1
|
Ailioaie O, Essig M, Levassort H. [Substitution treatments for chronic kidney disease in geriatrics: dialysis, transplantation and medical treatment without dialysis]. Soins Gerontol 2024; 29:14-20. [PMID: 38418067 DOI: 10.1016/j.sger.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
Kidney disease, whether acute or chronic, is a particularly common condition in the elderly, due to its main risk factors, the prevalence of which increases with age, and the fact that recovery from acute tubular damage is slower. Wherever possible, treatment of renal failure should be anticipated and discussed with the patient as part of a shared medical decision. Numerous treatment options are available to ensure maximum integration into the patient's life and care plan: renal transplantation for the most robust patients, hemodialysis in a care facility or at home, peritoneal dialysis at home, or medical treatment without dialysis. The choice of one of these treatments must leave the patient free to change his or her treatment modality at any time.
Collapse
Affiliation(s)
- Oana Ailioaie
- Service de néphrologie, Université Paris-Saclay, Site Ambroise-Paré, AP-HP, Boulogne-Billancourt, France
| | - Marie Essig
- Service de néphrologie, Université Paris-Saclay, Site Ambroise-Paré, AP-HP, Boulogne-Billancourt, France; Inserm UMRS 1018, Équipe épidémiologie clinique, Université Paris-Saclay, UVSQ, CESP, Villejuif, France
| | - Hélène Levassort
- Service de néphrologie, Université Paris-Saclay, Site Ambroise-Paré, AP-HP, Boulogne-Billancourt, France; Inserm UMRS 1018, Équipe épidémiologie clinique, Université Paris-Saclay, UVSQ, CESP, Villejuif, France; Service de gériatrie, Université Paris-Saclay, Site Ambroise-Paré, AP-HP, Boulogne-Billancourt, France.
| |
Collapse
|
2
|
Zakhama L, Hammami R, Mzoughi K, Ben Halima M, Antit S, Chaker F, Ben Fatma L, Jammoussi H, Gribaa R, Charfeddine S, Drissa M, Tarmiz A, Taamallah K, Milouchi S, Nouira S, Neffati E, Ouechtati W, Ouali S, Ben Halima A, Turki F, Skhiri H, Amrouch C, Slim I, Zghal K, Koubaa A, Karoui M, Boussarsar M, Besbes MH, Ben Jeddou K, Ouertatani H, Ben Hammouda M, Ben Brahem A, Hammouda C, Bezdah L, Said F, Lakhdhar R. Management of patients with cardiovascular diseases during Ramadan. Tunis Med 2022; 100:358-373. [PMID: 36206085 PMCID: PMC9552241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
During the month of Ramadan, over one billion Muslims observe a water and food fast from sunrise to sunset. The practice of this religious duty causes marked changes in eating and sleeping habits. With the increasing incidence of cardiovascular (CV) risk factors, the number of patients with CV pathologies who wish to fast is increasing worldwide, and in Tunisia, which is ranked as a high CV risk country. If fasting has been shown to be beneficial for the improvement of some metabolic parameters, its practice in patients with CV pathology remains debated. The Tunisian Society of Cardiology and Cardiovascular Surgery (STCCCV) in consultation with the National Instance of Evaluation and Accreditation in Health (INEAS) has established this document in the form of a consensus after having analysed the literature with the aim of addressing these questions: -What is the impact of fasting in patients with CV pathologies? -How to stratify the risk of fasting according to CV pathology and comorbidities? -How to plan fasting in patients with CV diseases? -What are the hygienic and dietary measures to be recommended during fasting in patients with CV pathologies? -How to manage medication during the month of Ramadan in patients with CV diseases?
