[Nephropathies caused by interferon alpha: apropos of 2 cases]. / Néphropathies secondaires aux interférons alpha: à propos de deux observations.

Two cases reports of interferon alpha-associated nephropathy are reported. The first observation is a membranoproliferative glomerulonephritis and the second a renal microangiopathy. The different cases in the literature are reviewed and the pathophysiology is discussed.

[Quantitative cytomegaloviral leukocytic antigenemia. Clinical aspects]. / Antigénémie leucocytaire cytomégalique quantitative. Intérêt clinique.

Cytomegalovirus infection, commonly observed in immunodepressed patients, raises a number of problems both in clinical practice (early rapid diagnosis, therapeutic options) and biological research (resistant strains, mutations). The classical methods of diagnosis do not provide specific information for decision making in each particular clinical situation. We report a case of cytomegalovirus infection in a renal transplant recipient in which quantitative cytomegalovirus antigen level in leukocytes provided rapid early diagnosis of the primary infection and two episodes of recurrent infection. Increase antigen level always preceded clinical manifestations. Three anti-cytomegalovirus regimens were given and the antigen level fell proportionally to clinical improvement. Based on the data in the literature and this clinical observation, it appears that cytomegalovirus antigen level in leukocytes is a precise tool for early diagnosis of cytomegalovirus infection. The technique is rapid, has an excellent sensitivity and the quantitative results are correlated with clinical manifestations. Quantitative anti-cytomegalovirus antigen assay can be a very helpful tool in the management of infected immunodepressed patients.

[Role of peritoneal dialysis in the treatment of terminal chronic renal insufficiency. Survival of patients and method]. / Place de la dialyse péritonéale dans le traitement de l'insuffisance rénale chronique terminale. Survie des patients et de la méthode.

Chronic peritoneal dialysis, especially continuous ambulatory peritoneal dialysis, is now a modality of treatment for patients with end stage renal failure. The proportion of patients varies considerably from country to country. Non medical considerations seem to be the main reason for the limited development of the treatment modality. Most of available reports point out no difference in patient or technique survivals on hemodialysis or peritoneal dialysis. Age, diabetes mellitus, cardiovascular diseases, infections complications (peritonitis and exit-site infections) impact on mortality and morbidity (number of hospital days per patient per year). The probability of death or dropout is much higher for patients with diabetes and patients in older age groups. Most patients with end stage renal failure, especially those waiting for a kidney transplant, are suitable for peritoneal dialysis.