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118 results on '"Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM]"'

51. Distinctive endothelial and inflammatory profiles characterize kidney transplants from extended criteria donors

Author: Boissier, Romain, Francois, Pauline, Meunier, Maite, Tellier, Bastien Gondran, Lyonnet, Luc, Simoncini, Stephanie, Legris, Tristan, Magalon, Jeremy, Françoise DIGNAT-GEORGE, Lechevallier, Eric, Sabatier, Florence, Paul, Pascale, Assistance Publique - Hôpitaux de Marseille (APHM), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Laboratoire d'hématologie biologique [Hôpital de la Timone - Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Département d'Urologie [Hôpital Nord - APHM], and Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM]
Subjects: INFLAMMATION, [SDV]Life Sciences [q-bio], ENDOTHELIAL FUNCTION, TRANSPLANTATION D'ORGANES, ComputingMilieux_MISCELLANEOUS
Abstract: Meeting Abstract; International audience
Published: 2019

52. toxins Endothelial Toxicity of High Glucose and its by-Products in Diabetic Kidney Disease

Author: Noémie Jourde-Chiche, Laetitia Dou, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), and HAL AMU, Administrateur
Subjects: medicine.medical_specialty, Health, Toxicology and Mutagenesis, lcsh:Medicine, Inflammation, Review, 030204 cardiovascular system & hematology, Kidney, Toxicology, medicine.disease_cause, AGEs, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, endothelial dysfunction, 03 medical and health sciences, 0302 clinical medicine, Polyol pathway, Glycation, Internal medicine, medicine, Animals, Humans, Diabetic Nephropathies, Endothelial dysfunction, Progenitor cell, glucose, 030304 developmental biology, 0303 health sciences, polyols, business.industry, lcsh:R, Endothelial Cells, medicine.disease, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, diabetic kidney disease, 3. Good health, Endocrinology, Albuminuria, Glomerular Filtration Barrier, medicine.symptom, business, Oxidative stress
Abstract: International audience; Alterations of renal endothelial cells play a crucial role in the initiation and progression of diabetic kidney disease. High glucose per se, as well as glucose by-products, induce endothelial dysfunction in both large vessels and the microvasculature. Toxic glucose by-products include advanced glycation end products (AGEs), a group of modified proteins and/or lipids that become glycated after exposure to sugars, and glucose metabolites produced via the polyol pathway. These glucose-related endothelio-toxins notably induce an alteration of the glomerular filtration barrier by increasing the permeability of glomerular endothelial cells, altering endothelial glycocalyx, and finally, inducing endothelial cell apoptosis. The glomerular endothelial dysfunction results in albuminuria. In addition, high glucose and by-products impair the endothelial repair capacities by reducing the number and function of endothelial progenitor cells. In this review, we summarize the mechanisms of renal endothelial toxicity of high glucose/glucose by-products, which encompass changes in synthesis of growth factors like TGF-β and VEGF, induction of oxidative stress and inflammation, and reduction of NO bioavailability. We finally present potential therapies to reduce endothelial dysfunction in diabetic kidney disease.
Published: 2019
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53. Severe renal insufficiency is not an absolute pitfall to autologous stem cell transplantation with BeEAM (bendamustine, etoposide, cytarabine, melphalan) conditioning regimen

Author: Geoffroy Venton, Raphaelle Fanciullino, Régis Costello, B Pourroy, Laure Farnault, P Roche, J Colle, N Jourde-Chiche, V Ivanov, Cédric Mercier, Robin Arcani, Theories and Approaches of Genomic Complexity (TAGC), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], and Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)
Subjects: Bendamustine, Oncology, medicine.medical_specialty, [SDV]Life Sciences [q-bio], 030226 pharmacology & pharmacy, Conditioning regimen, 03 medical and health sciences, 0302 clinical medicine, Autologous stem-cell transplantation, Internal medicine, Severity of illness, Medicine, Cytarabine/Melphalan, Etoposide, ComputingMilieux_MISCELLANEOUS, Transplantation, business.industry, Hematology, medicine.disease, 3. Good health, Lymphoma, 030220 oncology & carcinogenesis, Transplantation Conditioning, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, medicine.drug
Abstract: International audience
Published: 2019
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54. Emerging Roles of Aryl Hydrocarbon Receptors in the Altered Clearance of Drugs during Chronic Kidney Disease

Author: Tacy Santana Machado, Claire Cerini, Stéphane Burtey, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CAPES Foundation, Ministry of Education of Brazil, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Prémilleux, Annick, and Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM)
Subjects: Metabolic Clearance Rate, Health, Toxicology and Mutagenesis, [SDV]Life Sciences [q-bio], uremic toxins, Renal function, lcsh:Medicine, Review, Toxicology, Bioinformatics, urologic and male genital diseases, 030226 pharmacology & pharmacy, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Excretion, drug clearance, 03 medical and health sciences, 0302 clinical medicine, Animals, Humans, Medicine, Renal Insufficiency, Chronic, Medical prescription, Adverse effect, Receptor, 030304 developmental biology, 0303 health sciences, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, biology, business.industry, AhR, lcsh:R, Aryl hydrocarbon receptor, medicine.disease, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, female genital diseases and pregnancy complications, 3. Good health, [SDV] Life Sciences [q-bio], Pharmaceutical Preparations, Receptors, Aryl Hydrocarbon, biology.protein, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Clearance, Kidney disease
Abstract: International audience; Chronic kidney disease (CKD) is a major public health problem, since 300,000,000 people in the world display a glomerular filtration rate (GFR) below 60 mL/min/1.73m 2. Patients with CKD have high rates of complications and comorbidities. Thus, they require the prescription of numerous medications, making the management of patients very complex. The prescription of numerous drugs associated with an altered renal-and non-renal clearance makes dose adjustment challenging in these patients, with frequent drug-related adverse events. However, the mechanisms involved in this abnormal drug clearance during CKD are not still well identified. We propose here that the transcription factor, aryl hydrocarbon receptor, which is the cellular receptor for indolic uremic toxins, could worsen the metabolism and the excretion of drugs in CKD patients. Key Contribution: Patients with chronic kidney disease require the prescription of numerous medications. The alteration of renal-and non-renal clearance makes dose adjustment challenging in these patients, with frequent drug-related adverse events. We propose here that the transcription factor, an aryl hydrocarbon receptor, which is the cellular receptor for indolic uremic toxins, could worsen the metabolism and the excretion of drugs in CKD patients. Thus, the modulation of aryl hydrocarbon receptor (AhR) activity could be proposed as a possible and future potential target to modulate drug clearance in patients.
Published: 2019
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55. Endothelium structure and function in kidney health and disease

Author: Vincent Pernin, Claire Rigothier, Gilles Kaplanski, Jeremy Bellien, Pierre-André Jarrot, Lubka T. Roumenina, Marion Sallée, Stéphane Burtey, Dominique Guerrot, Moglie Le Quintrec, Véronique Frémeaux-Bacchi, Laetitia Dou, Noémie Jourde-Chiche, Fadi Fakhouri, Marie Frimat, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Immunotherapy in Transplantation And Autoimmunity (Team 3 - U1064 Inserm - CRTI), Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Service de pharmacologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Lille Inflammation Research International Center - U 995 (LIRIC), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Hôpital Lapeyronie [Montpellier] (CHU), Service de Néphrologie-transplantation-dialyse [Bordeaux], CHU Bordeaux [Bordeaux], Service d'immunologie biologique [Hôpital Européen Georges Pompidou [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Service de Néphrologie [Rouen], INSERM., Assistance Publique-Hôpitaux de Paris (AP-HP)-Programme Hospitaliser de Recherche Clinique (PHRC) AOM08198., Association pour l'Information et la Recherche sur les maladies rénales Génétiques., The French Society of Nephrology., A grant from Appel d'Offre de Recherche Clinique (AORC) 2011-A01347., Assistance Publique-Hôpitaux de Marseille (AP-HM)-PHRC grant 2012-A00217-36., ANR-15-CE15-0001,INFLACOMP,Inflammation et lésions endothéliales induites par le Complément et l'hémolyse(2015), European Project, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Centre recherche en CardioVasculaire et Nutrition (C2VN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Recherche Agronomique (INRA), Lille Inflammation Research International Center (LIRIC), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Service de Néphrologie et Transplantation rénale [CHRU-lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Médecine interne et immunologie clinique [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Service de Néphrologie, Dialyse et Transplantation (Hôpital Lapeyronie [Montpellier] CHU), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Bioingénierie tissulaire (BIOTIS), Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'immunologie [HEGP, Paris], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-École pratique des hautes études (EPHE), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Sorbonne Universités, Université Paris Descartes - Paris 5 (UPD5), The research was supported by grants from theAgence Nationale de la Recherche (ANR) JCJC–INFLACOMP2015–2018 (ANR-15-CE15-0001, to L.T.R.), INSERM (toL.T.R.), EU FP7 grant 2012–305608 (EURenOmics, to V.F.-B.), Assistance Publique-Hôpitaux de Paris (AP-HP)-Programme Hospitaliser de Recherche Clinique (PHRC)AOM08198 (to V.F.-B.), Association pour l'Information et laRecherche sur les maladies rénales Génétiques (AIRG) (toV.F.-B.), the French Society of Nephrology (to V.F.-B.), a grantfrom Appel d'Offre de Recherche Clinique (AORC) 2011-A01347 (to G.K.), and Assistance Publique-Hôpitaux deMarseille (AP-HM)-PHRC grant 2012-A00217-36 (to G.K.)., Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )-Assistance Publique - Hôpitaux de Marseille (APHM), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de pharmacologie [Rouen], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), École pratique des hautes études (EPHE)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Le Bihan, Sylvie, Inflammation et lésions endothéliales induites par le Complément et l'hémolyse - - INFLACOMP2015 - ANR-15-CE15-0001 - AAPG2015 - VALID, and EU FP7 grant 2012–305608 - INCOMING
Subjects: 0301 basic medicine, Pathology, medicine.medical_specialty, Endothelium, Angiogenesis, [SDV]Life Sciences [q-bio], TO-MESENCHYMAL TRANSITION, 030232 urology & nephrology, Kidney, urologic and male genital diseases, ANTIBODY-MEDIATED REJECTION, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, COMPLEMENT FACTOR-H, Podocyte, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Renal fibrosis, Medicine, Humans, DONOR-SPECIFIC ANTIBODIES, PROTEASE-ACTIVATED RECEPTOR-2, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, ANTIENDOTHELIAL CELL ANTIBODIES, Endothelial Cells, NEUTROPHIL EXTRACELLULAR TRAPS, medicine.disease, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 3. Good health, [SDV] Life Sciences [q-bio], 030104 developmental biology, medicine.anatomical_structure, Nephrology, Renal physiology, Glomerular Filtration Barrier, cardiovascular system, HEMOLYTIC-UREMIC SYNDROME, Kidney Diseases, RENAL VASCULAR DYSFUNCTION, business, GROWTH-FACTOR RECEPTOR, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Kidney disease
Abstract: International audience; The kidney harbours different types of endothelia, each with specific structural and functional characteristics. The glomerular endothelium, which is highly fenestrated and covered by a rich glycocalyx, participates in the sieving properties of the glomerular filtration barrier and in the maintenance of podocyte structure. The microvascular endothelium in peritubular capillaries, which is also fenestrated, transports reabsorbed components and participates in epithelial cell function. The endothelium of large and small vessels supports the renal vasculature. These renal endothelia are protected by regulators of thrombosis, inflammation and complement, but endothelial injury (for example, induced by toxins, antibodies, immune cells or inflammatory cytokines) or defects in factors that provide endothelial protection (for example, regulators of complement or angiogenesis) can lead to acute or chronic renal injury. Moreover, renal endothelial cells can transition towards a mesenchymal phenotype, favouring renal fibrosis and the development of chronic kidney disease. Thus, the renal endothelium is both a target and a driver of kidney and systemic cardiovascular complications. Emerging therapeutic strategies that target the renal endothelium may lead to improved outcomes for both rare and common renal diseases.
Published: 2019
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56. Myeloma cast nephropathy: the dusk of high cutoff haemodialysis

Author: Stéphane Burtey, Marion Sallée, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), and Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Oncology, 0303 health sciences, medicine.medical_specialty, business.industry, Bortezomib, Dusk, Hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Internal medicine, medicine, Cutoff, business, Myeloma cast nephropathy, Multiple myeloma, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 030304 developmental biology, medicine.drug
Abstract: International audience
Published: 2019
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57. Mechanisms of tissue factor induction by the uremic toxin indole-3 acetic acid through aryl hydrocarbon receptor/nuclear factor-kappa B signaling pathway in human endothelial cells

Author: Bertrand Gondouin, Françoise Dignat-George, Omar Kheroua, Kamel Eddine El Mecherfi, Nathalie McKay, Tawfik Addi, Stéphane Burtey, Alix de Macedo, Noémie Jourde-Chiche, Claire Cerini, Stéphane Poitevin, Laetitia Dou, Philippe Brunet, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université d'Oran 1 Ahmed Ben Bella [Oran], Université Mohamed Boudiaf de M'sila, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM), Hôpital Saint-Joseph [Marseille], Centre recherche en CardioVasculaire et Nutrition (C2VN), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Association des dialysés Provence-Corse (ADPC), DIGNAT-GEORGE, Françoise, and Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)
Subjects: Male, 0301 basic medicine, Health, Toxicology and Mutagenesis, [SDV]Life Sciences [q-bio], 010501 environmental sciences, Toxicology, Indole-3 acetic acid, 01 natural sciences, Umbilical vein, chemistry.chemical_compound, Chronic kidney disease, Basic Helix-Loop-Helix Transcription Factors, heterocyclic compounds, Prospective Studies, RNA, Small Interfering, Promoter Regions, Genetic, Cells, Cultured, ComputingMilieux_MISCELLANEOUS, Aryl hydrocarbon receptor, Aged, 80 and over, biology, NF-kappa B, food and beverages, General Medicine, Middle Aged, 3. Good health, [SDV] Life Sciences [q-bio], Gene Knockdown Techniques, Female, Signal transduction, Nuclear factor kappa-B, Signal Transduction, Adult, P50, p38 mitogen-activated protein kinases, Uremic toxins, Thromboplastin, Young Adult, 03 medical and health sciences, Tissue factor, Human Umbilical Vein Endothelial Cells, Humans, Renal Insufficiency, Chronic, Transcription factor, Aged, 0105 earth and related environmental sciences, Indoleacetic Acids, Molecular biology, 030104 developmental biology, Receptors, Aryl Hydrocarbon, chemistry, biology.protein, Indole-3-acetic acid
Abstract: International audience; Chronic kidney disease (CKD) is associated with high risk of thrombosis. Indole-3 acetic acid (IAA), an indolic uremic toxin, induces the expression of tissue factor (TF) in human umbilical vein endothelial cells (HUVEC) via the transcription factor aryl hydrocarbon receptor (AhR). This study aimed to understand the signaling pathways involved in AhR-mediated TF induction by IAA. We incubated human endothelial cells with IAA at 50 mu M, the maximal concentration found in patients with CKD. IAA induced TF expression in different types of human endothelial cells: umbilical vein (HUVEC), aortic (HAoEC), and cardiac-derived microvascular (HMVEC-C). Using AhR inhibition and chromatin immunoprecipitation experiments, we showed that TF induction by IAA in HUVEC was controlled by AhR and that AhR did not bind to the TF promoter. The analysis of TF promoter activity using luciferase reporter plasmids showed that the NF-B site was essential in TF induction by IAA. In addition, TF induction by IAA was drastically decreased by an inhibitor of the NF-B pathway. IAA induced the nuclear translocation of NF-B p50 subunit, which was decreased by AhR and p38MAPK inhibition. Finally, in a cohort of 92 CKD patients on hemodialysis, circulating TF was independently related to serum IAA in multivariate analysis. In conclusion, TF up-regulation by IAA in human endothelial cells involves a non-genomic AhR/p38 MAPK/NF-B pathway. The understanding of signal transduction pathways related to AhR thrombotic/inflammatory pathway is of interest to find therapeutic targets to reduce TF expression and thrombotic risk in patients with CKD.
Published: 2019
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58. Imbalance of Circulating Innate Lymphoid Cell Subpopulations in Patients With Septic Shock

