Nephrologie & therapeutique最新文献

Intraperitoneal pressure measurements in children: a retrospective study.

Nephrologie & therapeutique Pub Date : 2025-03-11 DOI: 10.1684/ndt.2025.106

Anne-Louise Sawaya, Ivan Damgov, Soraya Menouer, Joëlle Terzic, Claus Peter Schmitt, Ariane Zaloszyc

{"title":"Intraperitoneal pressure measurements in children: a retrospective study.","authors":"Anne-Louise Sawaya, Ivan Damgov, Soraya Menouer, Joëlle Terzic, Claus Peter Schmitt, Ariane Zaloszyc","doi":"10.1684/ndt.2025.106","DOIUrl":"https://doi.org/10.1684/ndt.2025.106","url":null,"abstract":"Background: The peritoneal dialysis (PD) regimes should be individualized based on clinical tolerance and adequacy. Routine hydrostatic intraperitoneal pressure (IPP) measurements have been suggested to define optimal intraperitoneal dialysate volume (IPV), data on applicability and variability in clinical routine are few.Methods: We retrospectively analysed 655 IPP measurements monthly performed in 21 children on stable automated PD. IPP was measured with the day-time dwell volume (IPV 606 ± 303 mL/m2) after two-hour dwell time (IPP1; n = 430), and again with the night-time dwell volume (IPV 958 ± 274 mL/m2) after 10 min dwell time (IPP2; n = 225), using bicarbonate (BPDF) and lactate buffered (LPDF) low GDP fluids and icodextrin fluid (IPDF), respectively. Findings were related to PD related complications and Kt/V.Results: Mean of all IPP measurements was 11.0 ± 2.6 cmH2O or 2.1 ± 0.8 cmH2O/100 mL/m2, with a mean IPV of 7.3 ± 3.4 mL/100 mL/m². Mean IPP1 was 10.3 ± 2.2 cmH2O, corresponding to 6.1 ± 3.1 mL/100 mL/m² IPV, IPP2 was 12.5 ± 2.5 cmH2O, corresponding to 9.6 ± 2.6 mL/100 mL/m² IPV (IPP1 vs IPP2 p < 0.0001).Conclusion: The values of IPP were acceptable in this pediatric population. IPP is relatively higher with higher fill volumes per BSA. Using single fill volume IPP measurements provides IPP with high intra- and interindividual variability. The relation to patient outcome is uncertain.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 1","pages":"13-22"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597987","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

Early conversion to belatacept post-transplantation: state of the art and expert opinion

Nephrologie & therapeutique Pub Date : 2025-03-11 DOI: 10.1684/ndt.2025.104

Johan Noble, Dany Anglicheau, Gilles Blancho, Dominique Bertrand, Lionel Couzi, Antoine Durrbach, Philippe Grimbert, Nassim Kamar, Yannick Le Meur, Bruno Moulin, Lionel Rostaing

{"title":"Early conversion to belatacept post-transplantation: state of the art and expert opinion","authors":"Johan Noble, Dany Anglicheau, Gilles Blancho, Dominique Bertrand, Lionel Couzi, Antoine Durrbach, Philippe Grimbert, Nassim Kamar, Yannick Le Meur, Bruno Moulin, Lionel Rostaing","doi":"10.1684/ndt.2025.104","DOIUrl":"https://doi.org/10.1684/ndt.2025.104","url":null,"abstract":"The standard immunosuppressive treatment after organ transplantation typically includes a calcineurin inhibitor (tacrolimus or cyclosporine A), an antimetabolite (mycophenolic acid) or an mTOR inhibitor, and corticosteroids. However, these treatments are associated with multiple side effects, including nephrotoxicity. Belatacept, a fusion protein blocking the CD80/86 costimulation pathway, emerges as an effective and well-tolerated alternative. Initial phase III studies showed that de novo belatacept improves renal function and reduces the incidence of donor-specific antibodies, despite a higher rate of acute cellular rejections. Early conversion studies (within the first 6 months post-transplantation) demonstrate significant improvement in renal function, particularly when conversion is performed early. However, the risk of acute rejection and opportunistic infections must be monitored. This article summarizes the available studies on early conversion to belatacept in kidney transplanted patients.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 1","pages":"37-47"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598674","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

Prevalence of self-medication in kidney transplant patients: a single-center cross-sectional study

Nephrologie & therapeutique Pub Date : 2025-03-11 DOI: 10.1684/ndt.2025.105

Elouan Demay, Camille Boissière, Florian Laval, Cécile Vigneau, Astrid Bacle

{"title":"Prevalence of self-medication in kidney transplant patients: a single-center cross-sectional study","authors":"Elouan Demay, Camille Boissière, Florian Laval, Cécile Vigneau, Astrid Bacle","doi":"10.1684/ndt.2025.105","DOIUrl":"https://doi.org/10.1684/ndt.2025.105","url":null,"abstract":"Self-medication among kidney transplant patients may pose a risk to the graft. This study examined the prevalence of self-medication in patients who had undergone kidney transplantation. These patients, receiving immunosuppressive therapy, are informed during post-transplant therapeutic education about the risks associated with drug interactions. This prospective single-center study, including 66 patients, shows that 80.3% of participants reported self-medicating one month after hospital discharge, with 18.2% engaging in practices deemed “risky”. Self-medication mainly involved analgesics, including non-steroidal anti-inflammatory drugs (NSAIDs), sleeping pills, and treatments for heartburn, such as proton pump inhibitors (PPIs) and antacids. The results show that neither age, sex, education level, nor employment status were significantly associated with risky self-medication. However, the high prevalence of this practice highlights the need for increased patient awareness of potential dangers, particularly those related to NSAIDs and drug interactions. PPIs, often used for heartburn, carry interaction risks, especially with tacrolimus, and prolonged use may lead to kidney complications. Herbal medicine, also used by some patients, may present interaction risks with immunosuppressants.\u0000The study suggests strengthening patient therapeutic education (PTE) by emphasizing the risks of inappropriate self-medication and proposes safe alternatives, such as antacids, or seeking medical consultation. These results, based on self-reported data, may underestimate the true prevalence of self-medication. The study recommends continuous vigilance and further research to assess these practices over the long term.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 1","pages":"5-11"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598008","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

Being autonomous in dialysis: association with occupational status, social activity level, quality of life, and physical activity level.

