B Diouf

Gaston Berger University, Saint-Louis, Ndar, Saint-Louis, Senegal

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Publications (70)13.7 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: It is now established that vitamin D acts as a steroid hormone via a nuclear receptor to perform its varied functions in mineral metabolism. Very few studies in sub-Saharan Africa, and in Senegal in particular, have focused on the prevalence of low vitamin D reserves in black individuals living in this sunny region. We conducted this study to assess the prevalence of a drop in vitamin D reserves in a population of blacks undergoing intermittent hemodialysis. This descriptive study took place at three hemodialysis centers in Dakar and included 37 patients whose 25-hydroxyvitamin D (25-OH-D) levels had been assayed. The patients' mean age was 51 years, and their sex ratio 1.49. The average concentration of 25-OH-D was 70 nmol/L. Below-normal reserves were found in 23 patients (62.2%), especially among those aged 50-75 years. All patients with low 25-OH-D reserves received vitamin D3 supplementation at a dose of 100,000 IU of cholecalciferol per month. This supplementation normalized 25-OH-D levels in the 10 patients subsequently tested. Given the small sample size, a study with a larger number of patients is needed to reach a conclusion about the exact prevalence of low vitamin D reserves in this population and to investigate possible associated factors.
    Medecine et sante tropicales. 10/2014;
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    ABSTRACT: 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. 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. 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.
    Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis. 03/2014;
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    ABSTRACT: Aspects epidemiologiques, cliniques et evolutifs de l'insuffisance renale chronique (IRC) chez l'enfant dans un hopital pediatrique Senegalais Résumé Introduction : Notre objectif dans cette étude était de décrire les aspects épidémiologiques, cliniques et les difficultés de prise en charge de l'IRC au S é n é g a l a f i n d e f o r m u l e r d e s recommandantions. Materiels et Methodes : Il s'agissait d'une étude rétrospective déscriptive et analytique de Janvier 2005 à Décembre 2013 au sein du service de pédiatrie de l'HALD. Etaient inclus les patients âgés de moins de 15 ans présentant depuis plus de 3 mois un débit de filtration glomérulaire 2 (DFG) inférieur à 60ml/min/1,73 m calculé par la formule de Schwartz. Les données ont été saisies et analysées grâce au logiciel SPSS 16.0. R ésultats : Nous avons inclus dans l'étude 53 cas d'IRC durant la période d'étude soit une prévalence en hospitalisation de 0,62%. L'âge moyen chez nos patients était de 10,6 ans. Sur le plan clinique, l'oedème de type rénal était présent chez 69,8% des malades, la 2014;1:83-89 83 () * protéinurie dans 88,7% des cas et l'hypertension artérielle chez 75,5% des patients. Sur le plan biologique, l'anémie était présent chez 100% de nos patients. La classification de l'IRC montrait que 71,7% des cas étaient diagnostiqués au stade 5 de la maladie rénale chronique. La lésion causale la plus retrouvée était representée par les glomérulopathies chroniques acquises (52,8%). La survie globale à 12mois, chez les enfants hémodialysés était de 34,3%. Conclusion : La prévalence de l'IRC chez l'enfant dans notre étude est de 0,62%. Les glomérulopathies chroniques représentaient les étiologies les plus fréquentes La mortalité globale est élevée. Nous recommendons la création d'une unité de néphrologie pédiatrique pour une meilleure prise en charge.
    African journal of Paediatric Nephrology. 01/2014; 1:83-89.
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    ABSTRACT: This study sought to assess the prevalence of lupus nephropathy and to determine its clinical, histological, therapeutic and outcome profiles. Patients and methods. This retrospective study examined records covering a 10-year period from 1999 to 2009 at the nephrology department of the Aristide Le Dantec University Hospital Center. Results. The records showed 43 patients with systemic lupus erythematosus (SLE), and 72% had lupus nephritis. The patients' mean age was 32.9 years; 40 were women and 3 men, for a sex ratio of 0.075. The lupus nephritis led to discovery of SLE in 27.9%. The mean proteinuria concentration was 2.01 g/dL. Seventeen patients had impaired renal function, and 26 had renal biopsies. It found class II nephritis in 2 patients, class IV in 10, and class V in 12. In addition, fifteen patients received combined corticosteroid + immunosuppressant treatment. Four patients died during the study period, one from SLE activity, two from complications of renal failure, and the fourth from sepsis. Conclusion. A larger study would be useful to assess more acurately the prevalence of various classes and severity of lupus nephropathy among blacks living in sub-Saharan Africa.
