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Néphrologie & Thérapeutique

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https://www.readbyqxmd.com/read/29150416/-bicarbonate-from-physiology-to-treatment-for-all-clinicians
#1
Julie Beaume, Antoine Braconnier, Thibault Dolley-Hitze, Jean-Philippe Bertocchio
Acid-base regulation is essential to maintain homeostasis in humans. Carbonic acid/bicarbonate (H2CO3/HCO3(-)) couple is the most predominant extracellular buffer to keep plasma pH within a physiological range. The ability to (re)generate such a buffer is a key milestone that necessitates to understand a precise physiology of both renal tubule and digestive tract. Here, we first reviewed renal and digestive cycles of bicarbonate in physiology. We also reviewed pathological findings where acid-base disequilibrium is involved and nutritional and/or alkali therapy could be necessary...
November 14, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29150415/-initiating-hemodialysis-in-morocco-impact-of-late-referral
#2
Abdelaali Bahadi, Mohammed Reda El Farouki, Yassir Zajjari, Driss El Kabbaj
INTRODUCTION: End-stage renal disease (ESRD) is a major public health concern in Morocco with an incidence in constant progression according to MAGREDIAL "Morocco Dialysis Registry". Patients are often sent late to nephrologists, which is a source of complications recognized in several countries. For these reasons, we tried to evaluate, in our context, the prevalence and factors of this late referral (LR). METHODS: This is a retrospective study which included all patients initiating hemodialysis between January 2007 and December 2015...
November 14, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29146282/-measurement-and-estimation-of-glomerular-filtration-rate
#3
Emmanuelle Vidal-Petiot, Martin Flamant
Glomerular filtration rate is the best quantitative marker of renal function. It allows diagnosis and classification of severe chronic kidney disease into five stages. Theoretically, the measurement of glomerular filtration rate is based on the calculation of urinary clearance of exogenous substances such as chromium 51-labeled inulin or ethylenediaminetetraacetic acid ([(51)Cr]-EDTA). In practice, glomerular filtration rate is most often estimated from equations derived from plasma creatinine. This article reviews the range of methods used to measure or approximate glomerular filtration rate and attempts to describe recent developments in this area, including those related to plasma creatinine assay methods, creatinine and cystatin C concentration-derived estimations...
November 13, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29133077/-chronic-kidney-failure-and-biotin-a-combination-inducing-unusual-results-in-thyroid-and-parathyroid-investigations-report-of-2-cases
#4
Miora Koloina Ranaivosoa, Sébastien Ganel, Arnaud Agin, Sarah Romain, Xavier Parent, Nathalie Reix
In clinical chemistry, many immunoassays apply biotin and streptavidin in the assay principle. Presence of high levels of biotin in patient samples can produce negative or positive interference depending on the assay format. In this study, we describe 2 clinical cases with chronic kidney failure and with unusual thyroid and parathyroid function test results due to biotin interference. We studied the impact of biotin levels on thyroid stimulating hormone (TSH), free thyroxine (T4L) and parathormone (PTH) results with a pool of sera loaded with several concentrations of biotin...
November 10, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29133076/comparison-of-the-hemodynamic-tolerance-and-the-biological-parameters-of-four-acetate-free-hemodialysis-methods
#5
George Kosmadakis, Enrique Da Costa Correia, Julie Albaret, Frédéric Somda, Didier Aguilera
PURPOSE: Acetate in hemodialysis solutions exerts inflammatory, vasodilatatory and cardio-depressive effects. Citrate has been proposed as an optimal substitute. The aim of the present trial was the comparison of the hemodynamic and biological parameters on a group of patients dialysed consecutively with 4 acetate-free haemodialysis techniques. METHODS: In a prospective crossover manner, we measured the hemodynamic and biological effects of four acetate-free hemodialysis methods: he acetate-free biofiltration with variable potassium (AFBK) and three methods with a citrate buffer: onventional hemodialysis (HD), on-line hemodiafiltration (HDF) and on-line hemofiltration (HF)...
