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Ailioaie O, Essig M, Levassort H. [Chronic kidney disease in geriatrics]. Soins Gerontol 2024; 29:8-13. [PMID: 38418074 DOI: 10.1016/j.sger.2024.01.003] [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
Chronic kidney disease (CKD) affects almost 10% of the world's population, and over 30% of people aged over 70 [1,2]. The overall incidence of treated CKD is stable in France, but continues to rise sharply in people aged over 85 [3]. In its advanced stages, CKD is associated with numerous complications linked to disturbances in water, acid-base and phosphocalcium balance, as well as anemia and increased cardiovascular risk. A better understanding of risk factors, improved practices to promote nephroprotection, and progress in therapeutic education and preparation for suppletive techniques would help reduce this risk.
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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.
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2
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Levassort H, Pépin M. [Neurocognitive disorders in chronic kidney disease]. Soins Gerontol 2024; 29:21-26. [PMID: 38418068 DOI: 10.1016/j.sger.2024.01.005] [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
Neurocognitive disorders (NCD) are common in patients with chronic kidney disease (CKD). It is essential to identify and characterize these disorders at an early stage, so as to be able to offer appropriate treatment. In a chronic disease such as CKD, the patient's involvement in decision-making is a major challenge, given the prospects for suppletive treatment: hemodialysis, peritoneal dialysis, kidney transplantation or non-dialytic drug therapy. Many factors are associated with the development and progression of NCD in patients with CKD, and a variety of conditions can influence the outcome of cognitive assessment in these patients.
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Affiliation(s)
- Hélène Levassort
- Service de néphrologie, Université Paris-Saclay, Site Ambroise-Paré, AP-HP, Boulogne-Billancourt, France; Service de gériatrie, Université Paris-Saclay, Site Ambroise-Paré, AP-HP, Boulogne-Billancourt, France; Inserm UMRS 1018, Équipe épidémiologie clinique, Université Paris-Saclay, UVSQ, CESP, Villejuif, France.
| | - Marion Pépin
- Service de gériatrie, Université Paris-Saclay, Site Ambroise-Paré, AP-HP, Boulogne-Billancourt, France; Inserm UMRS 1018, Équipe épidémiologie clinique, Université Paris-Saclay, UVSQ, CESP, Villejuif, France
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3
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Bestin M, Chanteloup C, Grégoire C, Lebastard S. [The benefits of home visits for peritoneal dialysis patients]. Rev Infirm 2023; 72:38-39. [PMID: 37633692 DOI: 10.1016/j.revinf.2023.07.010] [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: 08/28/2023]
Abstract
Peritoneal dialysis is exclusively an extrarenal purification technique performed in the patient's own home. The patient is either autonomous, or assisted by a private nurse or a member of his or her family. The nursing team at the center where the patient is being cared for organizes home visits to meet the patient and his or her family in their living environment. These visits provide an opportunity to review compliance with protocols and maintain the partnership with the patient. The team at the Caen Normandy university center for kidney disease shares its experience in this area of care.
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Affiliation(s)
- Magali Bestin
- Consultations/hôpital de jour, Centre universitaire des maladies rénales, CHU de Caen Normandie, Avenue de la Côte-de-Nacre, 14033 Caen, cedex 9, France.
| | - Céline Chanteloup
- Consultations/hôpital de jour, Centre universitaire des maladies rénales, CHU de Caen Normandie, Avenue de la Côte-de-Nacre, 14033 Caen, cedex 9, France
| | - Christophe Grégoire
- Consultations/hôpital de jour, Centre universitaire des maladies rénales, CHU de Caen Normandie, Avenue de la Côte-de-Nacre, 14033 Caen, cedex 9, France
| | - Sarah Lebastard
- Consultations/hôpital de jour, Centre universitaire des maladies rénales, CHU de Caen Normandie, Avenue de la Côte-de-Nacre, 14033 Caen, cedex 9, France
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Perrot A, Kassim D, Maurice E, Courivaud C. [Management of complications of renal failure in hemodialysis patients with IPA]. Soins 2023; 68:30-32. [PMID: 37419598 DOI: 10.1016/j.soin.2023.05.008] [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: 07/09/2023]
Abstract
The complications of renal failure are likely to have an impact on the quality of life of hemodialysis patients, which is why specific follow-ups are organized by the nephrologist. Advanced practice nurses (APNs) could take care of this alongside physicians. A survey conducted by the Santélys Bourgogne Franche-Comté association shows that professionals are in favor of working with APNs and that follow-up is carried out by medical and paramedical teams without standardized practices. The intervention of an RPN could improve coordination between the different actors.
