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  1. Article ; Online: Pathophysiology and management of enteric hyperoxaluria.

    Desenclos, Jordan / Forté, Valentine / Clément, Cécile / Daudon, Michel / Letavernier, Emmanuel

    Clinics and research in hepatology and gastroenterology

    2024  Volume 48, Issue 5, Page(s) 102322

    Abstract: Enteric hyperoxaluria is a metabolic disorder resulting from conditions associated with fatty acid malabsorption and characterized by an increased urinary output of oxalate. Oxalate is excessively absorbed in the gut and then excreted in urine where it ... ...

    Abstract Enteric hyperoxaluria is a metabolic disorder resulting from conditions associated with fatty acid malabsorption and characterized by an increased urinary output of oxalate. Oxalate is excessively absorbed in the gut and then excreted in urine where it forms calcium oxalate crystals, inducing kidney stones formation and crystalline nephropathies. Enteric hyperoxaluria is probably underdiagnosed and may silently damage kidney function of patients affected by bowel diseases. Moreover, the prevalence of enteric hyperoxaluria has increased because of the development of bariatric surgical procedures. Therapeutic options are based on the treatment of the underlying disease, limitation of oxalate intakes, increase in calcium salts intakes but also increase in urine volume and correction of hypocitraturia. There are few data regarding the natural evolution of kidney stone events and chronic kidney disease in these patients, and there is a need for new treatments limiting kidney injury by calcium oxalate crystallization.
    MeSH term(s) Humans ; Hyperoxaluria/therapy ; Hyperoxaluria/complications ; Hyperoxaluria/etiology ; Oxalates/metabolism ; Calcium Oxalate/metabolism ; Malabsorption Syndromes/therapy ; Malabsorption Syndromes/physiopathology ; Malabsorption Syndromes/complications ; Malabsorption Syndromes/etiology
    Chemical Substances Oxalates ; Calcium Oxalate (2612HC57YE)
    Language English
    Publishing date 2024-03-19
    Publishing country France
    Document type Journal Article ; Review
    ZDB-ID 2594333-9
    ISSN 2210-741X ; 2210-7401
    ISSN (online) 2210-741X
    ISSN 2210-7401
    DOI 10.1016/j.clinre.2024.102322
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Microbiology and outcomes of polymicrobial peritonitis associated with peritoneal dialysis: a register-based cohort study from the French Language Peritoneal Dialysis Registry.

    Forté, Valentine / Novelli, Sophie / Zaidan, Mohamad / Snanoudj, Renaud / Verger, Christian / Beaudreuil, Séverine

    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

    2022  Volume 38, Issue 5, Page(s) 1271–1281

    Abstract: Background: Previous studies have reported that polymicrobial peritonitis in peritoneal dialysis (PD) is associated with poor outcomes, but recent data from European cohorts are scarce.: Methods: We included from the French Language Peritoneal ... ...

    Abstract Background: Previous studies have reported that polymicrobial peritonitis in peritoneal dialysis (PD) is associated with poor outcomes, but recent data from European cohorts are scarce.
    Methods: We included from the French Language Peritoneal Dialysis Registry all patients ≥18 years of age who started PD between January 2014 and November 2020. We compared microbiology and patient characteristics associated with mono- and polymicrobial peritonitis. We assessed patient outcomes after a first polymicrobial peritonitis using survival analysis with competing events. We differentiated microorganisms isolated from dialysis effluent as enteric or non-enteric pathogens.
    Results: A total of 8848 patients contributed 13 023 patient-years of follow-up and 3348 culture-positive peritonitis episodes, including 251 polymicrobial ones. This corresponded to rates of 0.32 and 0.02 episodes/patient-year, respectively. For most patients (72%) who experienced polymicrobial peritonitis, this was their first peritonitis episode. Enteric pathogens were more frequently isolated in polymicrobial than in monomicrobial peritonitis (57 versus 44%; P < .001). In both cases of peritonitis with and without enteric pathogens, the polymicrobial versus monomicrobial character of the peritonitis was not associated with mortality in patients who did not switch to haemodialysis {adjusted cause-specific hazard ratio [acsHR] 1.2 [95% confidence interval (CI) 0.3-5.0], P = .78 and 1.1 [95% CI 0.7-1.8], P = .73, respectively}. However, the risks of death and switch to haemodialysis were higher for monomicrobial peritonitis with enteric pathogens compared with those without [acsHR 1.3 (95% CI 1.1-1.7), P = .02 and 1.9 (95% CI 1.5-2.4), P < .0001, respectively].
    Conclusion: Isolation of enteric pathogens, rather than the polymicrobial character of the peritonitis, is associated with poorer outcomes.
    MeSH term(s) Humans ; Cohort Studies ; Renal Dialysis ; Retrospective Studies ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/therapy ; Peritoneal Dialysis/adverse effects ; Peritonitis/epidemiology ; Peritonitis/etiology ; Registries ; Language ; Risk Factors
    Language English
    Publishing date 2022-10-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 90594-x
    ISSN 1460-2385 ; 0931-0509
    ISSN (online) 1460-2385
    ISSN 0931-0509
    DOI 10.1093/ndt/gfac267
    Database MEDical Literature Analysis and Retrieval System OnLINE

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