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The purpose of this study was to investigate the epidemiological, evolutionary and clinical features of the renal amyloidosis and to identify poor prognostic factors. We conducted a retrospective study focusing on all patients hospitalized for renal amyloidosis between January 2013 and December 2014. The diagnosis was confirmed by renal puncture-biopsy or by biopsy of minor salivary glands. We collected data from 25 patients, 17 men and eight women, with an average age of 47.2 ± 18 years. Hospitalization rate and prevalence were 2.4% and 12.5 cases/year respectively. On admission, nephrotic syndrome was detected in 100% of cases and renal failure in 68% of cases. Proteinuria was ≥6g/24h in 60% of cases. Digestive symptoms (n=14), cardiac symptoms (n=10) and arterial hypotension (n=11) were the other manifestations. Infectious and inflammatory diseases were the main causes found (60%). Tuberculosis alone accounted for 20%. After a mean follow-up period of 219.5 days, chronic renal failure was found in 16 cases (64%), including 11 cases with end-stage disease (44%). Six patients died. Renal insufficiency at the time of diagnosis, the worsening of renal function and readmission were associated with a risk for chronic terminal renal failure (p: 0.03-0.04). Cardiac damage, the readmission and proteinuria ≥6g/24h were factors associated with the risk of mortality (p< 0.03). Renal failure, cardiac damage, proteinuria ≥6g/24h and readmission were the main factors for poor prognosis in this cohort., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (© Gaël Clovis Gassongo Koumou et al.)

Pseudotumoral calcinosis (PTC) is characterized by calcium phosphate crystal deposition in periarticular soft tissues leading to the development of large calcified masses. Although PTC physiopathogeny is not completely clear, the increase in calcium-phosphorus product beyond the threshold value for precipitation as well as severe hyperparathyroidism seem to play a determining role. PTC may even cause recurrent minor joint traumas. In patients on hemodialysis, the frequency of PTC is estimated between 0.5 and 7%, according to case series. Its treatment is controversial. Surgical resection is often recommended. We here report a case of PTC in a patient on haemodialysis. The study involved a 56-year old patient on chronic haemodialysis for 9 years due to indeterminate nephropathy. The patient had suffered from gradual worsening of pain at the level of the right hip associated with difficulties in joint mobilization over the last 6 months. CT scan showed multiple lobed calcified mass, measuring 8.6 x 7.6 x 5.9cm, located very closely to the sciatic nerve, which probably explained the very painful physical symptoms. Laboratory tests showed high phosphocalcic product and hyperparathyroidism. Surgical resection was difficult due to the closeness of the tumor to vasculo-nervous elements. Our study highlights the diagnostic and therapeutic difficulties of PTC. This uncommon disease should be suspected in patients on chronic hemodialysis with periarticular calcified mass suggesting tumor.

Hydatidosis is a parasitic infection caused by the larval stage of Echinococcus granulosus. Renal hydatic cyst is unusual. It may fistulize into the urinary excretory system, requiring specific management. The aim of our study was to highlight the diagnostic and therapeutic specificity of this pathology in patients on chronic hemodialysis among whom diuresis is not always preserved, in order to focus attention on hydaturia and to give an indication to diagnosis. We report the case of a 47-year old patient with a 4-year history of hemodialysis due to glomerular nephropathy detected at the final stage. Moreover, the patient had a 6-month histoiry of impaired general condition associated with right lower back pain, without fever. Abdominal CT scan showed right kidney measuring 13.4cm, with important ureteropyelocaliceal dilation, pushing the renal parenchyma associated with renal pelvis measuring 4.3cm, without detectable lithiasic obstacle. However, it showed membranous cyst at the level of the lower right renal polar parenchyma, measuring approximately 76.5 x 54 mm, contacting the renal pelvis, also containing a few membranes. The patient underwent thorough interview revealing the presence of hydaturia in the few drops of residual diuresis. Given that the patient had end stage chronic renal failure and that he was under renal replacement therapy, therapeutic approach was based on total nephrectomy.