Author: Julien Carvelli, Christelle Piperoglou, Jeremy Bourenne, Catherine Farnarier, Nathalie Banzet, Clemence Demerlé, Marc Gainnier, Frédéric Vély, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM), Assistance Publique - Hôpitaux de Marseille (APHM), Aix Marseille Université (AMU), Laboratoire d'Immunologie [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Centre National de la Recherche Scientifique (CNRS), Hôpital de la Timone [CHU - APHM] (TIMONE), Aix-Marseille Université - Faculté de pharmacie (AMU PHARM), Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Centre d'Immunologie de Marseille - Luminy (CIML), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), APHM, MSDAvenir, and institutional grants to the CIML (INSERM, CNRS, and Aix- Marseille University) and to Marseille Immunopole, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Centre recherche en CardioVasculaire et Nutrition (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM) Hôpital Timone Enfants, Service d'Immunologie - Marseille Immunopôle, Marseille, and Service de Réanimation des Urgences
Subjects: Adult, Male, lcsh:Immunologic diseases. Allergy, 0301 basic medicine, Secondary infection, Immunology, NK cells, [SDV.IMM.II]Life Sciences [q-bio]/Immunology/Innate immunity, Immunophenotyping, Sepsis, sepsis, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Immune system, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, medicine, Humans, Immunology and Allergy, Lymphocytes, IL-2 receptor, innate lymphoid cells (ILC), Aged, Aged, 80 and over, immunosuppression, Septic shock, business.industry, Innate lymphoid cell, FOXP3, Middle Aged, lymphopenia, medicine.disease, Clinical Trial, Shock, Septic, Immunity, Innate, 3. Good health, 030104 developmental biology, sepsis-induced immunosuppression, [SDV.IMM]Life Sciences [q-bio]/Immunology, septic shock, Female, lcsh:RC581-607, business, 030215 immunology
Abstract: International audience; Background: Septic shock, a major cause of death in critical care, is the clinical translation of a cytokine storm in response to infection. It can be complicated by sepsis-induced immunosuppression, exemplified by blood lymphopenia, an excess of circulating Treg lymphocytes, and decreased HLA-DR expression on circulating monocytes. Such immunosuppression is associated with secondary infections, and highermortality. The effect of these biologicalmodifications on circulating innate lymphoid cells (ILCs) has been little studied.Methods: We prospectively enrolled patients with septic shock (Sepsis-3 definition) in the intensive care unit (ICU) of Timone CHU Hospital. ICU controls (trauma, cardiac arrest, neurological dysfunction) were recruited at the same time (NCT03297203). We performed immunophenotyping of adaptive lymphocytes (CD3(+) T cells, CD19(+) B cells, CD4(+) CD25(+) FoxP3(+) Treg lymphocytes), ILCs (CD3(-)CD56(+) NK cells and helper ILCs - ILC1, ILC2, and ILC3), and monocytes by flow cytometry on fresh blood samples collected between 24 and 72 h after admission. Results: We investigated adaptive and innate circulating lymphoid cells in the peripheral blood of 18 patients in septic shock, 15 ICU controls, and 30 healthy subjects. As expected, the peripheral blood lymphocytes of all ICU patients showed lymphopenia, which was not specific to sepsis, whereas those of the healthy volunteers did not. Circulating CD3(+) T cells and CD3(-)CD56(+) NK cells were mainly concerned. There was a tendency toward fewer Treg lymphocytes and lower HLA-DR expression on monocytes in ICU patients with sepsis. Although the ILC1 count was higher in septic patients than healthy subjects, ILC2, and ILC3 counts were lower in both ICU groups. However, ILC3s within the total ILCs were overrepresented in patients with septic shock. The depression of immune responses has been correlated with the occurrence of secondary infections. We did not find any differences in ILC distribution according to this criterion.Conclusion: All ICU patients exhibit lymphopenia, regardless of the nature (septic or sterile) of the initial medical condition. Specific distribution of circulating ILCs, with an excess of ILC1, and a lack of ILC3, may characterize septic shock during the first 3 days of the disease.
Published: 2019
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59. Prognostic Factors in Anti-glomerular Basement Membrane Disease: A Multicenter Study of 119 Patients

Author: Cindy Marques, Julien Carvelli, Lucie Biard, Stanislas Faguer, François Provôt, Marie Matignon, Jean-Jacques Boffa, Emmanuelle Plaisier, Alexandre Hertig, Maxime Touzot, Olivier Moranne, Xavier Belenfant, Djillali Annane, Thomas Quéméneur, Jacques Cadranel, Hassan Izzedine, Nicolas Bréchot, Patrice Cacoub, Alexis Piedrafita, Noémie Jourde-Chiche, David Saadoun, Immunologie - Immunopathologie - Immunothérapie [CHU Pitié Salpêtrière] (I3), CHU Charles Foix [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), CHU Pitié-Salpêtrière [AP-HP], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance Publique - Hôpitaux de Marseille (APHM), Aix Marseille Université (AMU), Service de biostatistique et information médicale de l’hôpital Saint Louis (Equipe ECSTRA) (SBIM), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut national du cancer [Boulogne] (INCA)-Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Saint-Louis, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre d'investigation clinique de Toulouse (CIC 1436), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Pôle Santé publique et médecine publique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Groupe Henri Mondor-Albert Chenevier, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier, CHU Tenon [AP-HP], AURA Paris - Plaisance, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Hôpital Raymond Poincaré [AP-HP], Gestionnaire, Hal Sorbonne Université, Service de rhumatologie [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Département de médecine interne et immunologie clinique [CHU Pitié-Salpêtrière] (DMIIC), Centre National de Référence Maladies auto-immunes Systémiques Rares [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Pôle Santé publique et médecine publique [CHU Toulouse], Service d'Urgences néphrologiques et transplantation rénale [CHU Tenon], Service de Réanimation Médicale [CHU Pitié-Salpétrière], Centre National de Référence du Lupus Systémique, Syndrome des Anticorps Anti-phospholipides et Maladies Auto-immunes Systémiques Rares [CHU Pitié Salpêtrière], Service de Médecine Interne 2, maladies auto-immunes et systémiques [CHU Pitié-Salpêtrière], Institut E3M [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Institut E3M [CHU Pitié-Salpêtrière], Immunologie - Immunopathologie - Immunothérapie (I3), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Service de rhumatologie, inflammation-immunopathologie- biothérapie [CHU Saint-Antoine] (DHU i2B ), CHU Saint-Antoine [APHP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Service de médecine interne et d'immunologie clinique [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Centre recherche en CardioVasculaire et Nutrition (C2VN), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint Louis [APHP]-Institut national du cancer [Boulogne] (INCA), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7), Hôpital de Rangueil, CHU Toulouse [Toulouse], CIC - Toulouse (CIC 1436 - CHU de Toulouse/Inserm/UPS), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Pierre-Paul Riquet [Toulouse], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Hôpital Albert Chenevier, Urgences néphrologiques et transplantation rénale [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Hôpital Universitaire Carémeau [Nîmes], AP-HP Hôpital Raymond Poincaré [Garches], CHU Tenon [APHP], Service de médecine chirurgicale intensive [CHU Pitié-Salpêtrière], Centre National de Référence du Lupus Systémique, Syndrome des Anticorps Anti-phospholipides et Maladies Auto-immunes Systémiques Rares[CHU Pitié Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut national du cancer [Boulogne] (INCA)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut E3M [CHU Pitié-Salpêtrière]
Subjects: Male, 0301 basic medicine, anti-glomerular basement membrane disease, Goodpasture's disease, glomerulonephritis, vasculitis, outcome, mortality, medicine.medical_treatment, urologic and male genital diseases, Gastroenterology, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 0302 clinical medicine, Immunologie, Immunology and Allergy, Medicine, Original Research, hémorragie, Acute kidney injury, Middle Aged, Prognosis, 3. Good health, Cohort, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Rituximab, maladie rénale, France, medicine.drug, lcsh:Immunologic diseases. Allergy, Adult, medicine.medical_specialty, Cyclophosphamide, [SDV.IMM] Life Sciences [q-bio]/Immunology, pronostic, Immunology, 03 medical and health sciences, Internal medicine, Humans, Renal replacement therapy, Aged, Retrospective Studies, Mechanical ventilation, business.industry, medicine.disease, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 030104 developmental biology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Kidney Failure, Chronic, Plasmapheresis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, lcsh:RC581-607, business, Dyslipidemia, 030215 immunology
Abstract: International audience; We report the overall and renal outcome in a French nationwide multicenter cohort of 119 patients with anti-glomerular basement membrane (anti-GBM) disease. Sixty-four patients (54%) had an exclusive renal involvement, 7 (6%) an isolated alveolar hemorrhage and 48 (40%) a combined renal and pulmonary involvement. Initial renal replacement therapy (RRT) was required in 78% of patients; 82% received plasmapheresis, 82% cyclophosphamide, and 9% rituximab. ANCA positive (28%) patients were older (70 vs. 47 years, p < 0.0001), less frequently smokers (26 vs. 54%, p = 0.03), and had less pulmonary involvement than ANCA- patients. The 5 years overall survival was 92%. Risk factors of death (n = 11, 9.2%) were age at onset [HR 4.10 per decade (1.89–8.88) p = 0.003], hypertension [HR 19.9 (2.52–157 0.2) p = 0.005], dyslipidemia [HR 11.1 (2.72–45) p = 0.0008], and need for mechanical ventilation [HR 5.20 (1.02–26.4) p = 0.047]. The use of plasmapheresis was associated with better survival [HR 0.29 (0.08–0.98) p = 0.046]. At 3 months, 55 (46%) patients had end-stage renal disease (ESRD) vs. 37 (31%) ESRD-free and 27 (23%) unevaluable with follow-up < 3 months. ESRD patients were older, more frequently female and had a higher serum creatinine level at presentation than those without ESRD. ESRD-free survival was evaluated in patients alive without ESRD at 3 months (n = 37) using a landmark approach. In conclusion, this large French nationwide study identifies prognosis factors of renal and overall survival in anti-GBM patients.
Published: 2019
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60. Not only disease activity but also chronic hypertension and overweight are determinants of pregnancy outcomes in patients with systemic lupus erythematosus

Author: Normand, G., Sens, F., Puthet, J., Jourde-Chiche, Noemie, Lemoine, S., Chauveau, D., Moranne, O., Remy, P., Doret, M., Daugas, E., Juillard, L., French Collaborative Grp, Lupus, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Universitaire Européen de la Mer (IUEM), Institut de Recherche pour le Développement (IRD)-Institut national des sciences de l'Univers (INSU - CNRS)-Université de Brest (UBO)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Service de néphrologie et transplantation, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Institut de Recherche pour le Développement (IRD)-Université de Brest (UBO)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Université de Montpellier (UM)-Université Montpellier 1 (UM1), and Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)
Subjects: Hypertension, Renal, Perinatal Death, [SDV]Life Sciences [q-bio], Lupus nephritis, Kaplan-Meier Estimate, Overweight, fetal outcomes, Body Mass Index, 0302 clinical medicine, Pre-Eclampsia, Risk Factors, nephritis, 030212 general & internal medicine, 2. Zero hunger, Age Factors, Pregnancy Outcome, Stillbirth, Prognosis, statement, 3. Good health, classification, Female, France, pregnancy, women, medicine.symptom, Nephritis, Infant, Premature, Maternal Age, Adult, medicine.medical_specialty, Disease activity, Young Adult, 03 medical and health sciences, Rheumatology, Internal medicine, medicine, Humans, definition, In patient, Chronic hypertension, Proportional Hazards Models, Retrospective Studies, 030203 arthritis & rheumatology, Pregnancy, business.industry, Infant, Newborn, medicine.disease, Pregnancy Complications, predictors, Multivariate Analysis, business, chronic kidney disease
Abstract: Introduction Pregnancies in women with lupus nephritis are at high-risk of complications, while scarcity of scientific knowledge on prognostic factors impedes a fair medical counseling. We aimed to identify determinants associated with maternal and fetal complications. Materials We retrospectively reviewed medical charts of pregnancies that lasted more than 22 weeks in 66 patients with pre-existing lupus nephritis between 2004 and 2013 in France. Univariate and multivariate analyses were conducted to identify determinants for maternal complications, lupus renal flare and fetal prematurity or death. Results Eighty-four pregnancies were identified. A maternal complication occurred in 31 pregnancies (36.9%): mostly preeclampsia (17 pregnancies, 20.2%) and renal flares (12 pregnancies, 14.3%). Overall fetal survival was 94.0% (79/84). Maternal pregnancy complications were independently associated with prepregnancy body mass index >25 kg/m2 (OR 3.81, 95% CI 1.03–14.09) and immunological activity (positive anti-dsDNA antibodies or Farr assay lupus) (OR 4.95, 95% CI 1.33–18.43). Renal lupus flares were independently associated with maternal age (OR 1.50, 95% CI 1.12–2.01) and prepregnancy immunological activity (OR 15.99, 95% CI 1.57–162.68) while a remission time >12 months had a protective effect (OR 0.17, 95% CI 0.04–0.68). Three parameters were associated with a higher risk of fetal prematurity or death: a prepregnancy body mass index >25 kg/m2 (HR 3.58, 95% CI 1.45–8.83), hypertension (HR 8.97, 95% CI 3.32–24.25), and immunological activity (HR 3.34, 95% CI 1.30–8.63). Conclusion Maternal age, prepregnancy hypertension, body mass index >25 kg/m2 and lupus immunological activity may be considered as the main determinants for fetal and maternal complications. A remission time above 12 months for patients with lupus nephritis could be associated with a reduced risk of renal flare during pregnancy.
Published: 2019
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61. Comparing health-related quality of life in chronic diseases: the importance of analyzing references

Author: Christine Maynié-François, Stéphane Burtey, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM)
Subjects: Gerontology, Health related quality of life, medicine.diagnostic_test, business.industry, 030232 urology & nephrology, General Medicine, Anemia, Sickle Cell, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Chronic Disease, medicine, Quality of Life, Humans, 030212 general & internal medicine, business, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Genetic testing
Abstract: International audience
Published: 2019
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62. Female AhR Knockout Mice Develop a Minor Renal Insufficiency in an Adenine-Diet Model of Chronic Kidney Disease

Author: Stéphane Poitevin, Benjamin Guillet, Stéphane Burtey, Fanny Nicolas, Guillaume Hache, Camélia Makhloufi, Samantha Fernandez, Nathalie McKay, Philippe Garrigue, Philippe Brunet, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Aix Marseille Université (AMU), Centre Européen de Recherche en Imagerie médicale (CERIMED), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-École Centrale de Marseille (ECM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Centre National de la Recherche Scientifique (CNRS), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], and Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)
Subjects: Male, 0301 basic medicine, Xanthine Dehydrogenase, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, lcsh:Chemistry, Mice, chemistry.chemical_compound, 0302 clinical medicine, Gene expression, Basic Helix-Loop-Helix Transcription Factors, Medicine, Receptor, lcsh:QH301-705.5, Spectroscopy, Mice, Knockout, Sex Characteristics, biology, aryl hydrocarbon receptor, General Medicine, respiratory system, 3. Good health, Computer Science Applications, Knockout mouse, Female, medicine.medical_specialty, mouse model, Article, Catalysis, Inorganic Chemistry, 03 medical and health sciences, Internal medicine, Animals, Mortality, Renal Insufficiency, Chronic, Physical and Theoretical Chemistry, indoxyl sulfate, adenine, Molecular Biology, Creatinine, business.industry, Organic Chemistry, Metabolism, medicine.disease, Aryl hydrocarbon receptor, Diet, Disease Models, Animal, aryl hydrocarbon receptor, indoxyl sulfate, 030104 developmental biology, Endocrinology, Receptors, Aryl Hydrocarbon, lcsh:Biology (General), lcsh:QD1-999, chemistry, Xanthine dehydrogenase, biology.protein, business, chronic kidney disease, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Kidney disease
Abstract: Cardiovascular complications observed in chronic kidney disease (CKD) are associated with aryl hydrocarbon receptor (AhR) activation by tryptophan-derived uremic toxins&mdash, mainly indoxyl sulfate (IS). AhR is a ligand-activated transcription factor originally characterized as a receptor of xenobiotics involved in detoxification. The aim of this study was to determine the role of AhR in a CKD mouse model based on an adenine diet. Wild-type (WT) and AhR&minus, /&minus, mice were fed by alternating an adenine-enriched diet and a regular diet for 6 weeks. Our results showed an increased mortality rate of AhR&minus, males. AhR&minus, females survived and developed a less severe renal insufficiency that WT mice, reflected by urea, creatinine, and IS measurement in serum. The protective effect was related to a decrease of pro-inflammatory and pro-fibrotic gene expression, an attenuation of tubular injury, and a decrease of 2,8-dihydroxyadenine crystal deposition in the kidneys of AhR&minus, mice. These mice expressed low levels of xanthine dehydrogenase, which oxidizes adenine into 2,8-dihydroxyadenine, and low levels of the IS metabolism enzymes. In conclusion, the CKD model of adenine diet is not suitable for AhR knockout mice when studying the role of this transcription factor in cardiovascular complications, as observed in human CKD.
Published: 2020
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63. In Vivo Feasibility of Arterial Embolization with Permanent and Absorbable Suture: The FAIR-Embo Concept

