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Outcome of permanent vascular access for haemodialysis in patients with end-stage renal disease in Cameroon: Results from the pilot experience of the Douala general hospital

par Ngatchou Djomo, William ;Evina, Achille Ngbwa;Halle, Marie Patrice E.;Massom, Annie;Ekane, Samuel;Essola, Basile;Origer, Pierre;Haquebard, Jean Pierre;Olinga Olinga, Alain ;Jansens, Jean-Luc ;Watel, Alain;Lecain, Antoine;Bol Alima, Maimouna;Van Uytvanck, Alexandra ;Segers, Bernard ;Haentjens, Lionel L;Berré, Jacques ;Bal, Ousmane;Preumont, Nicolas ;Kana, Albert Justin ;Kamdem, Félicité;Hentchoya, Romuald;Etori, Pauline;Ndofor, Brown;Ngote, Henri;Kasum, Adamo;Coulibaly, Aminata;Doualla, Marie Solange;Luma Namme, Henry;Cogan, Elie ;Lebrun, Eric ;Gamela, Gauthier;Germay, Olivier;Mouelle Sone, Albert;Priso, Eugène Belley;Dzudie, Anastase;Lemogoum, Daniel ;Dehon, Philippe
Référence Acta chirurgica Belgica (Ed. bilingue), 116, 1, page (36-40)
Publication Publié, 2016-04

Article révisé par les pairs

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Résumé :

Background: Chronic Kidney disease is a major health problem in the world. Native arteriovenous Fistula (AVF) is well established as the best vascular access for haemodialysis. Little is known about the outcome of AVF in sub-Saharan Africa. We aim to analyze the outcome of patients undergoing AVF creation during the pilot program established at the Douala general hospital (DGH). Method: This was hospital-based, longitudinal study with a retrospective phase (April 2010-January 2014) and a prospective phase (January 2014-April 2014). All consecutive patients operated for AVF creation were included in this study. Socio-demographics data, functionality, and complications were analyzed. Results: Eighty-one patients including 52 men were enrolled in this study (49 prospectively and 32 retrospectively). The mean age was 52, 3 years (range 18-81 years). Hypertension (66, 7%), diabetes (17, 3%), and HIV (8, 6%) were the most observed co-morbidities. About 96.3% of AVF were native and 3.7% were prosthetic graft. Radiocephalic AVF was performed at a rate of 77.8%. The primary function rate was 97.7% and the mean follow-up period 43.4 weeks. The overall rate of complications was 44.4% of whom 30.5% were early, 30.5% secondary, and 39% lasted. The treatment of these complications was conservative in 48.7% of cases. Conclusions: The results of the pilot program of AVF creation at the DGH are encouraging. However, the sustainability of this project requires human capacity building.