Nephrologie & therapeutique最新文献

{"title":"Practice survey on tunneled dialysis catheter placement by nephrologists in France","authors":"Jonathan Nicolas","doi":"10.1684/ndt.2025.142","DOIUrl":"10.1684/ndt.2025.142","url":null,"abstract":"<p><strong>Introduction: </strong>Renal replacement therapy (RRT) ensures the survival of patients with end-stage renal disease. It requires vascular access, such as an arteriovenous fistula or a tunneled central venous catheter. Catheters are inserted by different specialists using different techniques.</p><p><strong>Materials and methods: </strong>We conducted a practice survey on tunneled catheter placement in France developed by the French Intensive Renal Network (FIRN) commission. A comprehensive questionnaire was distributed via social networks to all dialysis centers in France.</p><p><strong>Results: </strong>Given the low response rate from other facilities, only responses from university hospitals were analyzed. Tunneled catheters are inserted by nephrologists in 68% of French university hospitals, of which only 20% use fluoroscopy for right jugular and femoral placement, and 40% for left jugular placement. The procedure is most often performed outside the operating room, in a dedicated room. Of the centers studied, 19% use antibiotic prophylaxis. The average time to insertion is around 48 hours for nephrologists, compared to 1 to 2 weeks for other specialists. Serious complications are rare but do occur and can be life-threatening. Anticoagulation and dual antiplatelet therapy are discontinued for this procedure. A few centers use tunneled catheters in acute renal failure and for plasma exchange.</p><p><strong>Conclusion: </strong>Our survey shows that nephrologists place tunneled dialysis catheters in the majority of French university hospitals, enabling rapid access to the procedure. This procedure is often performed without fluoroscopy but under ultrasound guidance. Fluoroscopy remains the gold standard. Echocardiography, being less invasive than fluoroscopy, could improve guidance and enable early diagnosis of serious complications. The rest of the survey presents the various types of practices observed and could serve as a basis for developing best practice recommendations.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 4","pages":"221-228"},"PeriodicalIF":0.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071420","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":"Once upon a time in nephrology - Episode 2: A brief history of creatinine measurement","authors":"Pierre Delanaye, Jean-François Focant, Christophe Mariat, Joris Delanghe, Étienne Cavalier","doi":"10.1684/ndt.2025.139","DOIUrl":"10.1684/ndt.2025.139","url":null,"abstract":"","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 4","pages":"199-207"},"PeriodicalIF":0.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796575","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":"Estimation of glomerular filtration rate in a pediatric setting at the Charles-de-Gaulle Pediatric University Hospital in Ouagadougou, Burkina Faso : A comparison of the Schwartz and Pottel methods","authors":"Hamidou Savadogo, Laure Tamini-Toguyéni, Arnaud Tiendrébéogo, Biebo Bihoun, Aimée Tarihidiga, Aïssata Kaboré, Juste Bonzi, Alain Saga Ouermi, Gérard Coulibaly, Diarra Yé","doi":"10.1684/ndt.2025.132","DOIUrl":"10.1684/ndt.2025.132","url":null,"abstract":"<p><p>Glomerular filtration rate (GFR) is the best indicator of kidney function. In clinical practice, it is most often estimated using equations derived from serum creatinine levels. The objective of our study was to evaluate the performance of two GFR estimators in a pediatric hospital setting in Ouagadougou.\u0000This was a prospective study conducted from October 1, 2018 to April 4, 2019. It included children aged 5 to 15 years hospitalized in the medical pediatrics department of the Charles de-Gaulle Pediatric University Hospital. The gold standard was creatinine clearance calculated from a 24-hour urine collection.\u0000One hundred patients were included in the study. The median age was 9 years and the sex ratio was 1.5. The median creatinine clearance was 79.69 mL/min/1.73 m2. The median GFR estimated using the Schwartz-2009 and Pottel formulas were 86.07 and 84.31 mL/min/1.73 m2, respectively. For 95% of patients, the differences between the GFR estimated by the Schwartz formula and the measured creatinine clearance ranged from -95.55 to 105.52 mL/min/1.73 m2. These differences range from -101.38 to 102.52 mL/min/1.73 m2 for the GFR estimated by the Pottel formula.