Collapse
Affiliation(s)
- Lilia Zakhama
- 1. Service de Cardiologie, Hôpital des Forces de Sécurité Intérieure, La Marsa, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Rania Hammami
- 2. Service de Cardiologie, Hôpital Hédi Chaker, Faculté de Médecine de Sfax, Université de Sfax, Tunisie.
| | - Khadija Mzoughi
- 3. Service de Cardiologie, Hôpital Habib Thameur, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunisie.
| | - Manel Ben Halima
- 4. Service des explorations fonctionnelles et de réanimation cardiaque, Hôpital de la Rabta, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunisie.
| | - Saoussen Antit
- 1. Service de Cardiologie, Hôpital des Forces de Sécurité Intérieure, La Marsa, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Fatma Chaker
- 5. Service d’Endocrinologie, Hôpital de la Rabta, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunisie.
| | - Lilia Ben Fatma
- 6. Service de Néphrologie, Hôpital de la Rabta, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunisie.
| | - Henda Jammoussi
- 7. Service de Nutrition A, Institut National de Nutrition de Tunis, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Rym Gribaa
- 8. Service de Cardiologie, Hôpital Sahloul, Faculté de Médecine de Sousse, Université de Sousse, Tunisie.
| | - Selma Charfeddine
- 2. Service de Cardiologie, Hôpital Hédi Chaker, Faculté de Médecine de Sfax, Université de Sfax, Tunisie.
| | - Meriem Drissa
- 9. Service de Cardiologie Adulte, Hôpital de la Rabta, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunisie.
| | | | - Karima Taamallah
- 11. Service de Cardiologie Adulte, Hôpital Militaire de Tunis, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunisie.
| | - Sami Milouchi
- 12. Service de Cardiologie, Hôpital de Mednine, Faculté de Médecine de Sfax, Université de Sfax, Tunisie.
| | - Samir Nouira
- 13. Service des urgences, Hôpital de Fattouma Bourguiba, Faculté de Médecine de Monastir, Université de Monastir, Tunisie
| | - Elyes Neffati
- 8. Service de Cardiologie, Hôpital Sahloul, Faculté de Médecine de Sousse, Université de Sousse, Tunisie.
| | - Wejdène Ouechtati
- 14. Service de Cardiologie, Hôpital Charles Nicolle, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunisie.
| | - Sana Ouali
- 4. Service des explorations fonctionnelles et de réanimation cardiaque, Hôpital de la Rabta, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunisie.
| | - Afef Ben Halima
- 15. Service de Cardiologie, Hôpital Abderrahmen Mami de l’Ariana, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunisie.
| | - Faten Turki
- 2. Service de Cardiologie, Hôpital Hédi Chaker, Faculté de Médecine de Sfax, Université de Sfax, Tunisie.
| | - Habib Skhiri
- 16. Service de Néphrologie, Hôpital de Fattouma Bourguiba, Faculté de Médecine de Monastir, Université de Monastir, Tunisie.
| | - Chiraz Amrouch
- 17. Consultations externes de Nutrition, Institut National de Nutrition de Tunis, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunisie.
| | | | - Khaled Zghal
- 18. Laboratoire de Pharmacologie, Faculté de Médecine de Sfax, Université de Sfax, Tunisie.
| | | | | | | | | | | | | | | | | | | | - Leila Bezdah
- 14. Service de Cardiologie, Hôpital Charles Nicolle, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunisie.
| | - Fatma Said
- 24. Service de Médecine Interne, Hôpital de la Rabta, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunisie.
