Search

Objectif Une etude faite par Sagheb et al. a montre une amelioration des symptomes de SJSR chez les patients hemodialyses supplementes en vitamines C et/ou E. Notre objectif est de detecter des facteurs associes au SJSR dans la population des hemodialyses en particulier les taux des vitamines E et C seriques. Methodes Etude descriptive transversale sur 77 patients hemodyalises a l’hopital universitaire Hotel-Dieu de France de Beyrouth. Patients âges de plus 18 ans et hemodyalises depuis plus que 6 mois. Le depistage du syndrome des jambes sans repos a ete fait selon les criteres proposes par l’IRLS-SG. Les variables âge, sexe, BMI, duree de l’hemodialyse, uree predialyse, hemoglobine, fer, ferritine, PTH et phosphore ont ete analysees avec en particulier le dosage serique de la vitamine C et de la vitamine E qui ont ete faits selon les exigences techniques necessaires (traites en Resultats 27 % des patients hemodialyses de notre centre presentent un SJSR (76 % leger, 5 % modere et 19 % severe). Le principal resultat de cette etude est que le pourcentage de SJSR diminue de facon significative avec l’augmentation du taux de vitamine C : 0 % des patients ayant une vitamine C elevee (> 14) presentent un SJSR, 36,3 % des patients ayant une vitamine C moyenne (3,3–14) presentent un SJSR et 91,6 % des patients ayant une vitamine C basse (≤ 3,3) presentent un SJSR. Ces differences sont significatives avec p = 0,041. Conclusion Chez les patients hemodyalises, un taux eleve de vitamine C serait protecteur contre le SJSR et le risque d’avoir un SJSR augmente de facon significative avec la baisse du taux de vitamine C.

Aspergillosis is a serious infection in renal transplant patients especially if dissemination occurs. We report a case of primary cutaneous aspergillosis, an extremely rare entity described in only four cases in renal transplant. It should be sought when surgical wound shows a rapidly growing necrotizing features early post transplant and without evidence of hematogeneous or contiguous tissue or organ involvement. Early suspicion, diagnosis, extensive surgical debridement as well as rapid institution of Amphotericin B can minimize the risk of dissemination.

To report our experience in novel surgical strategy in the treatment of tertiary hyperparathyroidism in hemodialysis patients for chronic renal failure and to assess the impact of this type of surgery on postoperative clinical and laboratory variables in this population.Fifteen hemodialysis (12 female and 3 male) patients with chronic renal failure were operated on for tertiary hyperparathyroidism. Cervical ultrasound was performed in all patients (n = 15).Preoperative cervical ultrasound showed one enlarged parathyroid gland (n = 4) or few enlarged parathyroid glands (n = 11). Group I consisted of four patients with single parathyroid gland enlargement on ultrasound. These patients underwent resection of only the enlarged gland; three by unilateral approach under local anesthesia and one by cervicotomy under general anesthesia. Group II consisted of 11 patients with enlargement of all parathyroid glands on ultrasound. These patients were assumed to have hyperplasia and underwent subtotal parathyroidectomy (3.5 glands) and thymectomy by cervicotomy under general anesthesia. Postoperatively, patients in group I were normocalcemic (n = 4) and patients in group II were normocalcemic (n = 4) or had transient hypocalcemia (n = 7). The pathology showed an adenoma in patients of group I (n = 4) and hyperplasia in patients of group II (n = 11). Postoperatively, both patients in Group I and II had a similar resolution of their symptoms.Tertiary hyperparathyroidism secondary to chronic renal failure may be treated by parathyroidectomy of one or few enlarged parathyroid gland(s). Parathyroidectomy by unilateral approach under local anesthesia may be of value when preoperative localization studies show a single parathyroid gland enlargement.

Twenty hemodialyzed patients, received rehabilitation while they were hospitalized. They were all handicapped in the beginning; when they left the hospital, 10 patients were completely independent, six needed help at home and 4 were completely dependent. The authors search, from their own practice, the etiologies of handicap with hemodialyzed patients and how to prevent this handicap, with the target of giving to their patients the best quality of life. The rehabilitation is very important in the strategies of global care of these patients.