Nephrologie & Therapeutique最新文献

{"title":"[Dialysis and quality of life: results of a national survey of patients on dialysis or with experience of dialysis].","authors":"Brigitte Thevenin-Lemoine, Didier Borniche, Aurélie Untas, François Vrtovsnik, Luc Frimat, Cécile Couchoud, Cécile Vandevivère","doi":"10.1684/ndt.2023.18","DOIUrl":"10.1684/ndt.2023.18","url":null,"abstract":"","PeriodicalId":51140,"journal":{"name":"Nephrologie & Therapeutique","volume":"19 2","pages":"145-151"},"PeriodicalIF":0.7,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9624838","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}

{"title":"Prediction of sarcopenia among peritoneal dialysis patients using a combination of irisin and phase angle","authors":"Jiaying Wu,&nbsp;Jichao Guan,&nbsp;Shuangxiang Lin,&nbsp;Xiujuan Wu,&nbsp;Miaojia Ding,&nbsp;Zhouhao Ren,&nbsp;Shuijuan Shen","doi":"10.1684/ndt.2023.7","DOIUrl":"https://doi.org/10.1684/ndt.2023.7","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia is associated with significant morbidity and mortality in patients undergoing peritoneal dialysis (PD). Three different tools must be applied to measure the three indices for diagnosing sarcopenia. Considering the cumbersome diagnostic steps and multi-layered mechanisms underlying sarcopenia, we combined new biomarker with bioelectrical impedance analysis (BIA) data to predict PD sarcopenia.</p><p><strong>Methods: </strong>Patients underwent regular PD were asked to complete sarcopenia screening, including appendicular skeletal muscle mass, handgrip strength, and the 5-time chair stand time test according to the newly revised diagnosis consensus of Asian Working Group for Sarcopenia (AWGS2019). Serum was collected for centralized detection of the irisin levels. BIA data, especially the phase angle (PhA), as well as patient's general clinical information, dialysis related indices, laboratory data and body composition data were recorded.</p><p><strong>Results: </strong>Among 105 enrolled PD patients (41.0% men, mean age 54.2 ± 8.89 years), the sarcopenia prevalence was 31.4% and the sarcopenic obesity was 8.6%. Binary regression analysis showed that serum irisin concentrations (OR = 0.98; 95% CI,0.97-0.99; p = 0.002), PhA (OR = 0.43; 95% CI, 0.21-0.90; p = 0.025) and body mass index (BMI) (OR = 0.64; 95% CI, 0.49-0.83; p = 0.001) were independently associated with PD sarcopenia. The AUC of the combination use of serum irisin concentrations and PhA for predicting PD sarcopenia was 0.925 with a sensitivity of 100% and specificity of 84.0% in male and was 0.880 with a sensitivity of 92.0% and specificity of 81.5% in female. PD sarcopenia score=1533.48+-0.75*Handgrip strength+4.63*BMI+-18.07*Total body water +-11.87*Extra-cellular water / total body water +9.26*Fat free mass index+-83.41*PhA+22.42*Albumin/Globulin+-26.38*blood phosphorus+-17.04*Total cholesterol+-29.02*Triglyceride+-0.29*Prealbumin+-0.17*Irisin.</p><p><strong>Conclusions: </strong>Sarcopenia is relatively common among PD patients. The combination of serum irisin concentrations and PhA facilitated the rapid prediction of PD sarcopenia and could serve as an optimal screening tool for PD sarcopenia in clinical settings.</p>","PeriodicalId":51140,"journal":{"name":"Nephrologie & Therapeutique","volume":"19 1","pages":"66-75"},"PeriodicalIF":0.7,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9517567","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}

