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      Insuffisance rénale chronique et hémodialyse à Lomé: l´hémodialysé et son entourage sont-ils bien informés? Translated title: Chronic renal failure and hemodialysis in Lomé: are patients on haemodialysis and their entourage well informed?

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          Abstract

          L´insuffisance rénale terminale nécessite un traitement de suppléance notamment l´hémodialyse. Avant l´initiation, le patient et son entourage reçoivent des informations sur la maladie rénale et les possibilités de traitement. Ce travail a pour objectif d´évaluer le niveau de connaissance ainsi que l´opinion de l´hémodialysé et de son entourage sur la maladie rénale chronique et les traitements de suppléances rénales. Il s´est agi d´une étude transversale descriptive qui s´est déroulée du 29 juillet au 19 août 2020 dans l´unité d´hémodialyse du CHU-SO. La population de notre étude était constituée de tous les patients hémodialysés de l´unité d´hémodialyse du CHU-SO et de leurs accompagnants qui ont donné leur consentement libre et éclairé. Les données ont été collectées de façon anonyme à partir d´un questionnaire. La saisie et l´analyse statistique des données ont été faites au moyen du logiciel Epi Info dans sa version 7.2.2.6. Quatre-vingt-et-un patients et 79 accompagnants ont été interrogés. Les âges moyens des patients et leur accompagnant étaient respectivement de 49,7 ans ± 13,5 et 39,6 ans ± 13,2. Tous les patients connaissaient leur pathologie et 94% des accompagnants, les informations sur la maladie de leurs parents. L´hémodialyse était considérée très chère par 95,1% des patients. L´avantage de l´hémodialyse le plus connu par les patients était la qualité de vie améliorée (80,2%) et 15% pensaient également que la transplantation rénale était tout aussi efficace. La majorité des accompagnants (85%) ont déclaré que l´hémodialyse était le meilleur traitement. L´éducation thérapeutique des patients hémodialysés et des accompagnants est importante pour une meilleure prise en charge globale des hémodialysés.

          Translated abstract

          End stage renal failure requires substitution therapy, including hemodialysis. Before initiation, patients and their entourage receive information on renal disease and treatment options. The purpose of this study is to assess the level of knowledge as well as the opinion of patients on haemodialysis and of their entourage on chronic kidney disease and substitution therapies. We conducted a cross-sectional descriptive study in the Department of Haemodialysis at the Sylvanus Olympio University Hospital (CHU-SO) from 29 July to 19 August 2020. The study population was composed by all the haemodialysis patients in the Department of Haemodialysis at the CHU-SO and by their accompanying persons who gave their free and informed consent. Anonymous survey was used to collect data. Data collection and statistical analysis were carried out using the Epi Info software 7.2.2.6. Eighty-one patients and 79 accompanying persons were interviewed. The average ages of patients and their accompanying persons were 49.7 years ± 13.5 and 39,6years ± 13.2 respectively. All patients knew their disease and 94% of accompanying persons were informed about their parents’ disease. Hemodialysis was considered very expensive by 95.1% of patients. Patients stated that improved quality of life was the most known benefit of hemodialysis (80.2%) while 15% also thought that renal transplantation was equally effective. The majority of accompanying persons (85%) stated that hemodialysis was the best treatment. Haemodialysis education program for patients and their accompanying persons is essential to better overall management of haemodialysis patients.

          Most cited references15

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          The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report.

          The definition and classification for chronic kidney disease was proposed by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) in 2002 and endorsed by the Kidney Disease: Improving Global Outcomes (KDIGO) in 2004. This framework promoted increased attention to chronic kidney disease in clinical practice, research and public health, but has also generated debate. It was the position of KDIGO and KDOQI that the definition and classification should reflect patient prognosis and that an analysis of outcomes would answer key questions underlying the debate. KDIGO initiated a collaborative meta-analysis and sponsored a Controversies Conference in October 2009 to examine the relationship of estimated glomerular filtration rate (GFR) and albuminuria to mortality and kidney outcomes. On the basis of analyses in 45 cohorts that included 1,555,332 participants from general, high-risk, and kidney disease populations, conference attendees agreed to retain the current definition for chronic kidney disease of a GFR 30 mg/g, and to modify the classification by adding albuminuria stage, subdivision of stage 3, and emphasizing clinical diagnosis. Prognosis could then be assigned based on the clinical diagnosis, stage, and other key factors relevant to specific outcomes. KDIGO has now convened a workgroup to develop a global clinical practice guideline for the definition, classification, and prognosis of chronic kidney disease.
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            Health status and quality of life reported by incident patients after 1 year on haemodialysis or peritoneal dialysis.

            It has been suggested that there are no large differences in the quality of life of incident patients starting on haemodialysis (HD) and peritoneal dialysis (PD), but few studies have addressed this issue. Association of modality with incident patients' health status and quality of life scores was investigated with propensity score (PS) analysis and also with traditional multivariable regression analyses. We compared patient reported health status and quality of life scores after 1 year of therapy in 455 HD and 413 PD patients who participated in a national study, stayed on the same modality and had complete socio-demographic and clinical information needed to create a PS indicating their expected probability of starting on PD. One year scores on the majority of health status and quality of life measures were not significantly different for HD and PD patients within propensity-matched quintiles. PD patients' scores were higher than HD patients' scores on effects of kidney disease, burden of kidney disease, staff encouragement and satisfaction with care in some quintiles, and traditional regression analyses confirmed that dialysis modality was associated with patients' scores on these variables. This study provides support for making the choice of PD more widely available as an option to patients initiating chronic dialysis therapy. Patient lifestyle opportunities associated with use of PD, a home-based and self-care therapy, may also apply to home-based HD or in-centre self-care HD. Patients' expectations regarding treatment and their attitudes toward management of their health may interact with treatment modality to shape patient-reported experience on dialysis; this is an important focus for future studies.
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              Worldwide growing epidemic of CKD: fact or fiction?

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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                28 May 2021
                2021
                : 39
                : 85
                Affiliations
                [1 ]Service de Néphrologie et d´Hémodialyse du CHU Sylvanus Olympio de Lomé, Lomé, Togo,
                [2 ]Service de Néphrologie du CHU de Kara, Kara, Togo,
                [3 ]Service de Néphrologie du CHU de Bouaké, Bouaké, Côte d´Ivoire,
                [4 ]Service de Néphrologie du CHU de Cocody, Cocody, Côte d´Ivoire
                Author notes
                Corresponding author: Badomta Dolaama, Service de Néphrologie et d'Hémodialyse du CHU Sylvanus Olympio de Lomé, Lomé, Togo. badomta@ 123456gmail.com
                Article
                PAMJ-39-85
                10.11604/pamj.2021.39.85.26685
                8379401
                0de3bfe4-ab84-4c71-8868-a0b6011ccbcb
                Copyright: Yawovi Mawufemo Tsevi et al.

                The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 October 2020
                : 01 April 2021
                Categories
                Short Communication

                Medicine
                insuffisance rénale,chronique,terminal,hémodialyse,patients,connaissance,lomé,renal failure,chronic,end-stage,hemodialysis,knowledge

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