Yassir Zajjari

Unité Inserm U1077, Caen, Lower Normandy, France

Are you Yassir Zajjari?

Claim your profile

Publications (40)17.28 Total impact

  • [Show abstract] [Hide abstract] ABSTRACT: Epidemiological studies on renal biopsies are necessary to establish the pattern and trends of renal diseases in a particular geographic area. In this retrospective study, we reviewed the medical records, histopathology findings and complications of renal biopsy in a region of Morocco. We studied a total of 130 native kidney biopsies taken between January 2008 and January 2012. All biopsies were examined by light microscopy and immunofluorescence microscopy. There were 86 males (66.2%) and 44 females (33.8%), with a mean patient age of 44.82 ± 17.86 (range 8-86) years. The most common indications of renal biopsy was nephritic syndrome (61.5%), followed by renal failure of unknown etiology (30.8%) and asymptomatic urinary abnormalities (5.4%). Primary glomerulonephritis (PGN) was found in 60 (46.2%) of the patients. Among the PGN cases, the most common one was membranous nephropathy (MN) (12.3%). Secondary glomerular disease (SGN) accounted for 48 (36.9%) of the cases. The most common SGN was lupus nephritis (LN) (10%). Tubulointerstitial disease [13 (10%)] and vascular disease [9 (6.9%)] were less common. The most common complications of the procedure were pain at the biopsy site in 12.3%, gross hematuria in 12.3%, perirenal hematoma in 7.7% and hematuria requiring nephrectomy in 0.8% of the patients. The most common indication for renal biopsy was nephrotic syndrome, MN was the most frequent PGN and LN was the most frequent SGN in our report.
    No preview · Article · Sep 2015 · Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia
  • [Show abstract] [Hide abstract] ABSTRACT: L'abcès hypophysaire est une pathologie rare et fatale en absence de traitement adéquat. Il est à évoquer devant un tableau clinique d'hypertension intracrânienne, une dysrégulation hormonale hypophysaire et un contexte infectieux. Une conduite thérapeutique basée sur une antibiothérapie pourrait être tenté si diagnostic précoce. Nous rapportons un cas d'abcès hypophysaire survenant chez un hémodialysé chronique pris en charge par une antibiothérapie seule dont l’évolution était favorable avec un recul de 2 ans.
    No preview · Article · Feb 2015 · Pan African Medical Journal
  • [Show abstract] [Hide abstract] ABSTRACT: Cardiovascular disease is the first leading cause of death in hemodialysis patients. In this population, cardiovascular calcifications occur at an earlier age and progress faster than in general population.
    No preview · Article · Jan 2015 · Annales de cardiologie et d'angeiologie
  • [Show abstract] [Hide abstract] ABSTRACT: In developing countries, little is known about renal replacement therapy (RRT) for acute kidney injury (AKI) in critically ill patients. The aim of this study is to describe characteristics of patients, clinical practice of renal support and outcomes in intensive care units (ICU) in a developing country. Patients who underwent RRT for AKI from May 2003 to July 2008, in four ICUs in our institution were included in this retrospective study. Patients with end stage renal disease or younger than aged 18 years were exclueded. We have considered: patient demographics, indications of RRT, number of dialysis session, comorbidities, APACH II score for illness severity, mechanical ventilation, use of vasoactive drugs, and mortality rate. 105 critically ill patients admitted during the study period were treated with RRT, with a mean age of 56.13 +/- 16.8 (19-85) years. Sixty five were male and 40 female; all received intermittent hemodialysis. The total number of dialysis sessions was 284, and the mean number was 3.7 +/- 2.9; mean length of session was 225.22 +/- 75.16 (60-290) min. The majority of the cases (67%) were from medical ICU, followed by 30.2% from surgical ICUs (including cardiothoracic surgery ICU) and 2.8% were from burn ICU. The most common comorbidities were type 2 diabetes mellitus in 46 (44%) and hypertension in 35 (33.4%). Sepsis was a contributing factor to AKI in 60 patients (57.14%), hypovolemia in 30 (28.5%), and cardiogenic shock in 9 (8.5%). The APACHE II score was 25.86 +/- 11.8; the majority of patients (66.7%) were ventilated; 63 (60%) were under vasoactive drugs and 88 (83.8%) were oliguric. The most common indication for initiation of dialysis was hyperkalemia in 51 (48.5%) of the cases, followed by severe acidosis in 35 (33.3%) and acute pulmonary edema for 20 (19%). ICU mortality was 68.5% and increased to 95.2% when more than two organs were involved. Our experience suggests that indications for initiation of RRT in ICU are not greatly different from that in industrialized countries; yet, the big difference is in a high mortality rate among our patients.
