Nephrologie & therapeutique最新文献

Associated factors of acute kidney injury during severe pre-eclampsia in Togo from 2019 to 2022: a case series study.

Nephrologie & therapeutique Pub Date : 2024-12-01 DOI: 10.1684/ndt.2024.97

Yawovi Mawufemo Tsevi, Latame Komla Adoli, Ayoko Ketevi, Badomta Dolaama, Kodjo Djagadou, D'Daah Hadabia, Sabi Kossi Akomola

{"title":"Associated factors of acute kidney injury during severe pre-eclampsia in Togo from 2019 to 2022: a case series study.","authors":"Yawovi Mawufemo Tsevi, Latame Komla Adoli, Ayoko Ketevi, Badomta Dolaama, Kodjo Djagadou, D'Daah Hadabia, Sabi Kossi Akomola","doi":"10.1684/ndt.2024.97","DOIUrl":"https://doi.org/10.1684/ndt.2024.97","url":null,"abstract":"Background: Acute Kidney Injury (AKI) in pregnant women admitted for severe pre-eclampsia (PE) is common in developing countries. The aim of this study was to determine the frequency and associated factors of AKI in severe pre-eclampsia in Lomé.Methods: A case series study was conducted from July 18, 2019, to August 17, 2022, at the Sylvanus Olympio University Hospital (CHU-SO) in Lomé, Togo. All pregnant women who were admitted with severe pre-eclampsia and had at least two measures of creatinine were included. AKI was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) 2012 criteria.Results: A total of 220 cases of severe preeclampsia were analysed during the study period. 44 cases of severe pre-eclampsia (20%) were complicated in AKI. The mean age of patients with AKI was 30 ± 5.40 years (versus 30.2 ± 6.94 years for patients without AKI). Factors associated with the occurrence of AKI in multivariate analysis were multigravidity (adjusted Odd Ratio [aOR] = 3.15, 95% CI, [1.16-8.57]); the presence of infectious syndrome (aOR = 2.69; 95% CI, [1.05-6.91]) and haemoglobin levels ≤ 10 g/dL (aOR: 2.76; 95% CI [1.34-5.69]). There were no maternal deaths.Conclusions: The occurrence of AKI during severe preeclampsia is high at the CHU-SO in Lomé, Togo. The factors associated to AKI occurrence were multigravidity, infectious syndrome and haemoglobin level. Pregnant women with these factors should be closely monitored to avoid the occurrence of AKI.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"20 7","pages":"632-639"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367170","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

Sleep disorders in patient with chronic kidney disease: proposal for a clinical pathway

Nephrologie & therapeutique Pub Date : 2024-12-01 DOI: 10.1684/ndt.2024.96

Benoit Franko, Lydie Houillon, Georgios Kosmadakis, Angelo Testa, Karim Belarbi, Valérie Desré-Follet, Sandrine Launois-Rollinat

{"title":"Sleep disorders in patient with chronic kidney disease: proposal for a clinical pathway","authors":"Benoit Franko, Lydie Houillon, Georgios Kosmadakis, Angelo Testa, Karim Belarbi, Valérie Desré-Follet, Sandrine Launois-Rollinat","doi":"10.1684/ndt.2024.96","DOIUrl":"https://doi.org/10.1684/ndt.2024.96","url":null,"abstract":"Sleep disorders are common in all stages of chronic kidney disease and significantly affect the quality of life of these patients. The main causes of sleep disorders are pruritus, depression, restless legs syndrome and obstructive sleep apnea. To date, there is no defined strategy or expert consensus for the screening of sleep disorders in this population, nor any recommendation on a specific management strategy according to etiology. We propose to use the PROMIS-29 questionnaire, to which two questions have been added: “Do you scratch yourself? Do you snore?” The answers to these questions, together with the scores for the “Sleep disorders” (score ≥ 12), “Depression” (score ≥ 11), “Pain” (score ≥ 11) and “Fatigue” (score ≥ 14) domains make it possible to screen for sleep disorders, specify their etiology and refer patients for appropriate management. We suggest a standardized management strategy for each major orientation. This pathway, to be adapted according to the resources of each center, should lead to the diagnosis of more patients suffering from sleep disorders and improve their quality of life.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"20 7","pages":"658-665"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367174","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

