[Arterial hypertension in chronic hemodialysis patients at the National Hospital of Niamey Lamordé].

A prospective study was conducted at the department of the National Hospital in Niamey, Niger Lamordé over a period of 12 months (from January 1 to December 31, 2009) on 99 patients on chronic hemodialysis. The purpose of this study was to analyze the epidemiological, clinical, paraclinical and therapeutic aspects of arterial hypertension in this population. The average age was 37 years (range 17 to 65) , the prevalence of arterial hypertension was 61.

[Current indications of azathioprine in nephrology].

Azathioprine is an immunosuppressive agent belonging to the antimetabolite family whose action blocks purine synthesis. It inhibits lymphocyte proliferation. In recent years, several trials have clarified the role of this compound used for three main indications: lupus glomerulonephritis, necrotizing vasculitis associated with antineutrophil cytoplasmic antibodies and renal involvement, and kidney transplantation.

[Malignant hyperparathyroidism with diffuse calcifications involving the lungs in a chronic hemodialysis patient].

Metastatic calcifications are a potentially severe complication of end-stage renal disease. In the lungs, they are often asymptomatic with a possible lethal evolution. We report the clinical case of a chronic hemodialysis patient who died from extensive metastatic calcifications both vascular and visceral specially localized in the lungs.

[Recurring peritonitis due to Streptococcus from the upper respiratory tract in a saxophone player under peritoneal dialysis].

This is a nephrectomized patient of 77 years, musician (saxophonist), in peritoneal dialysis, with diabetes, hypertension, and coronary disease. He presented a few months apart two successive episodes of peritonitis due to Streptococcus mitis/oralis and Streptococcus parasanguis. Before each episode he played the saxophone he played twice and each time he has peritonitis.

[Acute postinfectious glomerulonephritis].

Acute postinfectious glomerulonephritis are defined by an acute nonsuppurative inflammatory insult predominantly glomerular. Its current incidence is uncertain because of the frequency of subclinical forms. The most common infectious agent involved is beta hemolytic streptococcus group A.

[Treatment of iron deficiency in predialysis state by low molecular weight iron dextran high doses intravenously].

Anemia is a common complication of chronic kidney disease (CKD) in predialysis stage. Iron deficiency is more common than in normal patients and plays a key role in the genesis of anemia. Its correction avoids the use of erythropoiesis stimulating agents (ESA) or reduces their dosage.

[Diagnosis of Fabry disease: usefulness of the clinical investigation].

Fabry disease, an X-linked lysosomal storage disorder due to alpha-galactosidase A deficiency, leads to an accumulation of globotriaosylceramide resulting in a multisystemic disorder. The initial manifestations of the disease are not specific, leading to a delayed diagnosis. We report a patient in whom the diagnosis was obtained by family screening and the confrontation of clinical signs.

[Iron, hepcidin and chronic kidney disease].

Iron deficiency is commonly observed in chronic kidney disease. Blood loss and iron consumption under erythropiesis activating agents (ESA) induce absolute deficiency whereas defect of iron intestinal absorption and storage release account for functional deficiency. High hepcidin plasma levels are probably induced by inflammatory process and can explain functional deficiency.

[The role of the nurse in paediatric haemodialysis].

The care provided in paediatric haemodialysis is highly technical. The relational and educational aspect is also essential for the success of the considerable and almost daily monitoring of the children. Support is given to these children by nurses working within a multi-disciplinary team.

[Bariatric surgery, calcium oxalate urinary stones and oxalate nephropathy].

Bariatric surgery is now recognized as a sure and effective way for weight reduction in morbid obesity. However some procedures induce intestinal malabsorption leading to enteric hyperoxaluria. So bariatric surgery could place these patients not only at risk for nephrolithiasis but also for oxalate induced nephropathy and chronic renal failure.

[Use of fondaparinux during hemodialysis in heparin-induced thrombocytopenia. About a new observation].

Several alternative anticoagulation drugs are now available for patients with heparin induced thrombocytopenia type II (HIT II). However, their indication is not yet reaching a consensus. Moreover, some of them have not yet their marketing approval.

