Chronic Kidney Failure in the Elderly at the Nephrology Department of the Amirou Boubacar Diallo National Hospital in Niamey

Abstract

Introduction: Chronic Kidney Disease (CKD) is defined as the progressive and irreversible decrease in Glomerular Filtration Rate (GFR). It is a progressive stage of Chronic Kidney Disease (CKD). It affects individuals of all ages, with particularities in elderly subjects in whom its occurrence is influenced by many related factors, such as kidney aging. The objective of this study is to evaluate the profile of chronic kidney disease in elderly subjects in the Nephrology Department of the Amirou Boubacar Diallo National Hospital (HNABD) in Niamey (Niger). Methods: This was a cross-sectional, descriptive, and analytical retrospective study of 115 cases collected over an 18-month period from 01/01/2023 to 30/06/2024 at the HNABD in Niamey (Niger). All patients aged 65 years and over who consulted and/or were hospitalized in the nephrology department and diagnosed with chronic kidney failure were included. The Simplified MDRD Method is used to calculate the Glomerular Filtration Rate (GFR). Results : the frequency was 4.07%. The age group from 65 to 74 years old was the most affected, with 67.62%. The mean age of patients was 72.15 years, with extremes of 65 and 100 years. The male sex was the most affected, with 78.26% of cases and a sex ratio of 3.6. The mean length of hospital stay was 9.96 days, with extremes of one and 30 days. Patients with a low socio-economic level were the most affected in 64.34% of cases. High blood pressure was the predominant medical history in 45.21%. The mean GFR was 9.89 ml/min, with extremes of 2.13 and 57.34 ml/min. 3.48% of patients were in stage 3 CKD, 6.96% were in stage 4, and 89.56% were in stage 5. Obstructive nephropathy was the predominant etiology in 37.39% of cases. Therapeutically, the most commonly used treatments were antihypertensives, vitamin D, iron, calcium, and hemodialysis. The evolution of the patients in the study was marked as follows: 46.09% of the patients continued hemodialysis, 27.82% were on iron, calcium, and vitamin D alone, and 26.09% had died. We found an association between GFR degradation and advanced age (P-value = 0.0213); between GFR and male sex (P-value = 0.0032); and between CKD and diabetes (P-value < 0.05).