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Abstract

RÉSUMÉ
INTRODUCTION. Les études sur l’insuffisance rénale aigue (IRA) au cours de l’acidocétose diabétique (ACD) sont rares. Notre but était de décrire le profil épidémiologique, évolutif ainsi que la prise en charge de l’IRA-ACD en milieu de réanimation.
MÉTHODOLOGIE. Il s’agit d’une étude rétrospective menée sur une série de patients hospitalisés de Janvier à Juillet 2012 dans le service de réanimation médicale du CHU Ibn Rochd de Casablanca pour acidocétose diabétique. L’IRA a été définie en utilisant les critères de classification RIFLE (Risk Injury Failure Loss End stage).
RÉSULTATS. La prévalence de l’IRA à l’admission chez les 25 patients hospitalisés pour acidocétose diabétique était de 44%, soit 11 patients. L’âge moyen était de 45 ans (écart type : 16,6) et il y avait 7 femmes (64%). 7 patients (64%) étaient diabétiques connus et 5 (45%) étaient hypertendus connus. Selon le degré d’atteinte de la fonction rénale, 5(45%) étaient classés au stade «R» (baisse du DFG entre 25 et 50%), 4 (36,4%) étaient classés au stade «I» (baisse du DFG comprise entre 50 et 75%), et 2 (18,2%) étaient au stade «F» (baisse du DFG supérieure à 75%). les tableau cliniques les plus fréquents étaient le syndrome infectieux, l’hypertension artérielle, la dyspnée et la déshydratation. La glycémie moyenne était de 26,1±8,9 mmol/l, la glycosurie moyenne de 2,9± 0,7 croix, la cétonurie moyenne de 2,3±0,8 croix. Un seul patient a bénéficié d’une épuration extrarénale pour hyperkaliémie. La durée moyenne d’hospitalisation était de 6±4,5 jours. L’évolution a été favorable pour 9 cas (82%°. Aucun décès n’avait été noté.
CONCLUSION. L’IRA est fréquente au cours de l’ACD. Il faut mener des études complémentaires e en vue de la mise en oeuvre de stratégies préventives.

ABSTRACT
INTRODUCTION. The aim of our study was to describe epidemiology, evolution and take care of the Acute Renal Failure (ARF) during diabetic ketoacidosis in intensive care.
METHODOLOGY. This was a retrospective study on 6 months (January to July 2012) conduced in the medical intensive care unit of the University Hospital Ibn Rochd of Casablanca. Were included patients admitted for diabetic ketoacidosis. The ARF was defined using RIFLE criteria (Risk Injury Loss Failure End stage).
RESULTS. Of 25 patients hospitalized for diabetic ketoacidosis, 11 or 44% had ARF. Of these 45.4% were classified stage "R" (risk), 36.4% stage "I"(injury), and 18.2% stage "F"(failure). The mean age was 45 ± 16.6 years. Personal history of diabetes was found in 63.6 %. The main clinical findings on admission were: infectious syndrome 45.4%, hypertension, dyspnea and dehydration. The average blood glucose was 26.1 ± 8.9 mmol / l; glycosuria 2.9 ± 0.7 cross, ketonuria 2.3 ± 0.8 cross. One patient needed hemodialysis for hyperkalemia. The average hospital stay was 6 ± 4.5 days. The outcome was favorable in 82 % of cases... No deaths was recorded
CONCLUSION. ARF during diabetic ketoacidosis seems common. It is important to conduct additional prospective studies to better identify this disease entity for the implementation of preventive strategies.

Article Details

How to Cite
Noto-kadou-kaza, B., Sabi, K., Amekoudi, E., Imangue Okouango, G., Bikinga Wendkuuni, A., Mahamat, A., Badibanga Tsikpamba, J., Tsevi, C., Benghanem, M., & Ramdani, B. (2015). Insuffisance Rénale Aigue au Cours de l’Acidocétose Diabétique en Milieu de Réanimation. HEALTH SCIENCES AND DISEASE, 16(3). https://doi.org/10.5281/hsd.v16i3.558

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