Nephrologie & therapeutique最新文献

The complexity of the decision-making process from dialysis withdrawal to death 决定在死亡前停止透析的复杂性。

Nephrologie & therapeutique Pub Date : 2025-07-16 DOI: 10.1684/ndt.2025.130

Sandrine Letrecher, Angélique Thuillier

{"title":"The complexity of the decision-making process from dialysis withdrawal to death","authors":"Sandrine Letrecher, Angélique Thuillier","doi":"10.1684/ndt.2025.130","DOIUrl":"10.1684/ndt.2025.130","url":null,"abstract":"The working group of the Francophone Society of Nephrology, Dialysis, and Transplantation (SFNDT) recently published a guide for the reasoned adaptation of therapies (ART) in nephrology, which takes up the legal framework of the Claeys–Leonetti Law (2016) and highlights the specificities of palliative care in the context of a long-term chronic illness. In this literature review—drawing from both medical research and the humanities and social sciences—we offer a complementary perspective on the complex decision-making process from dialysis withdrawal to death (DWD), in the sense of sociologist and philosopher Edgard Morin’s concept of complex thought. Quantitative studies, both national and international, highlight the role of cultural differences between countries as well as the influence of legal frameworks on DWD, but other factors are also at play. Patient characteristics associated with DWD as well as differences in regional practices are identified. Qualitative studies and research in the humanities and social sciences further explore the experiences of caregivers, marked by uncertainty and complexity, as decisions unfold among patients, families or caregivers, and health care professionals. This literature review serves as a foundation for an ongoing mixed methods study on the variability of DWD practices in France.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 4","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644464","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

Exploring quality of life among chronic hemodialysis patients: Navigating the cumulative impact of multiple crises 探索慢性血液透析患者的生活质量：导航多重危机的累积影响

Nephrologie & therapeutique Pub Date : 2025-06-27 DOI: 10.1684/ndt.2025.123

Rayyan Wazzi-Mkahal, Ranim Razzouk, Krystel Aouad, Najat Fares, Valerie Hage

{"title":"Exploring quality of life among chronic hemodialysis patients: Navigating the cumulative impact of multiple crises","authors":"Rayyan Wazzi-Mkahal, Ranim Razzouk, Krystel Aouad, Najat Fares, Valerie Hage","doi":"10.1684/ndt.2025.123","DOIUrl":"10.1684/ndt.2025.123","url":null,"abstract":"Introduction: Hemodialysis patients have poorer health-related quality of life (HRQOL) compared to the general population. HRQOL is influenced by many sociodemographic and clinical factors. The aim of our study is to describe the HRQOL among adult patients undergoing hemodialysis during a period of economic and health crisis.Methods: This is a cross-sectional study including patients who had been on hemodialysis for at least 3 months. We interviewed a total of 90 hemodialysis patients using the 36-Item Short Form Health Survey (SF36). The SF-36 measures eight scales and two distinct concepts: the Physical Component Summary (PCS) and the Mental Component Summary (MCS). Data analyses was performed with RStudio version 2022.12.0.Results: The mean age (±SD) was 69.67±12.80 years. The mean PCS score (±SD) was 48.55±24.7 and the mean MCS score (±SD) was 58.62±22.1. The highest scores among the SF-36 were emotional well-being (66.65±20.02) and social functioning (66.53±27.40). Multivariate analysis showed that PTH levels and occupational status are significantly associated with PCS scores (p=0.007 and p=0.03 respectively), and that age at onset of dialysis, PTH levels, occupational status, marital status, and COVID-19 infection are significantly associated with MCS scores (p=0.04, p<0.001, p=0.003, p=0.006 and p=0.007 respectively).Conclusion: The overall PCS and MCS scores were low, indicating poor HRQOL. However, the crises did not appear to directly worsen it, due to a strong social support system. A multidisciplinary team approach may improve the HRQOL of these patients.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 2","pages":"153-160"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268288","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

Néphrologie & Thérapeutique on the way! nsamrology和thsamrapeutique在路上了！

Nephrologie & therapeutique Pub Date : 2025-06-27 DOI: 10.1684/ndt.2025.127

Valérie Moal, François Vrtovsnik, Bacchetta Justine, Olivia Boyer, Christophe Mariat, Sandrine Lemoine