    No preview · Article · May 2014 · Ethnicity & disease
  • [Show abstract] [Hide abstract] ABSTRACT: Aims: The main objective of this work was to evaluate the influence of end-stage renal disease (ESRD) on concentrations of five tumor markers (TMs): carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9 (CA19-9), CA15-3, CA125, and prostate specific antigen (PSA) in a group of chronic hemodialysis patients (CHPs); and to study the influence of hemodialysis (HD) sessions on concentrations of the same TMs. Methods: We compared TMs levels in CHP before HD sessions to a control group of 50 healthy volunteers, the dosages were determined before and immediately after the HD session Comparisons were made before and after correction for dialysis-induced hemoconcentrations. Results: We enrolled 74 CHPs, all TM concentrations were higher in this group compared to control group, but this increase was significant for CEA (4.25 ± 2.89 vs 2.41 ± 1.81ng/ml; p<0.0001), CA125 (27.84 ± 92.27 vs 13.30 ± 9.85 ng/ml; p = 0.048) and CA19-9 (19.65 ± 25.02 vs 10.23 ± 11.00 U/ml; p = 0.011). Post-dialysis levels were significantly higher than those in pre-dialysis. CEA (3.35 [2,46-5.51] vs 4,06 [2.60-6.78] ng/ml; p<0.0001), CA125 (13.24 [9.66-18.63] vs 16.01 [11.33-22.53] ng/ml; p<0.0001), CA19-9 (12.29 [5.59-21.97] vs 16.29 [7.18-24.7] U/ml; p<0.0001), CA15-3 (13.06 [10.05-17.48] vs 14.58 [11.72-19.35] ng/ml; p<0.0001 and PSA (0.83 [0.5-1.24] vs 1.06 [0.62-1.43] ng/ml; p<0.0001). Conclusions: Our work confirms that HD increases concentrations of the five TMs evaluated and suggests that the use of CA15-3 and PSA remains valid in CHPs since their concentrations were not altered by ESRD, unlike CEA, CA125, and CA19-9.
    No preview · Article · Feb 2014 · The International journal of artificial organs
  • Source
    [Show abstract] [Hide abstract] ABSTRACT: Background: Quantification of hemodialysis became more accurate and easier after the advent of ionic dialysance and the use of methods for estimating urea distribution volume (V). The aim of this study was to compare different methods of hemodialysis dose assessment: Kt/VDau (Daugirdas 2nd generation), Kt/VOCM (Kt by OCM (Online Clearance Monitor) and V by Watson), and Kt/VBCM (Kt by OCM and V by bio-impedance); and to assess the dialysis adequacy, defined by a Kt/V>1.4. Design: Prospective, observational study. Methods: 35 hemodialysis sessions were evaluated in 35 chronic hemodialysis patients. During each session, we measured simultaneously, Kt/VOCM, Kt/VBCM and calculated Kt/VDau by performing blood samples before and after each session. Results: 35 patients, gender (M/F: 19/16), mean age of 50.49 years, were evaluated. We noted a difference between the three methods of evaluating Kt/V index: Kt/VDau, Kt/VOCM and Kt/VBCM (1.82 ± 0.29; 1.45 ± 0.23; 1.8 ± 0.33, p<0.001). Comparison of Kt/VOCM with Kt/VDau and Kt/VBCM leads to a significant systematic underestimate of Kt/V by 22% and 20.5% respectively. Better agreement between Kt/VDau and Kt/VBCM was observed. The adequate hemodialysis was achieved, according to three methods: Kt/VDau, Kt/VOCM and Kt/VBCM respectively in 100%, 57,1% and 88.6% of the cases. Conclusions: The Kt/V index is different depending on the method used for its evaluation. The three methods can be used for quantification of hemodialysis with a better agreement between Kt/VDau and Kt/VBCM. In this study, Kt/VOCM results underestimate hemodialysis efficiency. This difference has to be considered when applying quantification of hemodialysis to clinical practice.