Typical pediatric hemolytic uremic syndrome in Algeria : prognostic factors

Nephrologie & therapeutique Pub Date : 2024-12-01 DOI: 10.1684/ndt.2024.101

Souad Chelghoum, Ghalia Khellaf, Naima Adjlane, Samira Abrouk, Athmane Seba

{"title":"Typical pediatric hemolytic uremic syndrome in Algeria : prognostic factors","authors":"Souad Chelghoum, Ghalia Khellaf, Naima Adjlane, Samira Abrouk, Athmane Seba","doi":"10.1684/ndt.2024.101","DOIUrl":"https://doi.org/10.1684/ndt.2024.101","url":null,"abstract":"HUS induced by shigatoxin-producing Escherichia coli (STEC HUS) is a serious disease requiring dialysis in 50% of cases, but renal recovery is frequent. Renal sequelae such as proteinuria, arterial hypertension (AH) and chronic renal failure (CRF) are possible in 30% of cases. Several prognostic factors have been identified, the main one being the duration of anuria. The aim of our paper is to describe the outcome of typical HUS in a cohort of patients followed over three years, and to detect reliable early predictors of poor prognosis in a specialized department in Algeria. Our study is observational and longitudinal. Inclusion criteria were the triad anemia-thrombocytopenia-acute renal failure (ARF) in children under sixteen years of age. Clinical and laboratory data were collected prospectively at baseline, at three months and every six months.\u0000A cohort of 23 children was recruited. The rate of recovery of renal function and death was 83% and 13%, respectively. There is a significant correlation between the presence of neurological damage, young age < 2 years and the occurrence of kidney damage. Late dialysis > 48 hours multiplies the relative risk of kidney damage by four. Event-free survival (death or occurrence of proteinuria, hypertension and/or CKD) is significantly related to young age and the time to dialysis > 48 hours. Delayed dialysis has a significant impact on overall survival. The latter factor increases the risk of death. Early diagnosis and management are important prognostic factors. Nephrological follow-up of all children with HUS is necessary in order to detect progression to CKD.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"20 7","pages":"613-622"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367175","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

ANCA-associated vasculitides: what nephrologists need to know

Nephrologie & therapeutique Pub Date : 2024-12-01 DOI: 10.1684/ndt.2024.100

Noémie Jourde-Chiche, Jean-François Augusto, Stanislas Faguer

{"title":"ANCA-associated vasculitides: what nephrologists need to know","authors":"Noémie Jourde-Chiche, Jean-François Augusto, Stanislas Faguer","doi":"10.1684/ndt.2024.100","DOIUrl":"https://doi.org/10.1684/ndt.2024.100","url":null,"abstract":"Renal involvement in ANCA vasculitides (AAV) is frequent and often severe, leading to end-stage kidney disease either immediately, in the follow-up or after episodes of relapses. Renal involvement is associated with other organ involvement in granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (PAM), but may also be isolated in vasculitis limited to the kidney. It is less common in eosinophilic granulomatosis with polyangiitis (GEPA). The classical clinical presentation is one of rapidly progressive glomerulonephritis, associated with the presence of PR3-ANCA or MPO-ANCA. Kidney biopsy (showing pauci-immune extra-capillary glomerulonephritis) is not essential for the diagnosis of VAA, but it does have a prognostic value, can rule out other causes of glomerulonephritis (especially in renal-limited forms of AAV) and can help for the decision of plasma exchange use.\u0000Treatment of AAV with renal involvement is based on a combination of corticosteroids and immunosuppressants (rituximab or cyclophosphamide). Avacopan may also be proposed as a cortisone-sparing treatment. This review sets out the various recommended therapeutic protocols and their scope of application. The role of plasma exchange is also discussed.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"20 7","pages":"666-673"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367166","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

Medullary sponge kidney: a pathology still full of unknowns

Nephrologie & therapeutique Pub Date : 2024-12-01 DOI: 10.1684/ndt.2024.98

Corentin Tournebize, Nadia Abid, Aurélie De Mul, Maxime Schleef, Laurence Derain-Dubourg, Sandrine Lemoine

引用次数: 0

Assessment using objective structured clinical examination of skills acquisition regarding hyponatremia in medical students following different teaching methods

Nephrologie & therapeutique Pub Date : 2024-12-01 DOI: 10.1684/ndt.2024.99

Weniko Caré, Hélène Lazareth, Adrien Flahault

{"title":"Assessment using objective structured clinical examination of skills acquisition regarding hyponatremia in medical students following different teaching methods","authors":"Weniko Caré, Hélène Lazareth, Adrien Flahault","doi":"10.1684/ndt.2024.99","DOIUrl":"https://doi.org/10.1684/ndt.2024.99","url":null,"abstract":"Objectives: To assess the impact of teaching methods on skill acquisition in medical students, using an objective structured clinical examination (OSCE).Methods: Observational study on medical students in France after training on hyponatremia using lecture course, individualized teaching without presentation, or reverse OSCE.Results: We included 77 students. Their mean score ± standard deviation was 55 ± 15 points [2.5-90]. Students using the reverse OSCE scored significantly lower in both the test and the overall evaluation, although this teaching modality was preferred, even after adjustment for the year of study. A significant correlation between self-evaluation and test results was observed. Most students felt that the OSCE evaluation allows them to measure their level of learning.Conclusion: The OSCE is an assessment method appreciated by medical students, but reverse OSCE were not associated with improved results at evaluation, although a possible bias due to center effect needs to be acknowledged.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"20 7","pages":"623-631"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367168","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

