Célébrée chaque année à la date du 13 mars, la journée mondiale du rein a été une occasion pour pour le professeur Younoussa Keïta, néphrologue pédiatrique à l’hôpital Abass Ndao de Dakar et enseignant à l’Université Cheikh Anta Diop, de faire la lumière un fléau souvent ignoré chez les enfants au Sénégal.
Selon l’enseignant chercheur, l’urgence est criante. « Beaucoup pensent que les maladies rénales épargnent les enfants, mais c’est une erreur dramatique », martèle-t-il. Depuis l’ouverture de la consultation de néphrologie pédiatrique en 2017, son service a accueilli environ 1 600 jeunes patients venus de tout le pays, preuve d’une crise silencieuse mais généralisée.
Les origines de ces pathologies sont multiples. Les infections mal soignées, comme les angines ou la gale surinfectée, favorisées par la promiscuité, peuvent dégénérer en insuffisance rénale aiguë. Le paludisme grave est aussi un coupable fréquent. Côté maladies chroniques, les malformations congénitales (20 % des cas) et le syndrome néphrotique idiopathique (40 % des consultations) dominent. Ce dernier, marqué par des œdèmes au visage et aux pieds, exige un traitement long et coûteux, souvent hors de portée des familles.
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Si l’État a multi plié les centres de dialyse pour adultes depuis 2012, les enfants restent les oubliés de cette politique. « En dehors de Dakar, aucun centre de dialyse pédiatrique n’existe », déplore le Pr Keïta. À l’hôpital Abass Ndao, une unique machine, opérationnelle depuis janvier 2024, ploie sous la demande. Avec 200 nouveaux cas annuels recensés dans cet établissement de référence, le chiffre réel est sans doute bien plus élevé, beaucoup d’enfants des régions n’atteignant jamais la capitale faute de moyens ou de structures spécialisées.
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Un vent d’optimisme souffle depuis les premières transplantations rénales au Sénégal, réalisées en novembre 2023 à l’hôpital Aristide Le Dantec et à l’hôpital militaire de Ouakam. Deux enfants sont actuellement en préparation pour cette intervention, mais le chemin reste semé d’embûches. « Ce n’est pas comme prescrire un médicament. Chaque étape doit être irréprochable pour éviter un rejet », insiste Keïta. Pour lui, des solutions s’imposent : créer un centre de dialyse pédiatrique national, former davantage de spécialistes déployables en régions, sensibiliser massivement au dépistage précoce et subventionner les traitements pour soulager les familles démunies. Car sans action rapide, ces enfants risquent de payer le prix fort d’un système encore trop fragile.
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