Nephrologie & therapeutique最新文献

{"title":"Cardiovascular-kidney-metabolic syndrome screening during National Kidney Week 2026 - Added value of an extended strategy combining HbA1c, capillary creatinine, and NT-proBNP","authors":"Nans Florens, Céline Medinger, Dominique Schmitt, Sophie Caillard","doi":"10.1684/ndt.2026.190","DOIUrl":"10.1684/ndt.2026.190","url":null,"abstract":"","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"22 4","pages":"266-268"},"PeriodicalIF":0.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883093","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":"Navigating pain in chronic kidney disease: Overcoming inertia!","authors":"Nada Sellami, Salah Saïed, Faïza Ben Messaoud, Soumaya Chargui, Ezzedine Abderrahim","doi":"10.1684/ndt.2026.181","DOIUrl":"10.1684/ndt.2026.181","url":null,"abstract":"<p><p>Despite being one of the most common symptoms in patients with chronic kidney disease (CKD), pain management in this population is challenging for healthcare professionals. We conducted a cross-sectional survey of 60 practicing Tunisian primary care physicians who agreed to complete a questionnaire developed using Google Forms and distributed via social media and specialized online pages over a two-week period. It revealed that 71% encountered difficulties initiating pain treatment for CKD patients due to knowledge gaps, fear of side effects, and limited access to nephrologists. Many doctors avoided prescribing maximum paracetamol doses, while 90% refrained from using NSAIDs due to concerns about long-term effects. For higher-level analgesics, 71% didn’t reach recommended doses due to fear of side effects. 55% didn’t seek a nephrologist’s opinion, with 39% deeming it unnecessary. One in four didn’t consult a specialist due to workload and location challenges. Our study provides novel insights by identifying, in the Tunisian context, the practical and cognitive determinants of this therapeutic inertia, an aspect that has been scarcely explored in the literature. It highlights the need for targeted strategies to improve clinical practice.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"22 3","pages":"144-152"},"PeriodicalIF":0.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201760","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":"Supporting patients and family members facing treatment choices in chronic kidney disease: What do professionals think of the decision aids used? - Professionals’ views on treatment decision support tools","authors":"Elisa Brun, Lucile Montalescot, Anne Kolko, Aurélie Untas","doi":"10.1684/ndt.2026.183","DOIUrl":"10.1684/ndt.2026.183","url":null,"abstract":"<p><strong>Context: </strong>Research has explored health care providers' perceptions of shared medical decision-making, but to our knowledge, no study in France has examined their use of decision aids. The objective of this study was to explore how nephrology professionals use and perceive the tools designed to support patients with chronic kidney disease and their families when choosing a treatment.</p><p><strong>Methodology: </strong>Semi-structured interviews were conducted with 17 professionals involved in treatment decisions for chronic kidney disease. The data were processed using inductive thematic content analysis.</p><p><strong>Results: </strong>Seven themes emerged from the analyses, highlighting both the wide variety of tools used and the central role played by professional stance in how they are used. The technical sophistication of these tools should not replace interaction between patients and health care professionals. According to the participants, the ideal tool should facilitate learning, empower patients, and strengthen the relationship between health care professionals and patients, or even between health care professionals and family members . The role accorded to family members varied greatly among respondents, with some expressing a degree of ambivalence regarding whether and how they should be involved in using these decision-making support tools.</p><p><strong>Conclusion: </strong>This study documents the existence of a wide variety of tools used by health care professionals. Beyond their informational role, these tools fulfil many other functions. On the basis of these results, a survey of a broad panel of professionals would provide a more detailed picture of practices in France.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"22 3","pages":"167-180"},"PeriodicalIF":0.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355142","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":"Analysis of the predictive value of serum Cys-C and IL-6 levels for acute kidney injury in patients with acute respiratory distress syndrome.","authors":"Diandian Cui, Mengzhu Li, Hua Wu","doi":"10.1684/ndt.2026.182","DOIUrl":"10.1684/ndt.2026.182","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate serum cystatin C (Cys-C) and interleukin-6 (IL-6) for predicting acute kidney injury (AKI) in patients with acute respiratory distress syndrome (ARDS).</p><p><strong>Methods: </strong>This retrospective study analyzed 220 ARDS patients (78 with AKI, 142 without). Serum Cys-C and IL-6 levels were measured. Correlations with renal function indicators were analyzed. Patients were stratified by biomarker median levels to compare AKI incidence. Logistic regression identified AKI risk factors, and ROC curves assessed diagnostic performance.</p><p><strong>Results: </strong>Serum Cys-C and IL-6 levels were significantly higher in the AKI group and correlated with worse renal function. High Cys-C/IL-6 expression groups had a significantly increased AKI incidence. APACHE II score, Cys-C, and IL-6 were independent risk factors for AKI, while eGFR was protective. The combination of Cys-C and IL-6 showed the best diagnostic performance.