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</o:shapelayout></xml><![endif]--></head><body lang=FR link=blue vlink=purple style='word-wrap: break-word;-webkit-nbsp-mode: space;-webkit-line-break: after-white-space'><div class=WordSection1><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Attention à l’administration de la vanco sur la dernière heure de dialyse cf lettre d’icar 2001 en effet la vanco est dialysable avec les membranes de haute perméabilité.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Nous faisons ici la perfusion sur 30 minutes à 1 heure après la fin de la séance. Faire un to (résiduelle) avant chaque dialyse pour dose à réinjecter.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Les résiduelle souhaitée sont à la hausse plutôt 20 en effet et enfin dans les infections graves telles les endocardites la vanco est administrée en continue iv se au chu de Nantes<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Dr Lefrançois <o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Echo nantes<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><div><div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0cm 0cm 0cm'><p class=MsoNormal><b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>De :</span></b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'> Renaliste [mailto:renaliste-bounces@nephrodial.org] <b>De la part de</b> miguel hotmail<br><b>Envoyé :</b> jeudi 4 février 2016 09:53<br><b>À :</b> Liste des néphrologues francophones<br><b>Objet :</b> Re: [Renaliste] Administration de la Vancomycine en hémodialyse et protocole d'anticoagulation chez le patient hémodialysé<o:p></o:p></span></p></div></div><p class=MsoNormal><o:p> </o:p></p><div><p class=MsoNormal>VANCOMYCINE<o:p></o:p></p></div><div><p class=MsoNormal>De notre coté nous préférons un taux résiduel vallée de 20-30.<o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal>Nous tenons compte dans ce raisonnement de l’évolution des CMI des MRSE plus que de MRSA, de ce qui doit être couvert (diffusion de la vancomycine parfois faible dans certains tissus cfr premier travaux de banco continue pour couvrir le LCR dans les année 90, ), et bien entendu on peut discuter aussi l’aspect fraction libre en IRC Vd<o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal>Selon le type d’infection suspectée et probabilité nous faisons revenir le patient le lendemain pour une dose supplémentaire (car souvent la premier charge aura une vallée <20 (foi >10) dans les 24h). <o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal>En secteur HDc nous obtenons le dosage de la vancomycine en 1h.<o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal>Nous préconisons une pompe volumétrique par sécurité (éviter les flush et red man syndrome).<o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal>Si vous souhaitez quelques références je pense que mon collègue a fait récemment un travail sur le sujet en DP <o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal>HEPARINE:<o:p></o:p></p></div><div><p class=MsoNormal>idem, <o:p></o:p></p></div><div><p class=MsoNormal>nous avons également simplifié note protocole héparine avec un tableau poids/risque pour nos ordres aux infirmières.<o:p></o:p></p></div><div><p class=MsoNormal>Il faut rester clinique, hémostase oblige , dernièrement nous avons eu un accident hémorragique d’une patient qui répondait trop bien à (l’héparine), un bilan est en cours…<o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal>en ps mon mail hospitalier<o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal>Bien à vous<o:p></o:p></p></div><div><p class=MsoNormal>Dr Guillen A MA<o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal>PS<o:p></o:p></p></div><div><p class=MsoNormal><a href="mailto:Miguel-Ange.Guillen@EpiCURA.be">Miguel-Ange.Guillen@EpiCURA.be</a><o:p></o:p></p></div><p class=MsoNormal><o:p> </o:p></p><div><div><p class=MsoNormal>Le 2 févr. 2016 à 17:19, BOUKELMOUNE MAKHLOUF <<a href="mailto:Makhlouf.Boukelmoune@ch-toulon.fr">Makhlouf.Boukelmoune@ch-toulon.fr</a>> a écrit :<o:p></o:p></p></div><p class=MsoNormal><br><br><o:p></o:p></p><div><p class=MsoNormal><span style='font-family:"Calibri","sans-serif"'><br>Bonjour,<o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p></div><div><p class=MsoNormal><span style='font-family:"Calibri","sans-serif"'>Pour les antibiotiques , on a tendance parfois à négliger leur posologie par poids du patient. Le GPR recommande : une dose de charge initiale de 30 mg/kg et un entretien 10 mg/kg toutes les 48h avec un Tx résiduel à 10 - 20 mg/l.