BACKGROUND:Dialysis is a life-sustaining therapy for patients with end-stage renal disease, yet it is among the most resource-intensive treatments in modern healthcare. Hemodialysis requires large volumes of treated water, substantial energy input, and extensive single-use consumables, resulting in significant greenhouse gas emissions and clinical waste when scaled to millions of treatments performed annually. Climate change further threatens kidney health through heat stress, dehydration, and climate-related disruptions, creating a bidirectional relationship in which kidney care both contributes to and is adversely affected by environmental degradation. METHODS:This white paper synthesizes current evidence surrounding environmentally sustainable dialysis practices, collectively termed "green dialysis," reviewing technical and system-level interventions across water stewardship, energy management, waste reduction, and clinical practice innovation. RESULTS:Green dialysis strategies, including dialysate flow optimization, improved reverse-osmosis efficiency and water reuse, energy-efficient infrastructure, renewable energy integration, waste segregation, central concentrate delivery systems, and incremental dialysis, have been shown to reduce water consumption, energy use, waste generation, and operational costs while maintaining dialysis adequacy and clinical outcomes. Adoption remains uneven due to operational complexity, regulatory gaps, and financial constraints, particularly in low- and middle-income countries. CONCLUSIONS:Context-sensitive implementation, staff education, standardized monitoring, and transparent reporting are essential for overcoming these barriers. Broader integration of sustainability into routine dialysis care represents a critical opportunity to reduce the environmental footprint of kidney replacement therapy without compromising patient safety or treatment efficacy.

ABSTRACT Background The European Renal Association (ERA) Registry collects data on kidney replacement therapy (KRT) in patients with end-stage kidney disease (ESKD). This paper is a summary of the ERA Registry Annual Report 2021, including a comparison across treatment modalities. Methods Data was collected from 54 national and regional registries from 36 countries, of which 35 registries from 18 countries contributed individual patient data and 19 registries from 19 countries contributed aggregated data. Using this data, incidence and prevalence of KRT, kidney transplantation rates, survival probabilities and expected remaining lifetimes were calculated. Result In 2021, 533.2 million people in the general population were covered by the ERA Registry. The incidence of KRT was 145 per million population (pmp). In incident patients, 55% were 65 years or older, 64% were male, and the most common primary renal disease (PRD) was diabetes (22%). The prevalence of KRT was 1040 pmp. In prevalent patients, 47% were 65 years or older, 62% were male, and the most common PRDs were diabetes and glomerulonephritis/sclerosis (both 16%). On 31 December 2021, 56% of patients received haemodialysis, 5% received peritoneal dialysis, and 39% were living with a functioning graft. The kidney transplantation rate in 2021 was 37 pmp, a majority coming from deceased donors (66%). For patients initiating KRT between 2012–2016, 5-year survival probability was 52%. Compared to the general population, life expectancy was 65% and 68% shorter for males and females receiving dialysis, and 40% and 43% shorter for males and females living with a functioning graft.

Chronic kidney disease (CKD), a global public health problem, is increasing at an alarming rate across Africa. The increasing CKD burden in this region is mainly driven by a rapid surge in the prevalence of risk factors including diabetes, hypertension, obesity, and infectious diseases. To further aggravate the situation, CKD is known to progress rapidly to kidney failure (KF) in patients of African ethnicity. Given the serious health implications and prohibitively expensive treatment, it is paramount to focus on novel therapeutic prospects in CKD management to delay its progression to KF, prevent complications, and prolong survival. In recent years, substantial clinical and real-world evidence confirmed the cardiorenal protective benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2is) in patients with CKD, with or without diabetes. In this context, a steering committee meeting was convened with 13 key experts from the African Association of Nephrology (AFRAN) to discuss the epidemiology and magnitude of region-specific CKD burden, unmet needs and challenges, and implications of SGLT2i use in CKD management. This paper summarizes the expert views and opinions on the applicability of SGLT2is in different populations with CKD to support their safe implementation in clinical practice with a focus on reducing the CKD burden in the region.

