[Time course of digital pressure during dialysis sessions in chronic hemodialysis patients. Prospective observational study of 49 patients]. / Évolution de la pression digitale pendant une séance de dialyse chez 49 patients.

OBJECTIVES: To describe and compare the evolution of digital pressure on both hands during a dialysis session in patients without digital ischemia, and to identify the parameters influencing the digital pressure. MATERIALS: Patients with an upper limb vascular access were prospectively included. Digital systolic pressure on the third finger of both hands measured by photoplethysmography and brachial systolic pressure were recorded before dialysis (H0) and every hour (from H1 to H4). RESULTS: Among 53 patients, 49 were included (exclusions: one surgery for ischemia, one hand tremor, two no consent). None of them had digital ischemia. Digital pressure homolateral to the vascular access was significantly lower compared with controlateral side before and during dialysis. Digital pressure significantly decreased on both sides during dialysis. Brachial pressure decreased significantly compared to H0. Only the brachial pressure decrease was correlated with the decrease of digital pressure. The digital pressure was less than 30 mmHg in six patients. No evidence of digital ischemia was reported after a 6-month follow-up. CONCLUSION: To our knowledge, this is the first study showing a significant decrease of digital pressure in both hands during hemodialysis in patients without digital ischemia. Further studies are necessary to investigate which parameters can affect digital pressure and to look for clinical consequence of this measurement.

[Renal manifestations of Kimura disease. Apropos of a case]. / Manifestations rénales de la maladie de Kimura. A propos d'un cas.

A nephrotic syndrome with focal sclerosis associated with Kimura's disease is reported in a young asiatic man. The nephrotic syndrome started three years prior to the usual skin tumors and lymph nodes involvement. Epidemiological, clinical and nosological characteristics of Kimura's disease are discussed. Renal manifestations are the only visceral localisations of the disease. Thirteen Kimura's disease associated with documented nephrotic syndromes have been reported in german-english literature. They display a wide variety of histologic patterns. Their clinical course do not differ from the primary form of nephrotic syndrome with identical histology.

[AN 69 membrane and conversion enzyme inhibitors: prevention of anaphylactic shock by alkaline rinsing?]. / Membrane AN 69 et inhibiteurs de l'enzyme de conversion: prévention des chocs anaphylactoïdes par le rinçage alcalin?

Thirty-three anaphylactoid reactions occurring in 19 ACE inhibitors-treated patients dialyzed with AN 69 membrane--plate and hollow fibers--dialyzers are reported. A careful analyze of these observations strongly suggests the preventive role of alkaline rinsing of the membrane.