<o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-family:"Calibri","sans-serif"'>Bien à vous.<o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p></div><div><p class=MsoNormal><span style='font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p></div><div><p class=MsoNormal><span style='font-family:"Calibri","sans-serif"'>Dr Boukelmoune.<o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p></div><div><p class=MsoNormal><span style='font-family:"Calibri","sans-serif"'>CH de Toulon<o:p></o:p></span></p></div><div><div class=MsoNormal align=center style='text-align:center'><span style='font-family:"Calibri","sans-serif";color:#212121'><hr size=2 width=635 style='width:476.25pt' align=center></span></div><div id=divRplyFwdMsg><p class=MsoNormal><b><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#212121'>De :</span></b><span class=apple-converted-space><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#212121'> </span></span><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#212121'>Renaliste <<a href="mailto:renaliste-bounces@nephrodial.org"><span style='color:#954F72'>renaliste-bounces@nephrodial.org</span></a>> de la part de Amar AMAOUCHE <<a href="mailto:aamaouche@aurar.fr"><span style='color:#954F72'>aamaouche@aurar.fr</span></a>><br><b>Envoyé :</b><span class=apple-converted-space> </span>mardi 2 février 2016 14:30<br><b>À :</b><span class=apple-converted-space> </span>'Liste des néphrologues francophones'<br><b>Objet :</b><span class=apple-converted-space> </span>Re: [Renaliste] Administration de la Vancomycine en hémodialyse et protocole d'anticoagulation chez le patient hémodialysé</span><span style='font-family:"Calibri","sans-serif";color:#212121'><o:p></o:p></span></p><div><p class=MsoNormal><span style='font-family:"Calibri","sans-serif";color:#212121'> <o:p></o:p></span></p></div></div><div><div><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'>Bonjour</span><span style='color:#212121'><o:p></o:p></span></p></div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'> </span><span style='color:#212121'><o:p></o:p></span></p><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'>Pour la Vanco plutôt 1g/30mn après la séance de dialyse(reco. d’ICAR)</span><span style='color:#212121'><o:p></o:p></span></p></div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'> </span><span style='color:#212121'><o:p></o:p></span></p><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'>Pour l’heparine 25u/kg en dose de charge (bolus) puis 15 u/kg en entretien avec arret 30mn avant la fin de la séance</span><span style='color:#212121'><o:p></o:p></span></p></div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'> </span><span style='color:#212121'><o:p></o:p></span></p><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'>Cordialement</span><span style='color:#212121'><o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'>Amar Amaouche</span><span style='color:#212121'><o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'>Saint pierre</span><span style='color:#212121'><o:p></o:p></span></p></div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'> </span><span style='color:#212121'><o:p></o:p></span></p><div><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'>_______________________________</span><span class=apple-converted-space><span style='font-family:"Calibri","sans-serif";color:navy'> </span></span><span style='font-family:"Calibri","sans-serif";color:navy'><br></span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'>Dr Amar AMAOUCHE</span><span class=apple-converted-space><span style='font-family:"Calibri","sans-serif";color:navy'> </span></span><span style='font-family:"Calibri","sans-serif";color:navy'><br></span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'>AURAR PNS 1</span><span class=apple-converted-space><span