , Email: bahalphaoumar1@yahoo.fr

Abstract

Background: Chronic kidney disease (CKD) is increasing worldwide and can lead to end-stage renal disease (ESRD).

Objectives: Because few patients with ESRD in the Republic of Guinea have access to haemodialysis, we retrospectively evaluated the prevalence of CKD, ESRD and access to supportive therapies.

Patients and Methods: 579 CKD patients (304 males; mean age: 44 ± 16 years) were admitted into Conakry nephrology department, the only centre in the Republic of Guinea, between 2009 and 2013. Most patients (63%) resided within Conakry (the capital), 12.5% came from lower Guinea, 11.7% from middle Guinea, 7.9% from upper Guinea and 4.8% from forest Guinea.

Results: Reasons for referral were increased serum creatinine (49.5%), hypertension (27%) and diffuse edema (17%). Also, 11% were diabetic, 12.5% were smokers, 17% were HIV-positive, 8.3% were HBV-positive and 15% were HCV-positive. The most frequent symptom at admission was nausea/vomiting (56%). Upon admission, 70.5% of patients already had ESRD. Although no kidney biopsies were performed it was assumed that 34% and 27% of patients had vascular nephropathy and chronic glomerulonephritis, respectively. Of the 385 ESRD patients, only 140 (36.3%) had access to haemodialysis (two sessions/week, 4 hours each). Most patients that received haemodialysis resided within the Conakry region (P < 0.0001). There were significant associations between mortality and (i) terminal stage of CKD (P = 0.0005), (ii) vascular nephropathy (P = 0.002), and (iii) nephropathies of unknown origin (P = 0.0001).

Conclusions: A fourfold increase in haemodialysis machines is needed in Conakry, plus four new nephrology/haemodialysis centres within the Republic of Guinea, each holding ≥30 haemodialysis machines.


Implication for health policy/practice/research/medical education:

This study shows that the prevalence of chronic kidney diseases (CKDs) in Republic of Guinea varies a lot from one area to the other. This is mainly due to the fact that there is a single nephrology center in the country: it is located in the capital, Conakry, which is excentrate. Therefore the referral to that center depends mainly on distance considerations and their related costs. In addition, when end-stage renal disease (ESRD) occurs the number of patients who are offered supportive therapy, i.e. dialysis depends on the place where they are living with regards to the distance to the single kidney center. This epidemiological study might help heath care authorities to establish the number of nephrology centers that might be opened in the country as well as the number of dialysis patients that might be treated.

Please cite this paper as: Bah AO, Lamine C, Balde MC, Bah MLY, Rostaing L. Epidemiology of chronic kidney diseases in the Republic of Guinea; future dialysis needs. J Nephropathol. 2015; 4(4):127-133. DOI: 10.12860/jnp.2015.24

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ePublished: 01 Oct 2015
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