Author: Vincent Vidal, Pauline Brige, Jean-François Hak, Benjamin Guillet, Mickaël Bobot, A Haffner, Jean-Michel Bartoli, Guy Moulin, A Jacquier, Gilles Soulez, Farouk Tradi, P. Gach, Sophie Chopinet, Département de Radiologie [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE), Centre Européen de Recherche en Imagerie médicale (CERIMED), Centre National de la Recherche Scientifique (CNRS)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-École Centrale de Marseille (ECM)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Laboratoire d'Imagerie Interventionnelle Expérimentale (LIIE), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de chirurgie générale et viscérale [Hôpital de la Timone - APHM], Centre recherche en CardioVasculaire et Nutrition (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Service d'Anatomie Pathologique et de Neuropathologie [Hôpital de la Timone - CHU - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Dpt Radiologie [Montréal], Université de Montréal [Montréal], Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), HOPITAL NORD MARSEILLE - APHM - SERV RADIOPHARM, Départment de Radiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-École Centrale de Marseille (ECM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Centre National de la Recherche Scientifique (CNRS), Department of Digestive Surgery University Hospital Timone, AP-HM, Département de Néphrologie et transplantation [Hôpital Saint Louis - APHP], Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Laboratoire d'Anatomie Pathologique-Neuropathologique [AP-HM Hôpital La Timone], Department of Radiology, Centre Hospitalier de l’Universite´ de Montre´al, Department of Radiopharmacy, AP-HM, Brige, Pauline, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), and Université de Montréal (UdeM)
Subjects: medicine.medical_specialty, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, Swine, medicine.medical_treatment, Life-threatening bleeding, [SDV]Life Sciences [q-bio], Absorbable suture, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Embolization, 0302 clinical medicine, Life-threatening bleeding Emerging countries, In vivo, Absorbable Implants, medicine, Animals, Radiology, Nuclear Medicine and imaging, Polyglactin 910, ComputingMilieux_MISCELLANEOUS, Kidney, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, medicine.diagnostic_test, Sutures, business.industry, Embolization Agent, Polyethylene Terephthalates, Arterial Embolization, Angiography, Digital Subtraction, Digital subtraction angiography, Arteries, Embolization, Therapeutic, 3. Good health, Surgery, Emerging countries, [SDV] Life Sciences [q-bio], Non-absorbable suture, medicine.anatomical_structure, [SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging, Treatment Outcome, Models, Animal, Feasibility Studies, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies
Abstract: International audience; Purpose Arterial embolization has been shown to be effective and safe for the management of bleeding, especially for postpartum and pelvic traumatic bleeding. We propose to evaluate the proof of concept of feasibility and effectiveness of arterial embolization with absorbable and non-absorbable sutures in a porcine model. Materials and Methods In the acute setting (n = 1), several different arteries (mesenteric, splenic, pharyngeal, kidney) were embolized using non-absorbable sutures (NAS): Mersutures braided sutures (polyethylene terephthalate). In the chronic setting (n = 3), only lower pole renal arteries were embolized. On the right side, NAS was used, whereas on the left side embolization was realized with absorbable suture (AS): Vicryl((R)) braided suture (polyglactin 910). The chronic group was followed for 3 months. The pigs received contrast-enhanced CT the day before embolization (D-1), after the embolization (D0), at 1 month and 3 months after embolization (M1 and M3); digital subtraction angiography (DSA) was done at D0 and M3 and histological analysis at M3. Results All vascular targets were effectively embolized without any pre- or postoperative complications. Both DSAs and CTs at M3 showed a 100% recanalization rate for the AS embolization and a partial reversal rate for the NAS embolization. A renal hypotrophy in the embolized region was observed during both the M1 and M3 scans for both sutures (AS and NAS) with a clear hypotrophy for the NAS embolized kidney. Conclusion Embolization by AS and NAS (FAIR-Embo) is a feasible and effective treatment which opens up the possibility of global use of this inexpensive and widely available embolization agent.
Published: 2018
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64. Thrombotic microangiopathy associated with gemcitabine use: Presentation and outcome in a national French retrospective cohort

Author: Julien Mancini, Pascale Poullin, Joëlle Micallef, Florence Daviet, Marion Sallée, Paul Coppo, Aurélie Grandvuillemin, Franck Rouby, Noémie Jourde-Chiche, Renaud Sabatier, Steven Grangé, Véronique Frémeaux-Bacchi, Bertrand Pourroy, Stéphane Burtey, Florence Duffaud, Julie Moussi-Frances, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )-Assistance Publique - Hôpitaux de Marseille (APHM), Centre régional de pharmacovigilance de Marseille [CHU de Marseille], CHU Marseille, Institut de Neurosciences des Systèmes (INS), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d\'hémaphérèse, Hôpital de la Conception, APHM, Marseille, France, Service d'hémaphérèse, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Centre recherche en CardioVasculaire et Nutrition (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Hôpital de la Timone [CHU - APHM] (TIMONE), Centre de Recherche en Cancérologie de Marseille (CRCM), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Aix Marseille Université (AMU), Service Pharmacie [Hôpital de la Timone - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Centre Régional de Pharmacovigilance, de Renseignement sur le Médicament et de Pharmaco épidémiologie de Bourgogne [Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de réanimation médicale [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHU Saint-Antoine [APHP], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre régional de pharmacovigilance de Marseille Provence Corse [CHU de Marseille] (CRPV-Marseille), Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de réanimation médicale [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM), CHU Marseille-Assistance Publique-Hôpitaux de Marseille (AP-HM), and Prémilleux, Annick
Subjects: Male, medicine.medical_specialty, Antimetabolites, Antineoplastic, Thrombotic microangiopathy, medicine.medical_treatment, [SDV]Life Sciences [q-bio], chemotherapy, 030226 pharmacology & pharmacy, Gastroenterology, Deoxycytidine, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Neoplasms, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Adverse effect, Dialysis, ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, Pharmacology, adverse drug reactions, business.industry, Thrombotic Microangiopathies, Acute kidney injury, Retrospective cohort study, Original Articles, Eculizumab, Middle Aged, medication safety, medicine.disease, Gemcitabine, 3. Good health, [SDV] Life Sciences [q-bio], acute kidney injury, pharmacovigilance, Female, Fresh frozen plasma, France, business, medicine.drug
Abstract: International audience; Aims Gemcitabine has been associated with thrombotic microangiopathy (TMA). We conducted a national retrospective study of gemcitabine-associated TMA (G-TMA). Methods From 1998 to 2015, all cases of G-TMA reported to the French Pharmacovigilance Network and the French TMA Reference Center, and cases explored for complement alternative pathway abnormalities, were analysed. Results G-TMA was diagnosed in 120 patients (median age 61.5 years), after a median of 210 days of treatment, and a cumulative dose of 12 941 mg m(-2). Gemcitabine indications were: pancreatic (52.9%), pulmonary (12.6%) and breast (7.6%) cancers, metastatic in 34.2% of cases. Main symptoms were oedema (56.7%) and new-onset or exacerbated hypertension (62.2%). Most patients presented with haemolytic anaemia (95.6%) and thrombocytopenia (74.6%). Acute kidney injury was reported in 97.4% and dialysis was required in 27.8% of patients. Treatment consisted of: plasma exchange (PE; 39.8%), fresh frozen plasma (21.4%), corticosteroids (15.3%) and eculizumab (5.1%). A complete remission of TMA was obtained in 42.1% of patients and haematological remission in 23.1%, while 34.7% did not improve. The survival status was known for 52 patients, with 29 deaths (54.7%). Patients treated with PE, despite a more severe acute kidney injury, requiring dialysis more frequently, displayed comparable rates of remission, but with more adverse events. No abnormality in complement alternative pathway was documented in patients explored. Conclusion This large cohort confirms the severity of G-TMA, associated with severe renal failure and death. Oedema and hypertension could be monitored in patients treated with gemcitabine to detect early TMA. The benefit of PE or eculizumab deserves further investigation.
Published: 2018
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65. Absence de bénéfice extra-osseux de doses élevées de vitamine D3 chez les transplantés rénaux dans une étude prospective, multicentrique, en double aveugle, randomisée

Author: S. Colas, N. Kamar, Corinne Alberti, Yannick Lemeur, Valérie Moal, Rebecca Sberro-Soussan, Laetitia Albano, Eric Thervet, Marie Courbebaisse, Antoine Thierry, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Physiologie - Clinique de la Dyspnée, Paris, URC, hôpital Necker Enfants Maladies, Paris, Service Néphrologie et transplantation rénale Adultes [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), CHRU Brest - Service de Nephrologie (CHU - BREST - Nephrologie), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Lymphocyte B et Auto-immunité (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Service de Néphrologie - Immunologie Clinique [Toulouse], CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse]-PRES Université de Toulouse, Service de Néphrologie, CHU Nice, Service de Néphrologie [CHU Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Département de Biostatistiques [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Néphrologie et Hémodialyse [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)
Subjects: 03 medical and health sciences, 0302 clinical medicine, Nephrology, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, 030204 cardiovascular system & hematology, ComputingMilieux_MISCELLANEOUS, 3. Good health
Abstract: Introduction De fortes doses de vitamine D3 (cholecalciferol, CL) ont ete preconisees pour reduire le risque de diabete de type 2, d’evenements cardiovasculaires majeurs (MACE) et de cancer, qui sont des complications frequentes chez les patients transplantes renaux (PTR). Patients/Materiels et methodes L’etude VITALE est un essai prospectif, multicentrique (30 departements Francais), en double aveugle, controle (NCT01431430). Les PTR adultes ayant des concentrations seriques de 25(OH)-vitamine D (25OHD) Observation/Resultats Entre janvier 2012 et decembre 2013, 536 PTR (âge moyen [ecart type] 50,8 [13,7] ans, 335 hommes) ont ete inclus. Les caracteristiques cliniques et biologiques de depart ne differaient pas entre les groupes DE (n = 269) et DF (n = 267). Dans les groupes DE et DF, la 25OHD etait de 20,2 (8,1) versus 19,2 (7,0) ng/mL a j0 et de 43,1 (12,8) versus 25,1 (7,4) ng/mL apres 24 mois, respectivement (p Discussion Nous rapportons les resultats du premier essai interventionnel visant a evaluer les effets extra-osseux du traitement par vitamine D3 apres transplantation renale. Le nombre de patients inclus correspond a notre objectif initial. Conclusion Par rapport aux ANC, de fortes doses de CL n’induisent pas d’effets indesirables notables mais ne reduisent pas l’incidence des complications non squelettiques apres transplantation renale.
Published: 2018
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66. Diagnosis and management of asymptomatic bacteriuria in kidney transplant recipients

