Nephrologie & therapeutique最新文献

{"title":"Nephrology highlights in 2025: Diagnostic and therapeutic advances and emerging challenges","authors":"Adrien Flahault","doi":"10.1684/ndt.2026.157","DOIUrl":"10.1684/ndt.2026.157","url":null,"abstract":"<p><p>In 2025, nephrology saw major advances in diagnosing and managing chronic kidney diseases. A new diagnostic framework, CKDx (chronic kidney disease of unexplained cause), was proposed to standardize patient evaluation by integrating genetic and histological tests. Therapeutic progress includes the demonstrated efficacy of atrasentan, an endothelin type A receptor antagonist, in IgA nephropathy, as well as that of iptacopan, an oral inhibitor of factor B, in IgA nephropathy and C3-deposit glomerulopathy. Obinutuzumab, a humanized anti-CD20 antibody, has also shown efficacy in lupus nephritis. Nephroprotective strategies, such as the finerenone-empagliflozin combination, have revealed significant benefits. Finally, emerging molecules such as baxdrostat, an aldosterone synthase inhibitor, and oral semaglutide, a GLP-1 analog, have demonstrated efficacy in resistant hypertension and in cardiovascular-risk reduction, respectively. These two molecules are currently being evaluated for preventing the progression of chronic kidney disease. However, challenges persist, including unequal access to innovative treatments, gaps in early screening, and the impact of climate change on kidney function. These results highlight the need for an integrated approach, combining innovation, equity, and adaptation to environmental changes to improve the care of patients with kidney diseases.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"22 S1","pages":"11-17"},"PeriodicalIF":0.7,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914030","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":"2025 Congress of the Société francophone de néphrologie, dialyse et transplantation (SFNDT): A magnificent edition concluded with an inspiring “What’s new?” session","authors":"Luc Frimat","doi":"10.1684/ndt.2026.159","DOIUrl":"10.1684/ndt.2026.159","url":null,"abstract":"","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"22 S1","pages":"3-4"},"PeriodicalIF":0.7,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914024","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":"SFNDT 2025: Priorities for the next two year","authors":"Christophe Mariat","doi":"10.1684/ndt.2025.147","DOIUrl":"10.1684/ndt.2025.147","url":null,"abstract":"","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 6","pages":"479-480"},"PeriodicalIF":0.7,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423770","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":"How do parents undergoing dialysis perceive the support provided by their children? A mixedmethods study to better identify young carers","authors":"Safiya Arrob, Julie Glatz, Filiz Eren, Michèle Koleck, Aurélie Untas","doi":"10.1684/ndt.2025.149","DOIUrl":"10.1684/ndt.2025.149","url":null,"abstract":"<p><strong>Background: </strong>Young carers are aged between 6 and 25 and regularly provide support to a sick relative. No study has yet focused on these young people in the context of parental dialysis. The aim of this study was to explore how parents on dialysis experience the support provided by their children, and to compare the experiences of parents undergoing dialysis at home and those treated in medical facilities.</p><p><strong>Method: </strong>Thirty parents on dialysis (19 at home, 11 in facilities) completed a questionnaire (sociodemographic and medical information, autonomy in activities, quality of life, and support provided by their children). Fifteen parents also took part in semi-structured interviews.</p><p><strong>Results: </strong>Overall, parents on dialysis reported low levels of support from their children, whether in terms of emotional support, household tasks, instrumental assistance, or personal care. Parents receiving dialysis outside the home perceived higher levels of support than those receiving dialysis at home. The interviews helped to clarify the observed differences and highlighted the specific forms of support provided by children of parents undergoing home dialysis. Parents also reported negative emotions among their children (anxiety, sadness) as well as the development of psychosocial skills.</p><p><strong>Conclusion: </strong>These results underline the importance of paying attention to the children of dialysis patients and the support they may provide. Further studies are needed to better understand the underlying family dynamics and to explore the children’s perspective.