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Guillaume Jean

Publications and source records attributed to Guillaume Jean.

5 recordsLinked to original sources
PubMed2006

Stability of nutritional parameters during a 5-year follow-up in patients treated with sequential long-hour hemodialysis.

Progressive nutritional impairment has been recently reported during conventional hemodialysis (HD) treatment. We studied the nutritional parameters during a 5-year follow-up in HD patients. Thirty-three patients (15F/18M; 65 years old at the study start) filled out a 3-day food questionnaire once a year between 1995 and 1999 (study group). Twenty patients, who did not fill out the food records during this period served as a control group (control group). The food record was run by the renal dietician using a dedicated software, providing daily energy and protein intakes (DEI and DPI). Serum albumin, normalized protein equivalent of nitrogen appearance (nPNA), and postdialysis body weight (BW) at the time of food record were collected in the study group and from the patient chart in the control group. The energy intake in the study group and the protein intake in both groups were close to the recommended intakes in ESRD patients. Protein intake assessed from food questionnaire or from urea kinetics were not statistically different. Using ANOVA for repeated measures, no difference along the 5 years was found for daily energy intake, daily protein intake, nPNA, and BW in the study group. The BW and nPNA remained stable in the control group. Hence, this study does not confirm the progressive nutritional impairment reported in the HEMO study, whereas the patients' age and vintage are largely higher in the present study. The role of a large dialysis dose in maintaining nutritional status in HD patients is discussed.

Aged↗
PubMedDate not supplied

Long 3 x 8 hr dialysis: a three-decade summary.

A long hemodialysis (HD), 3 x 8 hours/week, has been used without significant modification in Tassin for 35 years with excellent morbidity and mortality results. It can be performed during the day or overnight. The relatively good survival is mainly due to a lower cardiovascular mortality than usually reported in dialysis patients. This in turn is mainly due to the good control of blood pressure (BP) including drug-free hypertension control and low incidence of intradialytic hypotension. This control of BP is probably the result of the tight extracellular volume normalization (dry weight), although one cannot exclude the effect of other factors such as serum phosphorus control well achieved using long dialysis. The high dose of small and even more of middle molecules is another essential virtue of long dialysis, leading to good nutrition, correction of anemia, control of serum phosphate and potassium with low doses of medications and providing a very cost-effective treatment. In 2002 one must aim at optimal rather than just adequate dialysis. Optimal dialysis needs to correct as perfectly as possible each and every abnormality due to renal failure. It can be achieved using longer (or more frequent) sessions. Overnight dialysis is the most logical way of implementing long HD with the lowest possible hindrance on patient's life. Due to the change in case mix a decreasing number of patients are able or willing to go on overnight dialysis, education to be autonomous is more difficult, but the benefit is still there.

Adult↗