Acute Kidney Injury and Ad Hoc Consultancy Opinions of Nephrology Consultants in the Ivory Coast: Epidemiological, Diagnostic, and Prognostic Aspects
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Abstract
Context: Acute kidney injury is a serious and frequently encountered condition in hospital settings, with an increasing incidence. Given the increasing number of evidence reporting the benefits of specialized and early nephrology care, the Ad Hoc Consultancy Opinion regains a crucial interest in the nephrology care pathway. In the Ivory Coast, data concerning this activity are rare. The objective of this study was therefore to evaluate the Ad Hoc Consultancy Opinion impacts under our practice conditions.
Methods: Our study will focus on all patients of the CHU Treicheville without a history of kidney disease seen in the Ad Hoc Consultancy Opinion by the nephrology team of said center over the period from October 1, 2022, to March 31, 2023.
Results: The consultative nephrology service involved 106 patients with an average age of 45.1 +/- 21.1 years. The average delay for requesting the consultation was 2.6 +/- 2.5 days. Acute kidney injury was at stage 3 of the KDIGO classification in 73.6% (n = 78). Emergency hemodialysis accounted for 59.4% of the indications. The mortality was 22.6%, and the risk of death was associated with coma (p = 0.014), left heart failure (p = 0.009), ARDS (p = 0.035), the severity of AKI (p = 0.024), and the Ad Hoc Consultancy Opinion delay > 3 days (p = 0.010).
Conclusion: Our study adds weight to the claims that early specialized management of kidney disease affects the nephrological outcome and survival of patients.
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Kahindo CK, Mukuku O, Wembonyama SO, Tsongo ZK. Prevalence and factors associated with acute kidney injury in adults in sub-Saharan Africa: a review of the current literature. Int J Nephrol. 2022;2022:5621665. Available from: https://doi.org/10.1155/2022/5621665
Sawhney S, Marks A, Fluck N, Levin A, Prescott G, Black C. Intermediate and long-term outcomes of survivors of acute kidney injury episodes: a large population-based cohort study. Am J Kidney Dis. 2017;69(1):18-28. Available from: https://doi.org/10.1053/j.ajkd.2016.05.018
Smart NA, Dieberg G, Ladhani M, Titus T. Early referral to specialist nephrology services for preventing the progression to end-stage kidney disease. Cochrane Database of Systematic Reviews. 2014;18(6): CD007333. Available from: https://doi.org/10.1002/14651858.cd007333.pub2
Hommel K, Madsen M, Kamper AL. The importance of early referral for the treatment of chronic kidney disease: a Danish nationwide cohort study. BMC Nephrology. 2012;13:108. Available from: https://doi.org/10.1186/1471-2369-13-108
Levin A, Stevens PE, Bilous RW, et al. Kidney disease: Improving global outcomes (KDIGO) CKD work group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013. Available from: https://doi.org/10.1038/kisup.2012.73.
Milkowski A, Prystacki T, Marcinkowski W, Dryl-Rydzynska T, Zawierucha J, Malyszko JS, et al. Lack or inadequacy of predialysis nephrology care worsens outcomes in dialysis patients – call to action. Renal Failure. 2022;44(1):946-57. Available from: https://doi.org/10.1080/0886022x.2022.2081178
Ghimire A, Ye F, Hemmelgarn B, Zaidi D, Jindal KK, Tonelli MA, et al. Trends in nephrology referral patterns for patients with chronic kidney disease: Retrospective cohort study. PLoS ONE. 2022;17(8): e0272689. Available from: https://doi.org/10.1371/journal.pone.0272689
Acute Renal Failure - Anuria Item 348 - [Manual of Nephrology 10th Edition] Chapter 14 [Internet]. 10th EDITION 2024.
Babitt JL, Berns JS, Bozkurt B, Cheung Khedairy RS, Cuevas Y, Effa EE, et al. KDIGO Anemia Guideline Executive Summary. Kidney International. 2026;109:44-56. Available from: https://doi.org/10.1016/j.kint.2025.06.005
Stevens PE, Ahmed SB, Carrero JJ, Foster B, Francis A, Hall RK, et al. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney International. 2024;105(4S):S117-S314. Available from: https://doi.org/10.1016/j.kint.2023.10.018.
Prescott H, Antonelli M, Alhazzani W, Moller MH, Alshamsi F, Azevedo L, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026. Crit Care Med. 2026 ;54(4):725-812. Available from: https://doi.org/10.1097/ccm.0000000000007075
Konan SD, Diopoh SP, Guei MC, Sanogo S, Aka JA, Ouattara A, Yao KH. Acute Renal Failure and Hemodialysis: Clinical, Biological and Evolutionary Aspects at the Department of Nephrology-Internal Medicine D of the Treichville University Hospital. Health Sci. Dis: 2021;22(10):7-14. Available from: https://doi.org/10.1111/nep.13064
Samaké M, Sy S, Fofana A, Yattara H, Coulibaly S, Diallo D, et al. Epidemiological and clinical profile of patients undergoing primary nephrological consultation at Fousseyni DAOU Hospital in Kayes, Mali. Open Journal of Nephrology. 2022;12(1):142-53. Available from: https://doi.org/10.4236/ojneph.2022.121014
Failal I, Ezzaki S, Mtioui N, Elkhayat S.S, Zamed M, Medkouri G, et al. Acute renal failure: epidemiological, etiology, therapeutic and progressive profile. Nephrol ther. 2020; 16(5):326.
