[Recommendations for the measurement of blood 25-OH vitamin D].

The 25-hydroxyvitamin D (25OHD) serum concentration should not be measured to everybody but recommendations for this measurement in several clinical situations are available from numerous guidelines and expert positions. It can be proposed to measure 25OHD in diseases where a target range of 25OHD concentrations associated with better outcomes is defined with a sufficient level of evidence, and when this target concentration is difficult to reach without previous measurement (or may be exceeded in case of too large doses are provided). Many National and International Medical Societies recommend to measure 25OHD at least in any situation of « bone fragility » (defined by a low bone mineral density and/or a low energy fracture), in malabsorptions, in chronic kidney disease, in any « phosphocalcic pathology, in patients with clinical signs of profound vitamin D deficiency or excess, and, more generally in any biological exploration of calcium/phosphorus metabolism that includes the measurement of PTH.

[How valid are food surveys run by dieticians?].

International recommendations for dialysis treatment include food surveys among the necessary tools for nutritional status evaluation. Several methods are used: 24-hour food recall, 7-day food diary, 3-day food record, food frequency questionnaire, and the most innovative, pictures of the ingested food shot and sent to the dietician with a mobile phone. The information from these surveys is run on software that calculates the amount of ingested nutriments.

Is there a magic in long nocturnal dialysis?

Long 3 X 8 h/week hemodialysis (HD) has been used without modification in Tassin since 35 years with very satisfactory morbidity and mortality results. It can be performed in the day or overnight. The observed good outcome is mainly due to lower cardiovascular morbidity and mortality than usually reported in HD.

Long 3 x 8 hr dialysis: a three-decade summary.

A long hemodialysis (HD), 3 x 8 hours/week, has been used without significant modification in Tassin for 35 years with excellent morbidity and mortality results. It can be performed during the day or overnight. The relatively good survival is mainly due to a lower cardiovascular mortality than usually reported in dialysis patients.

Quest for postdialysis urea rebound-equilibrated Kt/V with only intradialytic urea samples.

Background: Postdialysis urea rebound (PDUR) is a cause of Kt/V overestimation when it is calculated from predialysis and the immediate postdialysis blood urea collections. Measuring PDUR requires a 30- or 60-minute postdialysis sampling, which is inconvenient. Several methods had been devised for a reasonable approach to determine PDUR-equilibrated Kt/V in short dialysis without the need for a delayed sample.

Length of Dialysis Session Is More Important Than Large Kt/V in Hemodialysis.

Long, slow hemodialysis (3 × 8 hours/week) has been used without significant modification in Tassin, France, for 30 years with excellent morbidity and mortality rates. A long dialysis session easily provides high Kt/V and allows for good control of nutrition and correction of anemia with a limited need for erythropoietin (EPO). Control of serum phosphate and potassium is usually achieved with low-dose medication.

Central venous catheters for haemodialysis: looking for optimal blood flow.

Central venous catheters are commonly used for haemodialysis patients and represent, in our centre, about 15% of the permanent vascular accesses with a total number of more than 230 central venous catheters over the last 10 years. Inadequate blood flow may occur and upsets the nurses, the patients, and the nephrologist. The aim of this study was to identify the factors of the catheter dysfunction.

Clinical assessment of dry weight.

Unsatisfactory control of blood pressure (BP) leading to an increased rate of cardiovascular events is the main cause of mortality in haemodialysis. BP control has deteriorated since haemodialysis session times have been reduced. Inadequate BP control most often is due to a failure to achieve and maintain dry weight.

Segmental necrosis of ascending colon in haemodialysis patients.

A segmental necrosis of the ascending colon sometimes affecting the terminal ileum was observed 13 times in 12 end-stage renal disease patients over a 5400 patient-years observation period. In all but three cases the patient was operated within 24 h of onset of the abdominal pain. Three patients had a bowel perforation; nine had a limited intestinal necrosis.

[Peritoneal dialysis of substitution: how to evaluate the quality of purification, the criteria of dialysis efficacy].

Peritoneal dialysis adequacy in the narrowest sense of the world can be evaluated by several indexes. Residual kidney function and caloric protein intake strongly affect the protein metabolism (creatinine, urea) they reflect. The correlation between dialysis adequacy indexes and clinical issue (survival, mortality and morbidity) is rather poor.

[Effect of catheter type on the functional survival of jugular access ports in chronic hemodialysis].

Silicone catheter (C) can be used in the hemodialysis setting as an alternative for the blood access. We analysed retrospectively the 3 types of the catheters used in 45 patients. 58 catheters were percutaneously inserted in the internal jugular vein (9 Bard (B)-Hickman; 17 Canaud (CD)-Vygon; 32 Permcath (PC)-Quinton).

[Comparison of the functional survival in chronic renal insufficiency of Permcath jugular catheters according to their mode of insertion].

The functional survival of the same silicone double lumen catheter (DLC) was analyzed in relation with the mode of its insertion. Thirty-seven catheters were surgically inserted (34 in the right internal Jugular vein, 3 in the left internal Jugular vein), while 28 were percutaneously inserted (25 in the right internal Jugular vein, 3 in the left internal Jugular vein). The functional survival was calculated using Kaplan Meier method.