Phenotypes influencing low physical activity in maintenance dialysis.

Objective: The "Pas à Pas" initiative aimed at evaluating the weekly physical activity (PA) and its determinants in a large cohort of dialysis patients.

Setting: Physical inactivity is a risk factor for mortality in maintenance dialysis patients and is still poorly documented in this population.

Design: A prospective national epidemiological study was performed.

[Physical activity in dialysis population: how and why to assess and establish a program?].

The studies that evaluated physical activity in dialysis patients show a significant inactivity. This inactivity is associated with increased mortality. In contrast, the benefits in terms of morbidity and mortality of physical activity in this population are numerous.

[Description of characteristics, therapy and outcome of patients older than 75 years presenting with severe renal insufficiency (eGFR below 20 mL/min/1.73 m(2): pilot study].

In France, the incidence of dialysis patients is increasing in people over 75 years and represents 40% of incident patients. In these elderly patients with many comorbidities, the benefit of dialysis in terms of survival and quality of life remains controversial. Using data from REIN, determinants of early mortality were identified and a prognostic score was provided.

[When to place a patient on the kidney transplantation waiting list?].

Practices for enrollment on kidney transplantation waiting lists are variable between geographical areas and centers. Early referral of patients with chronic renal failure (CRF) to a nephrologist, particularly one practicing in a transplantation center, is a prerequisite to early enrollment. Despite improved survival in elderly transplant recipients, being aged over 65 years is still a barrier against enrollment.

Aortic stiffness of kidney transplant recipients correlates with donor age.

Increased aortic stiffness is a major factor responsible for the high cardiovascular mortality in patients with end-stage renal disease, but the impact of kidney transplantation on recipient aortic stiffness remains poorly defined. The use of expanded-criteria kidney donors is associated with decreased recipient survival compared with the use of standard-criteria donors, although the underlying mechanisms are incompletely understood. It was hypothesized that donor characteristics may affect recipient aortic stiffness, which may contribute to cardiovascular mortality in these patients.