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Néphrologie & Thérapeutique

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https://www.readbyqxmd.com/read/27887845/-management-of-atherosclerotic-renal-artery-stenosis-in-2016
#1
Thomas Fournier, Florence Sens, Olivier Rouvière, Antoine Millon, Laurent Juillard
Endovascular revascularization as treatment of atherosclerotic renal-artery stenosis (aRAS) is controversial since 3 large and multicentric randomised trials (CORAL, ASTRAL, STAR) failed to prove the superiority of percutaneous transluminal renal-artery stenting (PTRAS) over medical treatment only (MT). However, considering the multiple bias of these trials, among which questionable inclusion criterias, these results must be extrapolated in clinical practice with caution. New pathophysiological data have been helping to understand why restoring blood flow does not necessarily lead to kidney function improvement...
November 22, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27876356/-low-flux-dialysate-daily-home-hemodialysis-a-result-for-the-62%C3%A2-first-french-and-belgian-patients
#2
Anaïs Benabed, Patrick Henri, Thierry Lobbedez, Eric Goffin, Simona Baluta, Abdelkader Benziane, Ahmed Rachi, Johan W van der Pijl, Clémence Bechade, Maxence Ficheux
Since 2011, a new device is available for low flux dialysate quotidian home hemodialysis in France and Belgium. This study aims to evaluate the characteristics and dialysis prescriptions for Nx Stage System One™ users. We retrospectively included patients trained between 2011 and 2013 in France and Belgium. We collected data concerning their clinical features, their dialysis prescriptions, their laboratory parameters until 6 months of dialysis and, reason for dropping in case of cessation. Sixty-two patients from 31 centers, aged 48±18 years old, with a sex ratio 46/16 (M/F) are included with a median Charlson comorbidity index of 1 [0-3]...
November 18, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27866939/-first-case-report-of-streptococcus-equi-subsp-zooepidemicus-post-infectious-acute-glomerulonephritis-in-france
#3
Nicolas Le-Berre, Pierre Filipozzi, Laurent Martin, Luc Frimat, Sophie Girerd
Post-infectious glomerulonephritis has become exceptional in France because streptococcus infections are well-treated. When they appear, clinical and biological symptoms are mostly typical and associate acute nephritic syndrome, acute renal failure, proteinuria, hematuria and low complement. We are reporting the first French case of acute post-infectious glomerulonephritis related to Streptococcus equi subsp. zooepidemicus, which is commonly found in horses and rarely in human pathology, and of which contamination is by direct contact with sick horses or by ingestion of non-pasteurized milk...
November 17, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27843013/-tuberculosis-among-chronic-hemodialysis-patients-in-togo-report-of-10%C3%A2-cases
#4
Mawufemo Yawovi Tsevi, Akomola Kossi Sabi, Laté Mawuli Lawson-Ananissoh, Befa Noto-Kadou-Kaza, Eyram Yoan Amekoudi
GOALS: To determine the frequency of tuberculosis among hemodialysis patients in Togo, specify its different localizations and identify its diagnostic and therapeutic difficulties. PATIENTS AND METHODS: This was a retrospective study over a period of 5 years (2010-2015). It includes the records of periodic hemodialysis patients in the Nephrology Department of the Sylvanus-Olympio University Teaching Hospital in Lomé. The diagnosis of tuberculosis was selected on the basis of clinical and laboratory data...
November 11, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27839963/-management-of-patients-with-end-stage-renal-disease-prior-to-initiation-of-renal-replacement-therapy-in-2013-in-france
#5
Philippe Tuppin, Anne Cuerq, Sylvie Torre, Cécile Couchoud, Anne Fagot-Campagna
This study evaluated the management of patients with end-stage renal disease prior to initiation of renal replacement therapy. Among the 51 million national health insurance general scheme beneficiaries (77% of the population), persons 18 years and older, starting dialysis or undergoing preemptive renal transplantation in 2013, were included in this study. Data were derived from the French national health insurance system (SNIIRAM). In this population of 6674 patients (median age: 68 years), 88% initiated renal replacement therapy by haemodialysis, 8% by peritoneal dialysis, and 4% by renal transplantation...