{"title":"New developments and future prospects in the field of glomerular filtration rate estimation","authors":"Thomas Stehlé,&nbsp;Emmanuelle Vidal-Petiot,&nbsp;Martin Flamant,&nbsp;Pierre Delanaye","doi":"10.1684/ndt.2023.11","DOIUrl":"https://doi.org/10.1684/ndt.2023.11","url":null,"abstract":"<p><p>Glomerular filtration rate (GFR) is estimated from equations based on serum or plasma concentrations of endogenous markers (creatinine and/or cystatin C), and demographic data (age, sex, ± ethnicity). These equations are accurate at the population level, but often inaccurate at the individual level. The creatinine-based Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation published in 2009 (CKD-EPIcr-2009), and the CKD-EPI equation published in 2012 based on creatinine and cystatin C, were recalibrated in 2021 to remove their dedicated race correction factors for black American subjects. All creatinine-based CKD-EPI equations overestimate true GFR in subjects younger than 30 years. The Full Age Spectrum (FAS) equation, applicable across the entire age spectrum (pediatrics to old age), solved this problem, but remained suboptimal at low GFR values. The European Kidney Function Consortium (EKFC) equation published in 2021 was an improvement of the FAS equation, which also includes the Q factor (median creatinine in the general population). EKFC is applicable across the age spectrum and is efficient at low and normal GFR values. The new creatinine-based CKD-EPI equation (CKD-EPIcr-2021) underestimates GFR in Black Americans and overestimates it in non-Black Americans. In European and African subjects, CKD-EPIcr-2021 overestimates true GFR and should not be adopted. The EKFC equation, which performs well in this population, also performs well in European Black subjects and in African subjects, provided dedicated Q factors are used.</p>","PeriodicalId":51140,"journal":{"name":"Nephrologie & Therapeutique","volume":"19 1","pages":"1-10"},"PeriodicalIF":0.7,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10846512","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}

{"title":"Estimation of glomerular filtration rate in children: interest of FAS formula","authors":"Pauline Ratouit,&nbsp;Jérôme Harambat,&nbsp;Annie M Bérard,&nbsp;Geneviève Lacape","doi":"10.1684/ndt.2023.12","DOIUrl":"https://doi.org/10.1684/ndt.2023.12","url":null,"abstract":"<p><p>The recommended equation to estimate the value of glomerular filtration rate (eGFR) among children is Schwartz equation updated in 2009. However, it is few frequently used because involves height, a factor rarely documented for laboratories, especially hospital laboratories. The FAS (Full Aged Spectrum) formula developed by a European group, allows to get away from this factor. We compared CKD-EPI (Chronic Kidney Disease-EPIdemiology collaboration) and FAS formulas to Schwartz equation to estimate GFR in children. We realized a retrospective study included 1.668 children between 2 and 14 years old, whose serum creatinine had been measured during their hospitalization stay. We showed that FAS formula is correlated to Schwartz (r = 0.88), with a mean underestimation of eGFR at 6.2% versus CKD-EPI which has a correlation coefficient equal to 0.45 and overestimates eGFR to approximatively 42.0% compared to Schwartz formula. Furthermore, concordance at 30% is 99% with FAS whereas it’s only 35% with CKD-EPI. Thus, we recommend using the FAS formula to estimate GFR in children between 2 and 14 years old when their height is not available.</p>","PeriodicalId":51140,"journal":{"name":"Nephrologie & Therapeutique","volume":"19 1","pages":"1-9"},"PeriodicalIF":0.7,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10839288","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}

{"title":"Emergency hemodialysis in the Joseph Raseta Befelatanana hospital, Antananarivo, Madagascar","authors":"Rova Malala Fandresena Randrianarisoa,&nbsp;Eliane Mikkelsen Ranivoharisoa,&nbsp;Ainasalohimanana Randrianarisoa,&nbsp;Benja Ramilitiana,&nbsp;Willy Franck Harilalaina Randriamarotia","doi":"10.1684/ndt.2023.5","DOIUrl":"https://doi.org/10.1684/ndt.2023.5","url":null,"abstract":"<p><strong>Introduction: </strong>Initiation of emergency dialysis is a critical situation responsible for high morbidity and mortality. This study describes the characteristics of emergency hemodialysis patients in a hospital in Madagascar.</p><p><strong>Patients and methods: </strong>It is a descriptive study over a period of 7 months, from September 1, 2018 to March 31, 2019, on emergency hemodialysis patients in the hemodialysis department of the University Hospital of Joseph Raseta Befelatanana, Antananarivo. Emergency hemodialysis was defined as dialysis performed immediately or within the first 48 hours of hospitalisation in a life-threatening situation.</p><p><strong>Results: </strong>Among 124 haemodialysis patients, 52 patients (41.93%) had started dialysis as an emergency. The mean age of patients was 50.5 years and the sex ratio (male/female) was 1.08. Hypertension (51.92%) and diabetes (34.61%) were the main comorbidities. Chronic kidney disease was found in 82.7%. The majority of patients were unprepared and had initiated dialysis with a central venous catheter. The most frequent indication was Kussmaul's breathing (32.6%) followed by anuria (28.84%). The mortality rate was 23.08% and the prognosis was influenced by their condition on arrival.</p><p><strong>Conclusion: </strong>The predominance of chronic kidney disease and the absence of a permanent vascular approach can be explained by the late referral to nephrologists of patients with chronic kidney disease. Efforts need to be made to increase the proportion of scheduled dialysis patients with a permanent approach.</p>","PeriodicalId":51140,"journal":{"name":"Nephrologie & Therapeutique","volume":"19 1","pages":"1-7"},"PeriodicalIF":0.7,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10846505","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}

