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Introduction Rituximab (RTX) is an effective alternative treatment for severe idiopathic nephrotic syndrome in children. Nevertheless, the actual indication of RTX within the therapeutic strategy remains controversial, given the lack of data on the safety of this treatment in this setting. Objective To retrospectively collect and describe all severe and significant adverse effects that had occurred in children treated with RTX for idiopathic nephrotic syndrome. Patients and methods All participating centres within the SNP network were asked to fill an online database for all their patients treated with RTX for INS. Data were collected from the patients’ medical charts. Severe or significant adverse effects were defined as follow: any event that led to (i) a vital risk, (ii) a hospitalization or a prolongation of hospitalization, (iii) the occurrence of sequelae or (iiii) the interruption of RTX therapy. Results Twenty-three centres participated to the study. In total, 196 cases were collected on October 10th. The mean age at diagnosis was 4.7 (± 3.2) years. The mean duration of disease was 7.5 (± 4.3) years when RTX was first used. The mean follow-up was 3.2 (± 2.5) years and 1.5 (± 1.7) years since the first and the last infusion of RTX respectively. Adverse effects were reported in 6.6% of cases during the infusion (dyspnea = 6, cardiac arrhythmia = 1, hemodynamic instability = 1, others = 7), and in 13.1% of cases after the infusion (in relation with neutropenia = 6, low IgM = 3, low IgG = 6, infectious disorder = 14, cardiac = 2, liver = 1, kidney = 1, digestive = 2, neurological = 2, others = 6, several complications can be present in the same patient). The main consequences of these adverse effects were: non-planned hospitalizations (n = 30), modifications or interruptions of RTX treatment (n = 6), significant invalidity (n = 3). A single adverse effect led to a life-threatening situation. Conclusion Adverse effects were reported in 18.9% of these 196 patients treated by RTX for INS. RTX treatment was interrupted or modified in 6 cases. Only 4 adverse effects led to severe consequences (either life threatening event or significant invalidity). These results will help to evaluate the benefit/risk ratio or RTX for INS in children. This is an ongoing study, therefore results can be different when they will be presented during the meeting.

Introduction Kidney transplantation (KT) is the treatment of choice for end-stage renal disease. Pre-emptive KT is considered to be the most optimal treatment of ESRD particularly in children but reports on the results of paediatric pre-emptive KT are scarce. The objective of this study was to evaluate the impact of pre-emptive KT on the risk of graft failure in children with ESRD. Methods We analyzed all first kidney transplants performed in children Results A total of 1920 paediatric patients were included, of whom 387 (20.2%) received a pre-emptive KT. Median time of follow-up was 7.0 years [IQR (3.0–11.7)]. At 10 years post-transplant, graft survival was 85.2% in pre-emptive KT and 67.1% in non-pre-emptive KT (P Conclusion In France, pre-emptive KT in children is associated with a lower risk of graft failure than KT performed after the initiation of dialysis, and should be encouraged when feasible.

L’hypertension chez les enfants anephriques en hemodialyse chronique est frequente, en depit des strategies mises en place pour estimer le poids de base. L’objectif de l’etude etait d’evaluer l’efficacite d’un profil de conductivite sodique personnalise sur l’equilibre tensionnel. Patients et methodes Cinq patients anephriques en dialyse chronique 6 jours/7 (âge median 6,3 ans) ont ete dialyses selon 2 modalites. Pendant 4 semaines (S-4–S-1), le debit d’ultrafiltration (UF) et la conductivite sodique (14,2 mS/cm, soit une concentration sodique du dialysat [DNa] de 140 mM) etaient constants. Pendant les 4 semaines suivantes (S1–S4), la prescription etait personnalisee : profil decroissant lineaire d’UF et de conductivite (en debut de seance, la DNa est egale a la natremie moyenne predialytique du patient et d’au minimum 140 mM ; en fin de seance, la DNa est de 136 mM). Les donnees cliniques et biologiques ont ete recueillies prospectivement. Pour chaque patient, nous avons compare les resultats observes en modalite « profil » (moyenne des valeurs de S3 et S4) a ceux observes en modalite « constant » (moyenne des valeurs de S-4 a S-1). Resultats Quatre patients recevaient un traitement a visee antihypertensive a S-4. A S4, le traitement anti-HTA avait ete diminue ou arrete chez tous, alors que le poids de base etait stable ou en augmentation ( Tableau 1 ). Le double profil a ete parfaitement tolere, sans augmentation du nombre d’hypotensions perdialytiques. Conclusion L’augmentation de la perte sodee diffusive perdialytique s’est accompagnee d’une amelioration de l’equilibre tensionnel chez les enfants anephriques, sans augmentation des episodes d’hypotension.