| | | |
Collapse
|
3
|
Deus LAD, Corrêa HDL, Neves RVP, Reis AL, Honorato FS, Araújo TBD, Souza MK, Haro AS, Silva VL, Barbosa JMDS, Padula IA, Andrade RV, Simões HG, Prestes J, Stone WJ, Melo GF, Rosa TS. Metabolic and hormonal responses to chronic blood-flow restricted resistance training in chronic kidney disease: a randomized trial. Appl Physiol Nutr Metab 2022; 47:183-194. [PMID: 35062832 DOI: 10.1139/apnm-2021-0409] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Maintenance of glycemic and lipemic homeostasis can limit the progression of diabetic kidney disease. Resistance training (RT) is effective in controlling glycemia and lipemia in kidney disease; however, the effect of RT with blood flow restriction (RT+BFR) on these metabolic factors has not been investigated. We aimed to verify if chronic (6 months) RT and RT+BFR performed by patients with stage-2 chronic kidney disease (CKD) improves their glycemic homeostasis and immunometabolic profiles. Patients with CKD under conservative treatment (n = 105 (33 females)) from both sexes were randomized into control (n = 35 (11 females); age 57.6 ± 5.2 years), RT (n = 35 (12 females); age 58.0 ± 6.2 years), and RT+BFR (n = 35 (10 females); 58.0 ± 6.4 years) groups. Chronic RT or RT+BFR (6 months) was performed 3 times per week on non-consecutive days with training loading adjusted every 2 months, RT 50%-60%-70% of 1RM, and RT+BFR 30%-40%+50% of 1RM and fixed repetition number. Renal function was estimated with the glomerular filtration rate and serum albumin level. Metabolic, hormonal, and inflammatory assessments were analyzed from blood samples. Six months of RT and RT+BFR were similarly effective in improving glucose homeostasis and hormone mediators of glucose uptake (e.g., irisin, adiponectin, and sirtuin-1), decreasing pro-inflammatory and fibrotic proteins, and attenuating the progression of estimated glomerular filtration rate. Thus, RT+BFR can be considered an additional exercise modality to be included in the treatment of patients with stage 2 chronic kidney disease. Trial registration number: U1111-1237-8231. URL: http://www.ensaiosclinicos.gov.br/rg/RBR-3gpg5w/, no. RBR-3gpg5w. Novelty: Glycemic regulation induced by resistance training prevents the progression of CKD. Chronic RT and RT+BFR promote similar changes in glycemic regulation. RT and RT+BFR can be considered as non-pharmacological tools for the treatment of CKD.
Collapse
Affiliation(s)
- Lysleine Alves de Deus
- Graduate Program in Physical Education, Catholic University of Brasília (UCB), Taguatinga, DF, Brazil
| | - Hugo de Luca Corrêa
- Graduate Program in Physical Education, Catholic University of Brasília (UCB), Taguatinga, DF, Brazil
| | | | - Andrea Lucena Reis
- Graduate Program in Physical Education, Catholic University of Brasília (UCB), Taguatinga, DF, Brazil
| | - Fernando Sousa Honorato
- Graduate Program in Physical Education, Catholic University of Brasília (UCB), Taguatinga, DF, Brazil
| | | | - Michel Kendy Souza
- Department of Nephrology, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Anderson Sola Haro
- Department of Nephrology, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Victor Lopes Silva
- Graduate Program in Physical Education, Catholic University of Brasília (UCB), Taguatinga, DF, Brazil
| | | | | | - Rosângela Vieira Andrade
- Graduate Program in Genomic Sciences and Biotechnology, Catholic University of Brasília (UCB), Taguatinga, DF, Brazil
| | - Herbert Gustavo Simões
- Graduate Program in Physical Education, Catholic University of Brasília (UCB), Taguatinga, DF, Brazil
| | - Jonato Prestes
- Graduate Program in Physical Education, Catholic University of Brasília (UCB), Taguatinga, DF, Brazil
| | - Whitley J Stone
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, KY, USA
| | - Gislane Ferreira Melo
- Graduate Program in Physical Education, Catholic University of Brasília (UCB), Taguatinga, DF, Brazil
| | - Thiago Santos Rosa
- Graduate Program in Physical Education, Catholic University of Brasília (UCB), Taguatinga, DF, Brazil
| |
Collapse
|
4
|