[Feasibility between AN69 and hemodiafiltration online].

Removal of the middle molecules (MM) weight toxins, and particularly of beta-2-microglobuline (b2M) is made first by convection technique with membranes habitually used in hemodiafiltration online (HDFOL). AN69 was in standard hemodialysis (HD) the reference membrane for the removal of b2M mostly (60%) by adsorption. Its use with convective methods is generally restricted to low efficiency modalities with low substitution rates (Qs), either with continuous HF or HDF for acute renal failure, or with acetate free biofiltration (AFB) for chronic renal failure.

[Robotic-assisted laparoscopic donor nephrectomy for kidney transplantation. An evaluation of 35 procedures].

Introduction: Renal transplantation with living donor is actually the best technique for renal replacement therapy, particularly with the problem of shortage of organs. Laparoscopic nephrectomy is actually developed because of low surgical mortality and morbidity. Our medical centre uses an original removal method: robot-assisted laparoscopic donor nephrectomy.

[Renal diseases in cystic fibrosis].

Patients with cystic fibrosis (CF) show a continuing improvement in their life expectancy thanks to advances in knowledge of this disorder, allowing better multidisciplinary routine monitoring and earlier therapeutic interventions. Likewise, more than of 40% of these patients are adults and CF is no more only a pediatric disease. Due to their higher life expectancy, CF patients present new and unusual complications that were not recorded before.

[Ophthalmic manifestations in Wegener's granulomatosis. Review of literature about an observation].

Wegener's granulomatosis mainly affects the upper respiratory tract, the lungs and the kidneys but many other organs and tissues may be affected, as well including any eye structures. Ocular and orbital structures involvement is frequently encountered, sometimes inaugural, with or without obvious systemic manifestations, sometimes leading to visual loss. The most frequent ophthalmic lesions are inflammatory orbital disease, (necrotising) scleritis with or without keratopathy, episcleritis, conjunctivitis and even conjunctival ulcer, nasolacrimal ducts obstruction, uveitis, retinal vasculitis and even central retinal vascular occlusion, optic neuritis.

[Digestive adverse effects due to sodium polystyrene sulfonate (Kayexalate) in dialysis patients].

Administered to reduce hyperkaliema in patients with chronic renal failure, sodium polystyrene sulfonate (Kayexalate) can cause digestive complications. The most severe complication could be the intestinal necrosis or perforation. In the present report, we evoke these complications and illustrate them with some pictures from personal observations.

[Disseminated strongyloidiasis with parasitemia in a patient under corticosteroid-treatment].

We report a case of disseminated strongyloidiasis with parasitemia in a 53-year-old man under corticosteroid therapy. It occurred more than 16years after contamination and led to severe sepsis and acute respiratory failure with P. aeruginosa pneumonia.

[Emphysematous pyelonephritis of single kidney: review of literature about one case].

Introduction: Emphysematous pyelonephritis is a rare and severe form of acute pyelonephritis. It is defined as the presence of gas-producing bacteria in the kidney and in peri-nepheretic areas. We report a case of emphysematous pyelonephritis on a single kidney associated with urolithiasis.

[Rabeprazole induced acute interstitial nephritis].

A 84-year-old women underwent renal biopsy because of rapidly progressive renal failure. Rabeprazole induced interstitial nephritis was diagnosed. Interstitial nephritis may complicate the course of any proton pump inhibitor treatment.

[A rare cause of peripheral edema: exudative lymphocytic gastritis induced hypoprotidemia].

Diagnosis of edema secondary to hypoprotidemia but without nutritional, renal, hepatic or cardiac cause, must consider exudative digestive disease, of which the lymphocytic gastritis, as the authors report here a new observation diagnosed in a 73 year-old woman. Gastroscopy reveals varioliform gastritis and biopsy demonstrates diffuse infiltration of the gastric epithelium by lymphocytes, making of it a real histopathologic entity among the gastropathies. Etiology and pathogeny remain still unknown but proton pump gastric inhibitors are an effective treatment.