November 10, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29126841/-exercise-as-a-protective-cardiovascular-and-metabolic-factor-in-end-stage-renal-disease-patients
#6
Myriam Isnard-Rouchon, Céline Coutard
OBJECTIVE: The aim of the study was to test the effectiveness of Physical Activity (PA) during haemodialysis as a protective treatment against cardiovascular (CV) diseases. METHODS: Eighty volunteer patients were included in this multicentric prospective study and followed for two years: 40 patients in the Exercise group (EX), 40 patients in the Control group (Ctrl). CV risk factors: Total Cholesterol, HDL Cholesterol (HDL-c), LDL cholesterol (LDL-c), Triglycerides (TG) and Hemoglobin (Hb), and Prealbumin, Albumin, Parathormon, 25-OH Vitamin D, were checked at Month 0 (M0) and Month 24 (M24)...
November 7, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29113907/assessing-the-prevalence-of-protein-energy-wasting-in-haemodialysis-patients-a-cross-sectional-monocentric-study
#7
Rajaa Essadik, Rajaa Msaad, Halima Lebrazi, Hassan Taki, El Hassane Tahri, Anass Kettani, Ghizlane Madkouri, Benyounes Ramdani, Rachid Saïle
INTRODUCTION: Protein-energy wasting (PEW) is a strong predictive factor for morbidity and mortality in haemodialysis (HD) patients. However, there is no consensus for its assessment. The present study aimed to assess the nutritional status of patients on chronic HD by use of different nutritional assessment parameters, and at verifying which can identify the greatest number of HD patients with PEW. Also, to investigate predictors of nutritional status in a haemodialysis center in Morocco...
November 4, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29100716/acute-renal-cortical-necrosis-in-pregnancy-clinical-course-and-changing-prognosis
#8
Soumaya Beji, Meriam Hajji, Lamia Rais, Rania Kheder, Hela Jebali, Wided Smaoui, Madiha Krid, F Ben Hamida, Lilia Ben Fatma, Mohammed Karim Zouaghi
Obstetric cortical renal necrosis is a serious complication that can lead to chronic renal failure and the need for chronic dialysis. The aim of renal cortical necrosis therapy is to restore hemodynamic stability, institute early dialytic therapy, and treat the underlying cause of the disease. Most cases of renal cortical necrosis do not recover a normal renal function despite intensive care. We describe the course of a patient who was diagnosed with acute renal cortical necrosis in pregnancy treated with hemodialysis for three years but then she recovered her renal function...
October 31, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29031490/-survey-on-the-perception-of-competencies-acquired-during-nephrology-resident-training-in-france
#9
Olivier Moranne, Marie-Noëlle Peraldi, Gabriel Choukroun, Philippe Brunet, Éric Rondeau, Bruno Moulin
Due to a national theoretical training provided to all resident for many years and the ongoing discussions to change the organization of the resident training of specialized study diploma (SSD) of nephrology, a survey was done to assess the perception of skills acquired in the management of different clinical situations in terms of knowledge, expertise and attitudes. The expected results are intended to identify new training procedures for future nephrologists in France. The study was performed in 112 resident from 3rd and 4th year of nephrology resident training attending an educational seminar of the University College of Nephrology Teachers in May 2014...
October 11, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29031489/-pediatric%C3%A2-nephrology-what%C3%A2-should-an%C3%A2-adult%C3%A2-nephrologist-know-about%C3%A2-these%C3%A2-diseases
#10
Sandrine Lemoine, Pierre Cochat, Aurélia Bertholet-Thomas, Charlène Levi, Catherine Bonnefoy, Anne-Laure Sellier-Leclerc, Justine Bacchetta
In nephrology, some diseases begin specifically during childhood; however, they must be known by adult nephrologists so that to ensure continuity and homogeneity for their management. The aim of this review is therefore to propose a brief overview of the main pediatric diseases, for which a specific knowledge is warranted, and notably pediatric idiopathic nephrotic syndrome, cystinosis, primary hyperoxaluria and hereditaries tubulopathies.
