Pronostic des Hémodialysés en Urgence dans le Service de Néphrologie et de Dialyse du Centre Hospitalier Universitaire Souro Sanou (Bobo Dioulasso)

RESUMEIntroduction. La survenue d’une insuffisance renale, a fortiori la necessite d’epuration extrarenale serait un facteur de mauvais pronostic. L’objectif ce travail etait d’etudier l’hemodialyse en urgence dans le service de nephrologie du CHUSS. Methodologie. Il s’est agi d’une etude transversale a visee descriptive avec collecte retrospective sur une periode de 18 mois allant de mars 2018 a octobre 2019. Ont ete inclus tous les patients, sans antecedent de suppleance renale, ayant beneficie de seances d’hemodialyse en urgence dans le service de nephrologie du CHUSS. Resultats. Le taux de prevalence de l’hemodialyse d’urgence etait de 40%. 65 patients ont ete inclus. L’âge moyen des patients etait de 37.12 ans et le sex-ratio de 1.24. Les patients provenaient des urgences medicales dans 53.85% des cas. On retrouvait 46.15% d’hypertendus,  4.62% de diabetiques et  15.38% de nephropathies. Les principales indications etaient l’uremie mal toleree (30.78%) suivie de l’œdeme aigu du poumon  (24.62%) et de l’hyperkaliemie (20.00%). Le delai moyen de mise en dialyse etait de quatre jours. Le nombre moyen de seance d’hemodialyse supplementaires etait de 2.35. On a note que 40% des patients avaient evolue vers la recuperation fonctionnelle renale, 20% vers l’insuffisance renale chronique et 40% vers le deces. Les facteurs associes au deces etaient le terrain diabetique (P=0.03) et l’alteration de l’etat de conscience (P=0.02). Conclusion. L’hemodialyse en urgence merite un regain d’interets du fait des resultats satisfaisants constates sur la recuperation fonctionnelle renale. ABSTRACTIntroduction. The occurrence of renal failure, and a fortiori the need for extrarenal purification, would be a factor of poor prognosis. The objective of this work was to study emergency hemodialysis in the nephrology department of the CHUSS. Methodology. This was a descriptive cross-sectional study with retrospective collection over a period of 18 months from March 2018 to October 2019. All the patients, without a history of renal replacement, who benefited from urgently hemodialysis sessions in the nephrology department of the CHUSS were included. Results. The prevalence rate for emergency hemodialysis was 40%. 65 patients were included. The mean age of the patients was 37.12 years and the sex ratio was 1.24. The patients were from medical emergencies in 53.85% of cases. We found 46.15% hypertensive, 4.62% diabetic and 15.38% nephropathy. The main indications were poorly tolerated uremia (30.78%) followed by acute pulmonary edema (24.62%) and hyperkalemia (20.00%). The average time to dialysis was four days. The average number of additional hemodialysis sessions was 2.35. It was noted that 40% of patients progressed to renal functional recovery, 20% to chronic renal failure and 40% to death. Factors associated with death were diabetic background (P = 0.03) and altered state of consciousness (P = 0.02). Conclusion. Emergency hemodialysis deserves renewed interest because of the satisfactory results observed on renal functional recovery.