Nephrologie & Therapeutique最新文献_第3页

Pathophysiology of ANCA vasculitis ANCA血管炎的病理生理学

IF 0.7 4区医学

Nephrologie & Therapeutique Pub Date : 2023-06-13 DOI: 10.1684/ndt.2023.29

Jean-François Augusto, Benoit Brilland

{"title":"Pathophysiology of ANCA vasculitis","authors":"Jean-François Augusto, Benoit Brilland","doi":"10.1684/ndt.2023.29","DOIUrl":"https://doi.org/10.1684/ndt.2023.29","url":null,"abstract":"ANCA vasculitides (AAV) are autoimmune diseases responsible for damage to small-size vessels. Three entities are distinguished from clinical, histological and biological criteria: micropolyangiitis (MPA), granulomatosis with polyangiitis (GPA) and eosinophilic granulomatosis with polyangiitis (EGPA). The neutrophil-ANCA couple is central to the pathophysiology of AAV. The mechanisms that lead to the breakdown of tolerance to myeloperoxidase or proteinase-3 remain hypothetical, however, probably multifactorial, occurring on a predisposing genetic background. The understanding of the injury mechanisms involved in AAV has made great progress thanks to the study of a murine model of immunization against myeloperoxidase. This work has made it possible to show the central role of the PNN in vivo, which are activated under sterile conditions, under the effect of the ANCAs which recognize the self-antigen expressed on their surface. Understanding the role of the alternative complement pathway and in particular that of C5a, a powerful anaphylatoxin, was a major advance. C5a acts as an amplifying factor for PNN activation and blocking its receptor (C5aR) prevents the occurrence of vasculitis lesions in the mouse model. These discoveries led to therapeutic trials in humans highlighting the interest of blocking C5aR and validating this therapeutic strategy. It should be emphasized that the AAV study model is, above all, an anti-MPO model and that the mechanisms involved in anti-PR3 ANCA or ANCA negative vasculitis remain very hypothetical. Finally, the mechanisms that account for the heterogeneity relating to the presentation or severity of AAV remain poorly understood.","PeriodicalId":51140,"journal":{"name":"Nephrologie & Therapeutique","volume":"19 S1","pages":"1-9"},"PeriodicalIF":0.7,"publicationDate":"2023-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10084381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comprehensive conservative care for the management of advanced chronic kidney disease: overview and perspectives 晚期慢性肾脏疾病的综合保守治疗:综述与展望

IF 0.7 4区医学

Nephrologie & Therapeutique Pub Date : 2023-06-12 DOI: 10.1684/ndt.2023.28

Aghiles Hamroun, François Glowacki

引用次数: 0

Contribution of immunology: immune response to vaccination and limits 免疫学的贡献:免疫应答和限制

IF 0.7 4区医学

Nephrologie & Therapeutique Pub Date : 2023-06-12 DOI: 10.1684/ndt.2023.27

Étienne Brochot

引用次数: 0

Cardio-renal syndrome: what’s new in 2023? 心肾综合征:2023年有什么新情况?

IF 0.7 4区医学

Nephrologie & Therapeutique Pub Date : 2023-04-26 DOI: 10.1684/ndt.2023.15

Valentin Maisons, Mouad Hamzaoui, Mélanie Hanoy, Théo Pezel, Dominique Guerrot, Dorian Nezam

引用次数: 0

Bee venom: an unusual cause of acute kidney injury 蜂毒:急性肾损伤的不寻常原因

IF 0.7 4区医学

Nephrologie & Therapeutique Pub Date : 2023-04-26 DOI: 10.1684/ndt.2023.19

Aboubacar Sidiki Fofana, Magara Samaké, Seydou Sy, Sah Dit Baba Coulibaly, Abdoulaye Cissé, Moctar Coulibaly, Modi Sidibé, Bakary Sayon Keita, Hamadoun Yattara, Saharé Fongoro