October 11, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28958905/-uro-and-nephrotoxic-effects-of-drugs-of-abuse-literature-review-and-pharmaco-epidemiological-survey-in-france-and-in-the-marseille-area
#11
Marion Gully, Élisabeth Frauger, Michel Spadari, Liselotte Pochard, Vanessa Pauly, Fanny Romain, Bertrand Gondouin, Marion Sallée, Julie Moussi-Frances, Stéphane Burtey, Bertrand Dussol, Laurent Daniel, Joëlle Micallef, Noémie Jourde-Chiche
A great diversification of drugs of abuse has been observed in recent years, both in the populations using them and in the types of drugs. Although dependency and psychiatric disorders associated with the abuse of these substances is well known, somatic complications, uro-nephrotoxicity in particular, are less recognized. We propose here an overview of the products used by drugs abusers in France, through the analysis of the national pharmaco-epidemiological study Observation des produits psychotropes illicites ou détournés de leur utilisation médicamenteuse (OPPIDUM)...
September 25, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28958670/limited-sampling-strategy-for-the-estimation-of-mycophenolic-acid-area-under-the-curve-in-tunisian-renal-transplant-patients
#12
Emna Gaies, Mouna Ben Sassi, Hanene El Jebari, Nadia Jebabli, Rim Charfi, Ichraf Chokri, Issam Salouage, Anis Klouz, Sameh Trabelsi
Mycophenolate mofetil is a prodrug widely used in renal transplantation to prevent organ rejection. It is hydrolyzed to its active compound mycophenolic acid (MPA). MPA area under the curve (AUC0-12h) is considered the best pharmacokinetic parameter for the estimation of MPA exposition and for prediction of rejection. MPA-AUC requires several blood samples, making it impractical for clinical practice. Therefore, development of a limited sampling strategy (LSS) to estimate MPA AUC0-12h using three blood samples is very helpful for MPA individual dose adjustment...
September 22, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28958669/-infections-on-catheters-in-hemodialysis-temporal-fluctuations-of-the-infectious-risk
#13
S Izoard, L Ayzac, J Meynier, J-C Seghezzi, B Jolibois, M L Tolani
BACKGROUND: International guidelines recommend to limit the long-term use of central-veinous catheters in patients undergoing hemodialysis, because they expose the patient to a higher infectious risk than the fistulas. However, for some patients with comorbidity, switching to a permanent vascular access is not possible. In such case, the catheter is used for a longer period. It seems therefore important to study the influence of a prolonged duration of catheterization on infectious complications...
September 22, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29031488/-outcome-of-living-kidney-donors-for-transplantation
#14
Antoine Lanot, Nicolas Bouvier, Valérie Chatelet, Angélique Lecouf, Xavier Tillou, Bruno Hurault de Ligny
Nowadays, several treatments exist to treat terminal chronic renal failure. Best results for the recipients are obtained with kidney transplantation concerning mortality and quality of life. Transplantation is also the cheaper option for society. Living kidney donation raises the issue of the becoming of the donor, an absolutely healthy subject who gets to a surgical procedure. The becoming of living kidney donors has been compared with the one of controls subjects in several studies. The evaluations focused on the complications of nephrectomy in the short and long-term: kidney failure, hypertension, proteinuria, possibility of pregnancy, quality of life, and mortality...
November 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28843391/-management-of-bone-and-mineral-metabolism-disorders-before-the-dialysis-stage-remains-still-perfectible-data-from-the-french-phosphorus-and-calcium-survey-photo-graphe
#15
Guillaume Jean, Éric Daugas, Hubert Roth, Tilman Drueke, Jean-Louis Bouchet, Thierry Hannedouche, Gérard London, Denis Fouque
Only limited data is available on the management of the chronic kidney disease-associated bone and mineral metabolism disorder (CKD-MBD) in the pre-dialysis stages of CKD in France. A better knowledge of current management habits could lead to an improvement in the implementation of international recommendations (KDIGO). The 3rd version of the French Phosphorus and Calcium Survey Photo-Graphe (Sanofi) included a cohort of CKD stages 4 and 5 patients, whose aim was to examine the prevalence of CKD-MBD and the quality of its management in patients under the care of 62 nephrologists from over 20 geographical regions in France...