    Full-text · Article · Jan 2014 · The International journal of artificial organs
  • Source
    [Show abstract] [Hide abstract] ABSTRACT: We measured NT-proBNP levels in 30 stable patients on maintenance haemodialysis, before and after hemodialysis session with low-flux polysulfone dialyzers, all mesures were done by a third-generation assay (Elecsys Analyzer, Roche Diagnostics, Mannheim, Germany). We hypothesized that serum NTproBNP cut-off value could serve as a biochemical marker to detect LVH in patients on haemodialysis treatment, regardless of chronic fluid overload. We assessed LV masse using trans-thoracic echocardiography, LVH was defined as an indexed left ventricular mass> 134 g/m(2) in man and 110 g/m2 in woman. NT-proBNP levels increased significantly after hemodialysis sessions (5575,93 5509,53 versus 4114,3856,37 +/- pg/ml p<0,0001). A significant positive correlation was found between NT-proBNP level and left ventricular mass (r = 0.75, P<0.0001). NT-proBNP was significantly higher in patients with LVH: (5270,35 +/- 3410,23 versus 2477,27 +/- 1421,91 pg/ml P = 0,045). In the multivariate regression analysis NT-proBNP was the only independent predictor of LVH (r = 0.75, P<0.0001 Our results suggests that NT-proBNP could be a potential marker of LVH in chronic renal failure patients on hemodialysis.
    Full-text · Article · May 2013 · The International journal of artificial organs
  • No preview · Article · May 2013 · Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia
  • [Show abstract] [Hide abstract] ABSTRACT: The bisalbuminemia acquired outside of the long-term antibiotic treatment is an exceptional event. It is a rare condition characterised by the presence of two distinct fractions of serum albumin on electrophoresis. This anomaly reflects the presence, at the same time, of a normal albumin and a modified albumin. These changes of albumin may be related to various causes. Their association with nephrotic syndrome is exceptional. We report a case of bisalbuminemia during a period of remission of nephrotic syndrome.
    No preview · Article · Nov 2012 · Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia
  • [Show abstract] [Hide abstract] ABSTRACT: The availability of hemodialysis machines equipped with online clearance monitoring (OCM) allows frequent assessment of dialysis efficiency and adequacy without the need for blood samples. Accurate estimation of the urea distribution volume (V) is required for Kt/V calculated from OCM to be consistent with conventional blood sample-based methods. A total of 35 patients were studied. Ionic dialysance was measured by conductivity monitoring. The second-generation Daugirdas formula was used to calculate the Kt/V single-pool (Kt/VD). Values of V to allow comparison between OCM and blood-based Kt/V were determined using Watson formula (VWa), bioimpedance spectroscopy (Vimp), and blood-based kinetic data (Vukm). Comparison of Kt/Vw ocm calculated by the ionic dialysance and Vw (Kt/Vw ocm) with Kt/VD shows that using VW leads to significant systematic underestimation of dialysis dose by 24%. Better agreement between Kt/V ocm and Kt/VD was observed when using Vimp and Vukm. Bio-impedancemetry and the indirect method using the second-generation Daugirdas equation are two methods of clinical interest for estimating V to ensure greater agreement between OCM and blood-based Kt/V.
    No preview · Article · Sep 2012 · Indian Journal of Nephrology
  • [Show abstract] [Hide abstract] ABSTRACT: Introduction: Intra-dialytic hypotension (IDH) is a common complication during hemodialysis (HD) treatment. Previous studies have reported that modulating dialysate sodium concentration combined or not with modulation of ultrafiltration (UF) rate may reduce the incidence of IDH. The aim of the present study was to evaluate the effect of sodium and UF profiles on the occurrence of intra-dialytic complications and dialysis quality. Methods: From a total of 64 patients, we selected 18 patients who suffered from recurrent IDH. Every patient received ten HD sessions utilizing each of the following treatments: (1) CONTROL: constant sodium concentration and UF rates. (2) Sodium and UF profiles: a linearly decreasing sodium concentration combined with a linearly decreasing UF rate. (3) Sodium profile: decreasing sodium concentration with constant UF rate. Results: Fourteen patients completed the study protocol. The incidence of IDH, mean inter-dialytic weight gain and the delivered dialysis dose were not different between the three treatments. However, symptomatic episodes of IDH were more commonand pre-dialysis systolic blood pressure was higher during the second and third treatment modalities compared to controls. Isolated sodium profile was associated with more malaise and less achievement of target session duration compared to the other two treatments. Isolated sodium profile was associated with less achievement of target UF while combined sodium and UF profiles were associated with more achievement of target UF compared to controls. Conclusion: Our results indicate that sodium profile with or without UF profile does not have a beneficial effect on the incidence of IDH, achievement of target session duration or the delivered dialysis dose. Keywords : Sodium Profile; Ultrafiltration; Intradialytic Complications.