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 6","pages":"483-493"},"PeriodicalIF":0.7,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508629","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 care and use of intradialytic parenteral nutrition in hemodialysis in France: A national survey among nephrology dietitians","authors":"Stanislas Trolonge, Stanislas Bataille, Céline Pasian, Laetitia Koppe, Philippe Chauveau","doi":"10.1684/ndt.2025.150","DOIUrl":"10.1684/ndt.2025.150","url":null,"abstract":"<p><p>Malnutrition remains a major concern among hemodialysis patients in France and worldwide. An online survey was disseminated by the Association de Diététique et Nutrition en Néphrologie (ADNN) between March and June 2023, targeting its dietitian members via email and professional social networks. A total of 88 responses were collected (35% of those solicited), of which 73% were from the public or non-profit sector, and 47% of professionals reported following more than 150 hemodialysis patients annually. The aim of this study was to assess the practices of dietitian-nutritionists regarding the screening, diagnosis, and treatment of malnutrition, with a particular focus on the use of intradialytic parenteral nutrition (IDPN) in France. The reported prevalence of malnutrition ranged from 20 to 75% of patients, with 60% of dietitians estimating it between 20 and 50%. Screening was performed every 1 to 3 months by 70% of respondents, mainly based on weight loss (98%), body mass index (BMI) (89%), and biological markers such as albumin and CRP (monitored monthly by 50 to 60%). Normalized protein nitrogen appearance (nPNA) was used monthly by 42% of dietitians and at least annually by 80%. Regarding IDPN, only 35% reported having a protocol, 69% initiated it in cases of severe malnutrition or significant weight loss, and 45% reported infusion volumes of between 500 and 1,000 mL per session. The mean duration of use was 3 months for 28% of respondents but could extend beyond a year depending on nutritional recovery. Overall, 81% reported insufficient knowledge, and 75% expressed a need for additional training. This survey highlights a marked heterogeneity in the choice, duration, and monitoring of IDPN, the frequent absence of standardized protocols, and substantial training needs. It also underscores the lack of dedicated time for dietitians to follow up with hemodialysis patients: More than half of the respondents reported spending less than 30% of their working time on this population, thereby compromising the effectiveness of nutritional screening and management. Better standardization of practices, increased time allocation for patient care, and enhanced competencies in artificial nutrition appear essential to optimize the nutritional management of hemodialysis patients.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 6","pages":"495-508"},"PeriodicalIF":0.7,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508553","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":"Treatment adherence and chronic kidney disease: Psychological aspects, contributing factors, and potential levers","authors":"Stanislas Bobot, Valentine Cazauvieilh, Flora Lefèvre, Justine Solignac, Safia Mecerli, Philippe Brunet, Mickaël Bobot","doi":"10.1684/ndt.2025.145","DOIUrl":"10.1684/ndt.2025.145","url":null,"abstract":"<p><p>Non-adherence to treatment affects 30% to 50% of patients with chronic diseases. It is associated with an increase in the frequency of acute complications and hospitalizations. In chronic kidney disease (CKD), non-adherence concerns drug treatment, diet, and lifestyle. It may affect up to 62% of hemodialysis patients and 28% of kidney transplant recipients. The long asymptomatic phase of CKD contrasts with a heavy medication burden—two factors that can hinder treatment adherence. In addition, the high prevalence of cognitive and depressive disorders, often underdiagnosed, is associated with the risk of non-adherence in CKD patients. Young age and social isolation have also been identified as risk factors. However, adherence is often difficult to assess. It may vary from one patient to the other, and in the same patient over the course of the disease. Non-adherence can sometimes reflect underlying psychological, personal, or social difficulties. Every health care professional involved in the care of CKD patients has a role to play in detecting poor adherence. In this general review, we discuss the psychological and medical aspects underlying non-adherence, as well as potential therapeutic levers.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 6","pages":"509-519"},"PeriodicalIF":0.7,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403310","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":"Mixed type II cryoglobulinemiaassociated glomerulonephritis revealing an extragastric marginal zone lymphoma in the absence of viral infection: A rare case report from Bourges Hospital","authors":"Belkacem Mansour, Jean-Michel Goujon, Yacine Foukia, Firas Easy, Anna Bourreau, Abdallah Maakaroun","doi":"10.1684/ndt.2025.146","DOIUrl":"10.1684/ndt.2025.146","url":null,"abstract":"<p><strong>Introduction: </strong>Type II mixed cryoglobulinemia is most commonly associated with chronic hepatitis C virus infection. The occurrence of marginal zone lymphoma as the underlying cause is rare, especially in the absence of gastric involvement.