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Néphrologie & Thérapeutique

Bayen Maalej, Mona Ben Amor, Manel Jallouli, Manel Weli, Mohamed Charfi, Yassine Abdelkefi, Olfa Chakroun, Khaoula Kamoun, Jamil Hachicha, Noureddine Rekik, Taher Gargah, Lamia Gargouri, Abdelmajid Mahfoudh
AIM: Post-streptococcal glomerulonephritis (PSGN) is a frequent cause of acute nephritis in children. This study aimed to describe the epidemiology, clinical characteristics and outcomes of PSGN and look for predictor's factors of severity. METHODS: A 12-year retrospective review of case notes and laboratory data was conducted at a department of pediatrics, pediatric emergency and intensive care, Hedi Chaker Hospital. RESULTS: One hundred seventy eight children were treated for PSGN with a mean age of 7...
May 4, 2018: Néphrologie & Thérapeutique
M Jalbert, A Mignot, A-S Gauchez, A-C Dobrokhotov, J Fourcade
INTRODUCTION: Hypercalcemia is not a rare event and can lead to severe consequences. Its main etiologies are primary hyperparathyroidism and neoplasic conditions. The iatrogenic etiology by vitamin D intoxication is more rarely found. CASE PRESENTATION: A 76-year-old finish woman comes to the emergency room for chest pain. Her medical history is impossible to specify due to the language barrier and initial confusion. She has severe hypercalcaemia (4.14mmol/L), renal insufficiency, cardiac arrhythmia later complicated by an ischemic cardiac episode...
April 27, 2018: Néphrologie & Thérapeutique
Clotilde Muller, Fabienne Knoerr, Isabelle Kolb, Antoine Garstka, Jean-Valère Fumaroli, Sarah Richter
Denutrition for chronic hemodialysed patients is common and severe, often the first step of many complication and comorbidities. This work was aimed to study the impact of the adjunction of hard-boiled egg during six months, at the time of the hemodialysis session, if the classic nutritional support with oral nutritional supplements and intradialytic parenteral nutrition has failed. Required criteria were: Albuminemia, prealbuminemia and Moreau and Gaudry's score. Thirty-six patients have been included. During the six months, the following nutritional parameters have improved: Moreau and Gaudry's score decreased of 0...
April 27, 2018: Néphrologie & Thérapeutique
Tomek Kofman, Julie Oniszczuk, Philippe Lang, Philippe Grimbert, Vincent Audard
Recurrence of glomerular disease after renal transplantation is a frequent cause of graft loss. Incidence, risk factors and outcome of recurrence are widely due to the underlying glomerular disease. Graft biopsy analysis is required to confirm the definitive diagnosis of recurrence and to start an appropriate therapy that, in some cases, remains challenging to prevent graft failure. Increased use of protocol biopsy and recent advances in our understanding of the pathogenesis of some glomerular diseases with the identification of some relevant biomarkers provide a unique opportunity to initiate kidney-protective therapy at early stages of recurrence on the graft...
April 26, 2018: Néphrologie & Thérapeutique
Suzy Hamo, Justine Bacchetta, Aurélia Bertholet-Thomas, Bruno Ranchin, Pierre Cochat, Laurence Michel-Calemard
OBJECTIVES: ARPKD is a recessive rare disease due to PKHD1 mutation. The main objective of the study was to characterize the phenotypic variability according to the different types of PKHD1 mutations. METHODS: This study was performed in 308 ARPKD patients with a genetic diagnosis from our genetic center. Related physicians provided minimal clinical and biological data. RESULTS: Patients were divided into three genotypic groups: the first group (G1; n=65) consisted of patients with two truncating mutations, the second group (G2; n=117) of patients with one truncating and one non-truncating mutation, and the third group (G3; n=126) of patients with two non-truncating mutations...
April 24, 2018: Néphrologie & Thérapeutique
Jacques Rottembourg, Guy Rostoker
The share of peritoneal dialysis (PD) in the spectrum of chronic dialysis has decreased in France over the last ten years. Despite various facilities offered by the health authorities, PD remains confidential in many private units and some public hospitals. The enthusiasm present at the beginning of this technology, forty years ago, is declining, despite a real improvement in new developments, a real increase in patient survival, today at least similar to that on hemodialysis. Then, the aim of this review is first to give a summary of the principles and practice of patient and staff education and to describe the role of the medical contribution in decision-making...