IntroductionSeveral studies suggest that preexisting of cardiovascular comorbidities are associated with an increased risk of mortality following COVID-19 infection. However, it remains unclear how COVID-19 prognosis differs between different types of cardiovascular comorbidities. In this way the Tunisian Anticoagulations Survey in COVID-19 patients General Practice experience (TASC-GP) was conducted.ObjectiveAnalysis of cardiovascular comorbidities in patients included in the TASC-GP study and their impact on the prognosis.MethodThe TASC-GP is an observational, multicenter study done between July 2021 and October 2021 included 3383 COVID-19 patients treated in ambulatory. Baseline characteristics and mortality rates were compared between patients with cardiovascular comorbidities and those without cardiovascular comorbidities. Statistical analysis was performed with SPSS (IBM, Chicago, IL).ResultsThe mean age was 51.6±15.5years with a sex ratio of 0.67. Forty percent of patients had at least one cardiovascular comorbidity. The distribution of cardiovascular comorbidities in the population was as follows: arterial hypertension in 1042 patients (30.7%), ischemic heart disease in 158 patients (4.6%) and heart failure in 121 patients (3.6%). Patients with at least one cardiovascular comorbidity had significantly more severe forms of COVID-19 compared to patients without comorbidities (10.8% vs. 5.6% P<0.001). Deaths occurred mostly in patients with cardiovascular comorbidities (2.9% vs. 0.3%, P<0.001).ConclusionCardiovascular comorbidities are common in ambulatory patients with COVID-19 dominated by hypertension and ischemic heart disease. Cardiovascular comrobidities have a pejorative impact on the prognosis of patients hospitalized for COVID-19.

Primary hyperoxalurias (PHs) are rare genetic diseases that increase the endogenous level of oxalate, a waste metabolite excreted predominantly by the kidneys and also the gut. Treatments aim to improve oxalate excretion, or reduce oxalate generation, to prevent kidney function deterioration. Oxalobacter formigenes is an oxalate metabolizing bacterium. This Phase III, double-blind, placebo-controlled randomized trial investigated the effectiveness of orally administered Oxabact™, a lyophilized O. formigenes formulation, at reducing plasma oxalate levels in patients suffering from PH. Subjects (≥ 2 years of age) with a diagnosis of PH and maintained but suboptimal kidney function (mean estimated glomerular filtration rate at baseline < 90 mL/min/1.73 m2) were eligible to participate. Subjects were randomized to receive Oxabact or placebo twice daily for 52 weeks. Change from baseline in plasma oxalate concentration at Week 52 was the primary study endpoint. Forty-three subjects were screened, 25 were recruited and one was discontinued. At Week 52, O. formigenes was established in the gut of subjects receiving Oxabact. Despite decreasing plasma oxalate level in subjects treated with Oxabact, and stable/increased levels with placebo, there was no significant difference between groups in the primary outcome (Least Squares mean estimate of treatment difference was − 3.80 μmol/L; 95% CI: − 7.83, 0.23; p-value = 0.064). Kidney function remained stable in both treatments. Oxabact treatment may have stabilized/reduced plasma oxalate versus a rise with placebo, but the difference over 12 months was not statistically significant (p = 0.06). A subtle effect observed with Oxabact suggests that O. formigenes may aid in preventing kidney stones. A higher resolution version of the Graphical abstract is available as Supplementary information.

In the study, we observed that patients with SRA inhibitors experienced less cardio-vascular related death, although it is not enough to conclude its cardioprotective status. Larger studies need to be carried to unveil its utility among haemodialysis patients.

Patients on hemodialysis are at high-risk for hepatitis B virus (HBV) infection compared to the general population. This infection in such patients can cause increased morbi-mortality. There still have insufficient data on occult HBV infection (OBI) in this group. The aim was to determine first the prevalence of OBI in a hemodialysis population at Hedi Chaker University Teaching Hospital in Sfax and then to identify the associated factors.

