Bulletin de la Dialyse à Domicile最新文献_第2页

Questioning one-size-fits-all dialysis prescription: balancing dialysis prescription and residual kidney function 质疑一刀切的透析处方:平衡透析处方与残余肾功能

Bulletin de la Dialyse à Domicile Pub Date : 2023-04-26 DOI: 10.25796/bdd.v6i1.74683

J. Fernandes, Anabela Soares Rodrigues

{"title":"Questioning one-size-fits-all dialysis prescription: balancing dialysis prescription and residual kidney function","authors":"J. Fernandes, Anabela Soares Rodrigues","doi":"10.25796/bdd.v6i1.74683","DOIUrl":"https://doi.org/10.25796/bdd.v6i1.74683","url":null,"abstract":"Recent awareness of the viability and benefits of incremental hemodialysis is an opportunity to review clinical practices and improve the process of dialysis induction. Incremental dialysis is a standard approach in peritoneal dialysis prescription, with a focus on the quality parameter of nephroprotection. The same should apply in hemodialysis, with individualization of the prescribed extracorporeal technique: frequency, duration and intensity, in either home or center hemodialysis, are prescription variables to adjust according to the patient’s residual renal function, medical condition and psycho-social priorities. Considering that fluid balance and smooth ultrafiltration critically impact patient survival, incremental dialysis schedules need to be carefully tailored and grounded in routine residual kidney function measurement. This paper raises concerns about both the benefits of incremental dialysis and its putative detrimental effects, these being mainly dependent on the quality of the hemodialysis prescription and external economic constraints. As a comparator, incremental peritoneal dialysis is a scientifically based model to pursue, whichever the modality, based on updated concepts of patient-centered prescription and adequacy in dialytic renal replacement therapies.","PeriodicalId":366938,"journal":{"name":"Bulletin de la Dialyse à Domicile","volume":"185 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134441339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

RDPLF annual report: Profile of peritoneal dialysis patients in France in 2022, synthetic raw results RDPLF年度报告:2022年法国腹膜透析患者概况，综合原始结果

Bulletin de la Dialyse à Domicile Pub Date : 2023-04-26 DOI: 10.25796/bdd.v6i1.77293

C. Verger, E. Fabre

引用次数: 1

Interest of HIF stabilizers in home dialysis HIF稳定剂在家庭透析中的作用

Bulletin de la Dialyse à Domicile Pub Date : 2023-04-26 DOI: 10.25796/bdd.v6i1.77073

G. Rostoker

{"title":"Interest of HIF stabilizers in home dialysis","authors":"G. Rostoker","doi":"10.25796/bdd.v6i1.77073","DOIUrl":"https://doi.org/10.25796/bdd.v6i1.77073","url":null,"abstract":"Hypoxia-inducible factor (HIF) stabilizers or dustats are orally administered small molecules with very low renal elimination (without adaptation during chronic kidney disease (CKD) analogues with antagonistic effect of 2-oxoglutarate, a naturally occurring substrate of HIF-Prolyl Hydroxylase at the origin of the inhibition of this enzyme. This results in a simulated state of hypoxia allowing the accumulation of HIF-α in the cells followed by coordinated erythropoiesis with erythropoietin synthesis, decreased hepatic hepcidin production and optimization of iron metabolism. HIF stabilizers have only been studied in non-inferiority clinical trials versus erythropoiesis stimulating agents (ESAs). The primary endpoint for the therapeutic trials of all these different molecules was the change in hemoglobin level. Dustat corrects anemia in advanced non-dialysis and dialysis CKD in a similar way to ESAs.Six HIF stabilizers molecules are in advanced development: Roxadustat, Daprodustat, Vadadustat, Enarodustat, Desidustat and Molidustat. Only Roxadustat or Evrenzo®, currently has a marketing authorization in Europe obtained in August 2021. Only two studies have been dedicated to peritoneal dialysis, one with Roxadustat, the other with Daprodustat. Home dialysis appears to be an elective indication for HIF stabilizers because of their absence of cold chain necessity and their positive impact on iron metabolism and the difficulties and imperfections of the current treatment of anemia with ESA and intravenous iron in this patient population.\u0000 ","PeriodicalId":366938,"journal":{"name":"Bulletin de la Dialyse à Domicile","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132602549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Caractéristiques et mortalité des patients avec et sans syndrome cardio-rénal traités par dialyse péritonéale en France 法国腹膜透析治疗的心肾综合征和非心肾综合征患者的特征和死亡率