</p><p><strong>Conclusion: </strong>Serum Cys-C and IL-6 are significantly elevated in ARDS patients with AKI. Although each marker individually correlates with AKI, their combination demonstrates a stronger association. Given the retrospective design and exclusion of patients with early AKI, these findings are strictly associative and hypothesis-generating, not predictive. The combination offers additive associative value for identifying ARDS patients who subsequently develop AKI, but this requires prospective validation before any clinical application.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"22 3","pages":"153-166"},"PeriodicalIF":0.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201725","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":"From Turing to ChatGPT: The origins and transformations of medical artificial intelligence","authors":"Raphaël Bentegeac, Aghiles Hamroun, Valentin Goutaudier, Mehdi Maanaoui, Vincent Bisaccia, Nans Florens","doi":"10.1684/ndt.2026.184","DOIUrl":"10.1684/ndt.2026.184","url":null,"abstract":"<p><p>Artificial intelligence (AI) has experienced rapid growth in recent years with the advent of high-profile tools such as ChatGPT. However, its roots extend deep into the twentieth century. This article retraces the origins of AI and its major developments, showing how medical AI forms part of a long-standing scientific trajectory that predates the emergence of recent generative models. We first revisit the symbolic origins of AI, with the work of Alan Turing and the first programs capable of reasoning from explicit rules. We then examine the shift toward connectionist approaches centered on neural networks, which have driven major advances through machine learning and the availability of large datasets. Finally, we describe the current rise of generative AI, exemplified by large language models, and discuss its promises and limitations in medicine.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"22 3","pages":"182-188"},"PeriodicalIF":0.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348025","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":"Shiga toxin-producing Escherichia coli O80 pyelonephritis complicated by hemolytic uremic syndrome in a 3-year-old girl","authors":"Jennifer Battista, Élise Larche, Antoine Tran, Hervé Haas, Camille Faudeux, Chloé Ribet, Etienne Berard, Julie Bernardor","doi":"10.1684/ndt.2026.185","DOIUrl":"10.1684/ndt.2026.185","url":null,"abstract":"<p><p>Typical hemolytic uremic syndrome (HUS) in children most often follows a gastrointestinal infection caused by Shiga toxin-producing Escherichia coli (STEC). In STEC gastrointestinal infections, antibiotic therapy is generally not recommended because of the risk of increased Shiga toxin release. Extraintestinal STEC infections, including urinary tract infections, are rare and raise a therapeutic dilemma. We report the case of a 3-year-old girl with acute pyelonephritis who subsequently developed HUS despite appropriate antibiotic therapy. Urine and stool cultures identified a Shiga toxin-producing E. coli O80 strain. This case highlights that STEC may cause urinary tract infections, a rare presentation that can precede HUS, and emphasizes the complexity of therapeutic management.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"22 3","pages":"206-210"},"PeriodicalIF":0.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407497","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":"Nutritional monitoring in peritoneal dialysis: Biological and non-biological markers and dietary strategies","authors":"Stanislas Trolonge, Raymond Azar, Belkacem Issad","doi":"10.1684/ndt.2026.186","DOIUrl":"10.1684/ndt.2026.186","url":null,"abstract":"<p><strong>Objective: </strong>To provide a practical overview of methods for assessing and monitoring nutritional status in patients undergoing PD, as well as the main dietary strategies aimed at preventing or correcting malnutrition.</p><p><strong>Methods: </strong>A literature search was conducted in the PubMed and Embase databases for publications published between 2000 and 2025. The search included the following keywords: peritoneal dialysis, nutrition, protein-energy wasting, nPNA, dietary management, and nutritional assessment. International guidelines from the Kidney Disease Outcomes Quality Initiative (KDOQI), the International Society of Renal Nutrition and Metabolism (ISRNM), and the French National Authority for Health (HAS), together with observational studies, clinical trials, and relevant reviews on nutritional monitoring in PD, were analyzed.</p><p><strong>Results: </strong>Nutritional assessment in PD relies on a multidimensional approach combining biological markers (albumin and prealbumin, interpreted in the context of inflammation); composite indices including the malnutrition-inflammation score (MIS), prognostic nutritional index (PNI), and subjective global assessment (SGA); evaluation of dietary intake; and functional tools such as handgrip strength and bioimpedance analysis. Calculation of normalized protein nitrogen appearance (nPNA) provides a useful indicator of protein intake and helps guide nutritional prescriptions. Current recommendations advocate a protein intake of approximately 1.2-1.3 g/kg/day, adjusted for dialysis-related protein losses and inflammatory status. Glucose absorption from the dialysate should also be taken into account when estimating energy intake. Management of sodium, phosphorus, potassium, and calcium intake is essential to limit metabolic and cardiovascular complications. Balanced dietary patterns, such as an adapted Mediterranean diet or well-designed plant-based approaches, may contribute to improving nutritional status.