[Preservation of residual kidney function in chronic haemodialysis]. / Préservation de la fonction rénale résiduelle et hémodialyse incrémentale.

Residual kidney function (RKF) is defined as the production of a clinically significant amount of urine in dialysis patients. Observational studies suggest that those with preserved RKF have a better prognosis than anuric patients. Preserved RKF allows the prescription of a lower dialysis dose compared to the traditional thrice weekly schedule. Such an "incremental" approach has also been associated with a better global prognosis. In view of the overall growth of incremental HD in the western world, we review the main studies supporting this approach, as well as the benefits and limitations related to RKF preservation.

Chez les patients hémodialysés, la fonction rénale résiduelle (FRR) est définie comme la production d'une quantité d'urine significative du point de vue clinique. Les données observationnelles suggèrent que les patients en hémodialyse (HD) ayant une FRR conservée ont un meilleur pronostic que les patients anuriques. Une FRR préservée permet également la prescription d'une dose d'HD inférieure au schéma traditionnel de 3 séances par semaine. Ce type d'approche «â€…incrémentale ¼ a elle aussi été associée à une amélioration du pronostic global. Au vu de l'essor de l'HD incrémentale dans les pays développés, nous revenons dans cet article sur les principales études qui soutiennent cette approche ainsi que sur les bénéfices et limitations liées à la préservation de la FRR.

Electrocardiographic findings in elite professional cyclists: The 2017 international recommendations in practice.

OBJECTIVES: To categorize ECG findings into normal, borderline or abnormal in a team of professional elite cyclists according to the 2017 international recommendations. DESIGN: A cross-sectional study was performed. METHODS: Twelve-lead ECGs collected between 2012 and 2015 as part of an annual routine examination for a team of professional elite cyclists were analysed, and findings classified as normal, borderline or abnormal according to the 2017 recommendations. Information on exercise capacity testing was also collected. RESULTS: A total of 43 professional cyclists, all Caucasian males ranging between 21 and 38years of age, were included. Given most were followed up for multiple years, a total of 103 ECGs were collected. Normal variations were found in 43 (100%) athletes; borderline findings in 4 (9.3%), and 2 (4.7%) athletes had abnormal findings. No pathology was identified on further investigation of the four cyclists with two concurrent borderline or any abnormal ECG findings, reflecting a false positive rate of 9.3%. CONCLUSIONS: In this team of professional cyclists, the prevalence of abnormal ECG findings requiring further investigation, and the false positive rate were low, despite a very high prevalence of normal variations expected in athletes. This may be as a result of heightened specificity of the new international recommendations for ECG interpretation in athletes.