    Medecine et sante tropicales. 08/2013; 23(3):328-331.
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    ABSTRACT: Autosomal polycystic kidney disease (ADPKD) is a genetic disorder with two causal PKD-1 and PKD-2. Genetic studies have demonstrated an important allelic variability between patients but few data are known about genetic variants in African populations. We report a new mutation found in a 41-year old women with mild chronic kidney disease secondary to ADPKD. Molecular genetic testing found a deletion of 2 nucleotides A and C at positions 7290 and 7291 followed by insertion of a 5-base pair (CTGCA) located in exon 18 of the PKD1 gene. This newly identified frame shifting was compared to the PKD gene database but no similar mutation was yet reported. Other screened family members did not present any mutation.
    Nephro-urology monthly. 01/2013; 5(2):769-72.
  • Néphrologie & Thérapeutique. 09/2012; 8(5):282.
  • Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 09/2012; 23(5):1061-4.
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    ABSTRACT: In recent years, measuring quality of life (QoL) to quantify the impact of disease on patients' lives has become widespread. We conducted a study to evaluate the QoL of hemodialysis patients in Dakar and to identify factors that influence it. Patients and methods. This cross-sectional study took place from May through July 2008 in two hemodialysis centers in the city of Dakar. It included all patients who had been undergoing dialysis for more than 3 months, were in stable clinical condition with no hospitalization in the previous month and consented to participate. QoL was assessed with the Kidney Disease Quality Of Life Short-Form version 1.2 (KDQoL-SF), which comprises 43 items specific to kidney disease as well as the 36 items of the SF-36. Results. Our study included 60 patients. Their mean age was 50.5 years, and the male/female sex ratio was 0.9. The global mean score (for the SF-36 was 45.7 ± 25.5, 41 ± 24.4 for the physical dimension and 53.6 ± 27.3 for the mental health dimension. The mean global KDQoL score was 55.2 ± 24.0, 44.8 ± 26.1 for the physical dimension, and 54.8 ± 24.4 for the mental health dimension, 60.8 ± 21.3 for the specific dimension of dialysis and 78.4 ± 22.3 for patient satisfaction. The study shows that the QoL of 90% of our patients was impaired by their kidney disease. Conclusion. Studies that focus on QoL of dialysis patients are rare in Africa. This one showed an impaired QoL, especially for physical health, among our hemodialysis patients.
    Medecine et sante tropicales. 08/2012;
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    ABSTRACT: INTRODUCTION: The objective of this study was to explore the potential for kidney donation in the Senegalese population, as a prelude to a proposed kidney transplant from living donors. METHOD: A survey of cross type, and descriptive analysis was conducted from June 15 to September 15, 2010 in Dakar (Senegal). A two-stage sampling was done. The data, collected on the basis of a questionnaire, were captured and analyzed with Epi Info software version 3.3.2 and R version 2.9.2. RESULTS: The study population comprised 400 people with 56.75% of men, a sex ratio of 1.3. The average age was 33.58±11 years. It consisted of people between 18 and 30 (48.5%), married (44.25%). The subjects surveyed were mostly Senegalese (91%), students and pupils (24%) and educated (86.75%). The questioned subjects heard of kidney failure (65%). They knew at least one person who died of renal failure or dialyzed respectively in 19% and 24% of cases. The respondents have heard of the graft (47.3%). They knew at least one grafted patient in 5%. The public has expressed a desire to donate a kidney to a relative or friend in treatment of chronic renal failure in 71.5% of cases. The subjects taught at secondary level, higher level and those informed of renal failure were more prone to kidney donation than others. CONCLUSION: This study shows a large pool of potential kidney donors, hence the need to conduct outreach activities to turn them into actual donors.