Bulletin de la Dialyse à Domicile Pub Date : 2022-12-28 DOI: 10.25796/bdd.v4i4.71833

Gabrielle Duneau, Mabel Aoun

{"title":"Caractéristiques et mortalité des patients avec et sans syndrome cardio-rénal traités par dialyse péritonéale en France","authors":"Gabrielle Duneau, Mabel Aoun","doi":"10.25796/bdd.v4i4.71833","DOIUrl":"https://doi.org/10.25796/bdd.v4i4.71833","url":null,"abstract":"IntroductionGlobalement, la dialyse péritonéale (DP) est de plus en plus indiquée dans l’insuffisance cardiaque réfractaire. Cette étude a pour but d’analyser les caractéristiques et la survie des patients traités par DP, en les divisant en deux groupes, avec et sans syndrome cardio-rénal (CRS).\u0000MéthodesIl s’agit d’une étude rétrospective incluant tous les patients inscrits dans le Registre de Dialyse Péritonéale de Langue Française (RDPLF) entre le 01/01/2010 et le 01/12/2021. La cohorte a été divisée en deux groupes afin de comparer les patients avec et sans CRS. La survie a été analysée par la méthode de Kaplan Meier et une régression de Cox a identifié les facteurs associés avec la mortalité dans les deux groupes.\u0000Résultats11730 patients en DP ont été inclus. L’âge moyen était de 66.78±16.72 ans. 766 patient (6,53 %) ont été pris en charge en DP pour CRS et 10 964 pour une autre néphropathie. Les malades avec CRS étaient plus âgés et comorbides. La survie est significativement meilleure dans le groupe sans CRS (Log Rank test < 0.001). La médiane de survie est de 17.7±1.2 mois et 49.6±0.7 mois chez les patients avec et sans CRS respectivement. En analyse multivariée, l’âge, le sexe masculin, le diabète, les pathologies cardio-vasculaires et le manque d’autonomie sont liés à une mortalité accrue dans le groupe sans CRS. Par contre, chez les patients avec CRS, seules les variables âge et antécédent d’hépatopathie sont significativement associées à un sur risque de décès. Le nombre de péritonites présentées par le patient est significativement associé à un moindre risque de décès dans les deux groupes.\u0000ConclusionCette étude nationale portant sur un grand nombre de patients traités par DP a révélé les grandes différences dans les caractéristiques et la survie entre ceux qui ont un CRS contre ceux qui n’en ont pas. En particulier, les deux facteurs les plus liés à la mortalité dans le groupe avec CRS sont l’âge et la pathologie hépatique.","PeriodicalId":366938,"journal":{"name":"Bulletin de la Dialyse à Domicile","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121647116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Seasonal variations of enteric peritonitis in Belgium and France : RDPLF data 比利时和法国肠性腹膜炎的季节变化:RDPLF数据

Bulletin de la Dialyse à Domicile Pub Date : 2022-12-28 DOI: 10.25796/bdd.v4i4.73553

Pacha Bakhtar, E. Maillart, F. Collart, C. Verger

引用次数: 0

Managing Transition between dialysis modalities: a call for Integrated care In Dialysis Units 管理过渡之间的透析模式:呼吁综合护理在透析单位

Bulletin de la Dialyse à Domicile Pub Date : 2022-12-28 DOI: 10.25796/bdd.v4i4.69113

