Emergency Hemodialysis at the Sylvanus Olympio University Hospital Center in Lomé

Abstract

In our context in Togo, the diagnosis of renal failure seems late. Patents were most often hemodialyzed in a clinical situation of vital distress due to threatening hyperhydration, hyperkalemia, acidosis, pericarditis or confusion of uremic origin. This is why we initiated this study: to update data on emergency hemodialysis situations. Method: This was a cross-sectional and descriptive study with retrospective collection of data over a period of 24 months from January 1, 2022 to December 31, 2023 in medical intensive care units, multipurpose intensive care units and in the medical emergency unit of the CHU-SO. Results: The frequency of performing emergency hemodialysis is estimated at 55.24%. The most common reasons for admission were repeated nausea and vomiting at 21.55% and asthenia at 19.82% ( F igure 2 ). The main signs observed on admission were dyspnea, edematous-ascitic syndrome in 13.73%, and anuria in 11.76%. Renal failure was chronic in 68.97% of patients and acute in 31.03% of cases. The main indication for emergency hemodialysis was poorly tolerated uremia (48.45%); uremic encephalopathy (15.55%); acute lung edema (APO) in 13.58%; threatening hyperkalemia (13.42%) and anuria of 24 hours or more (9%). Emergency hemodialysis was carried out within the first six hours in 7.75% of patients after its indication. The clinical evolution of patients after emergency hemodialysis was favorable in 69.83% and unfavorable in 30.17%. Conclusion: It would be interesting to conduct a prospective study on the socio-economic factors linked to the performance of hemodialysis in order to improve access to hemodialysis in the various hospital centers in Togo.