title: Epidemiology of chronic kidney diseases in the Republic of Guinea; future dialysis needs.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is increasing worldwide and can lead to end-stage renal disease (ESRD).
  
  
  OBJECTIVE
  Because few patients with ESRD in the Republic of Guinea have access to haemodialysis, we retrospectively evaluated the prevalence of CKD, ESRD and access to supportive therapies.
  
  
  METHODS
  579 CKD patients (304 males; mean age: 44 ± 16 years) were admitted into Conakry nephrology department, the only centre in the Republic of Guinea, between 2009 and 2013. Most patients (63%) resided within Conakry (the capital), 12.5% came from lower Guinea, 11.7% from middle Guinea, 7.9% from upper Guinea and 4.8% from forest Guinea.
  
  
  RESULTS
  Reasons for referral were increased serum creatinine (49.5%), hypertension (27%) and diffuse edema (17%). Also, 11% were diabetic, 12.5% were smokers, 17% were HIV-positive, 8.3% were HBV-positive and 15% were HCV-positive. The most frequent symptom at admission was nausea/vomiting (56%). Upon admission, 70.5% of patients already had ESRD. Although no kidney biopsies were performed it was assumed that 34% and 27% of patients had vascular nephropathy and chronic glomerulonephritis, respectively. Of the 385 ESRD patients, only 140 (36.3%) had access to haemodialysis (two sessions/week, 4 hours each). Most patients that received haemodialysis resided within the Conakry region (P < 0.0001). There were significant associations between mortality and (i) terminal stage of CKD (P = 0.0005), (ii) vascular nephropathy (P = 0.002), and (iii) nephropathies of unknown origin (P = 0.0001).
  
  
  CONCLUSIONS
  A fourfold increase in haemodialysis machines is needed in Conakry, plus four new nephrology/haemodialysis centres within the Republic of Guinea, each holding ≥30 haemodialysis machines.
authors.affiliation: Nephrology Unit, Donka National Hospital, Conakry, Republic of Guinea.
authors.forename: Alpha Oumar
authors.initials: AO
authors.lastname: Bah
authors.affiliation: Nephrology Unit, Donka National Hospital, Conakry, Republic of Guinea.
authors.forename: Cisse
authors.initials: C
authors.lastname: Lamine
authors.affiliation: Nephrology Unit, Donka National Hospital, Conakry, Republic of Guinea.
authors.forename: Mamadou Cellou
authors.initials: MC
authors.lastname: Balde
authors.affiliation: Nephrology Unit, Donka National Hospital, Conakry, Republic of Guinea.
authors.forename: Mamadou Lamine Yaya
authors.initials: ML
authors.lastname: Bah
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, TSA 50032, Université Paul Sabatier, Toulouse, France ; INSERM U563, IFR-BMT, CHU Purpan, Toulouse, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Rostaing
keywords: Chronic kidney diseases; End-stage renal disease; Hemodialysis