Rheumatological Manifestations in Chronic Hemodialysis Patients at the National Hospital of Zinder

Abstract

Introduction: Hemodialysis can be used restoratively for patients with end-stage chronic renal failure [1, 2]. However, patients with chronic kidney disease (CKD) can develop rheumatological complications that cannot be or only poorly controlled by hemodialysis. Indeed, rheumatological manifestations that develop in hemodialysis patients can be multiple and varied, and can occur early and then worsen depending on the duration of dialysis therapy [3,4]. Other complications, some not yet fully elucidated, can also adversely affect quality of life. Rheumatological abnormalities can result in clinical polymorphisms within bones and joints, but also entheses, muscles and tendons. Pathophysiologically, these manifestations can be associated with various abnormalities: e.g., calcium-phosphate metabolism disorders, immunological disturbances with increased susceptibility to infections, induced auto-inflammatory pathologies, microcrystalline arthritis, β2 microglobulin amyloidosis, etc…Despite scientific progress, there is a paucity of detailed knowledge on the many mechanisms involved and, in particular, on their multiple interactions. Overall, these conditions can lead to a significant deterioration in quality of life, and increased morbidity and mortality. Worldwide, rheumatological manifestations are found in hemodialysis patients with a frequency of between 47 and 72% in the West and in North Afric[5,6,7]. Although they have been the subject of several studies, few data are available from sub-Saharan Africa. Thus, we conducted a study in the Nephrology Department of the National Hospital of Zinder (Niger) to determine the epidemiological profiles and diagnostic characteristics of end-stage kidney disease (ESKD) patients receiving hemodialysis.