APPORT DE LHEMODIALYSE DANS LINSUFFISANCE RENALE AIGUE OBSTRUCTIVE : BENEFICES ET RISQUES

Obstructive acute renal failureis a life-threatening medical and surgical emergency, sometimes requiring emergency hemodialysis.The objective of our work is to describe the profile of emergency dialysis patients forobstructive acute renal failure, to determine the main indications of hemodialysis, and to identify the prognostic factors of mortality.

Material and methods:This is a prospective and descriptive study including patients who presented an obstructive acute renal failurerequiring urgent hemodialysis before a possible removal of the obstacle.

Results:Over 2 years, we collected 106 patients with a sex ratio of 1.4 and a mean age of 59.4 ± 14.5 years. Thehemodialysis indication is retained in the event of hyperkalemia (83%), and/or severe acidosis (38.7%), and/or poorly tolerated anemia (33%), and/or clinical uremic syndrome (13.2%), and/or an acute pulmonary edema (3.8%). Regarding the etiological diagnosis ofobstructive acute renal failure, the obstacle is of neoplastic origin in 73%.Complications related to dialysis are dominated by hemodynamic instability in per-dialysis in 22% of cases, as well as those related to catheter in 20% of cases.

Kidney function normalized in 30% of cases, while 70% progressed to CKD.We recorded 13 deaths and hemodynamic instability in per-dialysis is an independent factor of mortality.

Conclusion:The need for emergency dialysis is fraught with significant morbidity and mortality, particularly complications linked to KT of hemodialysis.