Nephrologie & therapeutique最新文献

{"title":"Catheter placement by nephrologists: A safe and effective method for improving access to peritoneal dialysis","authors":"Maria Lafrid, Abdelaali Bahadi, Narjiss Labioui, Ismail Hanine, Hajar Laasli, Theresia Peya Mponguili, Mohammed Hallak, Sanae Benbria, Driss El Kabbaj","doi":"10.1684/ndt.2025.119","DOIUrl":"10.1684/ndt.2025.119","url":null,"abstract":"<p><strong>Introduction: </strong>Peritoneal dialysis (PD) is an effective treatment option for patients with kidney failure and offers them a better quality of life. Despite its advantages, PD remains underutilized, particularly in Morocco. The aim of our study was to evaluate the impact of catheter placement by nephrologists on the number of incident PD patients, compare the success rates of this technique with those of surgical placement, and assess the short- and long-term complications associated with the two approaches.</p><p><strong>Methods: </strong>This was a single-center retrospective study including 69 PD patients, conducted from January 2008 to December 2022.</p><p><strong>Results: </strong>A total of 28 patients received PD catheter placement by nephrologists (Group A), while 41 underwent the procedure performed by urologists (Group B). Since the introduction of nephrologist-led catheter placement, the incidence of patients starting PD significantly increased, with a growth rate of over 100% every two years. The waiting time for catheter placement was significantly shorter in Group A (5 days versus 20 days; p < 0.001). No significant difference was observed in the incidence of short-term mechanical and infectious complications between the two groups. Although univariable analysis revealed a higher incidence of long-term mechanical and infectious complications in Group B compared to group A, this difference was not statistically significant in multivariable analysis (p > 0.05). The success rate of PD catheter placement in Group A was 92.85%, while it was 97.56% in Group B. The one-year catheter survival rate was significantly higher in Group B than in Group A (100% versus 75%; p = 0.031), and mean catheter survival was significantly longer in Group B (17 months versus 11 months; p = 0.026).</p><p><strong>Conclusion: </strong>PD catheter placement by nephrologists proved to be a safe and effective approach.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 2","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103446","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}

{"title":"Physical activity in hemodialysis","authors":"Quentin Bellanger, Antoine Desvergée, Mélanie Hanoy, Hélène Azambourg, Nicolas Gautier, Patrick Henri","doi":"10.1684/ndt.2025.116","DOIUrl":"https://doi.org/10.1684/ndt.2025.116","url":null,"abstract":"<p><p>A sedentary lifestyle is a major issue in today’s society, with its consequences being especially pronounced in the chronic hemodialysis population. This article begins with an overview of physical activity definitions and physiological insights, then explores the specifics of sedentary behavior in chronic hemodialysis patients. It also examines the practice of adapted physical activity and highlights the barriers to its development for hemodialysis patients in France.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 2","pages":"104-112"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083041","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}

{"title":"Are your kidneys ok? Early detection to protect kidney health.","authors":"Joseph A Vassalotti, Anna Francis, Augusto Cesar Soares Dos Santos, Ricardo Correa-Rotter, Dina Abdellatif, Li-Li Hsiao, Stefanos Roumeliotis, Agnes Haris, Latha A Kumaraswami, Siu-Fai Lui, Alessandro Balducci, Vassilios Liakopoulos","doi":"10.1684/ndt.2025.120","DOIUrl":"10.1684/ndt.2025.120","url":null,"abstract":"<p><p>Early detection of kidney disease can protect kidney health, prevent kidney disease progression and related complications, reduce the risk of cardiovascular disease, and decrease mortality. We must ask, “Are your kidneys ok?” by using serum creatinine to estimate kidney function and urine albumin to assess kidney and endothelial damage. Evaluation of causes and risk factors for chronic kidney disease (CKD) includes testing for diabetes, as well as measuring blood pressure and body mass index. This World Kidney Day we assert that case-finding in high-risk populations – or even population-level screening – can significantly reduce the global burden of kidney disease. Early-stage CKD is asymptomatic and simple to test for. Recent paradigm-shifting CKD treatments, such as sodium-glucose cotransporter-2 inhibitors, dramatically improve outcomes and favor the cost-benefit analysis for screening or case-finding programs. Despite this, numerous barriers exist, including resource allocation, health care funding, infrastructure, and both health care professionals’ and the public’s awareness of kidney disease. Coordinated efforts by major kidney-focused non-governmental organizations to prioritize kidney health within government agendas and align early detection efforts with other current programs will maximize efficiencies.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 2","pages":"65-72"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083039","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}