Management of patients with kidney stones

Nephrologie & therapeutique Pub Date : 2024-12-01 DOI: 10.1684/ndt.2024.102

Aurélie De-Mul, Justine Bacchetta, Sandrine Lemoine

{"title":"Management of patients with kidney stones","authors":"Aurélie De-Mul, Justine Bacchetta, Sandrine Lemoine","doi":"10.1684/ndt.2024.102","DOIUrl":"https://doi.org/10.1684/ndt.2024.102","url":null,"abstract":"Proper management of lithiasis-related diseases is essential, as they often cause pain that can be difficult to alleviate, leading to significant morbidity and substantial healthcare costs. In rare cases, lithiasis may indicate a more serious underlying condition that could progress to chronic kidney disease.\u0000The French Association of Urology (AFU) provides recommendations for the initial assessment of any patient experiencing a first episode of lithiasis, emphasizing the importance of stone analysis, dietary assessment, and crystalluria analysis when available. Simple measures, such as ensuring adequate hydration and a balanced intake of sodium, protein, and calcium, can help reduce the risk of stone formation in most cases. The use of a crystallization inhibitor, such as citrate, may also be indicated. Additional treatments may be considered depending on the stone type and any underlying biochemical abnormalities.\u0000These guidelines also describe criteria leading to a more comprehensive secondary evaluation, which may reveal conditions such as hyperoxaluria. This condition can be dietary, secondary to malabsorption, or due to genetic causes, such as primary hyperoxaluria (PH). Diagnosing PH is particularly crucial in the case of type 1 PH, as it can lead to renal failure and systemic oxalate accumulation, with a high risk of immediate recurrence in transplanted kidneys.\u0000Before the advent of RNA interference (siRNA) therapies, conservative treatment options—such as pyridoxine, hyperhydration, and crystallization inhibitors—were the primary strategies to slow the progression toward renal failure, with combined liver-kidney transplantation considered for end-stage renal disease. Current approaches now favor isolated kidney transplantation with adjunctive siRNA therapy, although this strategy requires careful, case-by-case consideration.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"20 7","pages":"650-657"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367172","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

Association between iron deficiency and risk of major events in chronic kidney disease 慢性肾病患者缺铁与重大事件风险之间的关系

Nephrologie & therapeutique Pub Date : 2024-11-19 DOI: 10.1684/ndt.2024.91

Gabriel Choukroun, Yasmine Baghdadi, Pascaline Rabiéga, Elise Cazaubon, Serge Maillet, Luc Frimat, Bénédicte Stengel

{"title":"Association between iron deficiency and risk of major events in chronic kidney disease","authors":"Gabriel Choukroun, Yasmine Baghdadi, Pascaline Rabiéga, Elise Cazaubon, Serge Maillet, Luc Frimat, Bénédicte Stengel","doi":"10.1684/ndt.2024.91","DOIUrl":"10.1684/ndt.2024.91","url":null,"abstract":"Introduction: Iron deficiency (ID) is common in patients with chronic kidney disease (CKD) but remains under-diagnosed and its prognosis poorly documented in the absence of anemia. The aim of the study was to assess the relationship between ID and the risk of major adverse outcomes in patients with CKD.Methods: Using data from the French Chronic Kidney Disease - Renal Epidemiology and Information Network (CKD-REIN) cohort which included and followed over five years, 3,033 patients with CKD stages 2 to 5 CKD, we estimated the prevalence of ID, defined by a ferritin level < 100 μg/L and/or a transferrin saturation < 20%, and associated hazard ratios (HR) of kidney failure with replacement therapy, kidney failure defined by an eGFR < 15 mL/min per 1.73 m2 or initiation of kidney replacement therapy, all-cause mortality, and death or hospitalization for heart failure.Results: Baseline prevalence of ID in the cohort (66% men; mean age 67 ± 13 years) was 50% (48-52). Mean hemoglobin was 13 ± 1.7 g/dL, and only 31% of patients with ID also had a hemoglobin < 12 g/dL. In 2,803 patients with CKD stages 2-4 at baseline, ID was associated with significant increased risk of kidney failure, and of kidney failure with replacement therapy, with HRs adjusted for confounders and hemoglobin level of 1.22 (1.03-1.45) and 1.57 (1.27-1.94), respectively. Adjusted HRs for all-cause mortality and hospitalization or death for heart failure, were 1.31 (1.04-1.66) and 1.38 (1.07-1.80), respectively.Conclusion: This study shows that ID is significantly associated with the risk for kidney failure, all-cause mortality, and heart failure, independent of the presence of anemia.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"20 6","pages":"553-563"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142670182","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