August 23, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28774729/-thrombotic-microangiopathy-and-cancer
#16
Rania Kheder El-Fekih, Clément Deltombe, Hassan Izzedine
Thrombotic microangiopathy (TMA) is a group of disorders characterized by mechanical hemolytic anemia with thrombocytopenia and an ischemic organic lesion of variable and potentially fatal importance affecting mostly the kidneys and the brain with histologically a disseminated and occlusive microvasculopathy. The incidence of TMA represents 15% of acute kidney failure in oncological setting, largely due to the introduction of anti-angiogenic agents over the past decade. It may be more rarely related to cancer itself...
July 31, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28760516/-rare-complication-of-renal-transplantation-emphysematous-pyelonephritis
#17
Ahmed Saadi, Haroun Ayed, Omar Karray, Walid Kerkeni, Abderrazak Bouzouita, Mohamed Cherif, Riadh Ben Slama, Amine Derouiche, Mohamed Chebil
Emphysematous pyelonephritis is a necrotizing infection of the renal parenchyma and peri-renal tissues, characterized by the presence of air within the parenchyma of the urinary tract and peri-renal space. This is a severe complication, which involves the functional prognosis of the kidney and the patient's prognosis. The emphysematous pyelonephritis is a rare complication of renal transplantation. Its gravity is linked particularly to the fragility of immunosuppressed patients. The authors report the case of an emphysematous pyelonephritis having occurred 9 months after transplantation in a patient 58 years...
July 28, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28606408/-common-therapeutic-approaches-of-sarcopenia-in-the-elderly-and-uremic-myopathy
#18
Philippe Chauveau, Karine Moreau, Catherine Lasseur, Christian Combe, Michel Aparicio
The gradual loss of weight and function of muscle in patients with chronic kidney disease as in the elderly impacts the quality of life. Early management should help slow the functional limitation. Physical activity is the first therapy to propose that ensures stability of muscle mass and improved function. Resistance training programs have proven effective but are not yet widely available in nephrology units. The nutritional management should not be forgotten because there is a resistance to anabolism and protein intake should be involved in physical activity program...
June 9, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28606407/munchausen%C3%A2-syndrome-by%C3%A2-proxy-and%C3%A2-pediatric%C3%A2-nephrology
#19
Cristina Bertulli, Pierre Cochat
Munchausen syndrome by proxy is a persistent fabrication of illness done by a person to another. Renal and urologic forms of this syndrome are not as uncommon as can be thought; a review of all the cases of Munchausen-by-proxy syndrome reveals that 25% of the children had renal or urologic issues. This syndrome can result in a serious diagnostic dilemma for the physicians; knowing this entity can allow early recognition of falsification and limit the physical and psychological damages caused in the victim. In this study, we reviewed the pediatric nephrology cases of Munchausen syndrome by proxy, grouping them through the principal signs of presentation...
June 9, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28606406/-quality-of-life-in-patients-with-autosomal-dominant-polycystic-kidney-disease
#20
Laurent Lecardeur, Dominique Joly
Autosomal dominant polycystic kidney disease (ADPKD) is an inherited disease that usually occurs in adulthood. The majority of affected patients will develop renal complications related to cysts during their life, but may sometimes also develop severe extrarenal complications. The aim of this study is to review quantitative and qualitative results of researches that have investigated quality of life of patients suffering ADPKD. The results obtained with health-relative quality of life scales are contradictory and lack of sensibility according to the special features of ADPKD, for psychological impact for instance...
June 9, 2017: Néphrologie & Thérapeutique
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