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INTRODUCTION: Autodialysis is the dialysis performed by the patient himself at a local center instead of a hemodialysis center. In Morocco, the practice of hemodialysis dates back to 1970; however, an autodialysis center does not yet exist. The objective was to assess the potential medical fitness and adherence of the patients to an autodialysis program. METHODS: descriptive and analytical multicenter study conducted in March 2015 involving patients from of eight hemodialysis centers in Casablanca (Morocco). The study was conducted in two steps: 1) a transversal assessment of the medical potential to achieve autodialysis that included 556 patients; 2) a survey of the autodialysis membership that included 383 out of 556 patients who were deemed eligible for autodialysis. RESULTS: the average age was 54.63 , 15.16 years; the average of hemodialysis duration was 85.9 , 78.1 months. Diabetic nephropathy (22.7%) was the predominant cause of kidney disease. The assessment of medical potential to achieve autodialysis highlighted that almost all of the patients were in good condition (93%), independent (81%), and those without major comorbidities were less than 76 years old. Regarding the potential patients' adherence to autodialysis, among the 383 patients previously deemed suited for autodialysis, 293 (76.5%) responded favorably to the proposal of self-dialysis. CONCLUSION: the practice of hemodialysis should be implemented in a short time in Morocco because our patients' profile is perfectly suitable to this therapeutic method especially when they are young, in good general condition, autonomous, without major comorbidities, and willing to learn.

Introduction: Pulmonary arterial hypertension (PAH), defined as a systolic pulmonary artery pressure above 35 mm Hg, is another vascular disease entity recently described in patients receiving hemodialysis. It is a major problem due to its high prevalence and morbidity and mortality. Its pathophysiological mechanism is just known and the strategies for its supported not yet defined. Aims: To determine the prevalence of PAH in our hemodialysis patients and its risk factors. Methodology: Single center descriptive and analytical cross-sectional study, including 111 hemodialysis patients who had benefit from a trans-thoracic cardiac Doppler ultrasound during 2014. A value greater than or equal to 35 mm Hg is considered PAH and classified as follows: mild PAH (35 50 mm Hg), moderate PAH (50 70 mm Hg), and severe pulmonary hypertension (>70 mm Hg). Patients with a high probability of secondary PAH, especially those with the following history: chronic obstructive pulmonary disease, pulmonary embolism, were not included. Results: The mean age was 44.3 ± 14.2 years. Among the 111 patients, 18 had pulmonary arterial pressure above 35 mm Hg corresponding to 16.22% of PAH prevalence. The average pressure was 45 mm Hg. Of these 18 patients, 11.8% had mild PAH, 3.4% moderate PAH and 0.8% severe PAH. The average hemodialysis duration was significantly associated with PAH (p = 0.003); as well as valvular calcification (p = 0.000), mitral regurgitation (p = 0.001) and tricuspid regurgitation (p = 0.002). Conclusion: Primary pulmonary hypertension is a major problem among our hemodialysis because of its high prevalence and its risk factors.

Introduction: Randall disease called “monoclonal immunoglobulin deposition disease (MIDD)” and is defined histologically by the presence of deposits immunoglobulin (Ig) monoclonal, diffuse and continuous linear, non-organized within the tubular basement membranes, and frequently glomerular basement and vascular, often associated with accumulation of extracellular matrix. Only 11 cases of de novo Randall disease post-renal transplantation have been reported in the literature. Case presentation: We report a case of de novo Randall kidney and liver disease associated with myeloma diagnosed in the 20th month post-renal transplant in a woman of 49 years. The treatment had consisted of a decrease of immunosuppression and put on chemotherapy. The evolution was marked by graft loss with return to dialysis. The death occurred in a context of septic shock after the first cure of chemotherapy. Conclusion: A de novo Randall disease post-renal transplantation is not only very rare, but also there is no consensus of it is a management.