POS-260 Polycystic kidney disease in Chad: about 26 cases

Abstract

Polycystic kidney disease is the most common inherited kidney disease with easy diagnosis by ultrasound. The aim of our work was to study the epidemiological, clinical, paraclinical and therapeutic aspects of renal polyskystosis in Chad and to assess the value of screening in patients at risk. We carried out a descriptive cross-sectional study over a period of 26 months (January 1, 2018 to May 1, 2020) in the two nephrology departments of the Renaissance and the National Reference centers of N’Djamena. were included all patients who had polycystosis (PEI ultrasound criteria). Then a family survey was carried out among family members of patients included between June 1, 2020 and October 1, 2020 During our study, 2229 patients had consulted in the 2 university hospitals. Fifteen (15) cases met the ultrasound criteria for PEI, as a hospital prevalence of 0.67% of cases. From these 15 cases, a family investigation was carried out on the members of 3 families. Eleven (11) patients were diagnosed as carriers of polycystic kidney disease (Figure 2). We identified a total of 26 cases in our study, as a prevalence of 1.16%. The average age was 42.4 years [15 and 70 years] with a sex ratio of 1.3. The mean age of onset of the first clinical signs was 37.7 years. Arterial hypertension (hypertension) was the main circumstance of discovery in 53.8% (n = 14) followed by abdominal pain, urinary tract infection and chronic renal failure in respectively 7.6% (n = 2); 7.6% (n = 2) and 3.8% (n = 1). Grade I, II and III hypertensions were found in 42.1%, respectively (n = 8); 36.9% (n = 7) and 21% (n = 4). There was a statistically significant relationship between circumstance of discovery and age (p = 0.034). A hemoglobin level of between 8 and 10g / dl was found in 57.7% of cases. The mean serum creatinine level was 45 mg / l with [4.5 to 274.42 mg / l]. It was noted that 12 patients or 46.1% of patients were in the chronic renal failure stage, including 26.9% in the end stage. All had received conservative treatment. In multivariate analysis, there was a statistically significant relationship between the different stages of chronic kidney disease and the occurrence of complications (p = 0.0000). Therapeutically, 14 patients (53.8%) were on antihypertensive drugs such as ACE inhibitors. No patient had received Tolvaptan. Urinary tract infections were the main complications (19.2%) of hypertension in the blood (15.3%) and macroscopic hematuria (15.3%). Polycystosis in Chad is an unrecognized and underdiagnosed pathology. Clinical screening should focus on the etiological research of arterial hypertension in the young subject and ultrasound screening of family members of the polycystic patient.