style='font-family:"Calibri","sans-serif";color:navy'> </span></span><span style='font-family:"Calibri","sans-serif";color:navy'><br></span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'>15 rue des Roches</span><span class=apple-converted-space><span style='font-family:"Calibri","sans-serif";color:navy'> </span></span><span style='font-family:"Calibri","sans-serif";color:navy'><br></span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'>97410 SAINT PIERRE</span><span class=apple-converted-space><span style='font-family:"Calibri","sans-serif";color:navy'> </span></span><span style='font-family:"Calibri","sans-serif";color:navy'><br></span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'>Tél. 0262 54 99 40</span><span class=apple-converted-space><span style='font-family:"Calibri","sans-serif";color:navy'> </span></span><span style='font-family:"Calibri","sans-serif";color:navy'><br></span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'>Fax 0262 54 99 38</span><span class=apple-converted-space><span style='font-family:"Calibri","sans-serif";color:navy'> </span></span><span style='font-family:"Calibri","sans-serif";color:navy'><br></span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:navy'>Portable : 0692 23 84 91</span><span style='font-family:"Calibri","sans-serif";color:#212121'><o:p></o:p></span></p></div></div><div><div class=MsoNormal align=center style='text-align:center'><span style='color:#212121'><hr size=2 width="100%" align=center></span></div><div><p class=MsoNormal><b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:#212121'>De :</span></b><span class=apple-converted-space><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:#212121'> </span></span><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:#212121'>Renaliste [<a href="mailto:renaliste-bounces@nephrodial.org"><span style='color:#954F72'>mailto:renaliste-bounces@nephrodial.org</span></a>]<span class=apple-converted-space> </span><b>De la part de</b><span class=apple-converted-space> </span><a href="mailto:seigneuric.b@chu-toulouse.fr"><span style='color:#954F72'>seigneuric.b@chu-toulouse.fr</span></a><br><b>Envoyé :</b><span class=apple-converted-space> </span>mardi 2 février 2016 15:46<br><b>À :</b><span class=apple-converted-space> </span><a href="mailto:coulibaly1981@yahoo.fr"><span style='color:#954F72'>coulibaly1981@yahoo.fr</span></a>;<span class=apple-converted-space> </span><a href="mailto:renaliste@nephrodial.org"><span style='color:#954F72'>renaliste@nephrodial.org</span></a><br><b>Objet :</b><span class=apple-converted-space> </span>Re: [Renaliste] Administration de la Vancomycine en hémodialyse et protocole d'anticoagulation chez le patient hémodialysé</span><span style='color:#212121'><o:p></o:p></span></p></div></div><p class=MsoNormal><span style='color:#212121'> <o:p></o:p></span></p><div><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Bonjour,</span><span style='color:#212121'><o:p></o:p></span></p></div><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='color:#212121'><o:p></o:p></span></p><div><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Concernant la vancomycine nous l’administrons à 1 g/H ; si la dose à administrer est supérieure à 1 g on prolonge sur 1H30 voire 2H en deuxième partie de séance.</span><span style='color:#212121'><o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Concernant l’HNF nous commençons par :</span><span style='color:#212121'><o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>- une dose de charge au branchement : ½ mg/Kg avec 10 mg = 1000U soit 3000 U pour un sujet de 60Kg, puis</span><span style='color:#212121'><o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>- une dose d’entretien de 333 à 666 U/ H d’héparine sur 3H30 lors d’une dialyse de 4H sur FAV et sur toute la séance pour un cathéter. On ne dépasse pas 999U/H.</span><span style='color:#212121'><o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>On adapte secondairement les doses en fonction de l’état du rein et du patient.</span><span style='color:#212121'><o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Avec les bains au citrate la dose d’héparine a pu être baissée.