{"title":"Bee venom: an unusual cause of acute kidney injury","authors":"Aboubacar Sidiki Fofana, Magara Samaké, Seydou Sy, Sah Dit Baba Coulibaly, Abdoulaye Cissé, Moctar Coulibaly, Modi Sidibé, Bakary Sayon Keita, Hamadoun Yattara, Saharé Fongoro","doi":"10.1684/ndt.2023.19","DOIUrl":"https://doi.org/10.1684/ndt.2023.19","url":null,"abstract":"Introduction: Bee sting venom is generally well tolerated. However, some rare cases of massive stings can lead to anaphylactic shock and even renal failure. This observation is the illustration of a case of acute kidney injury secondary to bee stings in a 64-year-old black african subject.Case presentation: A 64-year-old man without a known medical history was referred to the emergency department of the Fousseyni Daou hospital in Kayes (Mali) for disturbed consciousness 4 hours after massive stings from a bee swarm. Renal failure with serum creatinine level at 752,2 µmol/L was documented on day 3 in a context of total anuria. The patient was transferred to a nephrology unit and biology confirmed renal failure associated with intravascular haemolysis and rhabdomyolysis. The kidneys were of normal size and well differentiated. The diagnosis of severe acute kidney injury due to massive envenomation induced by bee venom was evoked. The evolution was favourable, with normalization of renal function at D26 after 5 sessions of haemodialysis in parallel with transfusions of packed red blood cells.Conclusion: A massive bee attack should be considered a medical emergency because of the organic damage it can inflict. The renal prognosis depends on the number of stings, and especially on the delay and the quality of the treatment. Early initiation of dialysis treatment reduces mortality.","PeriodicalId":51140,"journal":{"name":"Nephrologie & Therapeutique","volume":"19 2","pages":"139-144"},"PeriodicalIF":0.7,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9624841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Potentially inappropriate medications and anticholinergic and sedative burden in older community-dwelling patients with advanced chronic kidney disease 老年社区居住晚期慢性肾病患者的潜在不适当药物和抗胆碱能及镇静负担

IF 0.7 4区医学

Nephrologie & Therapeutique Pub Date : 2023-04-26 DOI: 10.1684/ndt.2023.6

Maryline Jaffuel, Frederic Gervais, Julien Vernaudon, Marie-Anne Cerfon, Pierre Krolak-Salmon, Christelle Mouchoux, Teddy Novais

{"title":"Potentially inappropriate medications and anticholinergic and sedative burden in older community-dwelling patients with advanced chronic kidney disease","authors":"Maryline Jaffuel, Frederic Gervais, Julien Vernaudon, Marie-Anne Cerfon, Pierre Krolak-Salmon, Christelle Mouchoux, Teddy Novais","doi":"10.1684/ndt.2023.6","DOIUrl":"https://doi.org/10.1684/ndt.2023.6","url":null,"abstract":"Objective: Regarding older patients, multiple chronic conditions lead to the intake of multiple medications, involving a higher risk of adverse drug events. In older patients with advanced chronic kidney disease, the medication exposure was poorly explored. The aim of this study was to describe the use of potentially inappropriate medications and medications with anticholinergic and sedative properties in older community-dwelling patients with advanced chronic kidney disease.Methods: An observational study was conducted in a geriatric day-care unit. All patients aged over 65 years with advanced chronic kidney disease, defined by estimated glomerular filtration rate < 20 mL/min/1.73 m2 or estimated glomerular filtration rate > 20 mL/min/1.73 m2 with rapid progression, and referred by nephrologist for pretransplant comprehensive geriatric assessment, were included in the study. Potentially inappropriate medications were identified using the EU(7)-PIM list, and he anticholinergic and sedative drug exposure was measured using the Drug Burden Index.Results: Overall, 139 patients were included in the study (mean age 74.4 ± 3.3 years, 32.4% females, 61.9% on dialysis). Potentially inappropriate medications were used by 74.1% (103/139) of patients and were mainly represented by proton pump inhibitors, alpha-1-blockers and central antihypertensive drugs. Regarding anticholinergic and / or sedative medications, 79.9% (111/139) of older patients were exposed.Conclusion: In older community-dwelling patients with advanced chronic kidney disease, the prevalence of potentially inappropriate medication exposure and anticholinergic and sedative exposure was high. Interventions focusing on deprescription of these inappropriate medications should be conducted in this specific population.","PeriodicalId":51140,"journal":{"name":"Nephrologie & Therapeutique","volume":"19 2","pages":"89-98"},"PeriodicalIF":0.7,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9716953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Kidney biopsy in subsaharan Africa 撒哈拉以南非洲的肾脏活检