Author: Coussement, Julien, Maggiore, Umberto, Manuel, Oriol, Scemla, Anne, López-Medrano, Francisco, Nagler, Evi, Aguado, José María, Abramowicz, Daniel, Adams, Brigitte, Agnelli, Caroline, Ailioaie, Oana, Akan, Hamdi, Amrouche, Lucile, Andrés, Amado, Anglicheau, Dany, Arnouts, Paul, Baas, Marije, Balgradean, Cristian, Bammens, Bert, Battaglia, Yuri, Baudoux, Thomas, Berto, Bert, Binet, Isabelle, Bistrup, Claus, Bonofiglio, Renzo, Bosmans, Jean-Louis, Bouatou, Yassine, Bouvier, Nicolas, Braconnier, Philippe, Bredewold, Edwin, Broeders, Nilufer, BRUNET, Philippe, Buchler, Matthias, Budde, Klemens, Buron, Fanny, Burtey, Stephane, Buscaroli, Andrea, Büttner, Stefan, Byrne, Catherine, Caldara, Rossana, Cassuto, Elisabeth, Catalano, Concetta, Cavaille, Guilhem, Corbel, Alice, Couzi, Lionel, Crespo, Marta, Daga, Sunil, Debellé, Frederic, Dedinska, Ivana, Devine, Paul, Dickenmann, Michael, Dratwa, Max, Drgona, Lubos, Durlik, Magdalena, Egidi, Maria Francesca, Errasti, Pedro, Etienne, Isabelle, Fariñas, María Carmen, Fehr, Thomas, Fernández-Ruiz, Mario, Founta, Paraskevi, Fourtounas, Konstantinos, Frangou, Eleni, Frimat, Luc, Furian, Luc, Garjau, Maria, Garrigue, Valérie, Gatault, Philippe, Geddes, Colin, Gerlinger, Paul, Gheuens, Eric, Ghisdal, Lidia, Gibbs, Paul, Giral, Magali, Girerd, Sophie, Golshayan, Dela, Gompou, Athina, Grossi, Paolo Antonio, Guglielmetti, Gabriele, Guirado, Luis, Hadaya, Karine, Hazzan, Marc, Helbert, Mark, Hellemans, Rachel, Heller, Katharina, Heemann, Uwe, Henckes, Manu, Hernandez, Domingo, Hertig, Alexandre, Hiesse, Christian, Hilbrands, Luuk, Hilton, Rachel, Hirzel, Cédric, Horcajada, Juan Pablo, Hougardy, Jean-Michel, Huynh-Do, Uyen, Idrizi, Alma, Ismaili, Khalid, Jiménez, Carlos, Jourde-Chiche, Noemie, Kamar, Nassim, Kaminski, Hannah, Kanter, Julia, Karras, Alexandre, Kemlin, Delphine, Kes, Petar, Kianda, Mireille, Klinger, Maria, Knight, Simon, Koneth, Irene, Krrashi, Anita, Kuypers, Dirk, Langlois, Anne, Lang, Philippe, Lauzurica, Ricardo, Le Moine, Alain, Lebeaux, David, Legendre, Christophe, Lemy, Anne, Len, Oscar, Liakopoulos, Vassilios, Lichodziejewska-Niemierko, Monika, Yague, Maria, Lopau, Kai, Madhoun, Philippe, Magott-Procelewska, Maria, Malik, Shafi, Montero, Anna Manonelles, Marchini, Marc, Marega, Alessandra, Mariat, Maria, Mark, Mark, Martin, Pierre-Yves, Martín, Leyre, Martín, Paloma Leticia, Massart, Annick, Matignon, Marie, Maurel, Stéphane, Mazuecos, Auxiliadora, Melexopoulou, Christina, Melilli, Edoardo, Merino, Esperanza, Mesic, Enisa, Messa, Piergiorgio, Michalak, Magdalena, Minetti, Enrico, Miserlis, Grigorios, Montejo, Miguel, Moriconi, Diego, Mottola, Clément, Mourad, Georges, Mueller, Thomas, Muñoz, Patricia, Nabokow, Alexander, Naesens, Maarten, Nikodimopoulou, Maria, Oberbauer, Rainer, Olmedo, María, Olsburgh, Jonathon, Oniscu, Gabriel, Øzbay, Lara Aygen, Palmisano, Alessandra, Papagianni, Aikaterini, Papasotiriou, Mario, Parodi, Angelica, Parry, Rob, Pascual, Julio, Flores, Isabel Pérez, Pérez-Sáez, María, Peruzzi, Licia, Petit-Hoang, Camille, Phelan, Paul, Pillebout, Evangeline, Piotti, Giovanni, Pipeleers, Lissa, Pleros, Christos, Popoola, Joyce, Pretagostini, Renzo, Psimenou, Erasmia, Puig, Josep, Rafat, Cédric, Bloudickova, Silvie Rajnochova, Bushljetikj, Irena Rambabova, Ratkovic, Marina, Redondo, Dolores, Reischig, Tomas, Robert, Thomas, Ferrero, Luis, Rroji, Merita, Rutkowski, Przemyslaw, Rydzewska-Rosolowska, Alicja, Sabé, Núria, Sahali, Dil, Salzberger, Bernd, San-Juan, Rafael, Sobrino, Beatriz Sánchez, Sandrini, Silvio, Santos, Lídia, Sava, Roxana, Schaub, Stefan, Schikowski, Johan, Schvartz, Betoul, Sester, Urban, Silva, Jose Tiago, Snanoudj, Renaud, Somenzi, Danio, Sørensen, Søren, Spanos, Georgios, Steiger, Jürg, Suwelack, Barbara, Theodoropoulou, Eleni, Thervet, Eric, Thorban, Stefan, Tognarelli, Giuliana, Tournay, Yasmina, Tricot, Leïla, Tulissi, Patrizia, Vacher-Coponat, Henri, Valerio, Maricela, Van Der Meijden, W, Van Hamersvelt, Henk, Van Laecke, Steven, Vandivinit, Alain, Vanholder, Raymond, Veroux, Massimiliano, Viklicky, Ondrej, Vigo, Emanuela, Viscoli, Claudio, Watschinger, W, Weekers, W, Welberry Smith, W, Martin, W, Zeneli, Nereida, Zervos, Angelos, Zibar, Lada, Zuber, Julien, Zukunft, Bianca, Nephrology, Department Infections Diseases, Université Libre de Bruxelles [Bruxelles] (ULB), Azienda Ospedaliero-Universitaria di Parma, Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Réseau CENTAURE, Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Service Néphrologie et transplantation rénale Adultes [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Bases moléculaires de la réponse aux xénobiotiques (U775 (IFR95)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut d’Électronique, de Microélectronique et de Nanotechnologie (IEMN) - UMR 8520 (IEMN), Centre National de la Recherche Scientifique (CNRS)-Université de Lille-Université Polytechnique Hauts-de-France (UPHF)-Ecole Centrale de Lille-Université Polytechnique Hauts-de-France (UPHF)-Institut supérieur de l'électronique et du numérique (ISEN), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Department of Nephrology, Humboldt Universität zu Berlin, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Centre recherche en CardioVasculaire et Nutrition (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de néphrologie, Hôpital Pasteur [Nice] (CHU), Hôpital de Brabois, CHU de Nancy, Vandoeuvre-lès-Nancy, Service de Néphrologie-transplantation-dialyse [Bordeaux], CHU Bordeaux [Bordeaux], Laboratoire des interactions plantes micro-organismes (LIPM), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Recherche Agronomique (INRA), CHU Rouen, Normandie Université (NU), Unit Infectious Diseases, Hospital 12 de Octubre, Service de Néphrologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Pédiatrie spécialisée, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Université de Lille, Department of Pulmonary Medicine, Tampere University Hospital, Urgences néphrologiques et transplantation rénale [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Service de néphrologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Swiss Transplantation Cohort Study, University of Basel (Unibas), Department of Nephrology and Hypertension, and Department of Clinical Research, University of Bern, Centro de Investigación en Ciencias del Mar y Limnología (CIMAR), Universidad Nacional de Costa Rica, Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Université de Bordeaux (UB), Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Department of Medicine, Division of Hematology-Oncology, University of Pennsylvania [Philadelphia], Department of Nephrology and Renal Transplantation, University Hospitals Leuven [Leuven]-Catholic University Leuven, Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes (UGA), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Service de néphrologie adultes [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Centre de Recherches Pétrographiques et Géochimiques (CRPG), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Division of Nephrology, Maggiore Hospital, IRCCS Foundation, Milano, Université de Lorraine (UL), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Clinical Microbiology and Infectious Diseases Department, Universidad Complutense de Madrid [Madrid] (UCM), University Hospitals Leuven [Leuven], Department of Internal Medicine III, Medizinische Universität Wien = Medical University of Vienna, Service de rhumatologie, Kidney and Pancreas Transplantation, Department d'enginyeria quimica agraria i tecnologia agroalimentaria, Universitat de Girona (UdG), Néphrologie Transplantation, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris (AP-HP), Section of Microbiology [Copenhagen], Department of Biology [Copenhagen], Faculty of Science [Copenhagen], University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU)-Faculty of Science [Copenhagen], University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU), University Hospital Basel [Basel], Service Néphrologie Transplantation Rénale, Hôpital Foch [Suresnes], Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )-Assistance Publique - Hôpitaux de Marseille (APHM), Renal Division, Freiburg University Medical Center, Nephrology Section [Ghent], Ghent University Hospital, Dept. of Nephrology, Institute for Clinical and Experimental Medicine, Division of Infectious Diseases, University of Genoa (UNIGE)-San Martino University Hospital, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université libre de Bruxelles (ULB), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut d’Électronique, de Microélectronique et de Nanotechnologie - UMR 8520 (IEMN), Centrale Lille-Institut supérieur de l'électronique et du numérique (ISEN)-Université de Valenciennes et du Hainaut-Cambrésis (UVHC)-Université de Lille-Centre National de la Recherche Scientifique (CNRS)-Université Polytechnique Hauts-de-France (UPHF), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Humboldt University Of Berlin, Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Université de Mons (UMons), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), University of Pennsylvania, Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH)-Faculty of Science [Copenhagen], University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Universitäts Klinikum Freiburg = University Medical Center Freiburg (Uniklinik), Università degli studi di Genova = University of Genoa (UniGe)-San Martino University Hospital, ERA-EDTA, ESCMID, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Humboldt-Universität zu Berlin, Institut National de la Recherche Agronomique (INRA)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut national des sciences de l'Univers (INSU - CNRS)-Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], Service d'Urgences néphrologiques et transplantation rénale [CHU Tenon], Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), and San Martino University Hospital-University of Genoa (UNIGE)
Subjects: Nephrology, Male, Cross-sectional study, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Practice Patterns, 030230 surgery, Antimicrobial stewardship, urologic and male genital diseases, 0302 clinical medicine, Surveys and Questionnaires, Bacteriuria/diagnosis, Medicine, Practice Patterns, Physicians'/statistics & numerical data, Practice Patterns, Physicians', Asymptomatic Infections, Kidney transplantation, ComputingMilieux_MISCELLANEOUS, Asymptomatic bacteriuria, Questionnaire, Transplantation, Urinary tract infection, Adult, Anti-Bacterial Agents, Bacteriuria, Cross-Sectional Studies, Europe, Female, Humans, Kidney Transplantation, Transplant Recipients, Response rate (survey), Kidney Transplantation/adverse effects, 16. Peace & justice, 3. Good health, medicine.medical_specialty, Asymptomatic Infections/epidemiology, Europe/epidemiology, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, Internal medicine, Dialysis, Physicians', business.industry, medicine.disease, Anti-Bacterial Agents/therapeutic use, Human medicine, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business
Abstract: Background Asymptomatic bacteriuria is frequent in kidney transplant recipients (KTRs). However, there is no consensus on diagnosis or management. We conducted a European survey to explore current practice related to the diagnosis and management of asymptomatic bacteriuria in adult KTRs. Methods A panel of experts from the European Renal Association-European Dialysis Transplant Association/Developing Education Science and Care for Renal Transplantation in European States working group and the European Study Group for Infections in Compromised Hosts of the European Society of Clinical Microbiology and Infectious Diseases designed this cross-sectional, questionnaire-based, self-administered survey. Invitations to participate were e-mailed to European physicians involved in the care of KTRs. Results Two hundred and forty-four participants from 138 institutions in 25 countries answered the survey (response rate 30%). Most participants [72% (176/244)] said they always screen for asymptomatic bacteriuria in KTRs. Six per cent (15/240) reported never treating asymptomatic bacteriuria with antibiotics. When antimicrobial treatment was used, 24% of the participants (53/224) said they would start with empirical antibiotics. For an episode of asymptomatic bacteriuria caused by a fully susceptible microorganism and despite no contraindications, a majority of participants (121/223) said they would use a fluoroquinolone (n = 56), amoxicillin/clavulanic acid (n = 38) or oral cephalosporins (n = 27). Conclusions Screening for and treating asymptomatic bacteriuria are common in KTRs despite uncertainties around the benefits and harms. In an era of antimicrobial resistance, further studies are needed to address the diagnosis and management of asymptomatic bacteriuria in these patients.
Published: 2018
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67. Comparison of individually tailored versus fixed-schedule rituximab regimen to maintain ANCA-associated vasculitis remission: results of a multicentre, randomised controlled, phase III trial (MAINRITSAN2)

Author: Charles, Pierre, Terrier, Benjamin, Perrodeau, Elodie, Cohen, Pascal, Faguer, Stanislas, Huart, Antoine, Hamidou, Mohamed, Agard, Christian, Bonnotte, Bernard, Samson, Maxime, Karras, Alexandre, Jourde-Chiche, Noémie, Lifermann, François, Gobert, Pierre, Hanrotel-Saliou, Catherine, Godmer, Pascal, MARTIN-SILVA, nicolas, Pugnet, Grégory, Matignon, Marie, Aumaître, Olivier, Viallard, Jean-François, Maurier, François, Meaux-Ruault, Nadine, Rivière, Sophie, Sibilia, Jean, Puéchal, Xavier, Ravaud, Philippe, Mouthon, Luc, Guillevin, Loïc, for the French Vasculitis Study Group,, Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Institut Mutualiste de Montsouris (IMM), CHU Cochin [AP-HP], Université Paris Descartes - Paris 5 (UPD5), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Centre d'épidémiologie Clinique [Hôtel-Dieu], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Hôtel Dieu, Université Sorbonne Paris Cité (USPC), Département de Néphrologie et Transplantation d'organes, Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Service de médecine interne [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (HOTE GREFFON), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-France-Comté] (EFS [Bourgogne-France-Comté])-Université de Franche-Comté (UFC), Service de médecine interne et immunologie clinique (SOC 1) [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Service de Médecine Interne [Dax], Centre Hospitalier de Dax, Centre Hospitalier Henri Duffaut, CHRU - Service de néphrologie, dialyse et transplantation rénale, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Médecine interne - Maladies hématologiques - Maladies infectieuses [Vannes], Centre Hospitalier Bretagne Atlantique [Vannes], Service de médecine interne [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU), Service de Médecine Interne, Centre Hospitalier Universitaire de Toulouse, PRES Université de Toulouse, Service de néphrologie [CHU Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Henri Mondor, Service de médecine interne, hôpital Gabriel-Montpied, CHU Clermont-Ferrand, Service de médecine interne et maladies infectieuses [Bordeaux], CHU Bordeaux [Bordeaux]-Groupe hospitalier Saint-André, Service de médecine interne [hôpitaux privés de Metz], Hôpitaux Privés de Metz (HPMetz), Service de médecine interne (Med Int - BESANCON), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Jean Minjoz, Département de médecine interne, centre d'investigation clinique, CHU de Montpellier, Service de rhumatologie [Strasbourg], CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Cochin [AP-HP], Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Hôtel Dieu, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre Hospitalier Henri Duffaut (Avignon), Centre hospitalier Bretagne Atlantique (Morbihan) (CHBA), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Henri Mondor, Service de Médecine Interne [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), and Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)
Subjects: Male, Birmingham Vasculitis Activity Score, Kaplan-Meier Estimate, CD19+ B lymphocytes, Severity of Illness Index, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Recurrence, Clinical endpoint, Immunology and Allergy, 030212 general & internal medicine, Precision Medicine, Infusions, Intravenous, microscopic polyangiitis, ANCA, Remission Induction, Middle Aged, 3. Good health, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antirheumatic Agents, Rituximab, Female, Drug Monitoring, Microscopic polyangiitis, Granulomatosis with polyangiitis, medicine.drug, Adult, medicine.medical_specialty, Cyclophosphamide, Immunology, B-Lymphocyte Subsets, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, ANCA vasculitis, General Biochemistry, Genetics and Molecular Biology, Drug Administration Schedule, Antibodies, Antineutrophil Cytoplasmic, 03 medical and health sciences, Rheumatology, Internal medicine, medicine, Humans, Lymphocyte Count, Aged, 030203 arthritis & rheumatology, granulomatosis with polyangiitis, business.industry, medicine.disease, Regimen, business, Biomarkers
Abstract: ObjectiveTo compare individually tailored, based on trimestrial biological parameter monitoring, to fixed-schedule rituximab reinfusion for remission maintenance of antineutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAVs).MethodsPatients with newly diagnosed or relapsing granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) in complete remission after induction therapy were included in an open-label, multicentre, randomised controlled trial. All tailored-arm patients received a 500 mg rituximab infusion at randomisation, with rituximab reinfusion only when CD19+B lymphocytes or ANCA had reappeared or ANCA titre rose markedly based on trimestrial testing until month 18. Controls received a fixed 500 mg rituximab infusion on days 0 and 14 postrandomisation, then 6, 12 and 18 months after the first infusion. The primary endpoint was the number of relapses (new or reappearing symptom(s) or worsening disease with Birmingham Vasculitis Activity Score (BVAS)>0) at month 28 evaluated by an independent Adjudication Committee blinded to treatment group.ResultsAmong the 162 patients (mean age: 60 years; 42% women) included, 117 (72.2%) had GPA and 45 (27.8%) had MPA. Preinclusion induction therapy included cyclophosphamide for 100 (61.7%), rituximab for 61 (37.6%) and methotrexate for 1 (0.6%). At month 28, 21 patients had suffered 22 relapses: 14/81 (17.3%) in 13 tailored-infusion recipients and 8/81 (9.9%) in 8 fixed-schedule patients (p=0.22). The tailored-infusion versus fixed-schedule group, respectively, received 248 vs 381 infusions, with medians (IQR) of 3 (2–4) vs 5 (5–5) administrations.ConclusionAAV relapse rates did not differ significantly between individually tailored and fixed-schedule rituximab regimens. Individually tailored-arm patients received fewer rituximab infusions.Trial registration numberNCT01731561; Results.
Published: 2018
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68. Aryl hydrocarbon receptor is activated in patients and mice with chronic kidney disease