Background: Chronic kidney disease is a worldwide public health issue which is associated with an increased risk of end-stage renal failure and cardiovascular disease. Systemic inflammation exists during chronic renal failure. Recent researches have highlighted the pivotal role of inflammation between renal and cardiovascular disease. The aim of our study is to determine the inflammatory profile of the patient suffering from chronic kidney disease and the influence of hemodialysis on this profile. Methods: We carried out a cross sectional study on 93 patients in the Nephrology Department at Hedi Chaker University Hospital, Sfax, South of Tunisia. Among those patients, 72 patients underwent hemodialysis and 21 patients had chronic kidney disease at stage 3. Clinical data and antecedents were collected. Biological samples were taken after informing the patients and taking their consent. Biological data consisted in lipid profile, albumin rate, hemoglobin rate, uric acid concentration and the usual markers of inflammation noting sedimentation rate, C - reactive protein and orosomucoid. Results: Hemodialysis group of the 72 patients had mean hemodialysis vintage of 54.6 ± 43 months. The inflammatory profile was worse in hemodialysis patients compared to chronic kidney disease patients. Both sedimentation rate, C - reactive protein and orosomucoid were higher in hemodialysis group than in chronic kidney disease group with 71 ± 35.3 mm vs. 42.1 ± 15.5 mm (p < 0.05); 14.6 ± 28.7 mg/l vs. 6.7 ± 8 mg/l (p = 0.02); 1.3 ± 0.7g/l vs. 0.9 ± 0.4 g/l (p = 0.01), respectively. Conclusion: Inflammation increases in dialysis patient. It deserves the nephrologist’s consideration in order to minimize its harmful effects. The monitoring of inflammation markers must be integrated into the nephrologist’s medical practice.

The treatment of chronic hepatitis C virus (HCV) infection in chronic hemodialysis patients remains an issue of great concern for nephrologists. In 2008 the kidney disease improving global outcomes working group suggested the use of pegylated interferon in end stage kidney disease patients treated by dialysis. Since then, series and some clinical trials on different direct-acting antiviral agents have shown better efficacy and tolerance than interferon-based regimens. Data on the efficacy, tolerance and the right dose of sofosbuvir in this population are still unclear. We report a case of chronic HCV genotype 1b infection in a 47-year-old patient on maintenance hemodialysis successfully treated by a combination of sofosbuvir and ledipasvir for 12 weeks. Evolution was marked by the complete regression of the hepatic cytolysis, a complete and sustained virologic response with HCV viral load undetectable for a 24 months follow-up period. No adverse reaction was found. The treatment of HCV genotype 1 or 4 infection in patients on maintenance hemodialysis is possible with sofosbuvir based regimens with a good efficacy/safety ratio in the absence of current recommended drugs for patients with eGFR<30ml/min/1.73m2. The prescription of sofosbuvir should be encouraged amongst this population in this setting.

The aims of this study were to determine the frequency of dialysis and kidney transplantation and to estimate the regularity of comprehensive conservative management (CCM) for patients with kidney failure in Europe. This study uses data from the ERA-EDTA Registry. Additionally, our study included supplemental data from Armenia, Germany, Hungary, Ireland, Kosovo, Luxembourg, Malta, Moldova, Montenegro, Slovenia and additional data from Israel, Italy, Slovakia using other information sources. Through an online survey, responding nephrologists estimated the frequency of CCM (i.e. planned holistic care instead of kidney replacement therapy) in 33 countries. In 2016, the overall incidence of replacement therapy for kidney failure was 132 per million population (pmp), varying from 29 (Ukraine) to 251 pmp (Greece). On 31 December 2016, the overall prevalence of kidney replacement therapy was 985 pmp, ranging from 188 (Ukraine) to 1906 pmp (Portugal). The prevalence of peritoneal dialysis (114 pmp) and home hemodialysis (28 pmp) was highest in Cyprus and Denmark respectively. The kidney transplantation rate was nearly zero in some countries and highest in Spain (64 pmp). In 28 countries with five or more responding nephrologists, the median percentage of candidates for kidney replacement therapy who were offered CCM in 2018 varied between none (Slovakia and Slovenia) and 20% (Finland) whereas the median prevalence of CCM varied between none (Slovenia) and 15% (Hungary). Thus, the substantial differences across Europe in the frequency of kidney replacement therapy and CCM indicate the need for improvement in access to various treatment options for patients with kidney failure.

Focal segmental glomerulosclerosis (FSGS) is a histological lesion with many causes, including inherited genetic defects, with significant proteinuria being the predominant clinical finding at presentation. FSGS is considered as a podocyte disease due to the fact that in the majority of patients with FSGS, the lesion results from defects in the podocyte structure. However, FSGS does not result exclusively from podocyte-associated genes. In this study, we used a genetic approach based on targeted next-generation sequencing (NGS) of 242 genes to identify the genetic cause of FSGS in seven Tunisian families. The sequencing results revealed the presence of eight distinct mutations including seven newly discovered ones: the c.538G>A (p.V180M) in NPHS2 , c.5186G>A (p.R1729Q) in PLCE1 and c.232A>C (p.I78L) in PAX2 and five novel mutations in COL4A3 and COL4A4 genes. Four mutations (c.209G>A (p.G70D), c.725G>A (p.G242E), c.2225G>A (p.G742E), and c. 1681_1698del) were detected in COL4A3 gene and one mutation (c.1424G>A (p.G475D)) was found in COL4A4 . In summary, NGS of a targeted gene panel is an ideal approach for the genetic testing of FSGS with multiple possible underlying etiologies. We have demonstrated that not only podocyte genes but also COL4A3/4 mutations should be considered in patients with FSGS.