Samaké M, Sy S, Coulibaly M, Yattara H, Soumbounou G, Kodio A, Diarra B, Fofana AS, Diallo D, Dolo AM, Maiga D, Coulibaly SB, Coulibaly K, Fongoro S. [Prevalence of the kidney disease at the emergency department of hospital Fousseyni Daou of Kayes]. Mali Med 2021; 36:1-7. [PMID: 37973567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Kidney disease (KD) is defined as a set of functional, morphological and histological kidney abnormalities. It is a truly global public health problem. Its prevalence is estimated to be 50 times that of end-stage renal disease (ESRD). In Kayes, there is no data on the prevalence of kidney disease, hence the interest of this study. OBJECTIVES to determine the prevalence of renal disease, its main causes and the main factors of aggravation of this pathology in the emergency department at hospital Fousseyni DAOU of Kayes. METHODOLOGY Retrospective cross-sectional study carried out from January 1, 2014 to February 1, 2015. We included all hospitalized patients in whom a renal damage marker (elevation of plasma creatinine, urinary sediment abnormality, ultrasound, histology and significant proteinuria) has been found. RESULTS the prevalence of kidney disease was 9.9% (109/1099). Eighty-nine met the inclusion criteria. The study population was composed of 47 women (52.8%) and 42 men (47.2%), with a sex ratio of 0.89 in favor of women. The average age was 40.09 years with a predominance of patients in the age group [40-59]. The main reasons for consultation were hypercreatininaemia (48.3%), edematous syndrome (16.9%), low back pain (10.1%). High blood pressure (55.1%) and lower extremity edema (46.1%) were the medical history frequently found in our study. The kidney disease found was in order of growth: chronic renal failure (51%); acute renal failure (28%); proteinuria (16%), hematuria (3%), morphological abnormality of the kidneys (2%). Tubulointerstitial nephropathy represented 64% of acute renal failure with P = 0.000306. Vascular nephropathy constituted 46.7% of chronic renal failure with P = 0.000251. No cases of glomerular nephropathy were found in patients over 60 years of age.The most common causes were represented by nephrotoxic drugs injuries; infectious; high blood pressure and diabetes. The most observed aggravating factors are herbal medicine, urinary tract infections, renal hypoperfusion and unbalanced hypertension. CONCLUSION kidney disease is not uncommon in the emergency room at Hospital Fousseyni Daou of Kayes. The most common causes are nephrotoxic drugs, hypertension and diabetes.
Collapse
Affiliation(s)
- M Samaké
- Unité de Néphrologie de l'hôpital Fousseyni DAOU de Kayes
| | - S Sy
- Service de Néphrologie et d'hémodialyse du CHU du Point G
| | - M Coulibaly
- Unité de Néphrologie de l'hôpital Mali GAVARDO
| | - H Yattara
- Service de Néphrologie et d'hémodialyse du CHU du Point G
| | - G Soumbounou
- Service des urgences de l'hôpital Fousseyni DAOU de Kayes
| | - A Kodio
- Service de Néphrologie et d'hémodialyse du CHU du Point G
| | - B Diarra
- Unité de Néphrologie de l'hôpital Fousseyni DAOU de Kayes
| | - A S Fofana
- Service de Néphrologie et d'hémodialyse du CHU du Point G
| | - D Diallo
- Service de Néphrologie et d'hémodialyse du CHU du Point G
| | - A M Dolo
- Unité de Néphrologie de l'hôpital régional de Sikasso
| | - D Maiga
- Unité de Néphrologie de l'hôpital régional de Sikasso
| | - S B Coulibaly
- Service de Néphrologie et d'hémodialyse du CHU du Point G
| | - K Coulibaly
- Unité de Néphrologie de l'hôpital Somino DOLO de Mopti
| | - S Fongoro
- Service de Néphrologie et d'hémodialyse du CHU du Point G
| |
Collapse
|
5
|
Genon C. [The 'City of the Kidney', a platform for co-constructing a therapeutic pathway]. Rev Infirm 2017; 66:34-35. [PMID: 29127979 DOI: 10.1016/j.revinf.2017.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Innovative in terms of assisting shared medical decision making, the internet platform 'the City of the Kidney' aims to provide reliable and independent information to patients with kidney disease requiring dialysis or transplant as well as to their relatives. A tool which health professionals can recommend to their patients as a source of detailed information.
Collapse
Affiliation(s)
- Clotilde Genon
- Association Renaloo, 48, rue Eugène-Oudiné, 75013 Paris, France.