Author: Marion Sallée, Tawfik Addi, Stéphane Burtey, Françoise Dignat-George, Claire Cerini, Philippe Brunet, A. Duval-Sabatier, Michael S. Denison, Bertrand Gondouin, Stéphane Poitevin, Laetitia Dou, Nathalie McKay, Noémie Jourde-Chiche, Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre recherche en CardioVasculaire et Nutrition (C2VN), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), and Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM)
Subjects: 0301 basic medicine, Male, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, urologic and male genital diseases, 0302 clinical medicine, Risk Factors, Cause of Death, Basic Helix-Loop-Helix Transcription Factors, Prospective Studies, Prospective cohort study, ComputingMilieux_MISCELLANEOUS, Whole blood, Aged, 80 and over, Mice, Knockout, biology, respiratory system, Middle Aged, Phenotype, female genital diseases and pregnancy complications, Nephrectomy, 3. Good health, Treatment Outcome, Nephrology, Cardiovascular Diseases, Female, Adult, medicine.medical_specialty, Mice, 129 Strain, 03 medical and health sciences, Renal Dialysis, Internal medicine, medicine.artery, Cell Line, Tumor, medicine, Cytochrome P-450 CYP1A1, Animals, Humans, Renal Insufficiency, Chronic, Transcription factor, Aged, Aorta, business.industry, Aryl hydrocarbon receptor, medicine.disease, respiratory tract diseases, Mice, Inbred C57BL, Repressor Proteins, Disease Models, Animal, 030104 developmental biology, Endocrinology, Receptors, Aryl Hydrocarbon, Case-Control Studies, biology.protein, business, Indican, Kidney disease
Abstract: Patients with chronic kidney disease (CKD) are exposed to uremic toxins and have an increased risk of cardiovascular disease. Some uremic toxins, like indoxyl sulfate, are agonists of the transcription factor aryl hydrocarbon receptor (AHR). These toxins induce a vascular procoagulant phenotype. Here we investigated AHR activation in patients with CKD and in a murine model of CKD. We performed a prospective study in 116 patients with CKD stage 3 to 5D and measured the AHR-Activating Potential of serum by bioassay. Compared to sera from healthy controls, sera from CKD patients displayed a strong AHR-Activating Potential; strongly correlated with eGFR and with the indoxyl sulfate concentration. The expression of the AHR target genes Cyp1A1 and AHRR was up-regulated in whole blood from patients with CKD. Survival analyses revealed that cardiovascular events were more frequent in CKD patients with an AHR-Activating Potential above the median. In mice with 5/6 nephrectomy, there was an increased serum AHR-Activating Potential, and an induction of Cyp1a1 mRNA in the aorta and heart, absent in AhR –/– CKD mice. After serial indoxyl sulfate injections, we observed an increase in serum AHR-AP and in expression of Cyp1a1 mRNA in aorta and heart in WT mice, but not in AhR –/– mice. Thus, the AHR pathway is activated both in patients and mice with CKD. Hence, AHR activation could be a key mechanism involved in the deleterious cardiovascular effects observed in CKD.
Published: 2018
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69. Diagnostic performance of [ 18 F]fluorodeoxyglucose positron emission tomography–computed tomography in cyst infection in patients with autosomal dominant polycystic kidney disease

Author: Bertrand Gondouin, Marion Sallée, Serge Cammilleri, Tristan Legris, P. Souteyrand, C. Ghez, Mickaël Bobot, Stéphane Burtey, Noémie Jourde-Chiche, Bertrand Dussol, L. Tessonnier, Yvon Berland, Pierre-Edouard Fournier, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM), ESCMID (ESCAR), ESCMID [Basel], European Network for Surveillance of Tick-Borne Diseases, European Community, Unité des Rickettsies et pathogènes émergents (URPE), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, and Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Adult, Male, Microbiology (medical), medicine.medical_specialty, 030232 urology & nephrology, Autosomal dominant polycystic kidney disease, Infections, Sensitivity and Specificity, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Fluorodeoxyglucose F18, medicine, Humans, Cyst, Hospitals, Teaching, Aged, Retrospective Studies, Fluorodeoxyglucose, Staining and Labeling, medicine.diagnostic_test, Cysts, business.industry, Magnetic resonance imaging, General Medicine, Middle Aged, Polycystic Kidney, Autosomal Dominant, medicine.disease, Magnetic Resonance Imaging, 3. Good health, Contrast medium, Infectious Diseases, Positron-Emission Tomography, Hypermetabolism, Female, France, Radiology, Differential diagnosis, Tomography, X-Ray Computed, Complication, business, medicine.drug
Abstract: International audience; Cyst infection is a common complication of autosomal dominant polycystic kidney disease (ADPKD). Diagnosis is challenging with standard imaging techniques. We aimed to evaluate the diagnostic performance of [F-18] fluorodeoxyglucose positron emission tomography-computed tomography (18-FDG PET-CT) for the diagnosis of cyst infections among ADPKD patients, in comparison with computed tomography (CT) and magnetic resonance imaging (MRI). All APKD patients who underwent 18-FDG PET-CT for suspected cyst infection between 2006 and 2013 in a French teaching hospital were included. Diagnosis of cyst infection was retained a posteriori on an index of clinical suspicion. 18-FDG PET-CT findings were was considered to be positive in cases of cyst wall hypermetabolism. CT or MRI findings were were considered to be positive in cases of cyst wall thickening (and enhancement if contrast medium was injected) and infiltration of the adjacent fat. A control group of ADPKD patients with 18-FDG PET-CT performed for other reasons was included. Thirty-two 18-FDG PET-CT scans were performed in 24 ADPKD patients with suspected cyst infection. A diagnosis of cyst infection was retained in 18 of 32 cases: 14 with positive 18-FDG PET-CT findings, and four false negatives. There were no false positives and no hypermetabolism of cyst walls in nine ADPKD control patients. 18-FDG PET-CT had a sensitivity of 77%, a specificity of 100%, and a negative predictive value of 77%. 18-FDG PET-CT allowed a differential diagnosis in three patients. In contrast, CT had a sensitivity of 7% and a negative predictive value of 35% (p < 0.001 vs. 18-FDG PET-CT). Only eight MRI scans were performed. The diagnostic performance of 18-FDG PET-CT is superior to that of CT in cyst infections, for comparable radiation doses and with no injection of nephrotoxic contrast medium, in ADPKD patients. (C) 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Published: 2016
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70. Development of a risk stratification algorithm to improve patient-centered care and decision making for incident elderly patients with end-stage renal disease

Author: Jean-Claude Aldigier, Philippe Brunet, Olivier Moranne, Cécile Couchoud, Jean-Baptiste R. Beuscart, Agence de la biomédecine [Saint-Denis la Plaine], Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Néphrologie, Dialyse, Transplantations [CHU Limoges], CHU Limoges, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP), and Université Montpellier 1 (UM1)-Université de Montpellier (UM)
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Decision Making, Logistic regression, Risk Assessment, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, End stage renal disease, Patient-Centered Care, Epidemiology, Humans, Medicine, Registries, Renal replacement therapy, Intensive care medicine, Dialysis, Aged, business.industry, Incidence, Incidence (epidemiology), Middle Aged, Prognosis, 3. Good health, Renal Replacement Therapy, Nephrology, Emergency medicine, Cohort, Kidney Failure, Chronic, Female, France, business, Risk assessment, Algorithms
Abstract: International audience; A significant number of elderly patients die during their first 3 months of dialysis. Because dialysis can impair the quality of both life and death, a personalized care plan based on both early prognosis and patient choices is required. We developed a prognostic screening tool to identify older patients in need of specific care based on a multidisciplinary approach. Our study included 24,348 patients aged 75 years and older from the French national renal epidemiology and information network (REIN) registry who began dialysis between 1 January 2005 and 30 September 2012. Our primary outcome was overall mortality during the first 3 months of renal replacement therapy. Multivariate logistic regression was used to construct a scoring system in a random half of the cohort (training set). This score, which included age, gender, specific comorbidities, albumin levels, and mobility, was then applied to the other half (validation set). In all, 2548 patients died during the first 3 months after dialysis initiation, 22% after dialysis withdrawal. Three risk groups were identified: low risk (score under 12 points, 3-month expected mortality under 20%), intermediate risk (score from 12 to 16, mortality between 20 and 40%, 9.5% of patients) and high risk (score 17 or more, mortality over 40%, 2.5% of patients). We developed a decision-making process that classifies patients according to their risk of early death in view of their potentially imminent need for supportive care or treatment.
Published: 2015
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71. Specialists to the Rescue of Oncologists for the Management of Toxicity Occurring Under Combination of Anticancer Therapies

Author: Thomas Chevalier, Stéphane Burtey, Fabrice Barlesi, Aix Marseille Université (AMU), Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Simulation and Modeling of Adaptive Response for Therapeutics in Cancer (SMARTc), Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'oncologie multidisciplinaire innovations thérapeutiques [Hôpital Nord - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Centre recherche en CardioVasculaire et Nutrition (C2VN), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Paoli-Calmettes, and Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Aix Marseille Université (AMU)
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, MEDLINE, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Oncology, Toxicity, medicine, 030212 general & internal medicine, Intensive care medicine, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2018
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72. Home Dialysis: is patient autonomy for an artificial organ possible?

Author: BRUNET, Philippe, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and ProdInra, Migration
Subjects: HEMODIALYSIS, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, PERITONEAL DIALYSIS, [SDV]Life Sciences [q-bio], DIALYSIS, HOME, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; The best way to make a dialysis patient autonomous is to have his dialysis done himself at home, either by ``home'' hemodialysis (HD) or by peritoneal dialysis (PD). Home HD has been performed since the 1970s. Its maximum was reached in the 1980s with 20% of dialysis patients in some facilities. Then the percentage decreased in France probably because of renal transplantation and self-dialysis units. Currently there is renewed interest in this method due to the arrival of new simplified machines and due to new short daily dialysis programs. PD began in the 1980s. It developed in an inhomogeneous way in France, for questions of medical care traditions. Currently it is a mature treatment and the survivals in PD and HD are equivalent. France is among the European countries where home HD and PD have the lowest prevalence. The levers of action to try to develop home dialysis in France are reviewed. Professional incentives have shown their limits and it is likely that regulatory or financial incentives are now needed alongside a proactive policy.
Published: 2018

73. Tryptophan-Derived Uremic Toxins and Thrombosis in Chronic Kidney Disease

Author: Tawfik Addi, Stéphane Burtey, Laetitia Dou, Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM), Centre recherche en CardioVasculaire et Nutrition (C2VN), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), and Prémilleux, Annick
Subjects: insuffisance rénale, Health, Toxicology and Mutagenesis, medicine.medical_treatment, [SDV]Life Sciences [q-bio], uremic toxins, 030232 urology & nephrology, lcsh:Medicine, Review, 030204 cardiovascular system & hematology, Pharmacology, Toxicology, chemistry.chemical_compound, 0302 clinical medicine, néphrologie, tryptophane, Platelet, Endothelial dysfunction, thrombose, uremie, biology, Microbiota, Thrombosis, 3. Good health, [SDV] Life Sciences [q-bio], toxine, Alimentation et Nutrition, Hemodialysis, 03 medical and health sciences, Tissue factor, medicine, Animals, Humans, Food and Nutrition, tryptophan, Renal Insufficiency, Chronic, thrombosis, Toxicologie, Toxins, Biological, Uremia, business.industry, approche thérapeutique, maladie chronique, lcsh:R, Aryl hydrocarbon receptor, medicine.disease, Diet, chemistry, biology.protein, business, chronic kidney disease, Kynurenine, Kidney disease
Abstract: International audience; Patients with chronic kidney disease (CKD) display an elevated risk of thrombosis. Thrombosis occurs in cardiovascular events, such as venous thromboembolism, stroke, and acute coronary syndrome, and is a cause of hemodialysis vascular access dysfunction. CKD leads to the accumulation of uremic toxins, which exerts toxic effects on blood and the vessel wall. Some uremic toxins result from tryptophan metabolization in the gut through the indolic and the kynurenine pathways. An increasing number of studies are highlighting the link between such uremic toxins and thrombosis in CKD. In this review, we describe the thrombotic mechanisms induced by tryptophan-derived uremic toxins (TDUT). These mechanisms include an increase in plasma levels of procoagulant factors, induction of platelet hyperactivity, induction of endothelial dysfunction/impairment of endothelial healing, decrease in nitric oxide (NO) bioavailability, and production of procoagulant microparticles. We focus on one important prothrombotic mechanism: The induction of tissue factor (TF), the initiator of the extrinsic pathway of the blood coagulation. This induction occurs via a new pathway, dependent on the transcription factor Aryl hydrocarbon receptor (AhR), the receptor of TDUT in cells. A better understanding of the prothrombotic mechanisms of uremic toxins could help to find novel therapeutic targets to prevent thrombosis in CKD.
Published: 2018
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74. Hemodialysis vascular graft as a focus of persistent Q fever

Author: Pierre-Edouard Fournier, Didier Raoult, Eric Guedj, Vincent Ernest, Yvon Berland, Raafat Boustani, Cindy Perron, Serge Cammilleri, Stéphane Burtey, Valérie Moal, Noémie Jourde-Chiche, M. Pelletier, Mathilde Fedi, Clarissa Von Kotze, Philippe Brunet, Philippe Amabile, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )-Assistance Publique - Hôpitaux de Marseille (APHM), Hôpital de la Timone [CHU - APHM] (TIMONE), Centre recherche en CardioVasculaire et Nutrition (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Department of nuclear medicine aphm Timone, Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), HOPITAL DE MANOSQUE, Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), Département de Médecine Nucléaire [AP-HM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)- Hôpital Nord [CHU - APHM], Université Bordeaux Segalen - Bordeaux 2, Service de médecine nucléaire [Marseille], Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Institut Hospitalier Universitaire Méditerranée Infection (IHU AMU), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM), Institut de Recherche Biomédicale des Armées (IRBA)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Imagerie MOléculaire pour applications THéranostiques personnalisées (IMOTHEP), Institut FRESNEL (FRESNEL), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS)- Hôpital de la Timone [CHU - APHM] (TIMONE), and Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)
Subjects: DNA, Bacterial, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Prosthesis-Related Infections, COXIELLA-BURNETII, Vascular graft infection, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030106 microbiology, Q fever, DIAGNOSIS, Gastroenterology, Serology, 03 medical and health sciences, Renal Dialysis, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Positron Emission Tomography Computed Tomography, Internal medicine, INFECTION, medicine, Humans, Chronic fever, ComputingMilieux_MISCELLANEOUS, biology, business.industry, General Medicine, Middle Aged, Coxiella burnetii, biology.organism_classification, medicine.disease, bacterial infections and mycoses, 3. Good health, Treatment Outcome, Infectious Diseases, Hemodialysis, Hypermetabolism, bacteria, Female, Vascular Grafting, France, Complication, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Vascular graft
Abstract: International audience; Vascular access infection is a frequent complication in hemodialysis patients. We report the second case worldwide of a prosthetic hemodialysis vascular graft infection by Coxiella burnetii, with intense hypermetabolism on PET-CT, Q fever serology consistent with persistent infection, and positive C. burnetii DNA in the blood and removed vascular graft.
Published: 2018
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75. Factors associated with Health-Related Quality of Life in Kidney Transplant Recipients in France

Author: Bertrand Dussol, Valérie Moal, Georges Mourad, Nathalie Pedinielli, Aurélie Meurette, Marine Alessandrini, Elisabeth Jouve, Antoine Durrbach, Elisabeth Cassuto, Yosra Mouelhi, Stéphanie Gentile, Aix-Marseille Université - Faculté de médecine (AMU MED), Aix Marseille Université (AMU), Centre d'Investigation Clinique [Hôpital de la Conception - APHM] (CIC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), CHU Marseille, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institut de transplantation urologie-néphrologie (ITUN), Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Pasteur [Nice] (CHU), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut Francilien de recherche en Néphrologie et Transplantation (IFRNT), Interactions cellules souches-niches : physiologie, tumeurs et réparation tissulaire, Université Paris-Sud - Paris 11 (UP11)-Service de Santé des Armées-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), COMBE, Isabelle, Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Paul Brousse-Service de Santé des Armées-Université Paris-Sud - Paris 11 (UP11)
Subjects: Male, Gerontology, Nephrology, Longitudinal study, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, Health-related quality of life, 030232 urology & nephrology, lcsh:RC870-923, Kidney transplant, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 0302 clinical medicine, Quality of life, Bayesian multivariate linear regression, 030212 general & internal medicine, 10. No inequality, Kidney transplantation, Depression, Middle Aged, Antidepressive Agents, humanities, ReTransQol, Female, France, Research Article, Adult, medicine.medical_specialty, SF-36, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Kidney Transplant Recipients, 03 medical and health sciences, Social support, Cross sectional, Internal medicine, medicine, Humans, Aged, Internet, business.industry, Social Support, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, Kidney Transplantation, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Transplant Recipients, Cross-Sectional Studies, Socioeconomic Factors, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Quality of Life, Kidney Failure, Chronic, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: International audience; Background: Health-Related Quality of Life (HRQoL) assessment after kidney transplantation has become an important tool in evaluating outcomes. This study aims to identify the associated factors with HRQoL among a representative sample size of Kidney Transplant Recipients (KTR) at the time of their inclusion in the study.Methods: Data of this cross-sectional design is retrieved from a longitudinal study conducted in five French kidney transplant centers in 2011, and included KTR aged 18 years with a functioning graft for at least 1 year. Measures include demographic, psycho-social and clinical characteristics. To evaluate HRQoL, the Short Form-36 Health Survey (SF-36) and a HRQoL instrument for KTR (ReTransQol) were administered. Multivariate linear regression models were performed.Results: A total of 1424 patients were included, with 61.4% males, and a mean age of 55.7 years (+/- 13.1). Demographic and clinical characteristics were associated with low HRQoL scores for both questionnaires. New variables were found in our study: perceived poor social support and being treated by antidepressants were associated with low scores of Quality of Life (QoL), while internet access was associated with high QoL scores.Conclusion: The originality of our study's findings was that psycho-social variables, particularly KTR treated by antidepressants and having felt unmet needs for any social support, have a negative effect on their QoL. It may be useful to organize a psychological support specifically adapted for patients after kidney transplantation.
Published: 2018
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76. Enquête sur la perception des compétences acquises chez des internes de néphrologie de 3 e et 4 e années en France