    Néphrologie & Thérapeutique 04/2012; · 0.50 Impact Factor
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    ABSTRACT: Chronic kidney disease is now regarded as amajor public health concern. This is especially true in developing countries where it accounts for significant morbidity, mortality and decreased life expectancy. The main problem for developing countries is the cost of dialysis. Indeed, the availability of peritoneal dialysis for renal replacement therapy is low in sub-Saharan Africa. Since March 2004 peritoneal dialysis has been available to some patients with end-stage renal disease in Senegal. The purpose of this study was to assess epidemiologic, clinical, technical patterns and outcomes in patients who underwent peritoneal dialysis in the first three years of the program. This three-year retropective study identified 26 patients who underwent peritoneal dialysis for end-stage renal disease for a period of at least 15 days. Patients not meeting these criteria were not included. All patients had a Baxter type transfer set. Lactate-bicarbonate solution was used for countinuous ambulatory peritoneal dialysis. In 3 cases, Icodextrin- and amino-acid based-solutions were employed. In automated peritoneal dialysis, the Home Choice machine was used for all patients. Epidemiological, clinical/paraclinical data and outcomes were noted for each patient. Twenty-six patients were included in the study. Median age was 48 +/- 6 years with a M/F sex ratio of 1.17. Most patients (84%) were literate. Diabetic nephropathy and nephroangiosclerosis were the main causes of end-stage renal disease. The mean Charlson score was 3 (range, 2 to 5). Mean residual diuresis was 435 mL/day. The peritonitis rate was 1 per 20 patient months. Staphylococcus aureus and Pseudomonas aeruginosa were the most common germs. Six patients presented catheter infection: exit-site in 4 and tunnel in 2. Catheter obstruction occurred in three cases. At the end of the study, 6 patients were still in automated peritoneal dialysis and 8 in countinuous ambulatory peritoneal dialysis. Six 6 patients died and 6 were switched to hemodialysis. Peritoneal dialysis is available as a renal replacement therapy in Senegal. It has allowed end-stage renal disease patients greater autonomy in their working place.
    Médecine tropicale: revue du Corps de santé colonial 10/2011; 71(5):468-71.
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    ABSTRACT: Erectile dysfunction (ED) is very common in dialysis patients because of organic and psychological risk factors. It has a negative impact on patients' quality of life. In Senegal, ED is assumed to be frequent in the general adult population but its prevalence in dialysis patients is unknown. This cross-sectional study aimed to assess the prevalence and risk factors associated with ED in Senegalese dialysis patients. Seventy dialyzed men >18 years old were included. Erectile dysfunction was assessed using the abridged version of International Index of Erectile Function already validated in dialysis patients. Multivariate analysis was performed to identify the factors associated with ED in patients. The mean age of the patients was 52 ± 11.3 years (21-70 years) and the median dialysis vintage was 39.4 months (interquartile range 9-51 months). The prevalence of ED was 81.5% for all patients (80% in hemodialysis and 81.75% in peritoneal dialysis). Severe ED was found in 11.5% of patients. The prevalence of ED was 74.5% in patients younger than 50 years and 86.6% in those 50 years or older. Marital status, comorbidity, hemoglobin level, and use of antihypertensive drugs were not different between patients with and without ED. Libido was conserved in 77% of patients and 44.7% were not satisfied during sexual intercourse. Multivariate analysis identified age and dialysis vintage as risk factors of ED in our patients. Only 7 patients received treatment for ED and 22% sought a consultation with a specialist (urologist and psychologist).
    Hemodialysis International 04/2011; 15(2):280-3. · 1.44 Impact Factor
  • Nephrologie & Therapeutique - NEPHROL THER. 01/2011; 7(5):374-374.
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    ABSTRACT: Autosomal dominant polycystic kidney disease (ADPKD) is not well described in black Africans while some data suggesting the disease is exceptional in this race. A retrospective study of patients with ADPKD followed in nephrology department of a teaching hospital in Dakar (January 1, 1995 to December 31, 2005) was therefore undertaken. Prevalence of ADPKD was one in 250. Mean age was 47 + or - 5 years with a predominance of male (57%). High blood pressure (HBP) was present in 68% of patients. Other renal manifestations were flank pain, hematuria and proteinuria. Majority of patients had impaired renal function at time of diagnosis. Extra-renal cysts were essentially found in liver (45.5%), pancreas and seminal vesicles. Main complications: ESRD (51%) occurred within a 6 year mean period, urinary tract infection (13%) and cerebral haemorrhage (2%). HBP control, in general needed 2 or more antihypertensive drugs. Fourteen patients died, ten patients had been on haemodialysis and four others died from uremic complications. In conclusion, ADPKD in black African adults is not rare and probably underdiagnosed. Early HBP and ESRD are likely more frequent than in other races. Earlier ultrasound detection and strategies to preserve renal function should be offered to at-risk individuals to improve outcomes.
    Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 01/2010; 21(1):81-6.
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    S M Seck, E F Ka, A Niang, B Diouf
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    ABSTRACT: A 42-year-old black African patient was admitted in the emergency department with severe headache, dizziness, and visual problems. He had been treated for hypertension diagnosed eight months ago after a similar episode. He was taking atenolol 100 mg /day, amlodipine 10 mg/day, and a combination of lisinopril 20 mg/hydrochlorothiazide 12.5 mg daily but experienced several hypertension peaks and hypotension. He adhered to treatment and was neither using traditional herbal medication nor illicit drugs. He did not smoke, but used to drink 1-2 glasses of wine after dinner. At admission, his blood pressure was 235/145 mm of Hg. His body mass index was 25.5 kg/m(2) and the waist/hip ratio was 0.9. Physical examination was unremarkable. Fundoscopic examination revealed hypertensive retinopathy. Biochemical and imaging explorations were compatible with diagnosis of pseudopheochromocytoma. Evolution was favourable after treatment with alpha-1 and beta-blokers.
    Indian Journal of Nephrology 07/2009; 19(3):122-4.
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    ABSTRACT: Authors report a 37-year-old Senegalese woman with no known history of nephropathy who was admitted for fever related to malaria, severe acute renal failure requiring dialysis with nephrotic syndrome. Biological examinations and bone marrow aspiration showed hemophagocytic syndrome. A kidney biopsy found a 'collapsing glomerulopathy' (CG). A protracted course of steroids yielded a complete, unexpected remission of the nephrotic syndrome and renal function was normal at 18 months.
    Nephrology Dialysis Transplantation 09/2008; 23(10):3359-61. · 3.37 Impact Factor
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    ABSTRACT: Poor adherence to medication regimens accounts for substantial morbidity, mortality and increased health care costs in developing countries. The aim of this study is to assess adherence to therapy in patients with chronic kidney diseases and to identify the major barriers to adherence. A prospective study of non-dialysed patients with chronic kidney diseases followed during three months. Sociodemographic, clinical and therapeutic data were collected from medical records and patient interviews. Rate of adherence (ROA) was defined as the percentage of the prescribed doses of the medication actually taken by the patient over a four-week period. Statistical analysis was done with SPSS 11.0. Mean age of the 118 included patients was 39.28 years +/-16.4 (range 13-76 years); they were 56% female and one third had low instruction level. Socio-economic level was low for 38.5% of patients. Mean ROA was 81+/-12% (range 46 to 100%) but there was a difference between male (75%) and female (84%). Almost three quarters of patients (71%) had ROA more than 80%. Patients' adherence was inversely correlated to daily frequency of dose but not number of drugs. Major obstacles to adherence were complexity of drug regimen, forgetfulness, healthcare system inaccessibility, lack of information, side effects, automedication with phytotherapy and high cost of medications. Most of barriers to adherence can be overcome by improving communication between patients, health provider and healthcare system.