November 10, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27838285/the-influence-of-mortality-rate-from-membrane-flux-for-end-stage-renal-disease-a-meta-analysis
#6
Feng Zhao, Zhipeng Wang, Lin Liu, Sheng Wang
To evaluate the influence of the high-flux hemodialysis (HFHD) and the low-flux hemodialysis (LFHD) on mortality rate for end-stage renal disease (ESRD). Four electronic databases including PubMed, EMBASE, the Cochrane Library, and ClinicalTrails were searched to identify relevant randomized clinical trials up to 31 August 2015. Seven studies enrolling a total of 4412 patients were included in this meta-analysis. For all-cause mortality comparing with LFHD, the result showed that there were significant difference (RR=0...
November 9, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27825643/-sofosbuvir-and-daclatasvir-combination-therapy-in-hemodialysis-patient-with-liver-transplantation
#7
Mourad Hachicha, Danielle Botta-Fridlund
We report a case of sustained remission of a liver transplant patient infected with hepatitis C virus (HCV) genotype 1 undergoing hemodialysis treatment. Oral treatment regimen of the HCV infection consists of a combination of sofosbuvir 400 mg after each hemodialysis session and daclatasvir 60 mg daily, for a period of 3 months. Laboratory testing indicate that the combination regimen was well-tolerated with no sign of drug-drug interaction. Confirmation of these clinical observations in large clinical studies may help improve morbidity and decrease mortality outcome in patients infected with HCV and undergoing hemodialysis treatment...
November 4, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27818031/-muscular-metastases-from-renal-cell-carcinoma
#8
Richard Montagnac, Justine Champion, Jean Pradel, Romulus Takin, Dominique Eychenne, Adeline Schendel
Renal cell carcinoma can metastasize to several locations but rarely in muscles. However, this possibility must never be overlooked because muscle metastases may occur a very long time after the initial nephrectomy. So the post-operative follow-up, according to the recommendations, with thoraco-abdomino-pelvic imaging (computed tomography or nuclear magnetic resonance) allowing to detect metastases, including muscle metastases in the trunk, does not have to neglect the metastases located in the members. This search is based upon a thorough clinical examination, completed by targeted imaging in case of symptoms and/or palpable mass...
November 3, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27816395/-alport-syndrome-hereditary-nephropathy-associated-with-mutations-in-genes-coding-for-type-iv-collagen-chains
#9
Laurence Heidet, Marie-Claire Gubler
Alport syndrome is an inherited disorder characterized by the association of a progressive haematuric nephropathy with ultrastructural abnormalities of the glomerular basement membranes, a progressive sensorineural hearing loss and sometimes ocular involvement. Its incidence is less than 1 per 5000 individuals and the disease is the cause of about 2% of end stage renal disease in Europe and the United States. Alport syndrome is clinically and genetically heterogeneous. It is related to mutations in the genes encoding one of three chains, α3, α4 α5 of type IV collagen, the main component of basement membranes, expressed in the glomerular basement membrane...
November 2, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27810277/-community-pharmacists-interventions-to-prevent-and-screen-chronic-kidney-disease-patients
#10
Stéphanie Belaiche, Edwige Mercier, Damien Cuny, Nicolas Kambia, Patrick Wierre, Élisabeth Bertoux, Daniel Mascaut, Raymond Azar, Pierre Bataille, Franck Bourdon, Évelyne Mac Namara, Nathalie Maisonneuve, Bernard Painchart, Laurence Vrigneau, Christian Noël, Bertrand Décaudin, François Glowacki
Chronic kidney disease (CKD) is a major concern of public health. The pharmacist is known as a health practitioner involved in prevention and therapeutic education. Our study aimed at defining the impact of community pharmacists' interventions for preventing and screening CKD. In our observational prospective study of 5 months conducted in 109 community pharmacy, we included 2 groups of patients: A (therapeutic optimization): CKD patients and B (CKD screening): population at risk. In group A, we included 354 patients, mainly women (51...