    No preview · Article · Sep 2012
  • No preview · Article · Sep 2012 · Néphrologie & Thérapeutique
  • F. El Guendouz · Y. Zajjari · G. Belmejdoub
    No preview · Article · Sep 2012 · Annales d Endocrinologie
  • No preview · Article · Sep 2012 · Néphrologie & Thérapeutique
  • No preview · Article · Sep 2012 · Annales d Endocrinologie
  • No preview · Article · Sep 2012 · Néphrologie & Thérapeutique
  • No preview · Article · Sep 2012 · Néphrologie & Thérapeutique
  • [Show abstract] [Hide abstract] ABSTRACT: The distinction between diabetic nephropathy lesions and non-diabetic renal lesions is not always obvious and is often based on renal biopsy. This study evaluated the prevalence and predictors of nondiabetic renal disease in people with type 2 diabetes. The study was conducted between January 2008 and October 2010 in the nephrology department of the military hospital in Rabat. The study included 16 patients with type 2 diabetes in whom renal biopsy was indicated. Non-diabetic renal disease was found in 6 of the patients (37.5%); IgA nephropathy was the most frequent non-diabetic renal disease (half of non-diabetic renal diseases). Hypertension was significantly less frequent in the non-diabetic renal disease group than the diabetic nephropathy group (16.7% versus 80.0%, P = 0024), duration of diabetes was a shorter (4.5 versus 15.5 years, P = 0.022) and diabetic retinopathy was absent (100% versus 40%, P = 0.026). There were no statistically significant differences between the 2 groups in relation to age, sex, creatinine level, 24-hour proteinuria, nephrotic syndrome and microscopic haematuria.
    No preview · Article · Jun 2012 · Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-ṣiḥḥīyah li-sharq al-mutawassiṭ
  • [Show abstract] [Hide abstract] ABSTRACT: Diffusive clearance depends on blood (Qb) and dialysate flow (Qd) rates and the overall mass transfer area coefficient (KoA) of the dialyzer. In this article we describe a model to predict an appropriated AutoFlow (AF) factor (AF factor = Ratio Qd/Qb), that is able to provide adequate Kt/V for hemodialysis patients (HDP), while consuming lower amounts of dialysate, water and energy during the treatment. We studied in vivo the effects of three various Qd on the delivered dose of dialysis in 33 stable HDP. Hemodialysis was performed at Qd of 700 mL/mn, 500 mL/mn, and with AF, whereas specific dialysis prescriptions (treatment time, blood flow rate [Qb], and type and size of dialyzer) were kept constant. The results showed that increasing the dialysate flow rate more than the model of AF predicted had a small effect on the delivered dose of dialysis. The Kt/V (mean ± SD) was 1.52 ± 0.16 at Qd 700, 1.50 ± 0.16 at Qd 500, and 1.49 ± 0.15 with AF. The use of the AF function leads to a significant saving of dialysate fluid. The model predicts the appropriate AF factor that automatically adjusts the dialysate flow rate according to the effective blood flow rate of the patient to achieve an appreciable increase in dialysis dose at the lowest additional cost.
    No preview · Article · Apr 2012 · Therapeutic apheresis and dialysis: official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
  • [Show abstract] [Hide abstract] ABSTRACT: Dialysis adequacy has been shown to have a significant impact on patient survival, but there are few data concerning the adequacy of the delivered hemodialysis dose in developing countries. To describe the level of implementation of dialysis practice guidelines in a dialysis center in Morocco, we retrospectively reviewed our 1-year experience of managing chronic hemodialysis patients (CHP), from May 2009 to May 2010. Demographic and biochemical data were collected, and the percentage of patients achieving targets recommended by the NKF-KDOQI guidelines were calculated. Our data suggests that dialysis units in a developing country can achieve current guidelines targets for dialysis adequacy, however, our results are not generalizable to all dialysis centers in Morocco.
    No preview · Article · Feb 2012 · The International journal of artificial organs