April 11, 2018: Néphrologie & Thérapeutique
Clarisse Grèze, Bruno Pereira, Yves Boirie, Laurent Guy, Cyril Garrouste, Anne-Élisabeth Heng
Post-kidney transplantation outcomes in obese patients remain uncertain. The aim of this study is to compare patient and graft survival and post-transplant complications in obese patients and non-obese patients. We performed a retrospective analysis of a sample of 245kidney transplantations performed between 2008 and 2014 in Clermont-Ferrand. Obese patients and non-obese patients have been compared. Then we compared obese patients who have lost at least 5% of their weight (OPP) with obese patients who did not lose weight (OPS), and non-obese patients who have lost at least 5% of their weight (NOPP) with non-obese patients who did not lose weight (NOPS)...
March 27, 2018: Néphrologie & Thérapeutique
Pablo Antonio Ureña-Torres, Mario Cozzolino, Jordi Bover
Secondary hyperparathyroidism (SHPT) is one of the most frequent and deleterious complication of chronic kidney disease (CKD). SHPT is also one of the principal components of the now called CKD-mineral and bone disorders (MBD) syndrome. It is usually prevented and treated by vitamin D derivatives. However, the rationale for the prescription of vitamin D sterols in those patients is still a matter of hotly debates, mainly because of unsatisfactory results from numerous observational and not well-controlled studies...
March 12, 2018: Néphrologie & Thérapeutique
Hassan Izzedine
Drug-induced nephrotoxicity (DIN) remains a current problem with economic and medical consequences. It affects all nephron segments. Recovery of renal function is based on the identification of risk factors, early diagnosis of renal disease, rapid (if possible) cessation of the causative agent and, in some cases, adjunctive therapy. Prevention is based on identification of early markers of DIN, correction of risk factors, initial assessment of renal function for adequate dosage adjustment and exclusion of other nephrotoxic factors...
March 11, 2018: Néphrologie & Thérapeutique
Thierry Krummel, Nicolas Keller, Éric Prinz, Thierry Hannedouche
High blood pressure during renal disease is highly prevalent and an important risk factor for cardiovascular disease and renal progression. Its optimal management is therefore necessary to improve the prognosis of patients. Several trials concerning the blood pressure target in patients with chronic non-diabetic kidney disease have been published in recent years, we will detail them in this article in order to determine which blood pressure target provides the best benefit in terms of progression of renal diseases and cardiovascular prevention...
March 1, 2018: Néphrologie & Thérapeutique
Majda Berkane, Latifa Adarmouch, Mohamed Amine, Aicha Bourrahouat, Imane Ait Sab, Mohamed Sbihi
INTRODUCTION: Cyclophosphamide (CYP) has been used for over 40 years in patients with steroid-sensitive nephrotic syndrome (NSSS) presenting frequent relapses (NSRF) or steroid dependence (NSSD). However, the long-term success of treatment with cyclophosphamide is difficult to predict. The objectives of this study are to determine long-term outcomes of cyclophosphamide and identify the factors associated with sustained remission. METHODS: We retrospectively studied the data from 50 patients with idiopathic nephrotic syndrome, treated by oral cyclophosphamide and followed at service of pediatric for more than 8 years for idiopathic nephrotic syndrome and related factors for survival without relapse were evaluated by univariate analysis...
April 2018: Néphrologie & Thérapeutique
Giorgina B Piccoli, Mona Alrukhaimi, Zhi-Hong Liu, Elena Zakharova, Adeera Levin
No abstract text is available yet for this article.
April 2018: Néphrologie & Thérapeutique
P Chauveau, C Lasseur, C Nodimar, K Moreau, S Trolonge, M Aparicio, C Combe
Restricted protein diets in patients with chronic kidney disease have been debated for several decades. In chronic kidney disease as in other chronic diseases, the modulation of the nutritional intake is the object of a certain renewal. It is supported by recent studies that highlight the importance of modulating nutrient intake by diets that are healthier, less rich in animal proteins and richer in plants. The recent reintroduction in France of amino acid supplements and ketoanalogs of amino acids allows the prescription of a very restricted diet...