| |
Collapse
|
6
|
Peck R, Baisley K, Kavishe B, Were J, Mghamba J, Smeeth L, Grosskurth H, Kapiga S. Decreased renal function and associated factors in cities, towns and rural areas of Tanzania: a community-based population survey. Trop Med Int Health 2016; 21:393-404. [PMID: 26644310 PMCID: PMC4784164 DOI: 10.1111/tmi.12651] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Data on renal dysfunction in sub-Saharan Africa, comparing urban and rural areas, have not yet been reported. Therefore, we aimed to determine the distribution of low estimated glomerular filtration rates (eGFRs) in urban and rural Tanzania, to describe factors associated with low eGFR and to quantify fractions attributable to common risk factors. METHODS We conducted a community-based survey of 1095 randomly selected Tanzanian adults (≥18 years). A structured questionnaire and examinations were used to document sociodemographic characteristics, diet, physical activity, anthropomorphic measurements and blood pressure. Blood tests were performed for HIV infection, diabetes mellitus and creatinine. eGFR was calculated using two equations recommended for African adults. RESULTS Serum creatinine was available for 1043 participants: 170 in Mwanza city, 326 in district towns and 547 in rural areas. Mean age was 35.5 years and 54% were females. The prevalence of eGFR < 60 ml/min/1.73 m(2) in these 3 strata was 2.3% (95% CI = 0.8-6.6%), 7.5% (4.7-11.8%) and 7.4% (5.1-10.6%), respectively. When age standardised to the WHO world population, prevalences were 3.8%, 10.1% and 8.1%. Factors associated with low eGFR included district town residence, older age, greater wealth, less physical activity and hypertension. Only 21% of cases with eGFR < 60 ml/min/1.73 m(2) were attributable to HIV, hypertension or diabetes. CONCLUSIONS Decreased renal function is common in Tanzania, particularly in district towns, and unique risk factors for kidney disease may exist in this population. Population-specific strategies for prevention, early diagnosis and treatment of kidney disease are needed for Africa.
Collapse
Affiliation(s)
- Robert Peck
- Mwanza Intervention Trials UnitMwanzaTanzania
- Weill Bugando School of MedicineMwanzaTanzania
| | - Kathy Baisley
- London School of Hygiene & Tropical MedicineLondonUK
| | | | | | - Janneth Mghamba
- Tanzanian Ministry of Health and Social WelfareDar es SalaamTanzania
| | - Liam Smeeth
- London School of Hygiene & Tropical MedicineLondonUK
| | | | | |
Collapse
|
7
|
Lytvyn Y, Perkins BA, Cherney DZI. Uric acid as a biomarker and a therapeutic target in diabetes. Can J Diabetes 2015; 39:239-46. [PMID: 25600084 DOI: 10.1016/j.jcjd.2014.10.013] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 08/21/2014] [Accepted: 10/10/2014] [Indexed: 02/07/2023]
Abstract
Diabetic nephropathy is a long-standing microvascular complication of diabetes mellitus and is the leading cause of end stage renal disease in developed countries. Current therapeutic strategies used to prevent or delay diabetic nephropathy exert limited clinical protective effects and can have serious adverse effects. Thus, identification of new pharmacologic agents that protect against the initiation and progression of complications of diabetes is of the utmost importance. Uric acid (UA) recently emerged as an inflammatory factor that increases oxidative stress and promotes activation of the renin angiotensin aldosterone system. As a consequence, higher UA levels are associated with various stages of the onset and progression of diabetic nephropathy, including metabolic, cardiovascular and kidney function abnormalities. If UA-lowering drugs, such as the xanthine oxidase inhibitors, block the mechanisms responsible for micro- and macrovascular injury in diabetes, these agents could represent a critical step toward preventing the progression of diabetes. This review focuses on the evidence that supports serum UA levels as a biomarker of renal and cardiovascular risk and as a potential additional therapeutic target in diabetes.