引用次数: 0

Catheter placement by nephrologists: A safe and effective method for improving access to peritoneal dialysis 肾科医师置管：一种安全有效的改善腹膜透析的方法。

Nephrologie & therapeutique Pub Date : 2025-06-27 DOI: 10.1684/ndt.2025.119

Maria Lafrid, Abdelaali Bahadi, Narjiss Labioui, Ismail Hanine, Hajar Laasli, Theresia Peya Mponguili, Mohammed Hallak, Sanae Benbria, Driss El Kabbaj

{"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":"Introduction: 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.Methods: This was a single-center retrospective study including 69 PD patients, conducted from January 2008 to December 2022.Results: 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).Conclusion: PD catheter placement by nephrologists proved to be a safe and effective approach.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 2","pages":"143-152"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","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}

引用次数: 0

Administration of lumasiran in a child with infantile oxalosis undergoing chronic peritoneal dialysis: A case report 鲁马西兰治疗慢性腹膜透析的草化病患儿1例

Nephrologie & therapeutique Pub Date : 2025-06-27 DOI: 10.1684/ndt.2025.121

Chloé Grosyeux, Arnaud Wiedemann, Marie-Christine Camoin-Schweitzer, Cécile Acquaviva-Bourdain, Noël Boussard, Justine Bacchetta, Isabelle Vrillon

引用次数: 0

Vitamin D, anemia, and fibroblast growth factor 23: Ethnic disparities in Algerian chronic kidney disease patients 维生素D、贫血和成纤维细胞生长因子23：阿尔及利亚慢性肾病患者的种族差异

Nephrologie & therapeutique Pub Date : 2025-06-27 DOI: 10.1684/ndt.2025.124

Lydia Ziouani, Damien Gruson, Messaoud Saidani, Elhadj-Ahmed Koceir

{"title":"Vitamin D, anemia, and fibroblast growth factor 23: Ethnic disparities in Algerian chronic kidney disease patients","authors":"Lydia Ziouani, Damien Gruson, Messaoud Saidani, Elhadj-Ahmed Koceir","doi":"10.1684/ndt.2025.124","DOIUrl":"10.1684/ndt.2025.124","url":null,"abstract":"This study investigates ethnic differences in vitamin D levels and bone-related biomarkers among Algerian CKD patients, focusing on the interactions between vitamin D, anemia, and FGF23. A multicenter, cross-sectional study involved 284 CKD patients in stages 3 and 4, with a mean age of 54±1.17 years. Participants were recruited from nephrology units in three distinct geographic regions of Algeria: Algiers (Mediterranean), Ghardaïa (sub-Saharan), and Tamanrasset (Saharan). Biochemical analyses included serum levels of 25OH vitamin D, iPTH, iFGF23, calcium, phosphorus, and hemoglobin. Multiple logistic regression was used to assess the association between anemia and vitamin D levels. Linear regression analysis identified predictors of iFGF23 in hemoglobin levels. A two-way ANOVA was performed to examine the influence of vitamin D levels across different ethnic groups. Patients from Tamanrasset exhibited significantly lower levels of 25OH vitamin D and hemoglobin, and higher levels of phosphorus, iFGF23, and iPTH, compared to those from Ghardaïa and Algiers. Anemia was independently associated with lower serum 25OH vitamin D concentrations (β=-0.11, P=0.001), while iFGF23 levels were inversely associated with hemoglobin levels (β=-3.3, P=0.01). A significant interaction between anemia and vitamin D status was observed among Black patients (P=0.0001), but not among white patients (P=0.7). These findings underscore notable ethnic disparities in vitamin D status and mineral biomarkers among Algerian CKD patients. The interplay between vitamin D, anemia, and FGF23 highlights the need for ethnically tailored care, particularly for patients in the Saharan region of Tamanrasset.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 3","pages":"161-169"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268291","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

Once upon a time in nephrology - Episode 1: Management of thrombotic microangiopathy 曾几何时在肾脏病-第1集：血栓性微血管病的管理