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Affiliation(s)
- Amélie Perrot
- Santélys Bourgogne Franche-Comté, 4 rue de la Brot, 21850 Saint-Apollinaire, France.
| | - Delphine Kassim
- Service de néphrologie, Centre hospitalier universitaire de Besançon, 3 boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Elsa Maurice
- Santélys Bourgogne Franche-Comté, 4 rue de la Brot, 21850 Saint-Apollinaire, France
| | - Cécile Courivaud
- Service de néphrologie, Centre hospitalier universitaire de Besançon, 3 boulevard Alexandre-Fleming, 25030 Besançon cedex, France
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Frimat L. [Nephrologist-IPA collaboration for better patient management]. Soins 2022; 67:37-38. [PMID: 36127019 DOI: 10.1016/j.soin.2022.05.028] [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: 06/15/2023]
Abstract
Chronic kidney disease, the extreme consequence of which is dialysis or transplantation, requires a highly structured care pathway, marked by precise care and treatment recommendations. Given the aging of the population, the increase in the number of patients is inevitable. Synergy between nephrologists and advanced practice nurses allows the implementation of organization protocols in fields of competence including consultations and prescriptions.
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Affiliation(s)
- Luc Frimat
- Service de néphrologie, Hôpitaux de Brabois, Centre hospitalier régional universitaire de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France; Société francophone de néphrologie, dialyse et transplantation, 24 montée des Roches, Saint-Sorlin, 69440 Chabanière, France.
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Guillouët S, Thibault C. [Reception of patients with chronic renal failure, COVID-19]. Rev Infirm 2021; 70:41-42. [PMID: 34024584 DOI: 10.1016/j.revinf.2021.03.017] [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: 06/12/2023]
Abstract
The renal disease center of the university hospital of Caen Normandy (14) is dedicated to the ambulatory care of patients with chronic renal disease, including those treated by dialysis or transplanted. These are fragile patients and, for many of them, coming to the center is inevitable for their care. Faced with the COVID-19 pandemic, the care teams have shown a great capacity to adapt, even to be creative, in order to welcome and care for them in optimal safety conditions.
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Affiliation(s)
- Sonia Guillouët
- Centre universitaire des maladies rénales, CHU de Caen Normandie, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France.
| | - Catherine Thibault
- Centre universitaire des maladies rénales, CHU de Caen Normandie, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France
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7
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Brunet P. [The management of chronic kidney disease in France in 2021]. Rev Infirm 2020; 70:16-19. [PMID: 33608088 DOI: 10.1016/j.revinf.2020.12.007] [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: 11/25/2022]
Abstract
Chronic kidney disease affects approximately 3 million people in France. The number of patients suffering from chronic kidney failure treated by dialysis or transplantation, which stood at around 90,000 at the end of 2018, is increasing constantly. In recent years, there have been improvements in the current management of this pathology and a reform in the financing of follow-up care.
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Affiliation(s)
- Philippe Brunet
- Centre de néphrologie et transplantation rénale, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France.
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Abstract
In the course of his life, a patient with chronic kidney disease will have to hear the announcement of a diagnosis, live with a pathology for which there is no hope of cure, undergo a multitude of tests and, finally, choose a mode of substitution (dialysis and/or transplantation). The advanced practice nurse has a role to play in bringing added value to these patients. In this function lies a constant questioning of his practices, a development of his intellectual curiosity in the service of patients.
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Affiliation(s)
- Maxime Mathy
- Association régionale pour la promotion de la dialyse à domicile, 12, rue Fernand-Brunet, 51100 Reims, France
| | - Élodie Touin
- Centre de néphrologie et de dialyse d'Armorique, B. Braun Avitum France, 385, rue Ernestine- de-Trémaudan, 29200 Brest, France
| | - Ludivine Videloup
- Service de néphrologie-dialyse-transplantation, centre universitaire des maladies rénales, avenue de la Côte-de-Nacre, 14033 Caen, France.