Introduction: membranoproliferative glomerulo nephritis (MPGN) is a rare kidney disease with a poor prognosis as 50% of patients attend the end stage renal failure after 10 years of follow up. Several factors have been described associated with poor renal prognosis. The aim of our study is to determine the epidemiologic profile and to identify prognostic factors of MPGN. Methods: our study is retrospective over a period of 16 years (January 1996 - December 2011) including all cases of primary MPGN aged more than 15 years, collected at the nephrology department of Hedi Chaker University Hospital, Sfax, Tunisia. Results: we collected 118 cases of primary MPGN, with mean age of 45 (SD 19) years. The incidence of MPGN has decreased from 10 cases/year between 1996 and 1999 to 5 cases/ year between 2008 and 2011. Seventy-nine percent of patients (n=93) had renal failure at the moment of diagnosis (e-GFR less than 60 ml/min/1.73m(2);). After a mean follow-up of 51.9 (SD 44) months, progression to end stage renal failure was observed in 43.5% of followed cases (n=20). On univariate analysis, factors associated with death or progression to end stage renal failure were initial renal failure and sclerotic glomeruli (respectively p at 0.040 and 0.032). Multivariate analysis indicated that initial renal failure was significantly correlated with death or progression to end stage renal failure (HR: 0.14, 95% CI (0.033-0.593), p=0.008). Conclusion: there has been a decline in the number of cases of MPGN diagnosed in our hospital. The presence of renal failure at diagnosis was associated with death or progression to end stage renal failure.

We re-examine the infrequent paradigm of a biweekly dialysis at the start of renal replacement therapy. The current method is to launch hemodialysis among patients using a ‘full-dose’ posology three times a week. As a matter of fact, recent data has suggested that frequent hemodialysis leads to high mortality at the onset of dialysis. The aim of our study is to show the factors affecting early mortality especially the hemodialysis frequency. We undertook an observational study in the hemodialysis unit of Sfax University Hospital (south Tunisia). We enrolled the incident patients during one year. Baseline demographic and clinical characteristics of patients were noted. The survival status of each patient is observed at 6 months after the onset of hemodialysis. We analyzed the factors associated with mortality, especially the hemodialysis frequency (twice or thrice weekly hemodialysis regimen). We enrolled 88 patients with mean age of 56 ± 18 years old. Thirty patients underwent twice weekly dialysis (Group 1) and 58 patients underwent thrice weekly dialysis (Group 2). The mortality at 6 months was similar in the 2 groups (the rate of death = 30% in group 1 vs 13.8% in group 2, p = 0.07). However, the mortality was lower in the group with preserved residual diuresis (35.3% vs 64.7% in the group without residual diuresis, p = 0.02). The mortality was higher in diabetes patients (64.7% vs 35.5%, p = 0.02). It was concluded that twice or threefold weekly treatment have some considerable similar outcomes on the patients survival (at 6 months).

Background. This article presents a summary of the 2017 Annual Report of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry and describes the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in 37 countries. Methods. The ERA-EDTA Registry received individual patient data on patients undergoing RRT for ESRD in 2017 from 32 national or regional renal registries and aggregated data from 21 registries. The incidence and prevalence of RRT, kidney transplantation activity and survival probabilities of these patients were calculated. Results. In 2017, the ERA-EDTA Registry covered a general population of 694 million people. The incidence of RRT for ESRD was 127 per million population (pmp), ranging from 37 pmp in Ukraine to 252 pmp in Greece. A total of 62% of patients were men, 52% were >= 65 years of age and 23% had diabetes mellitus as the primary renal disease. The treatment modality at the onset of RRT was haemodialysis for 85% of patients. On 31 December 2017, the prevalence of RRT was 854 pmp, ranging from 210 pmp in Ukraine to 1965 pmp in Portugal. The transplant rate in 2017 was 33 pmp, ranging from 3 pmp in Ukraine to 103 pmp in the Spanish region of Catalonia. For patients commencing RRT during 2008-12, the unadjusted 5-year patient survival probability for all RRT modalities combined was 50.8%.

