[Etiologies of chronic renal insufficiency in a adult internal medicine service in Dakar].

Chronic renal failure (CRF) sets public health problems both as its prevalence and its morbidity. The treatment is costly, that's why developing countries must engage in preventive strategies. In this view, a retrospective study was led in Le Dantec Hospital from January 1st, 1998 to December 31st 1993. As a preliminary to a countrywide survey, it is necessary to find out the causes of CRF clarify the causes of CRF in a hospital setting and sketch out a preventive strategy. The patients included in this study were those with CRF. The diagnosis of CRF were based on medical history data, anemia, but mainly biological and ultrasound imaging: creatininima more than 18 mg/l, and/or creatinine clearance less than 80 ml/mn, whose diagnosis was little sized kidney. Of the 5276 in patients, 384 had CRF representing 7% of sample. Only 261 cases were retained broken down into 119 females and 142 males (sex-ratio: 1.19). Age span ranges from 15 to 88 years with a mean of 44 years. Etiologies were dominated by unknown causes, 89 cases (34.23%). Nephroangiosclerosis was the most common known cause, 65 cases (25%) followed by diabetes nephropathy with 54 cases (20.69%) and chronic glomerulonephretic representing 41 cases (15.76%). Other causes were identified in various proportions: cortical necrosis (4 casesà, hereditary nephropathies (2 cases), interstitial nephropathy (1 case), nephroponophteois, kidney polykystosis, prostate adenoma and bilharziosis were all found in one case each. This study pointed out to a need for a nation-wide survey to define the aetiologies of CRF. The study also showed that an early diagnosis and adequate treatment of high blood pressure, diabetes and GNC should certainly constitute the principal axes of investigation for prevention.