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Harhay MN, Harhay MO, Coto-Yglesias F, Rosero Bixby L. Altitude and regional gradients in chronic kidney disease prevalence in Costa Rica: Data from the Costa Rican Longevity and Healthy Aging Study. Trop Med Int Health 2016; 21:41-51. [PMID: 26466575 PMCID: PMC4718874 DOI: 10.1111/tmi.12622] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Recent studies in Central America indicate that mortality attributable to chronic kidney disease (CKD) is rising rapidly. We sought to determine the prevalence and regional variation of CKD and the relationship of biologic and socio-economic factors to CKD risk in the older-adult population of Costa Rica. METHODS We used data from the Costa Rican Longevity and Health Aging Study (CRELES). The cohort was comprised of 2657 adults born before 1946 in Costa Rica, chosen through a sampling algorithm to represent the national population of Costa Ricans >60 years of age. Participants answered questionnaire data and completed laboratory testing. The primary outcome of this study was CKD, defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 . RESULTS The estimated prevalence of CKD for older Costa Ricans was 20% (95% CI 18.5-21.9%). In multivariable logistic regression, older age (adjusted odds ratio [aOR] 1.08 per year, 95% CI 1.07-1.10, P < 0.001) was independently associated with CKD. For every 200 m above sea level of residence, subjects' odds of CKD increased 26% (aOR 1.26 95% CI 1.15-1.38, P < 0.001). There was large regional variation in adjusted CKD prevalence, highest in Limon (40%, 95% CI 30-50%) and Guanacaste (36%, 95% CI 26-46%) provinces. Regional and altitude effects remained robust after adjustment for socio-economic status. CONCLUSIONS We observed large regional and altitude-related variations in CKD prevalence in Costa Rica, not explained by the distribution of traditional CKD risk factors. More studies are needed to explore the potential association of geographic and environmental exposures with the risk of CKD.
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Affiliation(s)
- Meera N Harhay
- Division of Nephrology, Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Michael O Harhay
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Fernando Coto-Yglesias
- Department of Geriatric Medicine, National Geriatrics and Gerontology Hospital, San José, Costa Rica
| | - Luis Rosero Bixby
- Central American Population Center, University of Costa Rica, San José, Costa Rica
- Department of Demography, University of California, Berkeley, CA, USA
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Abstract
The optimal diet for chronic kidney disease (CKD) is an issue frequently brought up by patients and/or their relatives during outpatient visits. For patients without malnutrition who are motivated and supported by an experienced multidisciplinary team, the optimal protein intake of 0,6 g/kg of ideal body weight/day is recommended to halt the progression of CKD. A calorie intake of 30 to 35 kcal/kg of ideal body weight/day is necessary to reduce the risk of malnutrition from a low protein diet and to maintain a neutral nitrogen balance. A low-salt diet, namely 5 to 6 g/d, is useful to optimize the treatment of hypertension associated with CKD and to limit fluid overload. At the advanced stage of CKD, it is also necessary to restrict the intake of phosphorus and sometimes potassium. Given the complexity of optimal renal diet, coordination between general practitioners, nephrologists and dietitians is essential to foster optimal care.
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Affiliation(s)
- Yimin Lu
- Service de Néphrologie et d'Hypertension, Centre Hospitalier Universitaire Vaudois, Lausanne
| | - Nima Vakilzadeh
- Service de Néphrologie et d'Hypertension, Centre Hospitalier Universitaire Vaudois, Lausanne
| | - Daniel Teta
- Service de Néphrologie et d'Hypertension, Centre Hospitalier Universitaire Vaudois, Lausanne
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Abstract
Diabetic chronic kidney disease (CKD) is the cause of kidney failure in approximately 35% of Canadian patients requiring dialysis. Traditionally, only a minority of patients with type 2 diabetes and CKD progress to kidney failure because they die of a cardiovascular event first. However, with contemporary therapies for diabetes and cardiovascular disease, this may no longer be true. The classic description of diabetic CKD is the development of albuminuria followed by progressive kidney dysfunction in a patient with longstanding diabetes. Many exciting candidate agents are under study to halt the progression of diabetic CKD; current therapies center on optimizing glycemic control, renin angiotensin system inhibition, blood pressure control and lipid management. Lifestyle modifications, such as salt and protein restriction as well as smoking cessation, may also be of benefit. Unfortunately, these accepted therapies do not entirely halt the progression of diabetic CKD. Also unfortunately, the presence of CKD in general is under-recognized by primary care providers, which can lead to late referral, missed opportunities for preventive care and inadvertent administration of potentially harmful interventions. Not all patients require referral to nephrology for diagnosis and management, but modern risk-prediction algorithms, such as the kidney failure risk equation, may help to guide referral appropriateness and dialysis modality planning in subspecialty nephrology multidisciplinary care clinics.
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Affiliation(s)
- Alissa Lloyd
- University of Manitoba, Department of Medicine, Section of Nephrology, Winnipeg, Canada
| | - Paul Komenda
- University of Manitoba, Department of Medicine, Section of Nephrology, Winnipeg, Canada; Seven Oaks General Hospital, Department of Nephrology, Winnipeg, Canada.
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