BACKGROUND:After its outbreak in China, the novel COronaVIrus Disease 19 is spreading across the globe. It is an emergency the world has never seen before.MAIN TEXT:The attention of health systems is mainly focused on COronaVIrus Disease 19 patients and on the risk that intensive care units might be overwhelmed by the serious pulmonary complications. Different countries are also attempting to establish infection prevention and control strategies which proved effective in China where the outbreak was initially reported. We reflect on important lessons to be learnt from different countries. The effects that infection prevention and control strategies, such as social distancing or isolation, can have on the care of millions of patients with non-communicable diseases, who may be indirectly affected, have not been taken into consideration so much.CONCLUSIONS:When dealing with COronaVIrus Disease 19, policy makers and healthcare personnel should consider the indirect effects on the treatment of non-communicable diseases.

According to the Global Burden of Disease Study 2017, between 1990 and 2017, Italy experienced a more attenuate reduction in cardiovascular deaths than Western Europe. When considering risk factors, our Country experienced a reduction in the prevalence of hypertension in the last few decades, especially in women. On the other hand, the prevalence of obesity, abdominal obesity and hypercholesterolemia in Italy is on the rise. Likewise, the control of total blood cholesterol is not revealing favorable time changes and sedentary lifestyle remains highly prevalent especially among women. A negative relationship between long-term exposure to the economic crisis and cardiovascular diseases was observed and the association between cardiovascular risk and socioeconomic status is now clearly evident. It is, therefore, necessary to specifically target the efforts towards the weakest sections of the population so that prevention policies can offer their maximum benefit. The study is part of a series of manuscripts promoted by SIMI with the collaboration of the National Internal Medicine Societies of some Mediterranean countries (Tunisia, Algeria, Egypt). The goal was to highlight the health needs related to the growth of metabolic diseases in the area. The observed changes bring the two coasts of the Mediterranean closer together. It is time to work together to build more effective strategies for identifying and reaching population subgroups that have still remained little sensitive to prevention and specially to lifestyles changes.

Cardiovascular complications are a major public health problem. The Framingham Risk Score (FS) is a scoring system that assesses the 10-year risk of cardiovascular event. The objective of our study was to evaluate the association of this score with the different parameters of the ambulatory blood pressure monitoring (ABPM). We carried out a retrospective study including patients having an ABPM between January 2015 and December 2016. The FS of each patient was calculated according to the AHA recommendations, including the following parameters: age, sex, smoking, office blood pressure, body mass index, treatment of hypertension and diabetes. The comparison between the groups was carried out by One-Way ANOVA test, and the correlation between FS and ABPM parameters by the Pearson coefficient. A total of 231 patients were included, sex-ratio M/F = 0.83. The results of ABPM showed uncontrolled hypertension (37.2%), controlled hypertension (30.3%), masked hypertension (18.6%) and absence of hypertension (13.9%). Patients with uncontrolled hypertension had the highest FS (35.5 ± 26, P < 0.001). Patients without hypertension had the lowest FS (9.4 ± 10, P < 0.001). The mean FS were 20 ± 19%, 27 ± 24%, 35 ± 30%, 38 ± 28% respectively in the dippers, non-dippers, hyper-dippers and risers (P = 0.001). Patients with nocturnal hypertension had a higher FS than other patients (29 ± 25 vs. 23 ± 22, P = 0.06). The correlation study showed that FS was negatively correlated with glomerular filtration rate (r = −0.35, P < 0.001). FS was positively correlated with mean global systolic blood pressure (r = 0.16, P = 0.017), mean diurnal systolic blood pressure (r = 0.14, P = 0.4), and mean nocturnal systolic blood pressure (r = 0.2, P = 0.002). The Framingham score is higher in patients with riser profile and nocturnal hypertension. The ABPM parameters correlated to the Framingham score are 24-hour systolic BP, diurnal systolic BP, and nocturnal systolic BP. Adequate management of other risk factors could balance the blood pressure profile, reduce cardiovascular risk and thus ensure a better quality of life for these patients.