IF 0.7 4区医学

Nephrologie & Therapeutique Pub Date : 2023-04-26 DOI: 10.1684/ndt.2023.9

K J N'Dah, W M Tia, D A Lagou, M C Guei, A D Abouna, I Touré, K H Oka, Aar Kobenan, S Diopo, S Delma, I Cherif, E Amékoudi, B S Ouattara, K H Yao, N C Ackoundou, K L Adonis, G V Yao, D A Gnionsahié, Mijm Diomandé

{"title":"Kidney biopsy in subsaharan Africa","authors":"K J N'Dah, W M Tia, D A Lagou, M C Guei, A D Abouna, I Touré, K H Oka, Aar Kobenan, S Diopo, S Delma, I Cherif, E Amékoudi, B S Ouattara, K H Yao, N C Ackoundou, K L Adonis, G V Yao, D A Gnionsahié, Mijm Diomandé","doi":"10.1684/ndt.2023.9","DOIUrl":"https://doi.org/10.1684/ndt.2023.9","url":null,"abstract":"Materials and methods: We carried out a retrospective and descriptive study on biopsies examined between January 2015 and December 2019, in the pathological departments of University Teaching Hospital of Bouaké and Cocody-Abidjan. The KB came from four countries (Côte d'Ivoire, Togo, Guinea-Conakry and Burkina Faso). Optical microscopy and/or direct immunofluorescence techniques were used. All biopsy samples including epidemiological, clinical and pathological data and an optical microscopy and/or direct immunofluorescence study were included. The parameters studied were indications for KB, epidemiological profile, clinic, proteinuria and pathological aspects.Results: Over the study period, we collected 179 KB, i.e. 35.8 KB/year. The mean age of the patients was 32.9 ±13.8 years (range 11-70 years). The sex ratio (M/F) was 1.03. Pure nephrotic syndrome was the main indication (64.2 %, n = 115) for KB, followed by impure nephrotic syndrome (11.7 %, n = 21), acute renal failure (ARF) (7.8 %, n = 14) and rapidly progressive glomerulonephritis (RPGN) (7.8 %, n = 14). Glomerulonephritis (GN) occurred in 86 % (n = 158), vascular nephropathy in 11.7 % (n = 21) and tubulointerstitial nephritis in 2.2 % (n = 4). The nephropathies were preferentially focal segmental glomerulosclerosis (34.6 %, n = 62), nephroangiosclerosis (10.6 %, n = 19), membranous GN (10 %, n = 18), post-infectious GN (8.9 %, n = 16) and lupus GN (7.3 %, n = 13).Conclusion: The KB is an essential step in the diagnosis of nephropathies. Focal segmental glomerulosclerosis is frequent in our study. The establishment of a Kidney registry would allow better knowledge of renal pathologies in sub-Saharan Africa.","PeriodicalId":51140,"journal":{"name":"Nephrologie & Therapeutique","volume":"19 2","pages":"99-108"},"PeriodicalIF":0.7,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9927383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Living donor, first choice]. [活体捐献者，首选]。

IF 0.7 4区医学

Nephrologie & Therapeutique Pub Date : 2023-04-26 DOI: 10.1684/ndt.2023.21

Michel Tsimaratos, François Kerbaul

引用次数: 0

A call for promoting living kidney donation in France in 2023 呼吁2023年在法国推广活体肾脏捐赠

IF 0.7 4区医学

Nephrologie & Therapeutique Pub Date : 2023-04-26 DOI: 10.1684/ndt.2023.20

Christophe Mariat, François Gaillard, Thomas Fournier, Clémentine Rabate, Émilie Pincon, Justine Bacchetta, Manon Aurelle, Antoine Bouquegneau

引用次数: 0

[Dialysis and quality of life: results of a national survey of patients on dialysis or with experience of dialysis]. [透析与生活质量：对透析患者或有透析经历的患者进行的全国调查的结果]。