{"title":"The 2022-2026 Transplantation Plan: objectives and priorities for a new development of kidney transplantation","authors":"Maryvonne Hourmant,&nbsp;Philippe Gatault,&nbsp;Dany Anglicheau,&nbsp;Bruno Moulin,&nbsp;Sébastien Canet,&nbsp;Valérie Chatelet,&nbsp;Camille Dubart,&nbsp;Alexandre Hertig,&nbsp;Betoul Schvartz,&nbsp;Christophe Mariat","doi":"10.1684/ndt.2023.3","DOIUrl":"https://doi.org/10.1684/ndt.2023.3","url":null,"abstract":"<p><p>The 2022-2026 Transplantation Plan has been launched by the French government to stimulate the activities of organ harvesting and transplantation, after the failure of the previous one. It has been designed by the Biomedicine Agency in collaboration with learning societies, including the SFNDT, and patient associations. The plan is original in its objectives, its regional organization with its driving by the Regional Health Agencies, the involvement of advanced practice nurses and its funding. The ambition is to transplant every transplantable patient. The increase in the number of kidney transplantations, more of all from a living donor, requires the active participation of all the nephrologists, who are the first in delivering information to the patients and their family on advanced chronic kidney disease treatment and living donation.</p>","PeriodicalId":51140,"journal":{"name":"Nephrologie & Therapeutique","volume":"19 1","pages":"1-5"},"PeriodicalIF":0.7,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10846508","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}

{"title":"New year, new publisher, new format for Néphrologie & Thérapeutique","authors":"Luc Frimat,&nbsp;François Vrtovsnik,&nbsp;Justine Bacchetta,&nbsp;Cécile Vigneau,&nbsp;Valérie Moal","doi":"10.1684/ndt.2023.8","DOIUrl":"https://doi.org/10.1684/ndt.2023.8","url":null,"abstract":"","PeriodicalId":51140,"journal":{"name":"Nephrologie & Therapeutique","volume":"19 1","pages":"1-2"},"PeriodicalIF":0.7,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10846509","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}

{"title":"Epidemiology of chronic kidney disease stage V treated in southeastern Algeria: prospective study from 2016 to 2018","authors":"Nassim Meguellati,&nbsp;Tahar Rayane,&nbsp;Younes Boulahia,&nbsp;Messaoud Saidani,&nbsp;Ahsène Atik,&nbsp;Abderrahmane Saidi,&nbsp;Mohamed Tayeb Saadi,&nbsp;Zoheir Laib,&nbsp;Mustapha Hanba,&nbsp;Mebarek Kellil,&nbsp;Nacereddine Regaiguia,&nbsp;Mahmoud Bousakhria,&nbsp;Djahid Bendjeddou","doi":"10.1684/ndt.2023.4","DOIUrl":"https://doi.org/10.1684/ndt.2023.4","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease stage V, by its incidence and its prevalence which are constantly increasing in the world and in Algeria, the morbidity and mortality it generates, the high cost of its treatment, represents a major public health issue. Our objective is to describe the epidemiology of stage V chronic kidney disease treated in south-eastern Algeria.</p><p><strong>Patients and methods: </strong>In our regional, multicenter, prospective descriptive study, all patients with stage V chronic kidney disease, residing and treated in south-eastern Algeria between September 1, 2016, and December 31, 2017, were included and followed up until December 31, 2018.</p><p><strong>Results: </strong>Stage V chronic kidney disease is a frequent pathology in the region: 1934 patients were included. It mainly affects young people: the average age of patients was 50.17 ± 16.98 years, with a male predominance of 59.10%. High blood pressure and diabetes are the two main causes. The start of dialysis on a temporary catheter represents 81.5% of cases, the initial management requires emergency dialysis in 91.2% of cases. In total, 97.1% of chronic hemodialysis patients use an arteriovenous fistula as a permanent vascular access.</p><p><strong>Conclusion: </strong>Our study population is younger than that of developed countries and has fewer comorbidities and disabilities but lower survival and high mortality. The developing national chronic kidney disease stage V registry is becoming an absolute necessity. It will allow to have a better knowledge of its epidemiology and the needs of its care in each region. It can contribute to improving the prevention and management of this disease.</p>","PeriodicalId":51140,"journal":{"name":"Nephrologie & Therapeutique","volume":"19 1","pages":"1-13"},"PeriodicalIF":0.7,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10855723","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}