</p><p><strong>Case report: </strong>A 63-year-old woman with hypertension and hypothyroidism initially presented with transient purpura following a urinary tract infection. Two months later, she developed acute kidney injury, proteinuria (2.3 g/24 h), and microscopic hematuria. Laboratory tests showed type II mixed cryoglobulinemia (IgM κ + IgG) with hypocomplementemia. Viral serologies, including HCV, were negative. Renal biopsy revealed membranoproliferative glomerulonephritis with IgM and IgG deposits. Blood and bone marrow immunophenotyping confirmed an extragastric marginal zone lymphoma. The patient was treated with six cycles of rituximab-bendamustine.</p><p><strong>Results: </strong>Complete remission was achieved: recovery of renal function (creatinine 84 μmol/L at 12 months), resolution of proteinuria, improvement of anemia, and regression of splenomegaly. No relapse was observed after 18 months of follow-up.</p><p><strong>Discussion/conclusion: </strong>This case represents a particularly rare presentation of type II mixed cryoglobulinemia revealing an extragastric marginal zone lymphoma in the absence of viral infection or gastric involvement. It contributes to the sparse literature on this uncommon association. Treatment with rituximab-bendamustine appears to be effective.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 6","pages":"530-537"},"PeriodicalIF":0.7,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403112","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":"Chyle leak in a hemodialysis tunneled catheter without associated chylothorax: An exceptional complication","authors":"Amine El Kesri, Bernard Vô, Gaelle Gillerot, Frank Hammer, Laura Labriola","doi":"10.1684/ndt.2025.154","DOIUrl":"10.1684/ndt.2025.154","url":null,"abstract":"<p><p>The presence of chyle in a hemodialysis catheter is a rare complication, usually observed in case of chylothorax secondary to central vein stenosis, particularly of the superior vena cava and the left brachiocephalic vein.\u0000We report the exceptional case of a 55-year-old woman in maintenance hemodialysis presenting with chyle in her left subclavian tunneled cuffed catheter during each interdialytic period, without any recent history of trauma or tumoral disease. The chest CT scan was unremarkable. The milky fluid was systematically observed by the nurses at the beginning of each hemodialysis session, before connection. The diagnosis of chyle was confirmed by a very high triglyceride concentration in the aspirated fluid, and the absence of biological and cytological arguments in favor of an infectious or tumoral pathology.\u0000A phlebography combining the opacification of the catheter and the left internal jugular vein revealed an aberrant trajectory of the catheter in an endothelial sheath, probably in communication with the outlet of the thoracic duct, which explains the leak of chyle.\u0000The removal of the tunneled catheter was followed by the insertion of a new one in the left internal jugular vein, taking a route outside the faulty endothelial sheath. This procedure resulted in complete resolution of the problem, with no recurrence at 10 months of follow-up.\u0000This is the first documented description of the presence of chyle in a tunneled catheter for hemodialysis, with no associated chylothorax nor central vein stenosis. This condition was due to a local mechanical complication, i.e., a communication between an aberrant path of the tunneled catheter within an endothelial sheath and the opening of the thoracic duct. We emphasize the importance of a complete phlebographic assessment in case of unexplained presence of chyle in a hemodialysis catheter.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 6","pages":"520-524"},"PeriodicalIF":0.7,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566864","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":"Tribute to Frank Bridoux","authors":"François Vrtovsnik, Christophe Mariat","doi":"10.1684/ndt.2025.153","DOIUrl":"10.1684/ndt.2025.153","url":null,"abstract":"","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 6","pages":"481-482"},"PeriodicalIF":0.7,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460628","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 kidney failure risk equation (KFRE): A tool suited to French clinical practices?","authors":"Julien Prouvot, Olivier Moranne","doi":"10.1684/ndt.2025.152","DOIUrl":"10.1684/ndt.2025.152","url":null,"abstract":"","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 6","pages":"545-546"},"PeriodicalIF":0.7,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508614","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}