Bruno Fraga Dias, A. Rodrigues

{"title":"Managing Transition between dialysis modalities: a call for Integrated care In Dialysis Units","authors":"Bruno Fraga Dias, A. Rodrigues","doi":"10.25796/bdd.v4i4.69113","DOIUrl":"https://doi.org/10.25796/bdd.v4i4.69113","url":null,"abstract":"Summary\u0000Patients with chronic kidney disease have three main possible groups of dialysis techniques: in-center hemodialysis, peritoneal dialysis, and home hemodialysis. Home dialysis techniques have been associated with clinical outcomes that are equivalent and sometimes superior to those of in-center hemodialysisTransitions between treatment modalities are crucial moments. Transition periods are known as periods of disruption in the patient’s life associated with major complications, greater vulnerability, greater mortality, and direct implications for quality of life. Currently, it is imperative to offer a personalized treatment adapted to the patient and adjusted over time.An integrated treatment unit with all dialysis treatments and a multidisciplinary team can improve results by establishing a life plan, promoting health education, medical and psychosocial stabilization, and the reinforcement of health self-care. These units will result in gains for the patient’s journey and will encourage home treatments and better transitions.Peritoneal dialysis as the initial treatment modality seems appropriate for many reasons and the limitations of the technique are largely overcome by the advantages (namely autonomy, preservation of veins, and preservation of residual renal function).The transition after peritoneal dialysis can (and should) be carried out with the primacy of home treatments. Assisted dialysis must be considered and countries must organize themselves to provide an assisted dialysis program with paid caregivers.The anticipation of the transition is essential to improve outcomes, although there are no predictive models that have high accuracy; this is particularly important in the transition to hemodialysis (at home or in-center) in order to plan autologous access that allows a smooth transition.","PeriodicalId":366938,"journal":{"name":"Bulletin de la Dialyse à Domicile","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125031569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EQ-5D in dialysis units: a PROM with a view 透析单元中的EQ-5D:带视图的PROM

Bulletin de la Dialyse à Domicile Pub Date : 2022-12-28 DOI: 10.25796/bdd.v4i4.69733

I. Sala, Anabela S Rodrigues

{"title":"EQ-5D in dialysis units: a PROM with a view","authors":"I. Sala, Anabela S Rodrigues","doi":"10.25796/bdd.v4i4.69733","DOIUrl":"https://doi.org/10.25796/bdd.v4i4.69733","url":null,"abstract":"Summary\u0000Chronic kidney disease (CKD) is a silent worldwide epidemic responsible for a high clinical and socioeconomic burden. Beyond disease-related outcomes, there is an urgent need for clinicians to focus on implementation of validated patient-reported outcome measures (PROMs) in routine care practice. This updated concept of high-quality renal care implies a changing paradigm, with a focus on patient experiences and health-related quality of life (HRQL) measures. This is even more crucial in end-stage renal disease, where adequate dialysis should aim at a multidimensional approach instead of only analytical targets. It is vital to emphasize interventions that positively affect the quality of life of the patient with CKD beyond improving their survival. Although the importance of using HRQL measures is well established, there has been resistance to their use in routine care. There are numerous tools to assess HRQL, but not all are easy to apply. It is essential to overcome these possible barriers and better adequate the HRQL tools to the patients. The shorter and simpler instruments are more appealing, as well as the electronic health questionnaires. The EuroQol-5 Dimensions tool (EQ5D) is a standardized measure of health status, is simple and quick, and provides information that can be used in economic assessments of healthcare.In this era of limited health resources, cost analysis and economic evaluations are becoming increasingly relevant. In dialysis units, sustainability management should include a pathway of integrated care, including home and center dialysis, that values the better adjustment of prescriptions to the individual patient. The authors advocate using the EQ5D to support this pathway of quality in dialysis units toward global health gains. The EQ5D is a PROM with a view centered on patient and sustainable health services.","PeriodicalId":366938,"journal":{"name":"Bulletin de la Dialyse à Domicile","volume":"28 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131653273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hyponatremia in peritoneal dialysis patients 腹膜透析患者的低钠血症

Bulletin de la Dialyse à Domicile Pub Date : 2022-12-28 DOI: 10.25796/bdd.v4i4.73443