\u0000Although the Schwartz-2009 and Pottel formulas were developed from populations different from our own, they are suitable for our context. However, the Pottel formula appears to have a certain superiority over the Schwartz formula, with narrower limits of agreement and a lower degree of overestimation of creatinine clearance.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 4","pages":"241-247"},"PeriodicalIF":0.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796573","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":"Evolution of the psychological repercussions of the COVID-19 pandemic on hemodialysis patients and caregivers between April 2020 and April 2022","authors":"Karelle Caprice-Grabiaud, Mathilde Prezelin-Reydit, Abdallah Guerraoui, Thibault Dolley-Hitze, Morgane Gosselin, Benoît Vendrely, Patrick Hallonet, Solene Pelletier, Arnaud Delizre, Gabrielle Duneau, Afehd Fessi, Anne Kolko, Marc Bouiller, Marie-Dorothée Hirigoyen, Lynda Azzouz, Denis Fouque, Cécile Vigneau, Émilie Pinçon, Simon Duquennoy, François Chantrel, Christian Combe, Philippe Chauveau, Agnès Caillette-Beaudoin, Catherine Lasseur, Nicole Rascle, Laetitia Idier","doi":"10.1684/ndt.2025.131","DOIUrl":"10.1684/ndt.2025.131","url":null,"abstract":"<p><strong>Introduction: </strong>The health crisis linked to the COVID-19 pandemic and the changes in practices it imposed in dialysis centers were accompanied by observable psychological repercussions for both patients and caregivers. Our aim was to assess the evolution of these repercussions in these two populations, to identify the coping strategies used, and to study the association between psychological symptoms and coping strategies.</p><p><strong>Methods: </strong>This multi-center, French, non-interventional study was conducted in two phases (T1 : April 2020 and T2 : April 2022) in 13 volunteer dialysis facilities. Pseudonymized questionnaires were used to collect sociodemographic data, self-reported psychological history, and, at both study times, stress levels (simple numerical stress scales), anxiety and depressive symptomatology (Hospital Anxiety and Depression Scale), and coping strategies (Brief COPE). Factors associated with anxiety and depression were studied with a multivariable logistic regression model.</p><p><strong>Results: </strong>177 patients and 99 caregivers participated in both phases of the study. In each population, stress and anxiety scores decreased significantly between T1 and T2 (p<0.001), while depression scores remained stable. The most frequently used coping strategy was the use of positive thoughts and was associated with lower anxiety and depression symptoms. By contrast, the avoidance strategy was associated with more anxiety-depressive symptoms.</p><p><strong>Conclusion: </strong>By April 2022, in France, hemodialysis caregivers' and patients' health crisis-related stress and anxiety levels had decreased compared with April 2020. Positive thinking coping strategies should be promoted among patients and caregivers because they have been shown to protect mood.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 4","pages":"229-239"},"PeriodicalIF":0.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796574","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 complexity of the decision-making process from dialysis withdrawal to death","authors":"Sandrine Letrecher, Angélique Thuillier","doi":"10.1684/ndt.2025.130","DOIUrl":"10.1684/ndt.2025.130","url":null,"abstract":"<p><p>The working group of the Francophone Society of Nephrology, Dialysis, and Transplantation (SFNDT) recently published a guide for the reasoned adaptation of therapies (ART) in nephrology, which takes up the legal framework of the Claeys–Leonetti Law (2016) and highlights the specificities of palliative care in the context of a long-term chronic illness. In this literature review—drawing from both medical research and the humanities and social sciences—we offer a complementary perspective on the complex decision-making process from dialysis withdrawal to death (DWD), in the sense of sociologist and philosopher Edgard Morin’s concept of complex thought. Quantitative studies, both national and international, highlight the role of cultural differences between countries as well as the influence of legal frameworks on DWD, but other factors are also at play. Patient characteristics associated with DWD as well as differences in regional practices are identified. Qualitative studies and research in the humanities and social sciences further explore the experiences of caregivers, marked by uncertainty and complexity, as decisions unfold among patients, families or caregivers, and health care professionals. This literature review serves as a foundation for an ongoing mixed methods study on the variability of DWD practices in France.