</span><span style='color:#212121'><o:p></o:p></span></p></div><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='color:#212121'><o:p></o:p></span></p><div><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Cordialement</span><span style='color:#212121'><o:p></o:p></span></p></div><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='color:#212121'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='color:#212121'><o:p></o:p></span></p><div><p class=MsoNormal><span style='font-size:10.0pt;color:#1F497D'>Dr B. Seigneuric</span><span style='color:#212121'><o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:10.0pt;color:#1F497D'>Praticien Hospitalier</span><span style='color:#212121'><o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:10.0pt;color:#1F497D'>Département de Néphrologie, Dialyse et Transplantation d’Organes - Unité de Dialyse Périodique</span><span style='color:#212121'><o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:10.0pt;color:#1F497D'>CHU Rangueil – Larrey</span><span style='color:#212121'><o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:10.0pt;color:#1F497D'>31059 Toulouse Cedex 9</span><span style='color:#212121'><o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:10.0pt;color:#1F497D'>Tel 05 67 77 18 90</span><span style='color:#212121'><o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:10.0pt;color:#1F497D'>Fax 05 67 77 18 88</span><span style='color:#212121'><o:p></o:p></span></p></div><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='color:#212121'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='color:#212121'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='color:#212121'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> </span><span style='color:#212121'><o:p></o:p></span></p><div><div style='border:none;border-top:solid #E1E1E1 1.0pt;padding:3.0pt 0cm 0cm 0cm'><div><p class=MsoNormal><b><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#212121'>De :</span></b><span class=apple-converted-space><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#212121'> </span></span><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#212121'>Renaliste [<a href="mailto:renaliste-bounces@nephrodial.org"><span style='color:#954F72'>mailto:renaliste-bounces@nephrodial.org</span></a>]<span class=apple-converted-space> </span><b>De la part de</b><span class=apple-converted-space> </span>moussa coulibaly<br><b>Envoyé :</b><span class=apple-converted-space> </span>mardi 2 février 2016 11:16<br><b>À :</b><span class=apple-converted-space> </span>Liste des néphrologues francophones<br><b>Objet :</b><span class=apple-converted-space> </span>[Renaliste] Administration de la Vancomycine en hémodialyse et protocole d'anticoagulation chez le patient hémodialysé</span><span style='color:#212121'><o:p></o:p></span></p></div></div></div><p class=MsoNormal><span style='color:#212121'> <o:p></o:p></span></p><div><div id="yui_3_16_0_1_1454407169002_5400"><div><p class=MsoNormal style='background:white'><span style='font-size:9.0pt;font-family:"Helvetica","sans-serif";color:#212121'>Bonjour,</span><span style='color:#212121'><o:p></o:p></span></p></div></div><div id="yui_3_16_0_1_1454407169002_5402"><p class=MsoNormal style='background:white'><span style='font-size:9.0pt;font-family:"Helvetica","sans-serif";color:#212121'> </span><span style='color:#212121'><o:p></o:p></span></p></div><div id="yui_3_16_0_1_1454407169002_5380"><div><p class=MsoNormal style='background:white'><span style='font-size:9.0pt;font-family:"Helvetica","sans-serif";color:#212121'>J'ai deux questions concernant l'administration de la vancomycine chez le patient hémodialysé et l'héparine en continue chez les patients hémodialysés</span><span style='color:#212121'><o:p></o:p></span></p></div></div><div id="yui_3_16_0_1_1454407169002_5379"><div><p class=MsoNormal style='background:white'><span style='font-size:9.0pt;font-family:"Helvetica","sans-serif";color:#212121'>qui ont un risque hémorragique et de coagulation du circuit.</span><span style='color:#212121'><o:p></o:p></span></p></div></div><div id="yui_3_16_0_1_1454407169002_5417"><div><p class=MsoNormal style='background:white'><span style='font-size:9.0pt;font-family:"Helvetica","sans-serif";color:#212121'>J'ai eu toujours l'habitude d'administrer la Vancomycine sur la dernière heure de dialyse. Avez vous d'autres habitudes?