Primary hyperoxaluria: results of a retrospective survey of the diagnostic practices of nephrologists 原发性高草酸尿症：肾病专家诊断方法回顾性调查的结果

Nephrologie & therapeutique Pub Date : 2024-11-19 DOI: 10.1684/ndt.2024.93

Sandrine Lemoine, Alexia Bakdache, Gabriel Choukroun

{"title":"Primary hyperoxaluria: results of a retrospective survey of the diagnostic practices of nephrologists","authors":"Sandrine Lemoine, Alexia Bakdache, Gabriel Choukroun","doi":"10.1684/ndt.2024.93","DOIUrl":"10.1684/ndt.2024.93","url":null,"abstract":"Introduction: Primary hyperoxalurias (PH) are rare and serious genetic diseases. Their prognosis is improved with early medical management. However, diagnosis often occurs at the end-stage of renal failure. To understand this delay, collecting real-world data on the clinical practices of nephrologists may be helpful.Materials and methods: Between October 2021 and October 2022, a retrospective survey was conducted in France among 76 nephrologists to assess management practices for patients with chronic kidney disease (CKD) of unknown aetiology, associated with urinary lithiasis and/or nephrocalcinosis. Data on patient profiles, tests conducted, diagnoses considered, and management of suspected PH cases were collected.Results: 97% of patients (n = 386/400) underwent a renal examination, 92% (n = 370/400) a thorough urinary check-up, and 65% (n = 260/400) had an interpretable oxaluria value from a 24-hour urine sample (Uox24h). Of these 260 patients, 50% (n = 130/260) had Uox24h > 500 µmol/24 h: 23% (n = 30/130) were suspected of PH by the nephrologists, and 15% (n = 19/130) were referred for genotyping. Considering all criteria, 52 patients were suspected of PH (42% of whom did not have Uox24h > 500 µmol/24 h), and 33% (n = 17/52) were not referred for genotyping.Discussion: The survey highlights nephrologists' adherence to recommendations for prescribing biological tests. However, in cases of hyperoxaluria or suspected PH, genotyping was not always prescribed. The barriers to this prescription need further exploration.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"20 6","pages":"575-587"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142670186","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

LUMIDIAL: feasibility of light therapy in hemodialysis, pilot study and real-life experience LUMIDIAL：光疗在血液透析中的可行性、试点研究和实际经验

Nephrologie & therapeutique Pub Date : 2024-11-19 DOI: 10.1684/ndt.2024.94

Benoit Franko, Marianne Jund, Cécile Herlet, Violaine Delsante, Lucas Pires, Anne-Laure Claudel, Tristan Delory

{"title":"LUMIDIAL: feasibility of light therapy in hemodialysis, pilot study and real-life experience","authors":"Benoit Franko, Marianne Jund, Cécile Herlet, Violaine Delsante, Lucas Pires, Anne-Laure Claudel, Tristan Delory","doi":"10.1684/ndt.2024.94","DOIUrl":"10.1684/ndt.2024.94","url":null,"abstract":"Introduction: Sleep and mood disorders are common in hemodialysis, but the effect of light therapy remains unknown in this population.Methods: We conducted a randomized, controlled, open-label pilot trial comparing two group of either 30 minutes of light therapy three times a week, or no exposure. The primary endpoint was change in sleep quality (PSQI) after five weeks of light therapy, with change in mood (DASS-21) as a secondary endpoint. We added the description of the same criteria in a prospective, non-randomized, real-life post-trial cohort.Study results: We included 28 analyzable patients in the pilot study. Light therapy had no significant effect on PSQI reduction (p = 0.496). There was a trend towards a reduction in depression (-6.2 [95% CI, -12.5 to -0.05], p = 0.058). In the real-life cohort, out of 27 patients, 12 had a significant reduction in depression score (≥ 6 points).Discussion: Light therapy performed in hemodialysis three times a week appears to have no effect on sleep quality, but could reduce depressive states. The technique is easy to implement, well tolerated and inexpensive. A multicenter randomized trial against the sham device will be needed to validate its effect on depression.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"20 6","pages":"564-574"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142670185","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