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 4","pages":"248-255"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644464","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":"Néphrologie & Thérapeutique on the way!","authors":"Valérie Moal, François Vrtovsnik, Bacchetta Justine, Olivia Boyer, Christophe Mariat, Sandrine Lemoine","doi":"10.1684/ndt.2025.127","DOIUrl":"10.1684/ndt.2025.127","url":null,"abstract":"","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 2","pages":"133-134"},"PeriodicalIF":0.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328247","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":"Exploring quality of life among chronic hemodialysis patients: Navigating the cumulative impact of multiple crises","authors":"Rayyan Wazzi-Mkahal, Ranim Razzouk, Krystel Aouad, Najat Fares, Valerie Hage","doi":"10.1684/ndt.2025.123","DOIUrl":"10.1684/ndt.2025.123","url":null,"abstract":"<p><strong>Introduction: </strong>Hemodialysis patients have poorer health-related quality of life (HRQOL) compared to the general population. HRQOL is influenced by many sociodemographic and clinical factors. The aim of our study is to describe the HRQOL among adult patients undergoing hemodialysis during a period of economic and health crisis.</p><p><strong>Methods: </strong>This is a cross-sectional study including patients who had been on hemodialysis for at least 3 months. We interviewed a total of 90 hemodialysis patients using the 36-Item Short Form Health Survey (SF36). The SF-36 measures eight scales and two distinct concepts: the Physical Component Summary (PCS) and the Mental Component Summary (MCS). Data analyses was performed with RStudio version 2022.12.0.</p><p><strong>Results: </strong>The mean age (±SD) was 69.67±12.80 years. The mean PCS score (±SD) was 48.55±24.7 and the mean MCS score (±SD) was 58.62±22.1. The highest scores among the SF-36 were emotional well-being (66.65±20.02) and social functioning (66.53±27.40). Multivariate analysis showed that PTH levels and occupational status are significantly associated with PCS scores (p=0.007 and p=0.03 respectively), and that age at onset of dialysis, PTH levels, occupational status, marital status, and COVID-19 infection are significantly associated with MCS scores (p=0.04, p<0.001, p=0.003, p=0.006 and p=0.007 respectively).</p><p><strong>Conclusion: </strong>The overall PCS and MCS scores were low, indicating poor HRQOL. However, the crises did not appear to directly worsen it, due to a strong social support system. A multidisciplinary team approach may improve the HRQOL of these patients.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 2","pages":"153-160"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268288","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":"Catheter placement by nephrologists: A safe and effective method for improving access to peritoneal dialysis","authors":"Maria Lafrid, Abdelaali Bahadi, Narjiss Labioui, Ismail Hanine, Hajar Laasli, Theresia Peya Mponguili, Mohammed Hallak, Sanae Benbria, Driss El Kabbaj","doi":"10.1684/ndt.2025.119","DOIUrl":"10.1684/ndt.2025.119","url":null,"abstract":"<p><strong>Introduction: </strong>Peritoneal dialysis (PD) is an effective treatment option for patients with kidney failure and offers them a better quality of life. Despite its advantages, PD remains underutilized, particularly in Morocco. The aim of our study was to evaluate the impact of catheter placement by nephrologists on the number of incident PD patients, compare the success rates of this technique with those of surgical placement, and assess the short- and long-term complications associated with the two approaches.</p><p><strong>Methods: </strong>This was a single-center retrospective study including 69 PD patients, conducted from January 2008 to December 2022.</p><p><strong>Results: </strong>A total of 28 patients received PD catheter placement by nephrologists (Group A), while 41 underwent the procedure performed by urologists (Group B). Since the introduction of nephrologist-led catheter placement, the incidence of patients starting PD significantly increased, with a growth rate of over 100% every two years. The waiting time for catheter placement was significantly shorter in Group A (5 days versus 20 days; p < 0.001). No significant difference was observed in the incidence of short-term mechanical and infectious complications between the two groups. Although univariable analysis revealed a higher incidence of long-term mechanical and infectious complications in Group B compared to group A, this difference was not statistically significant in multivariable analysis (p > 0.05). The success rate of PD catheter placement in Group A was 92.85%, while it was 97.56% in Group B. The one-year catheter survival rate was significantly higher in Group B than in Group A (100% versus 75%; p = 0.031), and mean catheter survival was significantly longer in Group B (17 months versus 11 months; p = 0.026).