Dialysis in patients over 65 years of age

In 44 patients with end-stage renal disease, 24 on hemodialysis and 20 on CAPD, the survival was calculated using the life table method. Median survival for CAPD was 19 months and for hemodialysis 47 months. Using Cox's proportional hazards model, treatment modality and performance score were significant determinants of survival. Performance score was influenced by age and kidney disease. When survival was analyzed separately for patients with a good or a bad performance score, the survival was better in the hemodialysis group only in patients with a bad score (ECOG 3 and 4). Patients with a good score had similar prognoses, irrespective of treatment modality

Pseudotuberculous pyelonephritis associated with nephrolithiasis

This report describes a 40-year-old man with an unusual form of granulomatous pyelonephritis, associated with nephrolithiasis, resulting in end-stage kidney disease and right pretransplant nephrectomy. The kidney specimen contained a staghorn calculus and showed chronic inflammation with confluent caseating granulomas and multinucleated giant cells, resembling renal tuberculosis. However, neither tubercle bacilli nor other microorganisms were demonstrated in the renal tissue or in urine cultures. Because these findings do not support a tuberculous etiology of the granulomatous pyelonephritis, we conclude that this patient had a pseudotuberculous reaction as a consequence of nephrolithiasis

Hypertension et dysplasie fibromusculaire :au-delà des artères rénales [Fibromuscular dysplasia and hypertension : beyond renal arteries]

Fibromuscular dysplasia (FMD) is a disease associated with abnormalities of the arterial wall of medium-sized arteries. These abnormalities can lead to stenosis or less frequently to dissections or aneurysms. FMD is probably more frequent than initially thought. Nowadays, it is often a chance finding during a radiologic exam. In symptomatic cases, poor organ perfusion due to stenosis, dissection or aneurysm rupture may lead to the diagnosis. The aim of this non-systematic review illustrated with a clinical case is to present our current knowledge of FMD and to highlight the necessity of a standardized and multidisciplinary work-up to improve management of affected patients and understanding of the disease