Collapse
Affiliation(s)
- Yuliya Lytvyn
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Division of Nephrology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Bruce A Perkins
- Department of Medicine, Division of Endocrinology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - David Z I Cherney
- Department of Medicine, Division of Nephrology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
8
|
Caligiuri SPB, Blydt-Hansen T, Love K, Grégoire M, Taylor CG, Zahradka P, Aukema HM. Evidence for the use of glomerulomegaly as a surrogate marker of glomerular damage and for alpha-linolenic acid-rich oils in the treatment of early obesity-related glomerulopathy in a diet-induced rodent model of obesity. Appl Physiol Nutr Metab 2014; 39:951-959. [PMID: 24927777 DOI: 10.1139/apnm-2013-0476] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2023]
Abstract
Obesity-related glomerulopathy (ORG) is a unique and emerging condition that can lead to renal failure. Early detection, aided by an earlier diagnostic marker, would improve patient outcomes; this could be facilitated by an accurate model. Such a model would be useful to examine interventions like dietary fatty acids, which are known to influence renal diseases in later stages. In this study, obese-prone rats were provided high-fat (55% of energy) diets for 12 weeks to generate a model of diet-induced obesity. The rats were subsequently provided dietary oils with various levels of alpha-linolenic acid (ALA) and linoleic acid (LA) for 8 weeks, as follows: (g ALA:LA per 100 g oil): canola/flax (20:18), canola (8:18), soy (9:53), high-oleic canola/canola (5:16), high-oleic canola (2:15), lard/soy (1:8), and safflower (0.2:73). The model developed obesity, glomerulomegaly, proteinuria, and scarce glomerular damage with an indolent course. Morphometry and histology revealed glomerulomegaly as the first renal structural alteration. The utility of this marker as a predictor for the presence of ORG and renal injury was evidenced by its correlation to visceral adiposity (p < 0.0001, r = 0.44), proteinuria (p < 0.0001, ρ = 0.55), change in proteinuria (p = 0.0092, ρ = 0.42), and glomerular damage (p < 0.0001, ρ = 0.48). Renal triglyceride ALA:LA was strongly correlated with dietary ALA:LA (p < 0.0005, ρ = 0.96), and inversely associated with mean glomerular volume (p = 0.02, ρ = -0.82). The diet-induced obese model accurately represents early ORG, and implicates glomerulomegaly as an early surrogate diagnostic marker. Early intervention with ALA-rich dietary oils slowed glomerular enlargement; these findings warrant further clinical investigation to promote optimal patient outcomes.
Collapse
Affiliation(s)
- Stephanie P B Caligiuri
- a Department of Human Nutritional Sciences, University of Manitoba, W383 Duff Roblin Building, Winnipeg, MB R3T 2N2, Canada
| | | | | | | | | | | | | |
Collapse
|
9
|
Bouattar T, Bezzaz A, Abdellaoui K, Lamchahab FE, Benamar L, Ezaitouni F, Hassam B, Bayahia R, Ouzeddoun N. [Preserving vascular asset in Ibn Sina Teaching Hospital, Rabat-Morocco: the role of the nurse]. Pan Afr Med J 2012; 11:57. [PMID: 22593793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Accepted: 03/24/2012] [Indexed: 11/16/2022] Open
Abstract
Introduction Tout patient ayant une maladie chronique nécessitant des prélèvements sanguins répétés ou des traitements par voie veineuse ou susceptible d’évoluer vers l’insuffisance rénale chronique, doit bénéficier d’une stratégie de préservation de son réseau veineux. Le but de ce travail etait de déterminer le rôle de l’infirmier dans la protection du réseau veineux superficiel. Méthodes Etude transversale réalisée au mois d’Avril 2010 à l’hôpital Ibn Sina de Rabat ayant intéressée les infirmiers exerçant dans différents services prenant en charge des patients ayant des pathologies rénales chroniques ou une maladie générale susceptible de se compliquer d’atteinte rénale. Résultats Parmi les 80 infirmiers sollicités, 66 ont complété le questionnaire avec un âge moyen de 42,7 ±11ans et un sex-ratio à 0,7. L’ancienneté moyenne en soins était de 227,7 ± 116,7 mois. 37 % des infirmiers n’étaient pas informés sur la préservation du capital veineux. Le membre supérieur droit était ponctionné dans 92,3% des cas. Le site de ponction le plus utilisé était le dos de la main dans 84,6 % des cas. La dilatation des veines par le réchauffement était notée dans 63,3% des cas, par passage d’alcool dans 54,5% des cas et l’emploi du garrot était retrouvé dans 95,5% des cas. Les venojects étaient de 18 gauge dans 18,2 % des cas et de 21 gauge dans 81,8% des cas. Les intranules étaient de 18 gauge dans 78,8% des cas et de 20 gauge dans 21,2 % des cas. Durant les six derniers mois avant l’étude, les complications au niveau du site de ponction étaient notées dans 41 % des cas. Conclusion L’information et l’éducation du personnel paramédical sont obligatoires ainsi que l’utilisation des cathéters veineux de petit calibre afin d’assurer cette protection.
Collapse
|