</span><span style='color:#212121'><o:p></o:p></span></p></div></div><div id="yui_3_16_0_1_1454407169002_5378"><div><p class=MsoNormal style='background:white'><span style='font-size:9.0pt;font-family:"Helvetica","sans-serif";color:#212121'>Concernant l'héparine, j'applique le protocole suivant : 25 UI/kg/h la première heure de dialyse puis 12.5 UI/kg/h la 2ème et 3ème heure de dialyse puis j'arrête la dernière heure de dialyse. Avez vous d'autres façons de faire en dehors de l'utilisation des membranes héparinées.</span><span style='color:#212121'><o:p></o:p></span></p></div></div><div id="yui_3_16_0_1_1454407169002_5416"><p class=MsoNormal style='background:white'><span style='font-size:9.0pt;font-family:"Helvetica","sans-serif";color:#212121'> </span><span style='color:#212121'><o:p></o:p></span></p></div><div id="yui_3_16_0_1_1454407169002_5452"><div><p class=MsoNormal style='background:white'><span style='font-size:9.0pt;font-family:"Helvetica","sans-serif";color:#212121'>Merci</span><span style='color:#212121'><o:p></o:p></span></p></div></div><div id="yui_3_16_0_1_1454407169002_5451"><p class=MsoNormal style='background:white'><span style='font-size:9.0pt;font-family:"Helvetica","sans-serif";color:#212121'> </span><span style='color:#212121'><o:p></o:p></span></p></div><div id="yui_3_16_0_1_1454407169002_5410"><div><p class=MsoNormal style='background:white'><span style='font-size:9.0pt;font-family:"Helvetica","sans-serif";color:#212121'>Dr COULIBALY Moussa</span><span style='color:#212121'><o:p></o:p></span></p></div></div><div id="yui_3_16_0_1_1454407169002_5408"><div><p class=MsoNormal style='background:white'><span style='font-size:9.0pt;font-family:"Helvetica","sans-serif";color:#212121'>Centre Hospitalier d'Agen</span><span style='color:#212121'><o:p></o:p></span></p></div></div><div id="yui_3_16_0_1_1454407169002_5409"><p class=MsoNormal style='background:white'><span style='font-size:9.0pt;font-family:"Helvetica","sans-serif";color:#212121'> </span><span style='color:#212121'><o:p></o:p></span></p></div></div><p class=MsoNormal><span style='color:#212121'> <o:p></o:p></span></p><div class=MsoNormal align=center style='text-align:center'><span style='color:#212121'><hr size=2 width="100%" align=center></span></div><div><p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif";color:gray'><br>Ce message et les éventuelles pièces jointes sont confidentiels et peuvent être protégés par la loi. Ils s'adressent uniquement aux personnes destinataires. Si vous n'êtes pas dans la liste des destinataires, veuillez en informer immédiatement l'expéditeur et ne pas utiliser, divulguer, stocker ou copier sur un quelconque support l'information qu'il contient. Il appartient au destinataire de vérifier que les messages et pièces jointes ne contiennent pas de virus.<br><br>This message and any attachments are confidential and may be protected by law. They are intended only for the individual(s) or entity named above. If you are not the intended recipient, any disclosure, copying, or distribution is strictly prohibited. Please notify the sender that you have received this email by error. It belongs to each recipient to check that e-mails and attachments are free from viruses.</span><span style='color:#212121'><o:p></o:p></span></p></div></div></div></div><p class=MsoNormal><span style='font-family:"Calibri","sans-serif";background:white'>_______________________________________________</span><span style='font-family:"Calibri","sans-serif"'><br><span style='background:white'>Renaliste mailing list</span><br></span><a href="mailto:Renaliste@nephrodial.org"><span style='font-family:"Calibri","sans-serif";color:#954F72'>Renaliste@nephrodial.org</span></a><span style='font-family:"Calibri","sans-serif"'><br></span><a href="http://nephrodial.org/cgi-bin/mailman/listinfo/renaliste"><span style='font-family:"Calibri","sans-serif";color:#954F72'>http://nephrodial.org/cgi-bin/mailman/listinfo/renaliste</span></a><o:p></o:p></p></div><p class=MsoNormal><o:p> </o:p></p></div></body></html>