Author: Philippe Brunet, Gabriel Choukroun, Eric Rondeau, Olivier Moranne, Bruno Moulin, Marie-Noëlle Peraldi, Service de néphrologie, Hôpital Pasteur [Nice] (CHU)-Centre Hospitalier Universitaire de Nice (CHU Nice), Service de maladies infectieuses et tropicales [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Néphrologie [Amiens], CHU Amiens-Picardie-hôpital Sud, Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Service de Néphrologie et Transplantation, CHU Strasbourg, Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), CHU Amiens-Picardie-Hôpital Sud, and Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )
Subjects: Nephrology, Medical education, medicine.medical_specialty, Standardization, Resident training, media_common.quotation_subject, [SDV]Life Sciences [q-bio], education, 030232 urology & nephrology, Context (language use), Training and development, Training (civil), Simulation training, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Perception, medicine, 030212 general & internal medicine, Psychology, ComputingMilieux_MISCELLANEOUS, media_common
Abstract: Due to a national theoretical training provided to all resident for many years and the ongoing discussions to change the organization of the resident training of specialized study diploma (SSD) of nephrology, a survey was done to assess the perception of skills acquired in the management of different clinical situations in terms of knowledge, expertise and attitudes. The expected results are intended to identify new training procedures for future nephrologists in France. The study was performed in 112 resident from 3rd and 4th year of nephrology resident training attending an educational seminar of the University College of Nephrology Teachers in May 2014. The survey was conducted with a self-administered anonymous questionnaire to assess the perception of the acquisition of different skills. The results show a heterogeneity acquisition between different areas of skills suggesting possible improvement with development of outpatient activity or with training in specialized units such as for peritoneal dialysis or plasma exchange activity. Therefore, these findings suggest further structuring of the regional training and development of the simulation training to acquire the expertise and attitudes. Finally, the use of an evaluation book of skills acquired throughout the training could be interesting in the context of standardization of validating training of nephrologists as proposed in the reform of the SSD of nephrology.
Published: 2017
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77. Uro-and nephrotoxic effects of drugs of abuse: Literature review and pharmaco-epidemiological survey in France and in the Marseille area

Author: Marion Sallée, Bertrand Dussol, Marion Gully, Vanessa Pauly, Bertrand Gondouin, Fanny Romain, Michel Spadari, Stéphane Burtey, Julie Moussi-Frances, Liselotte Pochard, Joëlle Micallef, Elisabeth Frauger, Noémie Jourde-Chiche, Laurent Daniel, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Service de Pharmacologie Clinique [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Service de Santé Publique et d'Information Médicale (SSPIM), Vascular research center of Marseille (VRCM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Laboratoire d'Anatomopathologie [Aix-Marseille], and Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)
Subjects: Vasculitis, 030232 urology & nephrology, 030204 cardiovascular system & hematology, Drug abuse, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 3. Good health, Acute kidney injury, 03 medical and health sciences, 0302 clinical medicine, Glomerulonephritis, Nephrology, Chronic kidney disease, [SDV.TOX]Life Sciences [q-bio]/Toxicology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Abstract: International audience; A great diversification of drugs of abuse has been observed in recent years, both in the populations using them and in the types of drugs. Although dependency and psychiatric disorders associated with the abuse of these substances is well known, somatic complications, uro-nephrotoxicity in particular, are less recognized. We propose here an overview of the products used by drugs abusers in France, through the analysis of the national pharmaco-epidemiological study Observation des produits psychotropes illicites ou détournés de leur utilisation médicamenteuse (OPPIDUM). Among the 5003 patients who participated in this survey, 84% were on prescribed psychoactive substances, with indicators of abuse in 28% of cases; more than half of these patients had also been using drugs of abuse (mainly cannabis) in the previous week. We then describe the main urological and renal toxicities of these drugs, in particular of heroin, cocaine, cannabis, ecstasy, LSD, amphetamine, new designer drugs, ketamine and opiate substitution treatment. We finally present a pharmaco-epidemiological survey of patients hospitalized for drugs complications in nephrology at the university hospital of Marseille. Between 2000 and 2015, 22 patients aged 18 to 57 years were hospitalized for renal adverse effects of drugs of abuse, such as glomerulonephritides, focal segmental glomerulosclerosis, acute kidney injury or chronic kidney disease. The somatic complications of drugs participate in their dangerousness and should be a red flag. They should be systematically reported to the addictovigilance national network to allow the improvement of information given to the patients and the medical community, and to adapt the prevention and risk reduction policies.; L’abus de substances psychoactives (SPA) s’est diversifié ces dernières années, tant au niveau des populations concernées que des produits consommés. Si la dépendance et les troubles psychiatriques liés à la consommation de ces substances sont généralement connus, les complications somatiques, en particulier uro-néphrologiques, le sont moins. Nous proposons tout d’abord dans cette revue un état des lieux des SPA consommées par les usagers de drogue en France, à partir des données de l’étude nationale pharmaco-épidémiologique OPPIDUM (Observation des produits psychotropes illicites ou détournés de leur utilisation médicamenteuse). Parmi les 5003 patients interrogés, 84 % étaient consommateurs d’au moins une SPA médicamenteuse, avec des indicateurs d’abus dans 28 % des cas, et plus de la moitié avaient consommé une SPA non médicamenteuse (principalement du cannabis) la semaine précédente. Nous décrivons ensuite les complications urologiques et néphrologiques des principales SPA, telles que l’héroïne, la cocaïne, le cannabis, l’ecstasy, le LSD, les amphétamines, les nouveaux produits de synthèse, la kétamine et les médicaments de substitution aux opiacés. Nous présentons enfin une enquête pharmaco-épidémiologique concernant les patients hospitalisés en néphrologie adulte au CHU de Marseille pour des complications liées à l’abus de SPA. Entre 2000 et 2015, 22 patients âgés de 18 à 57 ans ont été hospitalisés pour des complications néphrologiques des SPA, telles que glomérulonéphrite aiguë, hyalinose segmentaire et focale, insuffisance rénale aiguë ou chronique. Les complications somatiques liées à l’usage des SPA participent à leur dangerosité et peuvent avoir une valeur d’alerte. Il est important que les professionnels de santé signalent au centre d’addictovigilance de leur territoire les complications sanitaires liées à l’usage des SPA, afin d’optimiser l’information donnée aux patients et aux professionnels de santé et d’adapter des programmes de prévention et de réduction des risques.
Published: 2017
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78. CD16/FC gamma R PROFILING ALLOWS NON INVASIVE APPRAISAL OF ANTIBODY-DEPENDENT NK CELL ALLOREACTIVE POTENTIAL IN HEART AND KIDNEY TRANSPLANT RECIPIENTS

Author: Picard, Christophe, Sampol, Emmanuelle, Legris, Tristan, Lyonnet, Luc, Dicristofaro, Julie, Lano, Guillaume, Moal, Valerie, DANIEL, Laurent, Burtey, Stéphane, Dignat-George, Francoise, Sabatier, Florence, Dussol, Bertrand, Mouly-Bandini, Annick, Paul, Pascale, Etablissement Français du Sang - Alpes-Méditerranée (EFS - Alpes-Méditerranée), Etablissement Français du Sang, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), CIC biothérapies CBT 0503 [Nantes], Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), UMR 6578 : Anthropologie Bio-Culturelle (UAABC), Université de la Méditerranée - Aix-Marseille 2-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Physiopathologie de l'Endothelium, Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Chirurgie Cardiaque Adultes, Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), and COMBE, Isabelle
Subjects: [SDV] Life Sciences [q-bio], [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, [SDV]Life Sciences [q-bio], ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience
Published: 2017

79. 10-YEAR FOLLOW-UP OF A RANDOMIZED TRIAL IN KIDNEY TRANSPLANTATION COMPARING 2 IMMUNOSUPPRESSIVE STRATEGIES: CYCLOSPORINE/ AZATHIOPRINE VS. TACROLIMUS/MYCOPHENOLATE MOFETIL

Author: Fages, Lucie, Moal, Valerie, Boucekine, Mohamed, Brunet, Philippe, Moussi-Frances, Julie, Legris, Tristan, Purgus, Raj, Daniel, Laurent, Dussol, Bertrand, Berland, Yvon, Vacher-Coponat, Henri, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Vascular research center of Marseille (VRCM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and COMBE, Isabelle
Subjects: [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience
Published: 2017

80. Clinical and Genetic Spectrum of Bartter Syndrome Type 3

Author: Maria Mileva, Sandrine Lemoine, Christiane Mousson, Elsa Seys, Rosa Vargas-Poussou, Mathilde Cailliez, Gwenaëlle Roussey-Kesler, Aurélia Bertholet-Thomas, Paul Cozette, Theresa Kwon, Anne Blanchard, Guylhène Bourdat-Michel, Pauline Krug, Jean Sébastien Borde, Jacques Teulon, Christophe Simian, Laurence Dubourg, Robert Novo, Isabelle Vrillon, Bertrand Knebelmann, Brigitte Llanas, Djamal Djeddi, Dominique Chaveau, Stephen B. Walsh, Olga Andrini, François Nobili, Jean Daniel Delbet, Marc Fila, Georges Deschênes, Mathilde Keck, Ferielle Louillet, Lamisse Mansour-Hendili, Elodie Merieau, Stéphane Decramer, Noémie Jourde-Chiche, Marie-Pierre Lavocat, Pierre-Yves Courand, Luisa Mota-Vieira, Guillaume Bobrie, Pediatric Nephrology Unit, American Memorial Hospital, Reims University Hospital, Centre de Recherche des Cordeliers (CRC), Université Pierre et Marie Curie - Paris 6 (UPMC)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche des Cordeliers (CRC (UMR_S 872)), Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), Service de Génétique [CHU HEGP], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Cardiologie [Hôpital Croix- Rousse, HCL] (Centre d'excellence de la Société européenne d'hypertension artérielle), Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Génétique, Union nationale des coopératives d’élevage et d’insémination animale (UNCEIA), Unité de Néphrologie Pédiatrique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré, Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Référence des Maladies Rénales Rares Néphrogones, Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Nephrology Unit, Clinique du Vert Galant, Tremblay-en-France, Nephrology Unit, Centre hospitalier de Saintonge, Saintes, Centre Hospitalo-Universitaire de Grenoble (CHU de Grenoble), CHU Grenoble, Service de pédiatrie multidisciplinaire [Hôpital de la Timone Enfants - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE), Assistance Publique - Hôpitaux de Marseille (APHM), Pediatric Nephrology Unit, Centre Hospitalier du Pays d'Aix, Nephrology Unit, Centre Hospitalier du Pays d'Aix, CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Métabolomique et maladies métaboliques, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Référence du Sud Ouest des Maladies Rénales Rares, CHU Toulouse [Toulouse]-Hôpital des Enfants, CHU Toulouse [Toulouse], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Vascular research center of Marseille (VRCM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Service de néphrologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Pédiatrie médicale et médecine de l'adolescent [Amiens], CHU Amiens-Picardie, Service de pédiatrie néonatale et réanimation - neuropédiatrie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Department of Pediatrics, Centre Hospitalier Pierre Oudot de Bourgoin-Jallieu, Bourgoin-Jallieu, Molecular Genetics and Pathology Unit, Hospital of Divino Espirito Santo of Ponta Delgada, Service de néphrologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de néphrologie pédiatrique [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Department of Aeronautical and Automotive Engineering, Loughborough University, Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Diderot - Paris 7 (UPD7)-École pratique des hautes études (EPHE)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Santé Lyon Est - Louis Léopold Ollier, Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Union Nationale des Coopératives Agricoles d'Elevage et d'Insémination Animale, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Robert Debré, Unité d'hypertension artérielle, Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Necker - Enfants Malades [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Service de nephrologie pédiatrique, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Université de Paris - Faculté de Médecine Paris Centre (UP Médecine Paris Centre), Université de Paris (UP), Service de Génétique [AP-HP Hôpital Européen Georges Pompidou, Paris], Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre hospitalier universitaire de Grenoble (CHU de Grenoble), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Service de pédiatrie néonatale et réanimation - neuropédiatrie [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Université de Lyon, Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Pierre et Marie Curie - Paris 6 (UPMC)-École Pratique des Hautes Études (EPHE), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte [CHU-Necker] (MARHEA), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Charles Nicolle [Rouen], and Normandie Université (NU)-Normandie Université (NU)-CHU Rouen
Subjects: 0301 basic medicine, Adult, Male, medicine.medical_specialty, Adolescent, [SDV]Life Sciences [q-bio], Nonsense mutation, 030232 urology & nephrology, Bartter syndrome, urologic and male genital diseases, Hypocalciuria, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Tubulopathy, Clinical Research, Internal medicine, Genotype, medicine, Humans, Child, Genetic Association Studies, ComputingMilieux_MISCELLANEOUS, Retrospective Studies, CLCNKB, biology, business.industry, Bartter Syndrome, Infant, General Medicine, Gitelman syndrome, medicine.disease, 3. Good health, Bartter's syndrome, 030104 developmental biology, Endocrinology, Nephrology, Child, Preschool, Mutation, biology.protein, Female, medicine.symptom, business
Abstract: Bartter syndrome type 3 is a clinically heterogeneous hereditary salt-losing tubulopathy caused by mutations of the chloride voltage-gated channel Kb gene (CLCNKB), which encodes the ClC-Kb chloride channel involved in NaCl reabsorption in the renal tubule. To study phenotype/genotype correlations, we performed genetic analyses by direct sequencing and multiplex ligation-dependent probe amplification and retrospectively analyzed medical charts for 115 patients with CLCNKB mutations. Functional analyses were performed in Xenopus laevis oocytes for eight missense and two nonsense mutations. We detected 60 mutations, including 27 previously unreported mutations. Among patients, 29.5% had a phenotype of ante/neonatal Bartter syndrome (polyhydramnios or diagnosis in the first month of life), 44.5% had classic Bartter syndrome (diagnosis during childhood, hypercalciuria, and/or polyuria), and 26.0% had Gitelman-like syndrome (fortuitous discovery of hypokalemia with hypomagnesemia and/or hypocalciuria in childhood or adulthood). Nine of the ten mutations expressed in vitro decreased or abolished chloride conductance. Severe (large deletions, frameshift, nonsense, and essential splicing) and missense mutations resulting in poor residual conductance were associated with younger age at diagnosis. Electrolyte supplements and indomethacin were used frequently to induce catch-up growth, with few adverse effects. After a median follow-up of 8 (range, 1-41) years in 77 patients, chronic renal failure was detected in 19 patients (25%): one required hemodialysis and four underwent renal transplant. In summary, we report a genotype/phenotype correlation for Bartter syndrome type 3: complete loss-of-function mutations associated with younger age at diagnosis, and CKD was observed in all phenotypes.
Published: 2017
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81. Nocardiosis in the south of France over a 10-years period, 2004-2014

