A methodology for consensus conferences. Société Royale Belge de Gastro-entérologie.

Consensus conference is one of the methods proposed to develop clinical practice guidelines. This method is used when the topic is limited to a small numbers of questions (4 to 6) and when there is a controversy. This process is based on the meeting of a jury which reviews the scientific information provided by the literature and presented by experts.

Renal disease associated with HIV infection: a multicentric study of 60 patients from Paris hospitals.

Sixty HIV-infected patients presenting renal symptoms who underwent percutaneous renal biopsies were analysed. According to the CDC classification, 44 patients were staged in group IV, five in group III, and 11 in group II. Patients were divided in two groups according to their ethnic origin (29 black patients and 31 white patients).

Nephropathy associated with infection by human immunodeficiency virus: a report on 11 cases including 6 treated with zidovudine.

The human immunodeficiency virus (HIV) was recently suggested to be involved in generating kidney lesions in HIV-associated nephropathy (HIVN). The possibility that antiretroviral agents can slow down the usually explosive evolution of HIVN to end-stage renal failure (ESRF) has not been studied in many of the series of cases published. The present work is a retrospective analysis of 11 patients with histologically proven HIVN, 6 of whom were treated with zidovudine.

IgA polyspecific autoantibodies in IgA nephropathy.

The specificity of circulating and kidney-bound IgA during IgA nephropathy is still a matter of discussion. In the present study, high levels of IgA antibodies directed against a panel of self and non-self antigens were found in the serum from patients with IgA nephropathy and were eluted from four out of the seven kidney biopsies studied. After immunoadsorption of pooled selected serum samples on TNP and actin-coated columns, polyspecific IgA antibodies were eluted.

Experience with the Hemasite vascular prosthesis.

A 3-year experience with the no-needle vascular prosthesis Hemasite, implanted in 10 patients who underwent hemodialysis and have a long history of multiple vascular access failures, is described. During 182 months of follow-up study, 30 thromboses occurred, while nine of 10 patients did not receive any antiplatelet aggregant treatment. Hemasite was declotted 12 times with a local infusion of urokinase and 12 more times by thrombectomy.

[Peritoneal dialysis, the method of treatment for end-stage renal insufficiency: development of indications during the past 10 years in relation to the initial renal disease and extra-renal pathology].

A decade after its first introduction, the advantages and drawbacks of continuous ambulatory peritoneal dialysis over hemodialysis remain controversial. This present paper is a review of the literature, focused on the indications of this dialysis modality in different circumstances: extra-renal pathology, systemic diseases (lupus erythematosus--diffuse scleroderma--plasma cell disorders--amyloidosis--HIV infected patients) and complications related to hemodialysis.

Plasma exchange and immunosuppression for rapidly progressive glomerulonephritis: prognosis and complications.

Rapidly progressive glomerulonephritis frequently leads to death or dialysis. In 21 cases treated by plasma exchange and immunosuppression we observed seven deaths, with 12 others progressing to chronic renal failure within 3 months. Patients who died were older than those who survived (57.

[Tamm-Horsfall protein].

Tamm-Horsfall protein is the most abundant protein in normal urine and the main component of urinary casts, but its precise physiological role remains to be elucidated. The interest raised by this protein has recently been boosted by the finding that its gene is identical with that of uromodulin, a glycoprotein purified from urine of pregnant women and endowed with immunosuppressive activity. In this review, are analyzed successively: the structure and physico-chemical properties of Tamm-Horsfall protein which is remarkable by its capacity for gel formation, its localization along the nephron where it is synthesized by cells of the thick ascending limb of Henle's loop, its extra-renal distribution apparently restricted to the serum and its potential physiological and pathological roles.

Interleukin-2 production in Brown-Norway rats with HgCl2-induced autoimmune disease: paradoxical in vivo versus in vitro findings.

In autoimmune diseases, mitogen-induced IL-2 production in vitro is generally considered to be diminished despite evidence of lymphoid hyperactivity in vivo. HgCl2 is known to cause T-dependent polyclonal B cell activation in Brown-Norway (BN) rats, resulting in autoimmune disease. We show here that the IL-2 producing capacity of cells from HgCl2-treated BN rats is low, but that HgCl2 treatment in vitro (10(-7) M) enhances IL-2 production of normal BN splenocytes.

Natural autoantibodies in systemic lupus erythematosus.

We have tested the sera of 25 patients with systemic lupus erythematosus (SLE) for antibody activity against a panel of six antigens: DNA, TNP, actin, tubulin, myosin, albumin. Eluates from renal biopsy tissue were also tested. Sera from patients with lupus nephritis were found to contain high titres of IgA antibodies directed against the antigens of the panel, and marked IgG anti-DNA and anti-TNP antibody activity.