April 2018: Néphrologie & Thérapeutique
Nicolas Keller, Thierry Krummel, Thierry Hannedouche
Salt consumption has substantially increased these last years in our modern societies and far exceeds our needs. It has a great impact on cardiovascular and renal disease and represents a major issue in public health. The present work is a review of observational and interventional studies exploring the relationship between salt consumption, high-blood pressure and cardiovascular morbimortality in the general population but also in chronic kidney diseases.
April 2018: Néphrologie & Thérapeutique
Khalil El Karoui
IgA nephropathy can have various initial presentation and evolutive characteristics. In this article, specific forms of IgA nephropathy are described, such as hypertensive emergency, nephrotic syndrome, rapidly progressive glomerulonephritis, monotypic IgA deposits, or IgA nephropathy associated with inflammatory diseases. Identification of these specific forms is needed to better characterize and treat these rare pathologies.
April 2018: Néphrologie & Thérapeutique
Cécile Courivaud
The majority of incidental haemodialysis patients are systematically treated at the rate of three sessions per week, regardless of their level of residual kidney function. Incremental haemodialysis is a therapeutic strategy adapted to the residual kidney function level of each patient, to offer patients only the "dialysis dose" needed to supplement their residual kidney function, while ensuring that they achieve the objective of total clearance (renal+per-HD) recommended (weekly Standard Kt/V urea>2...
April 2018: Néphrologie & Thérapeutique
Marion Vallet, Acil Jaafar, Pierre-Yves Charles, Ivan Tack
INTRODUCTION: Estimation of volemic status can be useful in the diagnosis of some hydro-electrolytic disorders such as hyponatremia and dyskalemia. As a matter of fact, clinical examination and classical biological parameters are not discriminant enough. The aim of this study was to determine the biological parameters that are better correlated to volemic status. METHOD: Volemic status was established using extracellular fluid volume, measured by apparent distribution of inuline, in non-edematous patients and without cardiac or hepatic insufficiency...
April 2018: Néphrologie & Thérapeutique
Alexandre Seidowsky, Ève Vilaine, Nicolas Mansencal, Alexandre Ébel, Cédric Villain, Lynda Cheddani, Ziad A Massy
Profound deficit of the body fluid composition regulation system is present at the end stage kidney disease, leading to the increase the risk of acute or chronic volume overload, which impacts the morbidity and mortality in these patients. Pulmonary ultrasound by its ability to estimate extrapulmonary water at an infraclinical stage has helped to make progress in this area. Line B is the element of fundamental semiology that reflects the presence of water in the pulmonary alveoli. The alteration of left ventricular function and the increase of pulmonary capillary permeability are the determining factors in the genesis of subclinical pulmonary congestion and are positively correlated with B-lines...
April 2018: Néphrologie & Thérapeutique
François Gaillard, Marie Courbebaisse
End-stage renal disease risk of living kidney donors is lower than the one in general population. In 2014, two independent studies confirmed this result but evidenced an increased risk of end-stage renal disease after donation. In this context, long-term consequences of living donation need to be better defined. Evaluation of renal function is a cornerstone of living donor screening. Precise knowledge of kidney donation physiology is required to propose a relevant predonation screening. In this review, we present the risks of donation, the physiology of living donation and discuss international guidelines...
April 2018: Néphrologie & Thérapeutique
Pierre Delanaye
Glomerular filtration rate measurement is still the best way to assess the global renal function. In daily practice, glomerular filtration rate is estimated by creatinine-based equations. Serum creatinine as a renal biomarker has however several limitations. We discuss the current recommended creatinine-based equations. The potential added value of a new biomarker, cystatin C, and alternative equations will be discussed. Finally, the potential interest of measured glomerular filtration rate by a reference method in specific patients and/or situations will be discussed and justified...
April 2018: Néphrologie & Thérapeutique
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