Author: Henri Vacher-Coponat, Rajsingh Purgus, Tristan Legris, Martine Reynaud-Gaubert, Karamoko Djiguiba, Jeremy Bismuth, Pierre-Edouard Fournier, Delphine Haussaire, Valérie Moal, X. Elharrar, Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), INSB-INSB-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), and Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM)
Subjects: Male, 0301 basic medicine, Cystic Fibrosis, Opportunistic infection, Medical Records, Nocardia, Hospitals, University, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Neoplasms, Epidemiology, 030212 general & internal medicine, Immunodeficiency, Cancer, biology, Nocardiosis, General Medicine, Middle Aged, 3. Good health, Infectious Diseases, Female, France, Adult, Microbiology (medical), medicine.medical_specialty, 030106 microbiology, Nocardia Infections, History, 21st Century, lcsh:Infectious and parasitic diseases, Immunocompromised Host, 03 medical and health sciences, Internal medicine, Trimethoprim, Sulfamethoxazole Drug Combination, medicine, Humans, lcsh:RC109-216, Aged, Retrospective Studies, Nocardia farcinica, Transplantation, business.industry, medicine.disease, biology.organism_classification, Surgery, Chronic Disease, business, Rare disease
Abstract: International audience; Background: Nocardiosis is a rare disease with polymorphic presentations. The epidemiology and clinical presentation could change with the increasing number of immunocompromised patients. Methods: The medical records and microbiological data of patients affected by nocardiosis and treated at the university hospitals of Marseille between 2004 and 2014 were analyzed retrospectively. Results: The cases of 34 patients infected by Nocardia spp during this period were analyzed. The main underlying conditions were transplantation (n = 15), malignancy (n = 9), cystic fibrosis (n = 4), and immune disease (n = 3); no immunodeficiency condition was observed for three patients. No case of AIDS was observed. At diagnosis, 61.8% had received steroids for over 3 months. Four clinical presentations were identified, depending on the underlying condition: the disseminated form (50.0%) and the visceral isolated form (26.5%) in severely immunocompromised patients, the bronchial form (14.7%) in patients with chronic lung disease, and the cutaneous isolated form (8.8%) in immunocompetent patients. Nocardia farcinica was the main species identified (26.5%). Trimethoprim-sulfamethoxazole was prescribed in 68.0% of patients, and 38.0% underwent surgery. Mortality was 11.7%, and the patients who died had disseminated or visceral nocardiosis. Conclusions: The clinical presentation and outcome of nocardiosis depend on the patient's initial immune status and underlying pulmonary condition. Severe forms were all iatrogenic, occurring after treatments altering the immune system. (C) 2017 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
Published: 2017
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82. Facteurs influençant le choix de la dialyse péritonéale : le point de vue des patients et des néphrologues

Author: Olivier Moranne, A.C. Durand, Laurent Benhaim, Aida Habib, A. Duval-Sabatier, Philippe Brunet, Évelyne Bargas, Stanislas Bataille, Stéphanie Gentile, Physiopathologie cellulaire et moléculaire des cellules du sang et du vaisseau, Institut National de la Santé et de la Recherche Médicale (INSERM), Sciences historiques et philologiques, École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Département de santé publique, Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital Larchet, and École Pratique des Hautes Études (EPHE)
Subjects: Gynecology, medicine.medical_specialty, business.industry, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Nephrology, medicine, 030212 general & internal medicine, Dialysis technique, business, ComputingMilieux_MISCELLANEOUS
Abstract: Resume Objectif Identifier les facteurs lies au choix de la dialyse peritoneale (DP) comme premiere technique de dialyse selon le point de vue des patients et celui des nephrologues. Methodes Il s’agit d’une etude multicentrique retrospective, de type cas-temoins, qui a ete realisee aupres de patients ayant demarre la dialyse entre 2010 et 2014 dans quatre etablissements de la region Provence-Alpes-Cote d’Azur. Les nephrologues prenant en charge les patients inclus et acceptant de participer ont egalement ete interroges. Les donnees ont ete recueillies a l’aide de deux questionnaires standardises : un destine aux patients et un destine aux nephrologues. Les donnees demographiques et cliniques a l’initiation de la dialyse sont issues du registre Rein. Resultats Au total, 150 patients ont ete interroges, ils avaient en moyenne 63,7 ans. La DP etait contre-indiquee pour 26,7 % d’entre eux. Pour les patients eligibles aux deux techniques de dialyse, 46,7 % avaient exprime une preference pour la DP, 31,8 % pour l’HD et 21,5 % n’avaient exprime aucune preference. La preference etait influencee fortement par l’information et l’anciennete du suivi nephrologique. Les principaux facteurs lies au choix personnel de la DP etaient l’autonomie et le desir d’autonomie. La mise en dialyse en urgence influencait negativement le choix de la DP. Conclusion Un tiers des patients eligibles aux deux techniques pouvaient et voulaient etre sous DP. Les freins etaient essentiellement lies aux pratiques professionnelles. Une meilleure information pourrait augmenter ce potentiel de patients.
Published: 2017
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83. Hepatitis E virus genotype 4 in Southeastern France: still around

Author: Philippe Colson, Guillaume Lano, Philippe Brunet, Valérie Moal, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), CNRS UMR 7057 - Laboratoire Matières et Systèmes Complexes (MSC) (MSC), Centre National de la Recherche Scientifique (CNRS), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Matière et Systèmes Complexes (MSC), Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), and Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM)
Subjects: 0301 basic medicine, Genotype, Hepatology, Hepatitis E virus genotype, Biology, Virology, Hepatitis E, 3. Good health, 03 medical and health sciences, 030104 developmental biology, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Hepatitis E virus, Humans, France, ComputingMilieux_MISCELLANEOUS
Abstract: International audience; no abstract
Published: 2015
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84. Plasma Retinol Concentration Is Mainly Driven by Transthyretin in Hemodialysis Patients

Author: Jean-François Landrier, Charlène Tournier, Sylvie Cado, Marianne Serveaux, Stanislas Bataille, Julien Astier, Stéphane Burtey, Franck Tourniaire, Patrice Darmon, Jérôme Sallette, Julien Cohen, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Nutrition, obésité et risque thrombotique (NORT), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire CERBA [Saint Ouen l'Aumône], Institut phoceen de néphrologie, Vascular research center of Marseille (VRCM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Informatique, Biologie Intégrative et Systèmes Complexes (IBISC), Université d'Évry-Val-d'Essonne (UEVE)-Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE UMR T9405), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Aix Marseille Université (AMU)-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Lutein, prédicteur, medicine.medical_treatment, dialyse, 030232 urology & nephrology, Tocopherols, Medicine (miscellaneous), 030204 cardiovascular system & hematology, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, vitamin A, chemistry.chemical_compound, 0302 clinical medicine, Risk Factors, Prealbumin, Medicine, Longitudinal Studies, transthyretine, concentration plasmatique, Aged, 80 and over, 2. Zero hunger, Nutrition and Dietetics, biology, Retinol, Micronutrient, tocopherol, 3. Good health, Nephrology, Alimentation et Nutrition, Female, Hemodialysis, retinol, Vitamin, medicine.medical_specialty, Nutritional Status, transthyretin, 03 medical and health sciences, chronic hemodialysis, Renal Dialysis, Internal medicine, Humans, Food and Nutrition, Dialysis, Aged, Retrospective Studies, business.industry, Carotenoids, Transthyretin, Retinol binding protein, Endocrinology, chemistry, micronutrients, biology.protein, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Retinol-Binding Proteins, Plasma, Follow-Up Studies
Abstract: International audience; Objective: Micronutrients deficiencies in hemodialysis patients are due to low dietary intakes and intradialytic losses for hydrophilic micronutrients. Conversely, lipophilic nondialyzable compounds might accumulate because of a lack of elimination through renal metabolism or dialysis. Other compounds have complex metabolism: their concentration is not explained by these phenomenons. The aim of this study was to report plasma concentrations of lipophilic micronutrients in hemodialysis patients and to analyze if these concentrations were predictive of mortality.Design: The design was monocentric observational longitudinal study.Subjects: A total of 123 hemodialysis patients included in this observational study.Main Outcome Measure: Plasma concentration of lipophilic micronutrients retinol and its two co-transporters transthyretin and retinol-binding protein 4, tocopherol, and carotenoids (α-carotene and β-carotene, β-cryptoxanthin, lycopene, lutein, and zeaxanthin), and all factors associated with 1-year mortality.Results: Within the 123 patients of the study, median age (interquartile range) was 77.5 (69.5-84.5) years and 58.5% were male. Median retinol plasma concentration was 4.07 (2.65-5.51) μmol/L, and 91.9% of patient had high plasma retinol concentrations. In monovariate analysis, retinol levels were inversely correlated with mortality (hazard ratio = 0.57 [0.45-0.72]; P < .001). This effect remained significant after adjustment with several parameters. Nevertheless, the correlation between retinol and mortality disappeared as soon as transthyretin was added in the statistical model, suggesting an effect of transthyretin as confusing bias. Median tocopherol plasma concentration was 34.8 (28.3-42.9) μmol/L and 72.4% of patients had high plasma tocopherol concentration. Neither tocopherol plasma levels nor carotenoids concentrations were correlated with death in multivariate analysis.Conclusions: In hemodialysis patients, the correlation between retinol plasma concentration and mortality represents the nutritional status but not a direct biological effect of retinol. Retinol is only a surrogate predictor of mortality. It might not represent vitamin A levels, but likely the transthyretin level. Plasma retinol levels should be interpreted cautiously in hemodialysis patients.
Published: 2017
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85. Brincidofovir Use after Foscarnet Crystal Nephropathy in a Kidney Transplant Recipient with Multiresistant Cytomegalovirus Infection

Author: R. Vial, Raj Purgus, Laurent Daniel, Tristan Legris, Noémie Jourde-Chiche, Sophie Alain, Christine Zandotti, Alexandre Decourt, Charleric Bornet, Valérie Moal, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM), Aix Marseille Université (AMU), Fédération de Bactériologie-Virologie-Hygiène [AP-HM Hôpital La Timone], Hôpital de la Timone [CHU - APHM] (TIMONE), Service de Bactériologie, Virologie, Hygiène [CHU Limoges], CHU Limoges, Unité pharmacie hospitalière [AP-HM Hôpital de la Conception], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Laboratoire d'Anatomie Pathologique-Neuropathologique [AP-HM Hôpital La Timone], DIGNAT-GEORGE, Françoise, and Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)
Subjects: 0301 basic medicine, Foscarnet, Ganciclovir, Article Subject, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030106 microbiology, lcsh:Surgery, Salvage therapy, Case Report, Brincidofovir, 030230 surgery, Nephropathy, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Management of Technology and Innovation, medicine, business.industry, virus diseases, Immunosuppression, lcsh:RD1-811, biochemical phenomena, metabolism, and nutrition, medicine.disease, 3. Good health, Transplantation, [SDV] Life Sciences [q-bio], chemistry, Immunology, business, Cidofovir, medicine.drug
Abstract: Background. Cytomegalovirus (CMV) antiviral drug resistance constitutes an increasing challenge in transplantation. Foscarnet is usually proposed when resistance for ganciclovir is suspected, but its use is limited by its nephrotoxicity. Case Presentation. We report a case of multiresistant CMV disease in a kidney transplant recipient. Foscarnet was prescribed after ganciclovir treatment failure in a patient with two mutations in the UL97 viral gene. Foscarnet induced biopsy-proven kidney crystal precipitation that resulted in severe acute transplant failure and nephrotic syndrome. Despite a large decrease in immunosuppression, CMV disease was not controlled and a salvage therapy with Brincidofovir (BCV), which is an oral lipid conjugate of cidofovir with limited nephrotoxicity, was attempted. Clinical and virological remission was observed after a 21-day course of BCV, despite mild and reversible liver toxicity. However, a new relapse could not be effectively cured by BCV due to a new mutation in the UL54 gene, which is known to confer resistance to cidofovir. A new course of foscarnet finally resulted in prolonged CMV remission. Herein, we present a review of foscarnet nephropathy cases in solid-organ transplanted patients. Conclusions. This unique case highlights the potential benefit of BCV use during resistant CMV infection, although mutations in the UL54 gene may limit its therapeutic efficacy. These findings need to be confirmed in clinical trials.
Published: 2017
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86. THE IMPACT OF SEVELAMER ON GUT DERIVED UREMIC TOXINS LEVELS : RESULTS FROM A MULTICENTER, DOUBLE BLIND, RANDOMIZED, PLACEBO CONTROLLED CLINICAL TRIAL

Author: Sophie Liabeuf, youssef Bennis, Jennifer Romezin, Jean-Philippe Ryckelynck, Najeh El Esper, Pablo Urena, Christian Combe, Bertrand Dussol, Pascal Sonnet, Alexandra Dassonville-Klimpt, Dominique Prie, Gabriel Choukroun, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, CHU Amiens-Picardie, AURA [Paris], Service de Néphrologie-transplantation-dialyse [Bordeaux], CHU Bordeaux [Bordeaux], Bioingénierie tissulaire (BIOTIS), Université de Bordeaux (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Laboratoire de Glycochimie, des Antimicrobiens et des Agro-ressources - UMR CNRS 7378 (LG2A ), Université de Picardie Jules Verne (UPJV)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Centre de recherche Croissance et signalisation (UMR_S 845), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and DESSAIVRE, Louise
Subjects: [SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2017

87. Course of chronic kidney disease in French patients

Author: P. Nicoud, Nicolas Janus, Philippe Vanhille, Stéphane Burtey, Thierry Hannedouche, Myriam Isnard-Rouchon, Gilbert Deray, Malik Touam, Gérard Janin, Maurice Laville, Vincent Launay-Vacher, Laurent Juillard, J.-P. Ortiz, Service ICAR, Néphrologie, Hôpital La Pitie Salpetriere, Service de Néphrologie, Centre Hospitalier de l'Université de Montréal (CHUM), AURA Chamalières, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )-Assistance Publique - Hôpitaux de Marseille (APHM), Polyclinique de St Roch, Service de Néphologie, Hôpital des Chanaux, Hôpitaux du Pays du Mont-Banc, AURA Paris, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Montréal (UdeM)-Université de Montréal (UdeM), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )
Subjects: Nephrology, insuffisance rénale, medicine.medical_specialty, Pediatrics, médicament, medicine, Referral, medicine.medical_treatment, dialyse, 030232 urology & nephrology, Esrd Management, Dialysis patients, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, dosage, renal insufficiency, 03 medical and health sciences, Patient referral, 0302 clinical medicine, Internal medicine, Urology and Nephrology, Dialysis, Urologie et Néphrologie, Transplantation, chronic renal insufficiency, business.industry, 030503 health policy & services, Retrospective cohort study, drug dosage management, medicine.disease, 3. Good health, Chronic dialysis, mechanical kidney, dialysis, patient, France, 0305 other medical science, business, Kidney disease
Abstract: Background: In 1998, a French survey showed that the referral of patients with chronic kidney disease to a nephrologist was delayed, resulting in many emergency initiations of dialysis. In 2009, the ORACLE study aimed to describe the renal course of dialysis patients from their first nephrology visit to their first dialysis session. Methods: The ORACLE study was a multicentre retrospective study of all patients who started chronic dialysis. Data were collected at the first nephrology visit and at the first dialysis session. Results: In total, 720 patients were included (69 centres). At the first nephrology visit, the mean Cockcroft-Gault (CG) indicator was 31.8 mL/min (22.7 in 1998) and 52.4% of patients (73% in 1998) had a CG
Published: 2017
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88. 'Ndongobacter massiliensis' gen. nov., sp. nov., a new bacterial genus isolated from a human urine sample after de novo kidney transplantation

