Nephrologie & therapeutique最新文献

{"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}

{"title":"Activité physique adaptée en hémodialyse.","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":"","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 2","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039859","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":"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":0.7,"publicationDate":"2025-04-01","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":"Ten propositions to reduce the carbon footprint of clinical research","authors":"Maryvonne Hourmant, Anna-Julie Peired","doi":"10.1684/ndt.2025.114","DOIUrl":"10.1684/ndt.2025.114","url":null,"abstract":"<p><p>The healthcare sector emits 8% of France’s greenhouse gases. Working groups within healthcare establishments and learned societies are proposing actions to reduce emissions in the field of care, but clinical research studies also contribute to the healthcare system’s carbon footprint. Their greenhouse gas emissions are only just beginning to be calculated, and the measures to be put in place imagined. In this article, we present ten proposals for reducing the environmental impact of clinical research. The most significant measures for reducing greenhouse gaz emissions are intensive digitalization of clinical research and almost total elimination of research team and patients’transportation. The contribution of artificial intelligence is certain, but at what price. These measures must be adopted by the pharmaceutical industry and research funders. They also require an adjustment of current regulations.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 2","pages":"1-4"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712574","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":"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":0.7,"publicationDate":"2025-04-01","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":"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":"10.1684/ndt.2025.106","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","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}

{"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":"10.1684/ndt.2025.104","url":null,"abstract":"<p><p>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.</p>","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}

{"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":"10.1684/ndt.2025.105","url":null,"abstract":"<p><p>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.</p>","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}

{"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":"10.1684/ndt.2025.107","url":null,"abstract":"<p><strong>Introduction: </strong>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).</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","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}

{"title":"Conversion from single use to reusable in nephrology care","authors":"Maryvonne Hourmant, Didier Aguilera, Philippe Carenco, Clément Deltombe, Tristan Vérité, Pierre Filipozzi","doi":"10.1684/ndt.2025.103","DOIUrl":"10.1684/ndt.2025.103","url":null,"abstract":"<p><p>Replacement of disposable by reusable care materiel is a mandatory question in sustainability management in nephrology. Recommandations have already been edited for individual protection in the operating room and the DGOS (Direction générale de l’offre de soins) will soon launch an experimentation in the reuse of some catheters and endoscopes. The literature is unanimous on the advantage, in the fields studied, of reuse over disposable material regarding green house gaz emissions. However, this advantage can be lost when considering water consumption that partly results from washing and sterilization activities. Our article aims to encourage nephrologists to start applying some measures in their clinical practice and be aware of the coming innovations.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 1","pages":"49-52"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598673","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}