Nephrologie & therapeutique Pub Date : 2025-03-11 DOI: 10.1684/ndt.2025.107

Fabrice Huré, Éric Laruelle, Thibault Dolley-Hitze, Charles Chazot, Sahar Bayat, Cécile Couchoud

{"title":"Being autonomous in dialysis: association with occupational status, social activity level, quality of life, and physical activity level.","authors":"Fabrice Huré, Éric Laruelle, Thibault Dolley-Hitze, Charles Chazot, Sahar Bayat, Cécile Couchoud","doi":"10.1684/ndt.2025.107","DOIUrl":"https://doi.org/10.1684/ndt.2025.107","url":null,"abstract":"Introduction: End-stage kidney disease radically alters the patients' lives. The aim of this pilot study was to describe this impact in patients treated with autonomous dialysis modality in France: Long Nocturnal Hemodialysis (LNHD), Daily Home Hemodialysis (DHHD), Automated Peritoneal Dialysis (APD), and hemodialysis in a self-care unit (SCHD).Methods: French voluntary patients (n = 182) treated with an autonomous dialysis modality completed an anonymous e-questionnaire that included items on type of paid employment, voluntary work and leisure activities, and three self-report questionnaires (SONG-Fatigue, RPAQ, and EQ-5D-5L).Results: Overall, 33% of patients had a remunerated activity, 10% of patients were considered as sedentary and 39.6% reported an important physical activity. The SONG-Fatigue median score was 3 (IQR 2-5). 54%, 89% and 56% of patients did not report any problem with mobility, self-care, and usual activities, respectively. 35% of patients did not complain about pain or discomfort and 59% had no anxiety or depression symptoms. Patients estimated their global health status at 60 (IQ 50-80). Compared to SCHD, the LNHD group had more often a remunerated activity and the DHHD group reported fewer problems with usual activities. The APD and LNHD groups experienced pain more often.Conclusion: This pilot survey of middle-aged patients with autonomous dialysis showed that dialysis affected their professional status, social activities, fatigue, quality of life and energy expenditure with few differences according to dialysis modality.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 1","pages":"23-30"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598672","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

Conversion from single use to reusable in nephrology care

Nephrologie & therapeutique Pub Date : 2025-03-11 DOI: 10.1684/ndt.2025.103

Maryvonne Hourmant, Didier Aguilera, Philippe Carenco, Clément Deltombe, Tristan Vérité, Pierre Filipozzi

引用次数: 0

Novelties for the management of early complications after kidney transplantation

Nephrologie & therapeutique Pub Date : 2025-03-11 DOI: 10.1684/ndt.2025.109

Nassim Kamar, Arnaud Del Bello

引用次数: 0

Fine-tuning circulating oxalate levels to improve transplant strategies in primary hyperoxaluria: what is the ideal threshold in pediatrics?

Nephrologie & therapeutique Pub Date : 2025-03-11 DOI: 10.1684/ndt.2025.108

Marisca Carlina Makosso Afiavi, Anne-Laure Sellier-Leclerc, Ariane Zaloszyc, Sacha Flammier, Aurélie De Mul, Rouba Bechara, Julie Bernardor, Cécile Acquaviva-Bourdain, Justine Bacchetta

{"title":"Fine-tuning circulating oxalate levels to improve transplant strategies in primary hyperoxaluria: what is the ideal threshold in pediatrics?","authors":"Marisca Carlina Makosso Afiavi, Anne-Laure Sellier-Leclerc, Ariane Zaloszyc, Sacha Flammier, Aurélie De Mul, Rouba Bechara, Julie Bernardor, Cécile Acquaviva-Bourdain, Justine Bacchetta","doi":"10.1684/ndt.2025.108","DOIUrl":"https://doi.org/10.1684/ndt.2025.108","url":null,"abstract":"Background: Interfering RNA therapies (RNAi) have changed the management of patients with hyperoxaluria type 1 (PH1); data in dialysis remain scarce.Results: A PH1 teenager undergoing intensive hemodiafiltration received lumasiran. POx levels almost halved during the loading phase (98 to 52 µmol/L), but rebound occurred when doses were quarterly-spaced, with POx at 94 µmol/L at 5 months. Lumasiran injections were therefore performed monthly, allowing adequate POx control (52 µmol/L) and isolated kidney transplantation. We also evaluated POx in 26 non-PH1 children with current dialysis techniques at a median(range) age of 10.9 (2.6-17.0) years, time on dialysis 14 (0-52) months, and POx 35 (8-125) µmol/L; residual diuresis was associated with lower POx. Circulating glycolate levels were normal in non-PH1 patients.Conclusion: Intensification of lumasiran therapy is possible in dialysis and improves POx levels before kidney transplantation; POx levels in non-PH1 pediatrics patients in dialysis are provided to improve decision making in transplantation.","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 1","pages":"31-35"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597972","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

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