Uncontrolled hypertension is associated with an increased risk of cardiovascular complications. Determining the factors of poor blood pressure control helps to set up more effective therapeutic strategies. The objective of our study was to identify factors associated with uncontrolled hypertension confirmed by ambulatory blood pressure monitoring (ABPM) in our population. We conducted a retrospective case-control study including patients who had an ABPM between January 2014 and June 2017. The diagnosis of uncontrolled hypertension was defined as a mean 24-hour BP ≥ 130/80 mmHg. We divided our patients into 2 groups: G1: patients with uncontrolled hypertension and G2: patients with controlled hypertension. The comparison between the 2 groups was carried out by chi 2 tests for univariate analysis and logistic regression for multivariate analysis. A total of 175 hypertensive patients were included, sex-ratio M/F = 0.9. The indication of ABPM was an uncontrolled hypertension in office in 143 cases (82%) and blood pressure control in 32 cases (18%). The prevalence of uncontrolled hypertension was 51%. The 24-hour BP was 151/87 mmHg in the G1 and 123/69 mmHg and G2 group ( P < 0.001). In univariate analysis, factors associated with poorly controlled hypertension were: male gender ( P = 0.002), smoking ( P = 0.018), personal history of chronic renal failure ( P = 0.027), presence of metabolic syndrome ( P = 0.008) and hyper glycaemia ( P = 0.01). In multivariate analysis, uncontrolled hypertension was associated with male gender ( P = 0.05), presence of metabolic syndrome ( P = 0.044), and low HDL cholesterol level ( P = 0.05). In our population, more than half of hypertensive patients were not adequately controlled. The main determinants of this poor control were: male gender and metabolic syndrome. Adequate care, by monitoring these factors, is essential for a better blood pressure control.

Les AC anti-PLA2R sont associés principalement au GNEM idiopathique(GNEMi). Ils aident à établir un diagnostic étiologique. Toutefois, leurs valeurs pronostiques sont controversées dans la littérature. Les objectifs de notre étude sont de déterminer les caractéristiques clinicobiologiques et évolutives des GNEMi PLA2R(+) par rapport au GNEMi PLA2R(-) et de préciser l’apport des PLA2R dans l’évolution des GNEMi (syndrome néphrotique (SN) et fonction rénale(FR)). Étude rétrospective sur une période de18 ans (Janvier 2001–Mai 2019)incluant tous les patients âgés de 18 ans ou plus ayant une GNEM confirmée sur PBR avec une enquête étiologique négative. Les patients ayant une GNEM secondaire ou une enquête étiologique incomplète ont été exclus. La recherche des AC anti-PLA2R au niveau du sérum prélevés le jour de la biopsie rénale (sérothéque) a été effectuée par la technique d’immunofluorescence. Les patients ont été partagés en 2 groupes : groupe PLA2R(+) et groupe PLA2R(−). La comparaison des 2 groupes a été réalisée par le test de Chi2 (valeurs qualitatives) et One Way Anova (valeurs quantitatives). La survie a été déterminée par la méthode de Kaplan–Meier. La recherche des facteurs pronostiques a été réalisée par la comparaison des courbes de survie par le test de Log-Rank. Nous avons colligé 142 cas. Parmi ces patients, l’enquête étiologique a été complète et négative pour 65 cas d’âge moyen 43ans ± 15 [20–70 ans] avec un sex-ratio de 2,42. Un âge inférieur à 50 ans a été plus fréquent chez les patients PLA2R(+)(p = 0,02). Il n’y avait pas de différence significative concernant la protéinurie, la FR ou la fréquence du SN entre les 2 groupes. Le DFG moyen chez le groupe PLA2R(+) est 95 ± 37 ml/min/1,73m2 vs 88 ± 43 chez le groupePLA2R(−). La durée moyenne de suivi a été comparable entre les 2 groupes(p = 0,42). La survenue de rémission a été plus fréquente dans le groupe PLA2R(−) 28 % vs 4,2 %. Pour le DFG, il n’y a pas de différence significative concernant le DFG à 6 mois, 1 an et 5 ans. Mais à 10 ans il était plus bas chez le groupe PLA2R(+)19 ± 1 ml/min/1,73m2 vs 57 ± 14 pour le groupe PLA2R(−) (p = 0,024). Les AC anti-PLA2R ont un rôle diagnostique important mais aussi pronostique pour évaluer l’évolution des GNEMi.