Pilot experience in senegal with peritoneal dialysis for end-stage renal disease.
Introduction: Peritoneal dialysis (PD) is occasionally
used in western sub-Saharan Africa to treat patients with
end-stage renal disease (ESRD). The present study is a retrospective
review of the initial six years’ experience with PD
for ESRD therapy in Senegal, a West African country with a
population of over 12 million.
? Material and Methods: Single-center retrospective
cohort study of patients treated with PD between March
2004 and December 2010. Basic demographic data were
collected on all patients. Peritonitis rates, causes of death
and reasons for transfer to hemodialysis (HD) were determined
in all patients.
? Results: Sixty-two patients were included in the study.
The median age was 47 ± 13 years with a male/female ratio
of 1.21. Nephrosclerosis and diabetic nephropathy were
the main causes of ESRD. The mean Charlson score was
3 ± 1 with a range of 2 to 7. Forty five peritonitis episodes
were diagnosed in 36 patients (58%) for a peritonitis rate
of 1 episode/20 patient-months (0.60 episodes per year).
Staphylococcus aureus and Pseudomonas aeruginosa were
the most commonly identified organisms. Touch contamination
has been implicated in 26 cases (57.7%). In 23 episodes
(51%), bacterial cultures were negative. Catheter removal
was necessary in 12 cases (26.6%) due to mechanical dysfunction,
fungal or refractory infection. Sixteen patients
died during the study.
? Conclusion: Peritoneal dialysis is a suitable therapy
which may be widely used for ESRD treatment in western
sub-Saharan Africa. A good peritonitis rate can be achieved
despite the difficult living conditions of patients. Challenges
to the development of PD programs include training
health care providers, developing an infrastructure to support
the program, and developing a cost structure which
permits expansion of the PD program.
Auteur(s) : Niang A, Cisse MM, Mahmoud SM, Lemrabott AT, Ka el HF, Diouf B.
Pages : 539-43
Année de publication : 2014
Revue : Perit Dial Int.
N° de volume : 34(5)
Type : Article
Mise en ligne par : NIANG Abdou