October 31, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27810276/-peritoneal-equilibration-test-conventional-versus-adapted-preliminary-study
#11
Ariane Zaloszyc, Claus Peter Schmitt, Betti Schaefer, Armelle Doutey, Joëlle Terzic, Soraya Menouer, Laetitia Higel, Michel Fischbach
Conventional automated peritoneal dialysis (APD) is prescribed as a repetition of cycles with the same dwell time and the same fill volume. Water and sodium balance remains a common problem among patients on peritoneal dialysis. More recently, adapted automated peritoneal dialysis was described, as a combination of short dwells with a low volume, in order to enhance ultrafiltration, followed by long dwells with a large fill volume to favor solute removal. We performed a preliminary crossover study on 4 patients...
October 31, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27789324/-predictors-of-physical-incapacity-degree-to-chronic-hemodialysis-patients-in-kinshasa%C3%A2-key-role-of-the-residual-diuresis
#12
Vieux Momeme Mokoli, Justine Busanga Bukabau, Patrick Parmba Osa Izeidi, Jeanine Losa Luse, Stéphane Kalambay Mukendi, Désiré Kulimba Mashinda, Jean Robert Rissassy Makulo, Ernest Kiswaya Sumaili, François Bompeka Lepira, Nazaire Mangani Nseka
OBJECTIVE: Identifying predictors of physical incapacity degree in patients on chronic hemodialysis in Kinshasa. METHODS: Bicentric analytical study, between January 2007 and July 2013. Degree of physical handicap was evaluated at 6months of hemodialysis based on the scale of Rosser. Logistic regression sought the predictors of no or light physical incapacity (Rosser<3) vs. moderate to maximum (Rosser≥3). P was set at 0.05. RESULTS: One hundred twenty-seven patients (127) patients received at least 6months of hemodialysis (53...
October 24, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27789323/-results-of-conservative-management-of-emphysematous-pyelonephritis
#13
Ahmed Saadi, Haroun Ayed, Abderrazak Bouzouita, Mohamed Cherif, Walid Kerkeni, Selim Selmi, Riadh Ben Slama, Amine Derouiche, Mohamed Chebil
INTRODUCTION: Emphysematous pyelonephritis (EPN) is a rare and severe, necrotizing infection of the kidney. Diagnosis should be precocious based on computed tomography (CT). Its management remains controversial and its treatment is currently increasingly conservative. The aim of this paper is to discuss the conservative treatment of this disease through our experience in 21 patients. MATERIAL AND METHODS: A retrospective analysis including 21 patients managed conservatively for an emphysematous pyelonephritis in our department from January 2010 to April 2015...
October 24, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27776971/association-between-vascular-calcification-assessed-by-simple-radiography-and-non-fatal-cardiovascular-events-in-hemodialysis-patients
#14
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
https://www.readbyqxmd.com/read/27776970/-evaluation-of-educational-interventions-with-dialysis-patient
#15
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
https://www.readbyqxmd.com/read/27771192/-access-to-kidney-transplantation-s-waiting-list-setting-up-a-clinical-pathway
#16
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
https://www.readbyqxmd.com/read/27765466/-wasting-in-chronic-kidney-disease-refeeding-techniques-and-artificial-nutrition-practices
#17
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
https://www.readbyqxmd.com/read/27765465/-do-stop-igan-results-mean-stop-steroids-in-iga-nephropathy
#18
Perrine Jullien, Christophe Mariat, Nicolas Maillard
No abstract text is available yet for this article.
October 17, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27720135/-toward-a-customized-preservation-for-each-kidney-graft
#19
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
https://www.readbyqxmd.com/read/27692384/-compliance-and-leaflet-s-reading-which-link-and-which-media-results-from-a-french-population-with-chronic-kidney-disease
#20
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
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