</p><p><strong>Conclusion: </strong>Nutritional management of patients undergoing PD requires regular multidisciplinary assessment combining biological, clinical, and dietary indicators. An individualized approach that accounts for dialysis-related losses and patient-specific characteristics is essential to prevent malnutrition and improve long-term outcome.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"22 3","pages":"189-204"},"PeriodicalIF":0.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148393042","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":"When the heart breaks, the kidneys follow: A case of Takotsubo syndrome","authors":"Samia Zitouni, Isma Temacini, Mourad Kastali","doi":"10.1684/ndt.2026.175","DOIUrl":"https://doi.org/10.1684/ndt.2026.175","url":null,"abstract":"<p><p>We report the case of Takotsubo syndrome in a 32-year-old man with no particular medical history who presented with acute heart failure associated with severe renal failure following intense emotional stress. Cardiac and renal dysfunction gradually resolved without specific treatment, although there was a time lag between cardiac recovery (day 15) and renal recovery (day 30).\u0000Several factors make this observation particularly interesting: the young age and male gender of the patient; the presence of an exclusively emotional trigger in a man, which is unusual; and the severity of the renal damage, which took several weeks to improve. This severe acute kidney failure resulted from a complex interaction between renal hypoperfusion, massive neurohormonal activation, and direct renal vasospasm, leading to acute tubular necrosis.\u0000This observation highlights the importance of considering Takotsubo syndrome in the differential diagnosis of acute renal failure associated with unexplained cardiac dysfunction, particularly in patients who do not fit the typical demographic profile.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"22 2","pages":"130-134"},"PeriodicalIF":0.7,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978254","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":"Peritonitis due to Gardnerella vaginalis in a male patient undergoing peritoneal dialysis: A case report.","authors":"Eleonore Mourre, Yassine Berrada, Tiphaine Roger, Thomas Lamy, Nicolas Quirin","doi":"10.1684/ndt.2026.177","DOIUrl":"10.1684/ndt.2026.177","url":null,"abstract":"<p><p>We report the first documented case of Gardnerella vaginalis peritonitis in a 55-year-old man undergoing continuous ambulatory peritoneal dialysis (CAPD) for renal failure of unknown etiology.\u0000He was started on CAPD three months after catheter insertion and simultaneous umbilical hernia repair with mesh placement. His follow-up was notable for poor compliance and geographical isolation. He presented to the emergency department for abdominal pain associated with an abscess at the catheter exit site. Microbiological culture identified G. vaginalis, an organism typically found in the female vaginal flora.\u0000The outcome was favorable with metronidazole treatment, to which this organism is generally susceptible. This case highlights the potential role of atypical pathogens in peritoneal dialysis-related infections, and in particular the pathogenicity of G. vaginalis through biofilm formation in patients carrying implanted medical devices, including in men.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"22 2","pages":"127-129"},"PeriodicalIF":0.7,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825136","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":"Kidney health for all: caring for people, protecting the planet1.","authors":"Raymond Vanholder, Dina Abdellatif, Augusto Cesar Soares Dos Santos, Ricardo Correa-Rotter, Natarajan Gopalakrishnan, Bill Wang, Stefanos Roumeliotis, Alessandro Balducci, Ágnes Haris, Manjusha Yadla, Li-Li Hsiao","doi":"10.1684/ndt.2026.179","DOIUrl":"https://doi.org/10.1684/ndt.2026.179","url":null,"abstract":"<p><p>The current kidney care model—focused on late-stage disease and in-center hemodialysis—is unsustainable, because of costs, environmental burden, poor outcomes, and reduced quality of life. The 78th World Health Assembly’s recognition of kidney disease as a serious health threat presents a critical opportunity to reshape kidney care. Aligned with this, the 2026 World Kidney Day theme, “Kidney Health for All: Caring for People, Protecting the Planet”, calls for a systematic change. A sustainable model must prioritize early detection and prevention, reducing the need for kidney replacement therapy. Transplantation and home dialysis benefit people with kidney failure, environment and society. Dialysis itself must become more eco-friendly without compromising care quality, recognizing that planetary perturbations in turn affect kidney health. Conservative care should also be considered, particularly for elderly and frail patients, if the quality-of-life benefits outweigh the perspectives offered by dialysis. Achieving this shift requires coordinated action across all stakeholders;education and engagement of the public, policy makers and health professionals to raise awareness about the threat of kidney disease; and an urgent move toward patient-centered care.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"22 2","pages":"81-91"},"PeriodicalIF":0.7,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978241","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}