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Health related quality of life (HRQOL) indicators take into account the personal perception of health, and are proposed as an alternative for efficacy indicators in medical and therapeutic decision making. They provide, due to elaboration and validation of a questionnaire, a standardised assessment of the health status perception. This paper provides a review of a variety of HRQOL instruments developed for patients suffering end-stage renal disease (ESRD). Generic instruments are designed to be applicable in general population and disease-targeted instrument are potentially more sensitive to the characteristics of a specific population. Among HRQOL instruments, we found 4 generic questionnaires (the Sickness Impact Profile, the SF 36, the Nottingham Health Profile and the EQ-5D), 3 disease-targeted questionnaires developed for ESRD patient undergoing dialysis (the Kidney Disease Quality of Life instrument, the Kidney Disease Questionnaire and the Choice Health Experience Questionnaire), 1 questionnaire specific for ESRD patients (the HRQOL questionnaire), and 2 specific disease-targeted instruments for renal transplant (the Kidney Transplant Questionnaire and the ESRD Symptom Checklist-Transplantation Module). In France, very few studies on the quality of life of ESRD patients were published; no specific questionnaire validated in French is yet published.

Acute nephrotoxicity due to nonsteroidal anti-inflammatory drugs is usually observed in clinical situations in which renal perfusion is compromised as in volume contraction. We report a case of a 20 year-old woman who suffered from acute tubular necrosis after concomitant ingestion of nonsteroidal anti-inflammatory drugs and binge drinking. This acute tubular necrosis is likely to have an hemodynamic origin due to nonsteroidal anti-inflammatory drugs in a patient with volume contraction secondary to binge drinking. The risk appears to be even more important since ethanol has been implicated in tubular necrosis by direct toxicity. This observation underlines the danger in associating nonsteroidal anti-inflammatory drugs and ethanol.

We report the case of a 36 year-old-patient, hemodialyzed for idiopathic membranous glomerulonephritis, who suffers from type I membranoproliferative glomerulonephritis five years after a successful kidney transplantation. Etiologic evaluation evidenced chronic viral hepatitis C complicated by type III cryoglobulinemia. If hepatitis C induced membranoproliferative glomerulonephritis has yet been described among non transplanted patients, it is at our knowledge, the first observation in a renal transplant recipient.

We evaluated nasal carriage of Staphylococcus aureus (S. aureus) in 114 hemodialysis patients by performing two nasal swab cultures at a one month interval. The incidence of bacteremia was then followed for one year. Other factors associated with infections in hemodialysis patients, such as diabetes, central venous catheter, and high serum ferritin levels were also evaluated. Nasal carriage of S. aureus was present in 29.8% of patients (34/114). Six S. aureus bacteremia occurred in 6 patients. This represents an annual incidence of 0.058 bacteremia/patient-year. The incidence of bacteremia was higher in patients with S. aureus nasal carriage (0.0945) than in patients without (0.0417), but the difference was not significant. The relative risk (RR) was 2.35. On the contrary, bacteremia were significantly more frequent in patients with diabetes (RR = 11.41; p = 0.004) or in patients with central venous catheter (RR = 14.29; p = 0.002). In conclusion, in our population, diabetes and central venous catheter are more significant risk factors of bacteriemia than S. aureus nasal carriage.

Glomerulonephritis complicating primary Gougerot-Sjögren's syndrome is extremely rare. We report the case of a 72-year old woman with primary Gougerot-Sjögren syndrome complicated by progressive renal failure. Kidney biopsy revealed a crescentic glomerulonephritis. A rapid improvement occurred with corticosteroids. This observation is, at our knowledge, the first case of crescentic glomerulonephritis described during this disease. A review of the literature concerning glomerulonephritis complicating primary Gougerot-Sjögren syndrome is reported.

Human urine is supersaturated with respect to calcium salts especially calcium oxalate which is the major mineral phase of urinary stones. Inhibitors of crystallization prevent renal calcification in urine. Small molecular weight components account for 20% of total inhibitory activity of urine. Macromolecular inhibitors (molecular weight greater than 10 kDa) are more powerful. Recently, several macromolecules have been identified in urine, in urinary stones and in the kidney: Nephrocalcin, Tamm-Horsfall protein, Uropontin, Crystal Matrix Protein, renal Lithostathine. The role of these proteins is stressed.

We report two cases of tuberculosis in patients undergoing maintenance dialysis. In both cases Mycobacterium tuberculosis was not isolated in spite of multiple localizations and diagnosis was made with delay. Severe hypocalcemia was the main symptom in one patient, who had pulmonary, genito-urinary and spinal tuberculosis. The other patient had tuberculous lymphadenitis. The two patients survived their disease on antituberculous therapy. From the literature the authors give the actuarial data of tuberculosis occurring in patients undergoing hemodialysis.

Lithostathine is a protein of pancreatic secretion inhibiting calcium carbonate crystal growth. Antibodies to lithostathine were used to identify a related protein in urine and kidney stones. Western blot analysis of proteins extracted from concentrated normal urine or kidney stones demonstrated the presence of a protein with an apparent molecular weight of 23 kDa. The same antibodies were used in immunolocalization experiments on fresh human nephrectomy specimens cryosections. A positive signal was observed in the cells of proximal tubules and thick ascending limbs of Henle's loop. Protein extracts of renal stones inhibited calcium carbonate crystal growth. Because of its structural and functional similarities with pancreatic lithostathine, it was called renal lithostathine.

The association of membranous glomerulonephritis with carcinoma and minimal change disease with Hogkin's disease are well established. In contrast cancer and crescentic glomerulonephritis is an uncommon association. We report a patient with gastric carcinoma who developed synchronously acute renal failure due to crescentic glomerulonephritis. Corticosteroid therapy, plasma exchanges and tumor resection was associated with a regression of renal failure. Carcinoma must be considered as a possible cause of crescentic glomerulonephritis.