    Néphrologie & Thérapeutique 05/2008; 4(5):325-9. · 0.50 Impact Factor
  • Nephrology Dialysis Transplantation 03/2008; 23(2):769. · 3.37 Impact Factor
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    ABSTRACT: Destombes Rosaï Dorfman (DRD) syndrome is form of nonlangerhans cell sinus histiocytosis. The main symptoms are cervical adenopathy, fever and fluctuating hepatosplenomegaly. It can be confused with ganglionary tuberculosis especially in our region where tuberculosis is common. This report describes a case of Destombes Rosaï Dorfman syndrome in a 40-year-old woman from Senegal. The main presenting symptom was the presence of massive tumour-like lesions on the neck with altered general condition and fever. Based on these clinical findings, ganglionary tuberculosis was suspected and presumptive treatment was initiated in the local hospital. However further workup failed to confirm the diagnosis and the patient was transferred to the Internal Medicine Department. Clinical examination in our service revealed the presence of extensive adenopathy in the supraclavicular, axillary, and inguinal regions. Laboratory tests demonstrated a nonspecific inflammatory syndrome. Abdominal ultrasonography depicted extensive mesenteric and para-aortic adenopathy. Chest x-ray showed bilateral and asymmetric mediastinal adenopathy. Medullogram findings were normal. Histology confirmed DRD syndrome. DRD syndrome is rare disease of unknown aetiology. In tropical areas differential diagnosis with ganglionary tuberculosis, lymphoma, and reactive hemophagocytic syndrome can be challenging. Lymph node biopsy should be performed in all patients presenting fever and polyadenopathy.
    Médecine tropicale: revue du Corps de santé colonial 03/2008; 68(1):69-71.
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    ABSTRACT: Focal and segmental glomerulosclerosis (FSGS) is common and non-specific patterns of glomerular injury encountered in human renal biopsies. Cortico-resistant nephrotic syndrome is the main manifestation. We report epidemiological, clinical and pathological aspects of FSGS in Dakar. We report the results of a retrospective study about focal segmental glomerulosclerosis (FSGS) identified from 258 kidney biopsies performed in the medical clinic 1 of A. Le Dantec hospital from January 1993 to December 2003. FSG is found in 134 cases (52%), membranous glomerulonephritis in 32 cases (12,4%), minimal change disease in 20 cases (7.7%). Ninety eigths files were exploitable. FSGS has male gender predominance with a sex ratio of 3. Median age of patients is 28 years (15 and 79 years). Symptomatology is dominated by oedema in 86 cases (87,7%), hypertension in 12 cases (12.2%), hematuria in 5 cases (5.1%), nephrotic proteinuria in 65 cases (66,3%) and no nephrotic proteinuria in 33 cases (33.6%), renal failure in 25 cases (25%)and leucocyturia in 18 cases (18%). FSGS involving more than 50% of glomeruli is encountered in 41 cases (42%), severe interstitial fibrosis is associated in 26 cases. Different pathological aspects are: classical FSGS in 88 cases (88.7%), FSGS " collapsing" in 7 cases (7.1%), FSG "tip-lesion" in one case, FSGS associated to membranous glomerulosclerosis in 2 cases and to diabetic glomerulosclerosis in one case. FSGS is primitive in 88 cases (89,8%) and secondary in 10 cases (10.2%). FSGS is the most common primitive glomerulopathy in Dakar. Nephrotic syndrome is the main manifestation of this disease. Collapsing FSGS is not correlated with the HIV Infection.
    Bulletin de la Société médicale d'Afrique noire de langue française 02/2008; 53(1):45-51.
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    ABSTRACT: previously reported studies on systemic lupus erythematosus in Senegal were more then ten years old and reported few cases of patients. Our objectives were to update epidemiological, clinical, laboratory and evolutive aspects of systemic lupus erythematosus throughout a study of 74 patients. we conducted a retrospective study in the internal medicine and the dermatology units of the university teaching hospital Aristide Le Dantec from January 1993 to December 2002. All patients with systemic lupus erythematosus according to the ACR criteria were included. Those who didn't meet ACR criteria were excluded. we included 74 patients; their mean age was 32 years and the sex ratio 0.1 (male to female). At the entry general symptoms were constants, and cutaneous signs were found in 96% of cases, joints signs in 58.1% and renal sign in 56.8%. Haematological and immunologic abnormalities were nearly constant. All the patients received corticosteroids and in 35.71% they had in addition immunosuppressive drugs. Shorts term evolution was satisfactory. At the medium term 27.02% of the patients were lost and 10.81% of them died. currents aspects of systemic lupus erythematosus in Dakar are improved by the early diagnosis when the disease is pauci-symptomatic and by the use immunosuppressive drugs in association with corticosteroids.
    Bulletin de la Société médicale d'Afrique noire de langue française 02/2007; 52(3):160-4.