M. Taghavi, Lucas Jacobs, M. Dratwa, J. Nortier

引用次数: 0

Evolution de la dialyse péritonéale en France depuis 2018 et durant les « années COVID » Rapport RDPLF 2018年以来法国腹膜透析的演变和“COVID年”RDPLF报告

Bulletin de la Dialyse à Domicile Pub Date : 2022-09-06 DOI: 10.25796/bdd.v5i3.67903

C. Verger, E. Fabre

{"title":"Evolution de la dialyse péritonéale en France depuis 2018 et durant les « années COVID » Rapport RDPLF","authors":"C. Verger, E. Fabre","doi":"10.25796/bdd.v5i3.67903","DOIUrl":"https://doi.org/10.25796/bdd.v5i3.67903","url":null,"abstract":"La quasi-totalité (99 %) des patients traités par dialyse péritonéale en France est enregistrée dans la base de données du RDPLF. En dehors de toute analyse statistique visant à interpréter les chiffres, ce travail est un rapport des données brutes observées dans la population d’insuffisants rénaux Stade V traités par dialyse péritonéale depuis le début de l’épidémie COVID-19 et dans les deux années qui ont précédé. Depuis le début de l’épidémie ces données semblent montrer une diminution de l’incidence des traitements par dialyse péritonéale et une augmentation des transferts en hémodialyse en centre. On observe par ailleurs une diminution des inscriptions sur liste d’attente de transplantation et une diminution du nombre de transplantations. Si la baisse temporaire de l’activité de transplantation peut s’expliquer par la désorganisation qu’a provoquée l’épidémie dans les hôpitaux, une baisse des indications de mise à domicile mérite probablement une réflexion plus approfondie sur ses causes, d’autant plus que ce résultat est en opposition avec les tendances d’autres pays. Ce rapport a pour but d’encourager des études plus précises sur l’intérêt de la dialyse à domicile en période épidémique.","PeriodicalId":366938,"journal":{"name":"Bulletin de la Dialyse à Domicile","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134391605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intérêts et limites de l’Hémodialyse Longue Nocturne 长夜透析的兴趣和局限性

Bulletin de la Dialyse à Domicile Pub Date : 2022-09-06 DOI: 10.25796/bdd.v5i3.67683

C. Chazot, G. Jean

{"title":"Intérêts et limites de l’Hémodialyse Longue Nocturne","authors":"C. Chazot, G. Jean","doi":"10.25796/bdd.v5i3.67683","DOIUrl":"https://doi.org/10.25796/bdd.v5i3.67683","url":null,"abstract":"L’hémodialyse (HD) Longue Nocturne (HDLN) intermittente permet de combiner dialyse et sommeil. Ses avantages cliniques sont une vitesse d’ultrafiltration réduite, un meilleur contrôle de la volémie avec amélioration de la tolérance des séances et des performances cardiaques, une phosphatémie et des moyennes molécules mieux épurées et une meilleure survie dans les études de cohortes. La qualité de vie n’est pas altérée par la longueur des séances et elle s’améliore quand elle n’est pas optimale lors du transfert de l’HD standard vers l’HDLN. La qualité du sommeil n’est parfois perturbée mais elle n’est pas une cause importante de sortie du programme. La pérennité d’un programme d’HDLN passe par les volontés conjointes médicales et managériales, la sélection des patients stables, le respect des horaires et de la durée de séances, indispensable à la dialyse de sommeil. Les autorités de santé doivent jouer un rôle pour permettre cette modalité dans des conditions financières acceptables. L’information au patient de l’existence de l’HDLN avant le stade de la dialyse est essentielle, aidée par le témoignage des pairs. Les sociétés savantes doivent soutenir la recherche et l’information aux néphrologues. Enfin les conditions architecturales favorisant l’intimité et le sommeil sont une clé de réussite du programme.","PeriodicalId":366938,"journal":{"name":"Bulletin de la Dialyse à Domicile","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127446334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0