{"title":"The Green Nephrology Group of the SFNDT: initial reflections","authors":"Charles Chazot,&nbsp;Hafsah Hachad,&nbsp;Pierre Filipozzi,&nbsp;Cécile Legallais,&nbsp;Perrine Jullien,&nbsp;Fabrice Huré,&nbsp;Karim Dardim,&nbsp;Catherine Lasseur,&nbsp;Hubert Metayer,&nbsp;Didier Aguilera,&nbsp;Agnès Caillette-Beaudoin,&nbsp;Christophe Mariat,&nbsp;Maryvonne Hourmant","doi":"10.1684/ndt.2023.1","DOIUrl":"https://doi.org/10.1684/ndt.2023.1","url":null,"abstract":"<p><p>Preserving the environment is becoming a universal priority. Human activities must be redesigned to best adapt them to available resources and to reduce their deleterious impact on the planet. The Green Nephrology Group of the “Société française de néphrologie, dialyse et transplantation” (SFNDT) has started a reflection on these issues, in particular on dialysis, a vital treatment but with high carbon production, associated with high water consumption. The data available on these points are presented such as, among others, the collection of indicators and action plans, the recycling of waste from water treatment, the reduction of dialysate flow, the reuse and regeneration of spent dialysate as well as calculations of carbon emission by dialysis activity. Architectural experiences are reported as well as the regulatory constraints applying to manufacturers and organizations in the sector. Potential solutions require the mobilization of all stakeholders, ranging from patients to health authorities, including caregivers, pharmacists, technicians, nephrologists and facility managers. They will be formalized very soon in a guide being prepared by the SFNDT Green Nephrology Group.</p>","PeriodicalId":51140,"journal":{"name":"Nephrologie & Therapeutique","volume":"19 1","pages":"1-11"},"PeriodicalIF":0.7,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10855722","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}

{"title":"Place de l’avacopan dans le traitement de la vascularite associée aux ANCA What role for avacopan in the treatment of ANCA-associated vasculitis?","authors":"Alexandre Karras","doi":"10.1016/S1769-7255(22)00647-2","DOIUrl":"10.1016/S1769-7255(22)00647-2","url":null,"abstract":"<div><p>Des données expérimentales récentes ont révélé que le complément, et plus particulièrement le composé C5a, joue un rôle majeur dans la physiopathologie de la vascularite à ANCA. Le développement d’un inhibiteur oral du récepteur du C5a, l’avacopan, a permis de tester cette nouvelle piste thérapeutique, initialement dans un modèle murin de la maladie, puis chez l’homme, au cours d’un essai thérapeutique préliminaire de phase 2, avec des résultats encourageants. Dans l’étude internationale de phase 3, publiée en 2021, les auteurs ont démontré que l’avacopan pouvait remplacer efficacement les corticoïdes au cours du traitement d’induction de la vascularite à ANCA, en association avec un immunosuppresseur comme le rituximab ou le cyclophosphamide. L’adjonction de cet immunosuppresseur de nouvelle génération ne majore pas le risque infectieux, mais permet d’amplifier la récupération de la fonction rénale lors du traitement initial de la vascularite rénale. Ces résultats ont conduit à l’obtention d’une AMM pour l’avacopan en 2022, apportant désormais une nouvelle option thérapeutique dans la vascularite à ANCA.</p><p>© 2022 Publié par Elsevier Masson SAS au nom de Société francophone de néphrologie, dialyse et transplantation.</p></div><div><p>Recent experimental data have revealed the complement, and more specifically the C5a compound, plays a major role in the pathophysiology of ANCA associated vasculitis (AAV). The development of avacopan, an oral inhibitor of C5a receptor, has allowed to test the blockade of this immunological pathway, initially in a murine animal model of the disease, followed by a preliminary, phase 2 therapeutic trial in human disease, with promising results. An international phase 3 trial published in 2021 demonstrated that avacopan can be used instead of corticosteroids for the induction therapy of AAV, in association with an immunosuppressive drug such as cyclophosphamide or rituximab. The adjunction of this new-generation immunosuppressive drug does not increase the infectious risk, but seems to amplify the improvement of renal function during the initial treatment of renal vasculitis. These results have led to the recent registration of avacopan, opening new therapeutic options in AAV.</p><p>© 2022 Published by Elsevier Masson SAS on behalf of Société francophone de néphrologie, dialyse et transplantation.</p></div>","PeriodicalId":51140,"journal":{"name":"Nephrologie & Therapeutique","volume":"18 6","pages":"Pages 6S7-6S10"},"PeriodicalIF":0.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10815368","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}