[Calciphilaxis in chronic renal failure: 3 cases]

Calciphylaxis is a small vessel disease responsible for vascular calcification and skin necrosis. It occurs in association with chronic renal failure and has a poor prognosis. Report new cases. We report 3 cases of calciphylaxis occurred in patients with chronic renal failure secondary to interstitial nephritis in 1 case, diabetic nephropathy in 1 case and thrombotic microangiopathy in 1 case. They were 2 females a 1 man aged of 44.3 years meanly. Hyperphosphoremia and hyperparathyroidism were the essential risk factors. All patients died by sepsis. This course was precipitating by corticotherapy in 2 cases. Early recognition and treatment of risk factors is mandatory to reduce mortality in uremic patients with calciphylaxis

[Vascular trombosis of renal graft: 9 cases]

Allograft renal thrombosis can occur in 1 to 6% of cases. Many predisposing factors has been identified especially alteration of coagulation. We analyzed in this study frequency and predisposing factors of renal graft thrombosis. We report a retrospective study including 319 renal transplant recipients. Nine patients [2, 8%] presented veinous graft thrombosis in 5 cases and arterial thombosis in 4 cases. There were 6 men and 3 women aged of 30, 6 years meanly [10-56] which developed the thrombosis 6 days [1-48] after the transplantation. All patients were detransplanted after 16, 2 days and 1 patient died. Thrombosis constitute an important cause of graft loss. A perfect surgical technic and prophylactic treatment in high risk patients are necessary to reduce this complication

[Interest of bone alkaline phosphatase in hemodialysis patients]

The renal osteodystrophy represent a major complication in haemodialysis. Of this study is to evaluate the value of plasma bone-alkaline phosphatase [bAP] in the diagnosis of the type of renal osteodystrophy among hemodialysis patients and to seek a possible correlation between the bAP, total alkaline phosphatases [tAP] and the intact parathormone [iPTH]. We studied 67 chronic hemodialysis patients. Plasma bAP was determined by immunoenzymatic technic. iPTH [1-84] was measured by electrochimiluminescence. We found that bAP levels were normal 10-20 ng/ml] in 17 patients low [< 10 ng/ml] in 4 and high [> 20 ng/ml] in the 46 other patients. There is a good positive is e correlation between the plasmatic rate of bAP and the following parameters: the period of dialysis [R = 0.316, p = 0,009]. plasmatic rate of tAP [r = 0.781. p < 10[-3]] and the rate of iPTH [r = 0,650]. p < 10[-3]]. There is a good positive correlation between the plasmatic rate of bAP and the rates of the tAP and of iPTH, the correlation between bAP and the ipTh being more significant. A rate of bAP higher than 20 ng/ml had a sensitivity of 93,5% specificity of 63,3% in favour of a rate of iPTH > 400 pg/ml and consequently of the biological diagnosis of hyperparathyroidism. In addition, 4 patients have a bAP < 10 ng/ml with iPTH < 150 pg/ml evoking an adynamic osteopathy. plasma bAP provides useful information about bone remodelling in hemodialysis patients