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Néphrologie & Thérapeutique

Vaida Petrauskiene, Ruta Vaiciuniene, Inga Arune Bumblyte, Vytautas Kuzminskis, Edita Ziginskiene, Saulius Grazulis, Egle Jonaitiene
BACKGROUND: Vascular calcification (VC) is one of the factors associated with cardiovascular mortality in hemodialysis (HD) patients. Recommendations concerning screening for VC differ. Possible ability to prevent and reversibility of VC are major subjects on debate whether screening for VC could improve outcomes of renal patients. The objective of the study was to evaluate the significance of simple vascular calcification score (SVCS) based on plane radiographic films and to test its association with non-fatal cardiovascular events in patients on chronic HD...
October 21, 2016: Néphrologie & Thérapeutique
Matthieu Parmier, Bénédicte Gourieux, Thierry Krummel, Dorothée Bazin-Kara, Anne Dory, Thierry Hannedouche
The treatment of end-stage renal disease requires a significant number of drug treatments. At patient level, daily management is somewhat difficult: Number of prescribed pills, medication side effects, treatment of asymptomatic diseases… The objective of the study was to investigate the effect of guidance tailored to each patient receiving hemodialysis, performed by the pharmacist (educational interventions). Adult haemodialysis patients with hyperphosphatemia despite phosphate binders were eligible for study entry...
October 21, 2016: Néphrologie & Thérapeutique
Salvatore Citarda, Roula Galland, Jean-Michel Poux, Abdallah Guerraoui, Patrick Hallonet, Marie Lino-Daniel, Pascale Thivend, Agnès Caillette-Beaudoin
Early information about the kidney transplant is recommended to begin quickly the process of registration on the kidney transplantation waiting list, even for the patients not dialyzed at stage V of the renal insufficiency. It is a strategic choice for the patient care. From the arrival of all the patients in our center of dialysis, a systematic evaluation of the access to the kidney transplant waiting list is organized thanks to a clinical pathway. The impact of this new organization was estimated at 18 months with regard to the information about the kidney transplant transmitted to the patient, of the time required for the assessment of pre-kidney transplant evaluation, and of putting in contraindication...
October 19, 2016: Néphrologie & Thérapeutique
Céline Pasian, Raymond Azar, Denis Fouque
Protein energy wasting (PEW) is an independent factor associated with morbi-mortality in chronic kidney disease. Wasting is particularly common in chronic diseases of organs such as kidney disease with a major impact at the stage of dialysis. It covers 20 to 70% of patients diagnosed with chronic kidney disease according to the degree of evolution of the disease and the diagnostic method used patients. Mechanisms of PEW are based mainly on anorexia and metabolic abnormalities caused by kidney disease. Nutritional treatment differs depending on the stage of the kidney disease acute or chronic treated whether or not by dialysis...
October 17, 2016: Néphrologie & Thérapeutique
Perrine Jullien, Christophe Mariat, Nicolas Maillard
No abstract text is available yet for this article.
October 17, 2016: Néphrologie & Thérapeutique
Thomas Kerforne, Frédéric Favreau, Raphaël Thuillier, Thierry Hauet, Michel Pinsard
The increased number of patients in waiting list for renal transplantation requires the establishment of recommendations regarding graft preservation techniques. The preservation method impacts graft function and survival particularly in case of extended criteria donors. Based on our experience, the aim of this review is to establish a decisional diagram to draw graft management to 5years in relation to donor type and graft quality. Novel biomarkers are necessary to evaluate graft quality. Nuclear magnetic resonance or transcriptomic analyses are promising...
October 3, 2016: Néphrologie & Thérapeutique
Clotilde Muller, Dorothée Bazin Kara, Marion Fourtage, Julien Ott, Thierry Krummel, Olivier Imhoff, Antoine Garstka, Sarah Richter, Isabelle Kolb, Anne-Laure Faller, Philippe Petit-Jean, Clotilde Kiener, Farideh Alenabi, Henriette Sissoko, Émilie Léon, François Chantrel, Yves Dimitrov, Thierry Hannedouche
Leaflets inside drug boxes are complex and often poorly understood. Patients consulting in nephrology are mostly old and often suffer from multiple comorbidities. As so, they are often subject to various contra-indications and drug interactions. This paper aims to evaluate if patients actually read leaflets or other medical information on others medias such as Internet and whether this could, potentially, interfere with their observance. Results showed that leaflets were read by 65.1% of patients, leading to 12% of withdrawal or not taking drugs...