</p><p><strong>Conclusion: </strong>PD catheter placement by nephrologists proved to be a safe and effective approach.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 2","pages":"143-152"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103446","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":"Administration of lumasiran in a child with infantile oxalosis undergoing chronic peritoneal dialysis: A case report","authors":"Chloé Grosyeux, Arnaud Wiedemann, Marie-Christine Camoin-Schweitzer, Cécile Acquaviva-Bourdain, Noël Boussard, Justine Bacchetta, Isabelle Vrillon","doi":"10.1684/ndt.2025.121","DOIUrl":"10.1684/ndt.2025.121","url":null,"abstract":"<p><strong>Background: </strong>Lumasiran is a small interfering RNA molecule indicated for the treatment of primary hyperoxaluria type 1 (PH1).</p><p><strong>Case diagnosis/treatment: </strong>We report a case of infantile PH1 in a 3-month-old girl admitted with anuria and kidney failure. Peritoneal dialysis (PD) and conservative treatment were immediately initiated. The first dose of lumasiran was administered at 12 months, while the patient was still on PD. Despite very high baseline plasma oxalate (POx) levels of around 200 µmol/L, treatment with lumasiran led to a nearly 50% reduction in POx levels, even during PD. Once the patient reached a sufficient body weight to safely initiate hemodialysis (HD), she was switched to HD; POx levels remained around 100 µmol/L, despite an intensive HD regimen.</p><p><strong>Conclusion: </strong>This is one of the first reported cases of lumasiran therapy during PD in an infant with PH1; even with this dialysis modality, POx levels can be decreased to a certain extent.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 2","pages":"180-183"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268279","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":"Vitamin D, anemia, and fibroblast growth factor 23: Ethnic disparities in Algerian chronic kidney disease patients","authors":"Lydia Ziouani, Damien Gruson, Messaoud Saidani, Elhadj-Ahmed Koceir","doi":"10.1684/ndt.2025.124","DOIUrl":"10.1684/ndt.2025.124","url":null,"abstract":"<p><p>This study investigates ethnic differences in vitamin D levels and bone-related biomarkers among Algerian CKD patients, focusing on the interactions between vitamin D, anemia, and FGF23. A multicenter, cross-sectional study involved 284 CKD patients in stages 3 and 4, with a mean age of 54±1.17 years. Participants were recruited from nephrology units in three distinct geographic regions of Algeria: Algiers (Mediterranean), Ghardaïa (sub-Saharan), and Tamanrasset (Saharan). Biochemical analyses included serum levels of 25OH vitamin D, iPTH, iFGF23, calcium, phosphorus, and hemoglobin. Multiple logistic regression was used to assess the association between anemia and vitamin D levels. Linear regression analysis identified predictors of iFGF23 in hemoglobin levels. A two-way ANOVA was performed to examine the influence of vitamin D levels across different ethnic groups. Patients from Tamanrasset exhibited significantly lower levels of 25OH vitamin D and hemoglobin, and higher levels of phosphorus, iFGF23, and iPTH, compared to those from Ghardaïa and Algiers. Anemia was independently associated with lower serum 25OH vitamin D concentrations (β=-0.11, P=0.001), while iFGF23 levels were inversely associated with hemoglobin levels (β=-3.3, P=0.01). A significant interaction between anemia and vitamin D status was observed among Black patients (P=0.0001), but not among white patients (P=0.7). These findings underscore notable ethnic disparities in vitamin D status and mineral biomarkers among Algerian CKD patients. The interplay between vitamin D, anemia, and FGF23 highlights the need for ethnically tailored care, particularly for patients in the Saharan region of Tamanrasset.</p>","PeriodicalId":94153,"journal":{"name":"Nephrologie & therapeutique","volume":"21 3","pages":"161-169"},"PeriodicalIF":0.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268291","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}