{"title":"Intradialytic parenteral nutrition: theory and practical application","authors":"Céline Pasian, Raymond Azar, Denis Fouque, Laetitia Koppe, Fitsum Guebre-Egziabher, Frédéric V Valla, Stanislas Trolonge, Philippe Chauveau, Céline Nodimar, Laura Brien, Stanislas Bataille","doi":"10.1684/ndt.2025.117","DOIUrl":"https://doi.org/10.1684/ndt.2025.117","url":null,"abstract":"<p><p>Protein energy wasting is common in chronic kidney disease at the dialysis stage. It has an impact on morbidity and mortality, and must be diagnosed and treated as early as possible. Various strategies can be envisaged, including dietary counseling, prescription of Oral Nutritional Supplements or artificial nutrition (enteral or parenteral nutrition). Intradialytic parenteral nutrition (IDPN) involves administering parenteral nutrition during hemodialysis sessions to support a moderate food intake deficit.\u0000In this article, a group of nephrologists, dieticians and nutrition physician the indications, non-indications, administration and monitoring of IDPN. In particular, they analyze IDPN infusion rates in relation to the maximum metabolic capacities of the various nutrients.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 2","pages":"73-87"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083040","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}

{"title":"The effects of resins added to the milk of children suffering from chronic kidney disease: a clinical relevance to control potassium and phosphate levels?","authors":"Rouba Bechara, Véronique Chambon, Corentin Naud, Bruno Ranchin, Aurélie de Mul, Justine Bacchetta","doi":"10.1684/ndt.2025.118","DOIUrl":"https://doi.org/10.1684/ndt.2025.118","url":null,"abstract":"<p><strong>Background: </strong>In infants with chronic kidney disease (CKD), the management of nutrition and growth is highly challenging, particularly compared to older children. Management of hyperkalemia and hyperphosphatemia is difficult, and incorporating potassium and phosphate binders directly in formulas could be beneficial, as it avoids direct ingestion of resins by infants.</p><p><strong>Materials and methods: </strong>We conducted a study using Gallia® standard first-stage infant formula and Pregestimil®. We added either carbonate sevelamer (Renvela®, 200, 400 or 800 mg) or polystyrene sulfonate (Resikali®, 2000, 4000 or 8000 mg) to 90 ml of formula. Additionally, we evaluated the combined use of the resins with Gallia® by adding in 90 mL 200 mg/2000 mg, 400 mg/4000 mg, and 200 mg/4000 mg of Renvela® and Resikali®, respectively. The Milk was decanted for 10 minutes, and the resulting supernatants were weighted and analyzed for osmolality and pH. Sodium, potassium, chlore, bicarbonate, magnesium, glucose, calcium, phosphate, protein, cholesterol, triglycerides, iron, folate, vitamin B12 levels were measured after centrifugation.</p><p><strong>Results: </strong>With polystyrene sulfonate, potassium levels in milk decreased in a dose-dependent manner, by 36%, 52% and 68%, respectively. Polystyrene sulfonate also reduced magnesium levels and increased both calcium concentration (from 9.7 to 21 mmol/L) and osmolality (from 359 to 423 mOsm/kg). No significant effect on phosphate was observed. Sevelamer decreased both calcium and phosphate concentrations in a dose-dependent manner, by 14%, 26% and 29%, and by 24%, 36% and 40%, respectively. Sevelamer also increased pH from 6.9 to 9.1, and decreased folate levels by 32%, 66% and 81% respectively, from 465 to 88 mmol/L. The combined use of sevelamer and polystyrene sulfonate results in decreased levels of potassium (by 45%, 59% and 59%, respectively), phosphate (by 38%, 39% and 36%, respectively), and folate, albeit with a slighter increase in pH. Osmolality remained unchanged and no other relevant differences were observed.</p><p><strong>Conclusion: </strong>Pretreating formulas with resins is a reproducible and straightforward method when specific diets for CKD are unavailable. However, it is important to keep in mind that resins may impact the overall composition (osmolality) and the concentration of other nutrients (folates).</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 2","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059500","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}

{"title":"Efficient removal of oxalate from tea by pre-infusion.","authors":"Cécile Clément, Jordan Desenclos, Valentine Forté, Carole Martori, Catherine Prats, Jean-Philippe Haymann, Michel Daudon, Emmanuel Letavernier","doi":"10.1684/ndt.2025.115","DOIUrl":"https://doi.org/10.1684/ndt.2025.115","url":null,"abstract":"<p><strong>Purpose: </strong>Most kidney stones are made of calcium oxalate. Many kidney stone formers stop drinking tea, resulting in reduced diuresis. The oxalate in tea diffuses rapidly during infusion. We hypothesized that pre-infusion of tea could significantly reduce its oxalate content.</p><p><strong>Methods: </strong>Tea bags were infused for 0.5, 1, 2 or 3 minutes, with or without a pre-infusion of 10, 30 or 60 seconds (16 conditions, n=4/condition). Oxalate concentration was measured and a blind organoleptic analysis was carried out by 4 operators.</p><p><strong>Results: </strong>A 10 seconds pre-infusion reduced the oxalate concentration of tea by 10 to 33% (p<0.05). A 30 seconds pre-infusion reduced it by 38 to 51% (p<0.05) and a 1 minute pre-infusion by 59 to 65% (p<0.05). Pre-infusion had no significant impact on satisfaction scores for taste, smell or visual appearance.</p><p><strong>Conclusion: </strong>Pre-infusion of tea significantly reduces oxalate intake (by up to 2/3 depending on conditions).</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 2","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046795","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}