September 27, 2016: Néphrologie & Thérapeutique
Éric Sagou Yayo, Mireille Aye, Jean-Louis Konan, Arlette Emième, Marie-Laure Attoungbre, Appolinaire Gnionsahé, Étienne Cavalier, Dagui Monnet, Pierre Delanaye
Glomerular filtration rate (GFR) estimation is fundamental in clinical nephrology. It is usually estimated from equations based on serum creatinine. An ethnic factor is currently recommended for the black population for the two most used equations, i.e. the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) study equations. However, these factors were determined from African-American subjects. Therefore, their use in the African subject (non-American) remained questionable...
September 24, 2016: Néphrologie & Thérapeutique
Justine Perrin, Julien Carvelli, Bertrand Gondouin, Laurent Daniel, Megan Fraisse, Céline Gaudon, Fouad Bouzana, Henri Vacher-Coponat, Julie Moussi-Francès, Bertrand Dussol, Noémie Jourde-Chiche
Renal involvement of systemic vasculitides is an emergency in nephrology. Although it has become very rare, the diagnosis of polyarteritis nodosa must be considered in some patients. A 70-year-old patient, previously healthy, presented with acute renal failure and malignant hypertension and abundant albuminuria. Subcutaneous nodule, orchitis and mononeuritis appeared subsequently. The search for auto-immunity or viral infection was negative. Markers of thrombotic microangiopathy, present initially, resolved after blood pressure control...
September 24, 2016: Néphrologie & Thérapeutique
Georges Mourad, Jean-Emmanuel Serre, Cyrielle Alméras, Olivia Basel, Valérie Garrigue, Vincent Pernin, Moglie Le Quintrec
Infections and malignancies are the expected complications of immunosuppressive therapy, which non-specifically impairs cellular and humoral immune responses in renal transplant recipients. Infections were usually frequent and severe during the early post-transplant period (first year). Recent diagnostic methods (molecular biology) and availability of new antivirals, antifungal and antibiotic drugs made rapid diagnosis and systematic preventive strategies much easier and this resulted in a significant reduction of infections and infectious death in this population...
September 24, 2016: Néphrologie & Thérapeutique
Evangéline Pillebout, Jérôme Vérine
IgA nephropathy is the most common form of primary glomerulonephritis worldwide and an important cause of chronic kidney disease and end-stage kidney failure. Its pathophysiology remains in part unsolved but it is recognized as an immune complex disease. Recent years have brought progress in the field through the discovery of several genetic susceptibility loci and the formulation of the multi-hit pathogenesis model. Presentation, clinical course and histology can be extremely variable, making any histological classification still difficult...
July 2016: Néphrologie & Thérapeutique
Aida Habib, Anne-Claire Durand, Philippe Brunet, Jean-Christophe Delarozière, Bénédicte Devictor, Roland Sambuc, Stéphanie Gentile
PURPOSE: To analyze and compare survival of patients initially treated with peritoneal dialysis (PD) or hemodialysis (HD). METHODS: We used data from the French REIN registry. We included all patients aged 18 years or more who started dialysis between 1st January 2004 and 12 December 2012 in Provence-Alpes-Côte d'Azur Region (PACA). These patients were followed up until 30 June 2014. Survival curves were generated using the Kaplan-Meier technique and tested using the log-rank test...
July 2016: Néphrologie & Thérapeutique
Cindy Castrale, Raymond Azar, Marie-Astrid Piquet, Thierry Lobbedez
Protein energy wasting is a major complication in peritoneal dialysis. It is leading to a poor quality of life and increasing mortality. Diagnosis must be early, according to criteria defined by the International society of renal nutrition and metabolism. It is necessary to appropriate the diagnostic tools with dialysis method. The nutritional care is difficult in peritoneal dialysis. Indeed, studies are limited and practical nutrition is complex. In this point of view, we propose to treat guidelines for protein energy wasting, in peritoneal dialysis patients...
July 2016: Néphrologie & Thérapeutique
Yener Koc, Taner Basturk, Tamer Sakaci, Zuhal Atan Ucar, Elbis Ahbap, Mustafa Sevinc, Ayse Sinangil, Ekrem Kara, Arzu Ozdemir Kayalar, Feyza Bayraktar Caglayan, Tuncay Sahutoglu, Nuri Baris Hasbal, Abdulkadir Ünsal
BACKGROUND: Peritoneal dialysis (PD) is often avoided for patients with polycystic kidney disease (PKD) because of increased risk of complications and technique failure due to limited intra-abdominal space. In this study, we have aimed to determine clinical outcomes, patient and technique survivals in patients with PKD performing PD and to define whether PD is appropriate for these patients. METHODS: Totally 99 patients: 33 with PKD and 66 with diseases other than PKD were included in this retrospective study...