Montgomerie C, Spaak J, Evans M, Jacobson S.H. Acute Kidney Injury: Clinical Characteristics and Short-Term Outcomes in 1,519 Patients. Kidney Dis. 2023;9:39-48. Available from: https://doi.org/10.1159/000527299.
Wu Y, Luo L, Sun X, Ye X, Ren Y, Zhang W, et al. A closer look at severe acute kidney injury: risk factors and treatment outcomes with antibody-1/-L1 from a retrospective study. PairJ. 2025; 13:E19886. Available from: https://doi.org/10.7717/PeerJ.19886.
Yao KH, Tanon AK, Lagou AD, Konan SD, Diopoh SP, Meite F. Comparative study of community-based acute kidney failure in HIV-positive and HIV-negative subjects: experience of an internal medicine department in Abidjan (Ivory Coast). Nephrol ther. 2017. Available from: https://doi.org/10.1016/J.Nephro.2016.10.003.
Guei M.C, Sidibé M, Wognin A, Konan S.D, Choho M.C, Yao KH, et al. Outcome of acute renal failure in subjects with HIV living in Abidjan, Ivory Coast over the period 1st January 2014 to 31st December 2017. PAMJ. 2019;34:2. Available from: https://doi.org/10.11604/pamj.2019.34.2.20016.
Kouame KB. Update of the Ivory Coast. The second all-network dHTS meeting. 2024; Durban.
Faye MO, Ait AI, Lemrabott AT, Faye M, Cisse MM, Fall K, et al. (2018) Clinical and Paraclinical Profile of Patients in First Nephrology Consultation at the Aristide Le Dantec University Hospital Center (ALD-UHC) About 542 Cases. J Nephrol Kidney Dis. 2020;1(1):101. Available from: https://doi.org/10.15744/2767-9225.1.101
Burke MT, Kapojos J, Sammartino C, Gray NA. Kidney Disease Health Literacy among New Patients Referred to a Nephrology Outpatient Clinic. Internal Medicine Journal. 2014;44:1080-6. Available from: https://doi.org/10.1111/imj.12519
Prévot J, Bayat-Makoei S, Vigneau C. Reasons for first consultation in nephrology in health area 5 of Brittany during the year 2014. Nephrol ther 2017;13(2):67-75. Available from: https://doi.org/10.1016/j.nephro.2016.09.003
Haute Autorité de santé (HAS) (2021) Guide to the care pathway. Chronic kidney disease in adults. Available from: https://www.has-sante.fr/upload/docs/application/pdf/202109/guide__mrc.pdf
Favre N, Burnier M, Kissling S. When to call the nephrologist in the emergency room? Rev Med Switzerland. 2016;12:398-403.
Lengani A, Kargougou D, Fogazzi GB, Laville M. Acute kidney injury in Burkina Faso. Nephrol Ther. 2010; 6(1):28-34. Available from: https://doi.org/10.1016/j.nephro.2009.07.013
Aniort J, Heng A, Deteix P, Souweine B, Lautrette A. Epidemiology of acute renal failure. Nephrol Ther. 2019;15:63-9. Available from: https://doi.org/10.1016/j.nephro.2018.11.002
Diawara MS, Kane Y, Cisse MM, Lemrabott AT, Faye M, Bop MC et al. Hemodialysis in Emergency Situations: A Study of 107 Cases at the Hemodialysis Center of the CHR of Thiès (Senegal). Health Sci. Dis. 2020;21(3):48-52. Available from:https://doi.org/10.28933/gjun-2019-12-2205
Ilboudo CS, Doro H, Guibla I, Belem F, Konate S, Semdé A, et al. Prognosis of Emergency Hemodialysis Patients in the Nephrology and Dialysis Department of the Souro Sanou University Hospital Center (Bobo Dioulasso). Health Sci. 2021;6:11-4. Available from: https://doi.org/10.5281/hsd.v22i6.2806
Chijioke A, Makusidi AM, Rafiu MO. Factors influencing hemodialysis and outcome in severe acute renal failure from Ilorin, Nigeria. Saudi J Kidney Dis Transpl 2012;23:391-6. Available from: https://pubmed.ncbi.nlm.nih.gov/22382247/
Mehta RL, Cerda J, Burdmann EA, et al. International Society of Nephrology’s 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet. 2015;385:2616-43. Available from: https://doi.org/10.1016/s0140-6736(15)60126-x
Singh K, Waikar SS, Samal L. Assessing the Feasibility of KDIGO CKD Reference Recommendations. BMC Nephrol. 2017;18(1):223.
Hommel K, Madsen M, Kamper AL. The importance of early referral for the treatment of chronic kidney disease: a Danish nationwide cohort study. BMC Nephrology. 2012;13:1. Available from: https://doi.org/10.1186/s12882-017-0646-y
Smart NA, Dieberg G, Ladhani M, Titus T. Early referral to specialist nephrology services for preventing the progression to end-stage kidney disease. Cochrane Database of Systematic Reviews. 2014; 18(6):CD007333. Available from: https://doi.org/10.1002/14651858.cd007333.pub2