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Nowadays, several treatments exist to treat terminal chronic renal failure. Best results for the recipients are obtained with kidney transplantation concerning mortality and quality of life. Transplantation is also the cheaper option for society. Living kidney donation raises the issue of the becoming of the donor, an absolutely healthy subject who gets to a surgical procedure. The becoming of living kidney donors has been compared with the one of controls subjects in several studies. The evaluations focused on the complications of nephrectomy in the short and long-term: kidney failure, hypertension, proteinuria, possibility of pregnancy, quality of life, and mortality. The first results did not show any risk linked to kidney donation, compared to general population. However, since 2013, kidney donors were found at higher risk for kidney failure and even for mortality, compared with controls selected like donor candidates. The risk of kidney donation is nevertheless acceptable and minimal, on the condition of rigorous selection of candidates and regular follow-up., (Copyright © 2017 Société francophone de néphrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.)

Encapsulating peritoneal sclerosis is a rare but devastating complication of long-term peritoneal dialysis with a high mortality rate. The incidence is between 0.5 and 2.5%, decreasing with time. PSE is defined as a clinical syndrome with signs of gastrointestinal obstruction, inflammation parameters, radiological and macroscopic changes. The duration of treatment and the cessation of peritoneal dialysis are the main risks. About 75% occured in patients on hemodialysis or after kidney transplantation. Morphological alterations are disappearance of mesothelial layer, submesothelial fibrosis, interstitial sclerosis and vasculopathy. Ultrafiltration failure, fast transport status of the peritoneal membrane and loss of sodium sieving, the most powerful predictor, are the functional abnormalities. Biomarkers in peritoneal effluent include cancer antigen 125, interleukin-6. The pathophysiology is probably a consequence of a multiple-hit process in which expression of growth factors and cytokines play a central role. Medical strategies (corticosteroids, tamoxifen) in association with parenteral nutrition and/or surgery (enterolysis) are discussed. Prevention is the use of physiological peritoneal dialysis solutions, icodextrine instead of high glucose concentration solutions and peritoneal lavage after peritoneal dialysis stopping., (Copyright © 2017 Société francophone de néphrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.)

BK virus is near ubiquitous, with a seroprevalence of around 80% in the general population. Subsequent to an asymptomatic primary infection, BK virus then remains dormant in healthy subjects. Reactivation occurs in immunocompromised people. BKv is pathogenic mainly among patients who have received a kidney transplant, in whom the virus can cause specific tubulo-interstitial nephritis and even result in graft failure among approximately 20 to 30% of nephritic cases. Since the mid 90 s, incidence has increased with the use of new powerful immunosuppressor treatments. The cornerstone of BK virus infection or BK virus-associated nephropathy treatment is a decrease of the immunosuppressive regimen, which must then be offset with the risk of rejection. The use of several adjuvant therapies has been submitted (fluoroquinolones, leflunomide, intravenous immunoglobulins, cidofovir), with no sufficient proof enabling the recommendation of first-line prescription. The high frequency of this infection and its potential harmfulness argue for the use of prevention strategies, at least among patients presenting risk factors. Retransplantation is safe after a first kidney allograft loss caused by BK-virus nephropathy, on condition that a screening for viremia is frequently conducted., (Copyright © 2015 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.)

Introduction: Tobacco use increases the risk of mortality, cancers and cardiovascular diseases in transplanted patients. Transplanted patients are encouraged to quit tobacco use before and after renal transplantation. This study was carried out to evaluate the prevalence of tobacco consumption in transplanted patients in one French region. This survey was also conducted to identify factors associated with failure in smoking cessation., Materials and Method: A questionnaire was sent by mail to transplanted patients followed in our center between the 1/01/95 and the 31/12/10. A second mail was sent to increase the response rate., Results: During the study period, 544 questionnaires were sent to kidney transplant recipients. Among these 544 patients, there were 362 responders. Of these 362 patients, 121 patients (33.4%) were past smokers, and 21 (5.8%) were active smokers. Among the smokers, 20% were exposed to second-hand smoke, 48% had criteria for tobacco moderate to high dependency, and 13.4% were addicted to alcohol. In the multivariate analysis, exposure to second-hand smoke and living alone at home were associated with failure in smoking cessation., Conclusion: This study shows that the prevalence of tobacco use is not high in transplanted patients. Only 6% of our patients report tobacco use at the study time. Environmental factors are associated with failure in tobacco cessation. Living alone and exposure to second-hand smoke are associated with smoking. Therefore, in transplantation centers, programs devoted to tobacco cessation should be implemented and should take care of patients' lifestyle., (Copyright © 2015 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.)

Renal lymphangiectasia is a bilateral cystic infiltration of the perirenal and parapelvic space which is caused by the obstruction of the renal lymphatic tissue. To our knowledge only numbers have been reported in the literature. Renal lymphangiectasia usually asymptomatic and incidentally diagnosed has absolutely no effect on the patient outcome. Radiological imaging is typical so that the diagnosis does not need to be confirmed by a cyst punction. The lack of knowledge concerning renal lymphangiectasia make it usually confused with another cause of polycystic renal infiltration, such as the polycystic kidney disease. We report herein a case of renal lymphangiectasia diagnosed incidentally by an abdominal ultrasonography., (Copyright © 2015 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.)