July 2016: Néphrologie & Thérapeutique
Belkacem Issad, Guy Rostoker, Corinne Bagnis, Gilbert Deray
Acute renal failure (ARF) in adults in the intensive care unit (ICU) often evolves in a context of multiple organ failure, which explains the high mortality rate and increase treatment needs. Among, two modalities of renal replacement therapy, peritoneal dialysis (PD) was the first modality used for the treatment of ARF in the 1950s. Today, while PD is generalized for chronic renal failure treatment, its use in the ICU is limited, particularly, due to the advent of new hemodialysis techniques and the development of continuous replacement therapy...
July 2016: Néphrologie & Thérapeutique
Charles-Éric Lavoignet, Pierrick Le Borgne, Sarah Ugé, Rinaldo Veneziano, Claudia Brunhuber, Claire Kam, Pascal Bilbault
Acute renal infarction is an uncommon and often under diagnosed condition mostly because of misleading symptoms. Accurate data regarding clinical presentation, laboratory tests, diagnostic and treatment are lacking. Detection is often delayed or missed because of non-specific clinical presentation. The mechanisms of acute renal infarction are various, mainly embolic or thrombotic. Abdominal CT scan remains the most valuable exam to confirm the diagnosis. Therapeutic guidelines for the treatment of renal embolism have not been well established...
July 2016: Néphrologie & Thérapeutique
Gérard Coulibaly, Patrice Goumbri, Nadine Ouédraogo, Anselme Dabilgou, Christian Napon, Kapouné Karfo, Jean Gabriel Ouango, Adama Lengani, Arouna Ouédraogo
OBJECTIVE: To determine the factors associated with depressive symptoms in chronic hemodialysis patients at centre hospitalier universitaire Yalgado Ouédraogo de Ouagadougou (CHU-YO). PATIENTS AND METHODS: The study was cross sectional and descriptive, from June 2nd to July 30th, 2014. We included chronic hemodialysis patients of CHU-YO. The frequency of hemodialysis sessions was of every four to five days. The French version of Hamilton depression psychometric scale was used to assess depressive symptoms...
July 2016: Néphrologie & Thérapeutique
Caroline Morbieu, Pierre-Antoine Michel, Isabelle Brocheriou, Ana Canestri, Jean-Jacques Boffa
A 27-year-old man without any medical history presented concomitantly a pulmonary and urinary tuberculosis and a nephrotic syndrome with hematuria and renal failure. The renal biopsy showed increased mesangial matrix, few focal segmental lesions, and IgA deposits confirming the diagnosis of IgA nephropathy. Nephrotic syndrome remission occurred quickly after antituberculous treatment. The association between tuberculosis and IgA nephropathy has been previously reported in 9 patients. Renal outcome was always favorable with antituberculous treatment...
July 2016: Néphrologie & Thérapeutique
Élisabeth Botelho-Nevers, Paul O Verhoeven, Damien Thibaudin, Julie Gagnaire, Amandine Gagneux-Brunon, Frédéric Lucht, Philippe Berthelot, Christophe Mariat
Staphylococcus aureus nasal carriage is frequent in dialysis patients and is associated with an increased risk of staphylococcal infections in this population. Data from the literature showed that decolonization of S. aureus nasal carriers in hemodialysis and peritoneal dialysis reduce S. aureus catheter-related infections. During the last national congress of nephrology, a survey was conducted among volunteer dialysis physicians to evaluate their practice about screening and decolonization of S. aureus nasal carriage among their patients...
July 2016: Néphrologie & Thérapeutique
Hassan Bouzidi, Ali Majdoub, Michel Daudon, Mohamed Fadhel Najjar
Primary hyperoxalurias (PH) are inborn errors in the metabolism of glyoxalate and oxalate with recessive autosomal transmission. As a result, an increased endogenous production of oxalate leads to exessive urinary oxalate excretion. PH type 1, the most common form, is due to a deficiency of the peroxisomal enzyme alanine: Glyoxylate aminotransferase (AGT) in the liver. PH type 2 is due to the deficiency of the glyoxylate reductase/hydroxypyruvate réductase, present in the cytosol of hepatocytes and leucocytes...
June 29, 2016: Néphrologie & Thérapeutique
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