Nephrologie & therapeutique Pub Date : 2025-06-27 DOI: 10.1684/ndt.2025.128

Simon Ville, Pierre Delanaye, Christophe Mariat

引用次数: 0

Once upon a time in nephrology, or how did we get here? 从前在肾脏学，或者我们是怎么走到这一步的？

Nephrologie & therapeutique Pub Date : 2025-06-27 DOI: 10.1684/ndt.2025.126

Simon Ville, Pierre Delanaye, Christophe Mariat

引用次数: 0

Effectiveness of virtual reality interventions on anxiety and depressive symptoms in hemodialysis patients: A systematic review 虚拟现实干预对血液透析患者焦虑和抑郁症状的有效性：系统综述

Nephrologie & therapeutique Pub Date : 2025-06-27 DOI: 10.1684/ndt.2025.122

Safia Mecerli, Valentine Cazauvieilh, Romain Vial, Sébastien Colson, Christophe Roman, Mickaël Bobot, Philippe Brunet

{"title":"Effectiveness of virtual reality interventions on anxiety and depressive symptoms in hemodialysis patients: A systematic review","authors":"Safia Mecerli, Valentine Cazauvieilh, Romain Vial, Sébastien Colson, Christophe Roman, Mickaël Bobot, Philippe Brunet","doi":"10.1684/ndt.2025.122","DOIUrl":"10.1684/ndt.2025.122","url":null,"abstract":"Background: End-stage chronic kidney disease affects millions of people worldwide, and its treatment through hemodialysis results in a high rate of depression and anxiety. To address these disorders, virtual reality can be used as a non-pharmacological psychological intervention.Objective: To describe the effectiveness of virtual reality interventions on depression and anxiety symptoms in hemodialysis patients.Methods: A systematic review was conducted in the PubMed, Embase, ScienceDirect, and PsycInfo databases. Six quantitative studies published between 2019 and 2024 that address the impact of virtual reality on anxiety and depressive symptoms in hemodialysis patients were included according to the PRISMA method. A methodical analysis of these studies was performed.Results: These studies utilize various virtual reality interventions, both immersive and non-immersive, such as “exergaming.” They predominantly report a significant improvement in depression and anxiety scores in hemodialysis patients. The benefit of these studies varies according to the type and duration of the intervention. The main limitations include the small number of available studies and limited sample sizes.Conclusion: Virtual reality interventions show promising potential for improving anxiety and depressive symptoms in hemodialysis patients. They can find a place in non-pharmacological management. Large additional studies are needed to better understand their potential benefits and to optimize their handling by patients and caregivers.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 3","pages":"170-179"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268290","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

Biopsy-based transcriptomics in kidney transplantation: Where do we stand in 2025? 肾脏移植中的分子生物学工具用于诊断排斥反应。2025年我们在哪里？

Nephrologie & therapeutique Pub Date : 2025-06-27 DOI: 10.1684/ndt.2025.125

Rachna Baguant, Dominique Bertrand, Arnaud François, Steven Grangé, Dominique Guerrot, Charlotte Laurent, Mathilde Lemoine, Sophie Candon, Tristan de Nattes

{"title":"Biopsy-based transcriptomics in kidney transplantation: Where do we stand in 2025?","authors":"Rachna Baguant, Dominique Bertrand, Arnaud François, Steven Grangé, Dominique Guerrot, Charlotte Laurent, Mathilde Lemoine, Sophie Candon, Tristan de Nattes","doi":"10.1684/ndt.2025.125","DOIUrl":"10.1684/ndt.2025.125","url":null,"abstract":"Despite advances in the physiopathological understanding of kidney transplantation immunology, kidney transplant rejection remains the leading cause of allograft loss. The current gold standard for diagnosing rejection is histological assessment of kidney transplant biopsies.\u0000Biopsy-based transcriptomics have been the subject of numerous studies, enabling the analysis of hundreds of transcripts expressed in biopsy samples. These tools allow for the identification of new pathophysiological pathways, providing a better understanding of rejection and potentially revealing therapeutic targets.\u0000Biopsy-based transcriptomics may also improve the diagnosis of rejection, in particular antibody-mediated rejection. However, the use of these tools in routine practice is limited due to restricted availability, the challenge of interpreting data from hundreds of transcripts without clear guidelines, and their cost. In addition, due to the limited accessibility of molecular tools, their exact impact on patient management has not yet been determined.\u0000This update provides an overview of biopsy-based transcriptomics in 2025, focusing on the limitations of current diagnostic methods for rejection, the molecular biology tools available, and their use in clinical practice.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 2","pages":"184-194"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268289","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