Hemoglobin level variability in hemodialysis patients treated with epoetin-β during 1 year.

Aim: This analysis was performed to assess the prevalence and the factors associated with hemoglobin (Hb) variability during treatment with erythropoiesis-stimulating agents (ESA) in France.

Methods: Hb variability was evaluated in a subgroup of hemodialysis (HD) patients of the French cohort DiaNE. Eligible patients had received epoetin-β at least 6 months before entering DiaNE, 12 months during DiaNE and had no missing monthly Hb measurements.

[Anemia management in French hemodialysis patients: DiaNE study results at 3 years (DiaNE2)].

The observational study DiaNE provides a current state of anemia management with Epoetine bêta in hemodialysis patients regarding European recommendations over a 3-year period in France. Patients still treated with Epoetine bêta twelve months after their inclusion in DiaNE were eligible for a 24-month extension phase entitled DiaNE 2. Data regarding 439 patients followed during three years, from M0 to M36, were analyzed.

[Is the management of anemia in hemodialysis patients improving in France? Results of the DiaNE study].

French and international clinical practice guidelines recommend a minimum hemoglobin level of 11 g/dl in patients with chronic kidney disease. Previous studies implemented between 1996 and 2003 showed that only 35 to 55% the patients reach this target. Dialysis NeoRecormon Epidemiology (DiaNE) is a one-year French multicentric observational study designed to follow a cohort of 1200 patients with ESRD treated with epoetin beta to assess the management of anemia in routine nephrologic practice.

[Treatment of an asthmatic patient on dialysis and awaiting transplantation with anti-IgE].

Introduction: Omalizumab, a monoclonal antibody to IgE, is a possible treatment for severe, uncontrolled allergic asthma.

Case Report: A severe asthmatic patient with renal insufficiency and on dialysis was awaiting transplantation. The asthma was uncontrolled with poor respiratory function.

[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.

Renal involvement in Behçet's disease. Case report and review of the literature.

A female patient has suffered from Behçet's disease (BD) for 15 years. During one recurrent episode proteinuria and microscopic hematuria were discovered. Renal biopsy revealed focal segmental glomerulopathy with IgA deposits.

Pheochromocytoma in a long-term hemodialysis patient.

A right adrenal tumor was found incidentally by renal echography in a 25-year-old man, who had been on hemodialysis for 4 years. Inquiry and clinical examination suggested pheochromocytoma, which was confirmed by plasma catecholamine measurements. Subsequent adrenalectomy was uneventful.

Nephrotic syndrome associated with chronic lymphocytic leukemia: an immunological and pathological study.

Three patients with B chronic lymphocytic leukemia and the nephrotic syndrome had atypical membranous glomerulonephritis or lobular membranoproliferative glomerulonephritis with subepithelial and subendothelial deposits containing IgG1 kappa, IgG1 lambda or IgM and IgG by immunofluorescence, respectively. A monoclonal cryoglobulin was intermittently found in the serum in one case. In two patients, kidney deposits were made of organized microtubular structures.

[Acute renal failure in the course of occupational lead intoxication. Chelation therapy responsability (author's transl)].

In a patient with occupational plumbism and a normal kidney function, EDTA therapy (1 g/24 h) resulted in a massive lead excretion (15 000 microgram/24 h) together with acute renal failure. A direct nephrotoxic effect of EDTA was excluded: after renal function returned to normal, EDTA could be subsequently readministered at progressively increasing doses (250 mg to 1 g/24 h) without any renal dysfunction. These findings strongly suggest a close relationship between the burden of lead mobilized by EDTA and the acute renal failure.

[The nephrotoxicity of the methicillin-gentamycin combination. Apropos of 5 cases].

Interstitial nephritis with acute renal failure was observed in 5 cases out of 6 treated by the association of methicillin and gentamycin, wheras no case, was observed when each of these antibodies was used separately. The mechanisms which might explain the potentialisation of these two drugs are discussed.