Endoplasmic reticulum (ER) stress is a situation caused by the accumulation of unfolded proteins in the endoplasmic reticulum, triggering an evolutionary conserved adaptive response termed the unfolded protein response. When adaptation fails, excessive and prolonged ER stress triggers cell suicide. Important roles for ER-initiated cell death pathways have been recognized for several diseases, including diabetes, hypoxia, ischemia/reperfusion injury, neurodegenerative and heart diseases. The implication of the ER stress is not well recognized in solid organ transplantation, but increasing evidence suggests its implication in mediating allograft injury. The purpose of this review is to summarize the mechanisms of ER stress and to discuss its implication during tissue injury in solid organ transplantation. The possible implications of the ER stress in the modifications of cell functional properties and phenotypic changes are also discussed beyond the scope of adaptation and cell death. Increasing the understanding of the cellular and molecular mechanisms of acute and chronic allograft damages could lead to the development of new biomarkers and to the discovery of new therapeutic strategies to prevent the initiation of graft dysfunction or to promote the tissue regeneration after injury.

Increasing our understanding of the cellular and molecular mechanisms of acute and chronic kidney diseases will lead to the development of new biomarkers of early kidney injury and to the discovery of new therapeutic strategies to prevent the initiation of renal failure or to promote the renal regeneration after injury. The implication of the endoplasmic reticulum stress in kidney diseases is not well recognized, but increasing experimental evidences suggest its implication in a wide array of kidney insults. Beside its role in the regulation of cell death, the UPR response induced by the endoplasmic reticulum stress alters many cellular functions and constitutes an important mediator of inflammation and/or epithelial to mesenchymal transition. The purpose of this review is to summarize the existing data concerning the role of the endoplasmic reticulum stress during kidney injury and to clarify its precise role in chronic kidney disease.

Background: Metastatic bronchial carcinoid tumours are rare but some patients have a prolonged survival. A new functional imagery now makes it possible to supplement the assessment of the extent of disease., Observation: A 57 year old patient was referred for dyspnoea on exertion revealing an upper left lobar tumour, with carcinoid syndrome. The assessment enabled to find out a bronchial carcinoid tumour with liver and bone metastases, highlighted by positron-emission tomography and pentetreotide SPECT. A chemotherapy proved to be ineffective and upper left lobectomy was carried out because of the risk of pulmonary atelectasis. The patient was treated by somatostatin analogues then underwent liver transcatheter arterial chemo-embolization. The patient was alive 44 months after diagnosis (56 months after first computed tomography)., Conclusion: Metastatic bronchial carcinoid tumours are rare. They keep a metastatic potential, the histological type remaining the major prognosis factor. Carcinoid syndrome is suggestive. The assessment of extra-thoracic disease extent benefits by contribution of new functional imagery techniques such as the pentetreotide SPECT and positron-emission tomography. The management is essentially symptomatic since there is no effective chemotherapy. However survival can be prolonged, even in multimetastatic patients.

THE FIRST ROUTES OF RESEARCH: The first antidepressants were developed after the discovery of the existence during depression of a perturbation in the synaptic transmission of the principle monoamines: noradrenalin, serotonin and dopamine. The pharmacological effect of the various molecules developed is mainly on the metabolisation routes of neurotransmitters, but may also concern the different receptors present on synaptic level. THE AWARENESS OF NEW MEDIATORS: The progress in research on antidepressants has widened the scope of the development of such medicinal products to the domain of endocrinology (hypothalamo-pituitary-adrenal axis, progestogen hormones, thyreotropic axis) and studies on neuropeptides (substance P, neuropeptide Y). The complexity of the physiopathological mechanisms of depression hence appears enhanced.

REALITY OF SELF-MEDICATION IN PREGNANCY: Pregnant women use self-medication readily. Such behavior must not be overlooked by physicians and midwives during pregnancy. More epidemiology data would be useful. IATROGENIC RISKS: Drug toxicity, generally related to the advancement of somatic development of the embryo and fetus, can appear at variable stages during pregnancy. Moreover, the pharmacokinetic properties of drugs are different during pregnancy. These facts must be taken into account when assessing the risk of uncontrolled drug use by pregnant women. RECOMMENDATIONS FOR PREGNANT WOMEN: Obstetricians, midwives and primary care physicians caring for pregnant women should explain the risks of self-medication. The specific features of disease during pregnancy should be considered when giving relevant information.

Hyperthyroidism is associated with alterations in pharmacokinetic parameters such as absorption, distribution, metabolism and elimination. Beta-blockers are used in particular in the treatment of hyperthyroidism and are also subject to pharmacokinetic changes occurring during this pathology. The magnitude of these variations is examined when beta-blockers are used for clinical manifestations of hyperthyroidism or during thyroid surgery. Clinical means used to assess the accuracy of therapeutic drug monitoring are also described.

Several enzymes, the main being type I 5' deiodinase, ensure thyroxin (T4) into 3,5,3'-triiodothyronine (T3) deiodination, both in the thyroid and in peripheral tissues. One of the feature of this enzymatic reaction is its regulation. It depends in part on individual selenium and iodine status. It has been shown by an analysis of thyroid hormones concentrations variations, when one of these trace elements is missing. During thyroid hormone synthesis, selenium and iodine are also implied in oxidative process control. Then, how selenium and iodine status balance modifications contribute to thyroidal diseases outbreak, becomes easier to understand. Besides, providing, adapted to individual requirements, selenium and iodine supplies could be useful for hypothyroidism and hyperthyroidism treatment.