{"title":"The highlights of kidney transplantation in 2024","authors":"Thomas Jouve","doi":"10.1684/ndt.2025.111","DOIUrl":"10.1684/ndt.2025.111","url":null,"abstract":"<p><p>The year 2024 of kidney transplantation was rich in communications in five main selected fields: immunomonitoring biomarkers, therapeutic innovation with anti-CD38 antibodies, tele-monitoring opportunities, patients’ quality of life and health equity considerations. Two biomarkers were consecrated in 2024: the TorqueTenoVirus (TTV) viral load and donor-derived cell-free DNA (dd-cfDNA). Antibodies directed against CD38 both in the field of desensitization and treatment of antibody-mediated rejection showed promising results and promise further upcoming clinical trials. Tele-monitoring of transplanted patients, with the use of dedicated smartphone applications, suggests new ways to improve the logistic of care together with the quality of care. This notion of patient-reported quality of life is gathering importance in the field. It is associated with the patient’s microbiome, opening new potential treatment opportunities. Finally, ethical considerations bring us to think of quality of care in female kidney transplant recipients: as of 2024, this quality remains insufficient when compared to male recipients.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 S1","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059200","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}

{"title":"The highlights of nephrology in 2024","authors":"Camille Cohen","doi":"10.1684/ndt.2025.110","DOIUrl":"10.1684/ndt.2025.110","url":null,"abstract":"<p><p>The year 2024 marks significant progress in nephrology, particularly in immunoglobulin A (IgA) nephropathy and nephroprotection. In IgA nephropathy, new molecules such as sibeprenlimab and atacicept, targeting the BAFF and APRIL pathways, have shown a reduction in proteinuria and stabilization of glomerular filtration rate (GFR), confirming the importance of these pathways in the disease. Furthermore, the involvement of the microbiota in the pathology opens up promising therapeutic prospects. In nephroprotection, the combination of SGLT2 inhibitors, endothelin receptors and GLP1 agonists enhances the management of chronic kidney disease, including diabetic nephropathy, with positive effects on proteinuria and renal survival. The discovery of anti-nephrin antibodies in idiopathic nephrotic syndrome (INS) marks a major step forward, enabling better prediction of the response to immunosuppressants and a more refined diagnosis between autoimmune and genetic pathologies, and opening up the future prospect of more personalized management of this pathology. Derived from hematology, anti-CD38 therapies are also showing promising results in glomerulopathies, while CAR-T cells are opening the way to new therapeutic options for refractory autoimmune diseases such as lupus. These advances testify to a move towards precision medicine in nephrology, where the personalization of treatments could, in time, significantly improve the management of patients with kidney pathologies.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 S1","pages":"5-10"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039875","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}

{"title":"The highlights of dialysis in 2024","authors":"Sébastien Rubin","doi":"10.1684/ndt.2025.112","DOIUrl":"10.1684/ndt.2025.112","url":null,"abstract":"<p><p>In 2024, dialysis is experiencing advancements, particularly in environmental sustainability. “Green dialysis” is emerging as a priority, aiming to reduce the carbon footprint of dialysis centers (water and resource consumption, patient transportation). Innovative strategies, such as adjusting dialysate flow rate and temperature, have demonstrated similar effectiveness to standard dialysis in terms of Kt/V while reducing water consumption. A recent Cochrane review confirms the equivalence between peritoneal dialysis (PD) and hemodialysis (HD) in terms of mortality. Additionally, hemodiafiltration (HDF) is regaining attention thanks to the CONVINCE study and its ancillary studies, which show a reduction in mortality risk and an improvement in quality of life. Furthermore, technical adaptations are making HDF more environmentally friendly. Anticoagulation strategies are also evolving: heparin-free dialysis, using calcium-free dialysate and reinjection controlled by ionic dialysance, has proven effective. A large French study based on the Rein registry and the National Health Data System database shows that direct oral anticoagulants, particularly apixaban, although not officially approved for dialysis (off-label use), offer promising prospects for reducing thromboembolic risk. Chronic inflammation, a major cardiovascular risk factor in dialysis patients, is the focus of therapeutic trials targeting IL-6 (clazakizumab), with encouraging phase II results. Meanwhile, dialysate sodium management is being reassessed: individualized reductions can help better control blood pressure but must be used cautiously in certain patients. Finally, in elderly patients contraindicated for transplantation, initiating hemodialysis provides only a modest survival benefit, sometimes at the cost of reduced time spent at home. Decisions between dialysis and conservative management (opting not to dialyze) should therefore be guided by patient preferences and quality of life.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 S1","pages":"11-17"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048497","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}

{"title":"The highlights of the SFNDT congress - October 1st to 4th 2024, Bordeaux","authors":"François Vrtovsnik","doi":"10.1684/ndt.2025.109","DOIUrl":"https://doi.org/10.1684/ndt.2025.109","url":null,"abstract":"","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 S1","pages":"3-4"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056456","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}