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Impact of Dialysis Modality on Kidney Transplantation Outcomes

Journal of Biomedical Science and Engineering 2015年第2期8卷 67-72页

作者： imed helal Imen Gorsane Fethi Ben Hamida Adel Kheder Department of Medicine A (M8) Charles Nicolle Hospital Tunis Tunisia Laboratory of Kidney Pathology (LR00SP01) Charles Nicolle Hospital Tunis Tunisia Faculty of Medicine University of Tunis El Manar Tunis Tunisia

Survival benefits of renal transplantation over dialysis therapy are well established for patients with end-stage renal disease (ESRD). Transition from one treatment modality to another is common. Understanding the differences in outcomes with the various renal replacement therapies will help nephrologists to provide best advice for dialysis patients. The influence of pretransplant dialysis modality on post-transplant outcomes is not clear. An overview of the various issues related to dialysis modality on kidney transplantation outcomes is discussed in this topic review. These include allograft and recipient survival, the impact of dialysis vintage and choice of dialysis modality on transplant outcomes.

关键词： Peritoneal Dialysis Hemodialysis Kidney Transplantation

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Indications and Results of Kidney Biopsies in Patients over 65 Years Old

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Open Journal of Nephrology 2015年第2期5卷 49-53页

作者： Imen Gorsane Madiha Mahfoudhi imed helal Taieb Ben Abdallah Internal Medicine A Department Charles Nicolle Hospital Tunis Tunisia

Normal kidney aging is related to tissue and functional changes that make older patients very vulnerable to environmental modifications. Numerous factors can accelerate the impairment of renal function during aging. It was a single-center retrospective study extending over a period of 30 years from 1984 to 2014 and includes patients older than 65 years, hospitalized for nephropathy requiring renal biopsy and monitored in our service. There were 6 men and 7 women with an average age of 69.38 ± 4.5 years. Mean serum creatinine was 267.15 ± 124 mmol/l. Eleven patients had renal failure. Histological lesions were: Extramembranous glomerulonephritis (EMGN): 1 case, focal segmental glomerular sclerosis (FSGS): 3 cases, membranoproliferative glomerulonephritis (MPGN): 1 case, IgA nephropathy: 1 case, glomerulonephritis with IgG4 fibrillar deposits (GN IgG4): 1 case, diabetic nephropathy: 2 cases, myeloma-associated tubulopathy: 1 case, acute tubular necrosis: 1 case, acute interstitial nephritis: 1 case, vascular nephropathy: 1 case. Kidney disease will increasingly become a geriatric illness. Nephrologists are encountering a growing group of elderly patients with diminished equation for estimated glomerular filtration rate (eGFR) that require evaluation and management.

关键词： Renal Aging Chronic Kidney Disease Elderly Renal Biopsy

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Prevalence and Risk Factors of Hypertension in Hemodialysis

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Open Journal of Nephrology 2015年第2期5卷 54-60页

作者： Imen Gorsane Madiha Mahfoudhi Fathi Younsi imed helal Taieb Ben Abdallah Internal Medicine A Department Charles Nicolle Hospital Tunis Tunisia

The prevalence of hypertension in iterative hemodialysis (HD) remains high and was associated with a high morbidity and mortality. It was a single-center retrospective study including 124 pa-tients on chronic HD in our unit. The prevalence of hypertension was determined from blood pressure (BP) monitoring in beginning, middle and end of dialysis. We defined hypertension as systolic BP (SBP) greater than or equal to 140 mmHg and/or diastolic BP (DBP) greater than or equal to 90 mmHg on at least two measures. We have established a comparative study between the group of hypertensive dialysis and those not hypertensive. The prevalence of hypertension was 69.35% (86/124). The mean age was 57.15 years with a sex ratio of 1.2. Echocardiograms, performed in 64.5% of patients, showed a high prevalence of cardiac consequences of hypertension with left ventricular hypertrophy in 80% of patients and an average ejection fraction of 62%. Diabetes, dialysis one session per week and the non-compliance with lifestyle and dietary rules were significantly associated with hypertension in HD in our study. The effect of HD on BP is dose-dependent. The reduction of BP allows a lower risk of cardiovascular (CV) events and mortality in hypertensive patients.

关键词： Hemodialysis Blood Pressure Hypertension Ultrafiltration Volume Expansion

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Renal Replacement Therapy in Patients over 65 Years Old

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Open Journal of Nephrology 2015年第2期5卷 44-48页

作者： Imen Gorsane Madiha Mahfoudhi Mondher Ounissi Fathi Younsi imed helal Taieb Ben Abdallah Internal Medicine A Department Charles Nicolle Hospital Tunis Tunisia

Age at onset of renal replacement therapy (RRT) is increasing in all countries. Two substitution methods of renal function remain available: hemodialysis (HD) and peritoneal dialysis (PD). It was a retrospective study carried out on January 2015 and it included patients older than 65 years, monitored for HD and PD. We studied their epidemiological and clinical profile, their evolution, and the elements of prognosis. Two groups of 42 patients were included. The first was about 30 HD patients representing 25% of all patients on HD with an average age of 71 ± 4.5 years. The second was concerning 12 patients on PD having a mean age of 69.8 ± 3.5 years and representing 11.7% of all patients on PD. Functional and vital prognosis of a patient with end stage renal disease (ESRD) depends, in the elderly, on psychological, cognitive functions, and the degree of autonomy.

关键词： Renal Replacement Therapy Elderly Hemodialysis Peritoneal Dialysis

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