Author: Brahimi, S, Cadoret, Frederic, Fournier, Pierre-Edouard, Moal, Valérie, Raoult, Didier, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), and Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)
Subjects: kidney transplant, taxonomy, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Culturomics, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, ‘Ndongobacter massiliensis’, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, lcsh:RC109-216, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, urine, lcsh:Infectious and parasitic diseases
Abstract: International audience; We report the main characteristics of 'Ndongobacter massiliensis' strain Marseille-P3170(T) (= CSUR P3170), which was isolated from the urine sample of a 37-year-old man who had just received a kidney transplant for genetic focal segmental glomerulosclerosis.
Published: 2016
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89. Consequences of increasing convection onto patient care and protein removal in hemodialysis

Author: Caroline Guzman, Chantal Cazevieille, Moglie Le Quintrec, Àngel Argilés, Nathalie Gayrard, Flore Duranton, Alain Ficheux, Fernando Vetromile, Philippe Brunet, Ilan Szwarc, Marie-Françoise Servel, Biocommunication en Cardio-Métabolique (BC2M), Université de Montpellier (UM), RD-Néphrologie (R&D), Néphrologie Dialyse Saint Guilhem (NDSG), Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut des Neurosciences de Montpellier (INM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), and Herrada, Anthony
Subjects: Convection, Male, medicine.medical_specialty, medicine.medical_treatment, 030232 urology & nephrology, lcsh:Medicine, Hemodiafiltration, 030204 cardiovascular system & hematology, Dialysis patients, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Transmembrane pressure, Patient care, 03 medical and health sciences, 0302 clinical medicine, Osmotic Pressure, Renal Dialysis, Dialysis Solutions, medicine, Humans, lcsh:Science, Dialysis, Aged, Aged, 80 and over, Multidisciplinary, Mass removal, business.industry, lcsh:R, Correction, Membranes, Artificial, Blood Proteins, Middle Aged, Weight range, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 3. Good health, Surgery, Anesthesia, lcsh:Q, Female, Hemodialysis, Patient Care, business
Abstract: International audience; Introduction: Recent randomised controlled trials suggest that on-line hemodiafiltration (OL-HDF) improves survival, provided that it reaches high convective volumes. However, there is scant information on the feasibility and the consequences of modifying convection volumes in clinics.Methods: Twelve stable dialysis patients were treated with high-flux 1.8 m2 polysulphone dialyzers and 4 levels of convection flows (QUF) based on GKD-UF monitoring of the system, for 1 week each. The consequences on dialysis delivery (transmembrane pressure (TMP), number of alarms, % of achieved prescribed convection) and efficacy (mass removal of low and high molecular weight compounds) were analysed.Results: TMP increased exponentially with QUF (p56,000 monitoring values). Beyond 21 L/session, this resulted into frequent TMP alarms requiring nursing staff interventions (mean ± SEM: 10.3 ± 2.2 alarms per session, p 20L) is feasible by setting an HDF system at its optimal conditions based upon the GKD-UF monitoring. Prescribing higher convection volumes resulted in instability of the system, provoked alarms, was bothersome for the nursing staff and the patients, rarely achieved the prescribed convection volumes and increased removal of high molecular weight compounds, notably albumin.
Published: 2016
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90. Beware, polyarteritis nodosa still exists in nephrology!

Author: Perrin, Justine, Carvelli, Julie, Gondouin, Bertrand, Daniel, Laurent, Fraisse, Megan, Gaudon, Céline, Bouzana, Fouad, Vacher-Coponat, Henri, Moussi-Francès, Julie, Dussol, Bertrand, Jourde-Chiche, Noemie, Vascular research center of Marseille (VRCM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Héritages et Constructions dans le Texte et l'Image (HCTI), Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Institut Brestois des Sciences de l'Homme et de la Société (IBSHS), Université de Brest (UBO)-Université de Brest (UBO), Université Grenoble Alpes - UFR Pharmacie (UGA UFRP), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Physiopathologie de l'Endothelium, Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Brest (UBO), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Brestois des Sciences de l'Homme et de la Société (IBSHS), and Université de Brest (UBO)-Université de Brest (UBO)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)
Subjects: Male, Insuffisance rénale aiguë, [SDV]Life Sciences [q-bio], Angiography, Contrast Media, Vascularite systémique, Acute Kidney Injury, urologic and male genital diseases, Polyarteritis Nodosa, Diagnosis, Differential, Acute renal failure, Périartérite noueuse, Nephrology, Systemic vasculitis, Humans, Aneurysm polyarteritis nodosa, cardiovascular diseases, Anévrysme, Tomography, X-Ray Computed, Aged
Abstract: International audience; Renal involvement of systemic vasculitides is an emergency in nephrology. Although it has become very rare, the diagnosis of polyarteritis nodosa must be considered in some patients. A 70-year-old patient, previously healthy, presented with acute renal failure and malignant hypertension and abundant albuminuria. Subcutaneous nodule, orchitis and mononeuritis appeared subsequently. The search for auto-immunity or viral infection was negative. Markers of thrombotic microangiopathy, present initially, resolved after blood pressure control. After a renal computed tomography with contrast medium injection was considered normal, without any micro-aneurysm, a renal biopsy was performed. It showed vascular lesions and glomerular ischemia. It was complicated by hemorragic shock after 36hours. The diagnosis of periarteritis nodosa was finally made after arterial angiography showed millimetric renal micro-aneurysms. In case of systemic vasculitis with renal involvement, periarteritis nodosa must be part of differential diagnosis, especially in case of malignant hypertension, subcutaneous nodosa and orchitis, and despite albuminuria. This implies the search for micro-aneurysms with arterial angiography, and the contraindication of renal biopsy, associated with a high risk of severe hemorrhage. Periarteritis nodosa still exists in nephrology, even without hepatitis B infection. The association of acute renal failure with medium vessel vasculitis, with negative ANCA, must alert the nephrologist and lead to arterial angiography not to renal biopsy.
Published: 2016

91. Familial and syndromic lupus share the same phenotype as other early-onset forms of lupus

Author: François Maurier, Behrouz Kassai, Nicole Fabien, Hélène Lefebvre, Aurélia Carbasse, Maryam Piram, Irène Lemelle, Pauline Soulas-Sprauel, Bruno Ranchin, Hugues Flodrops, Eric Hachulla, Aurélia Lanteri, Brigitte Bader-Meunier, Alexandre Belot, Ulrich Meinzer, Isabelle Rouvet, Stéphane Burtey, Yanick J. Crow, Charlotte Samaille, Héloïse Reumaux, Christophe Malcus, Olivia Weill, Tiphanie Ginhoux, Frédéric Rieux-Laucat, Caroline Galeotti, V. Despert, Anne Pagnier, Isabelle Koné-Paut, Sandrine Morell Dubois, Stéphane Decramer, Service de Pédiatrie - Néphrologie, Médecine interne, Hypertension, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service d'immunologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Evaluation et modélisation des effets thérapeutiques, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), EPICIME-CIC 1407 de Lyon, Inserm, Service de Pharmacologie Clinique, hospices civils de Lyon, Centre de Biotechnologie cellulaire, Hospices Civils de Lyon (HCL), Academic Unit of Medical Genetic, University of Manchester [Manchester], Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Immunologie et chimie thérapeutiques (ICT), Cancéropôle du Grand Est-Centre National de la Recherche Scientifique (CNRS), Centre de Référence des Maladies AutoInflammatoires (CeRéMAI), Centre Hospitalier de Versailles André Mignot (CHV), Unité Néphrologie Pédiatrique [CHRU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Claude Huriez [Lille], CHU Lille, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Service de médecine interne [hôpitaux privés de Metz], Hôpitaux Privés de Metz (HPMetz), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de Pédiatrie [Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service Pédiatrique [Rennes], CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Service de Néphrologie Rhumatologie Dermatologie, Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)-HCL Groupement Hospitalier Est-Centre de référence Maladies Rénales Rares, Service de médecine interne [Lille], Service d'immuno-hématologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Department of Pathology, Hôpital Femme-Mère-Enfant, Réponse immunitaire innée dans les maladies infectieuses et auto-immunes – Innate immunity in infectious and autoimmune diseases, Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Toulouse [Toulouse]-Hôpital des Enfants, CHU Toulouse [Toulouse], Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier de Versailles (CHV), Hôpital Claude Huriez, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), HCL Groupement Hospitalier Est-Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)-Centre de référence Maladies Rénales Rares, and Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP]
Subjects: 0301 basic medicine, Male, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Autoimmunity, Disease, medicine.disease_cause, Pediatrics, Severity of Illness Index, Cohort Studies, 0302 clinical medicine, immune system diseases, Epidemiology, Lupus Erythematosus, Systemic, Monogenic lupus, Age of Onset, skin and connective tissue diseases, Child, Systemic lupus erythematosus, Incidence, Age Factors, Phenotype, 3. Good health, Child, Preschool, Cohort, Disease Progression, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, medicine.medical_specialty, Adolescent, Risk Assessment, 03 medical and health sciences, Sex Factors, Rheumatology, Internal medicine, medicine, Genetics, Humans, Genetic Predisposition to Disease, Retrospective Studies, business.industry, medicine.disease, 030104 developmental biology, Disease Presentation, Immunology, business, Anti-SSA/Ro autoantibodies, Follow-Up Studies
Abstract: Objective Studies of early-onset systemic lupus erythematosus (SLE) have identified monogenic forms of the disease. The primary objective of this study was to compare the clinical and laboratory features of the first patients included in the GENIAL/LUMUGENE cohort to those reported in previous publications. The secondary objective was to determine whether subgroups with a distinctive pattern of clinical and biological features are seen in predominantly genetic forms of SLE. Methods GENIAL/LUMUGENE is a French nationwide study of the clinical, immunological, and genetic features of juvenile-onset SLE (clinicaltrials.gov # NCT01992666 ). Clinical and laboratory data from the first 64 patients younger than 18 years who were included in the first part of the study were collected retrospectively. Predefined criteria were used to divide the patients into three subgroups: syndromic SLE ( n = 10) and familial SLE ( n = 12) – both presumed to have a strong genetic component – and other forms of early-onset SLE ( n = 42). Results The predefined criteria for identifying subgroups based on knowledge of the clinical and epidemiological features of monogenic SLE showed a significantly younger age at onset in syndromic SLE ( P Conclusions In this study, clinical and epidemiological data alone failed to identify a specific patient subgroup characterized by the same disease presentation or progression. This result may be related to the small sample size or indicate marked heterogeneity of juvenile-onset SLE. Genetic studies using new sequencing techniques in these patients might identify genetic factors responsible for marked phenotypic variability.
Published: 2016
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92. Antibody-Dependent NK Cell Activation Is Associated with Late Kidney Allograft Dysfunction and the Complement-Independent Alloreactive Potential of Donor-Specific Antibodies

Author: Tristan Legris, Christophe Picard, Dilyana Todorova, Luc Lyonnet, Cathy Laporte, Chloe Dumoulin, Corinne Nicolino-Brunet, Laurent Daniel, Anderson Loundou, Sophie Morange, Stanislas Bataille, Henri Vacher Coponat, Valerie Moal, Yvon Berland, Francoise Dignat George, Stephane Burtey, Pascale Paul, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Etablissement Français du Sang - Alpes-Méditerranée (EFS - Alpes-Méditerranée), Etablissement Français du Sang, Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiopathologie de l'Endothelium, Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Laboratoire d'anatomie, pathologie, neuropathologie, Hôpital de la Timone [CHU - APHM] (TIMONE), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, CIC - Biotherapie - Marseille, Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'Immunologie [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Centre National de la Recherche Scientifique (CNRS), This work was in part supported by translational research grants funded by the Assistance Publique des Hôpitaux de Marseille, Institut National de la Santé et de la Recherche Médicale, L’Institut National Du Cancer (INCa), and Direction Générale de l’Offre de Soins (DGOS) (Acronym FEG CO8-17, ID 2008-A00604-51, AORC MAT, Microangiopathies Thrombotiques, principal investigator: Pr G. Kaplanski). CL was supported by SATT (South East Accelerating Technology Transfer)., Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), and DIGNAT-GEORGE, Françoise
Subjects: 0301 basic medicine, lcsh:Immunologic diseases. Allergy, [SDV]Life Sciences [q-bio], Immunology, kidney transplantation, 030230 surgery, MESH: Anticoagulants, Antibody mediated rejection, donor-specific antibodies, MESH: Venous Thromboembolism, 03 medical and health sciences, Interleukin 21, 0302 clinical medicine, MESH: Risk Factors, MESH: Cell-Derived Microparticles, medicine, Immunology and Allergy, Cytotoxic T cell, MESH: Animals, MESH: Neoplasms, MESH: Thrombosis, Kidney transplantation, Original Research, Antibody-dependent cell-mediated cytotoxicity, Lymphokine-activated killer cell, natural killer cells, MESH: Humans, biology, MESH: Thromboplastin, natural killer (NK) cells, medicine.disease, MESH: Neoplasm Metastasis, 3. Good health, [SDV] Life Sciences [q-bio], Transplantation, 030104 developmental biology, MESH: Platelet Aggregation Inhibitors, MESH: Blood Coagulation, biology.protein, Interleukin 12, antibody-mediated rejection, MESH: Disease Progression, Antibody, MESH: Disease Models, Animal, lcsh:RC581-607, antibody-dependent cellular cytotoxicity
Abstract: International audience; Although kidney transplantation remains the best treatment for end-stage renal failure, it is limited by chronic humoral aggression of the graft vasculature by donor-specific antibodies (DSAs). The complement-independent mechanisms that lead to the antibody-mediated rejection (ABMR) of kidney allografts remain poorly understood. Increasing lines of evidence have revealed the relevance of natural killer (NK) cells as innate immune effectors of antibody-dependent cellular cytotoxicity (ADCC), but few studies have investigated their alloreactive potential in the context of solid organ transplantation. Our study aimed to investigate the potential contribution of the antibody-dependent alloreactive function of NK cells to kidney graft dysfunction. We first conducted an observational study to investigate whether the cytotoxic function of NK cells is associated with chronic allograft dysfunction. The NK-Cellular Humoral Activation Test (NK-CHAT) was designed to evaluate the recipient and antibody-dependent reactivity of NK cells against allogeneic target cells. The release of CD107a/Lamp1(+) cytotoxic granules, resulting from the recognition of rituximab-coated B cells by NK cells, was analyzed in 148 kidney transplant recipients (KTRs, mean graft duration: 6.2 years). Enhanced ADCC responsiveness was associated with reduced graft function and identified as an independent risk factor predicting a decline in the estimated glomerular filtration rate over a 1-year period (hazard ratio: 2.83). In a second approach, we used the NK-CHAT to reveal the cytotoxic potential of circulating alloantibodies in vitro. The level of CD16 engagement resulting from the in vitro recognition of serum-coated allogeneic B cells or splenic cells was further identified as a specific marker of DSA-induced ADCC. The NK-CHAT scoring of sera obtained from 40 patients at the time of transplant biopsy was associated with ABMR diagnosis. Our findings indicate that despite the administration of immunosuppressive treatments, robust ADCC responsiveness can be maintained in some KTRs. Because it evaluates both the Fab recognition of alloantigens and Fc-driven NK cell activation, the NK-CHAT represents a potentially valuable tool for the non-invasive and individualized evaluation of humoral risk during transplantation.
Published: 2016
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93. Haemodialysis patients with diabetes eat less than those without: A plea for a permissive diet

Author: bataille, stanislas, Landrier, Jean, Astier, Julien, Cado, Sylvie, Sallette, Jérôme, Giaime, Philippe, Sampol, Jérôme, Sichez, Hélène, Ollier, Jacques, Gugliotta, Jean, Serveaux, Marianne, Cohen, Julien, Darmon, Patrice, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Nutrition, obésité et risque thrombotique (NORT), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )-Assistance Publique - Hôpitaux de Marseille (APHM), Darmon, Patrice, and Aix Marseille Université (AMU)-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, dialyse, [SDV]Life Sciences [q-bio], Nutritional Status, Comorbidity, Recommended Dietary Allowances, Protein-Energy Malnutrition, diabetes, dietary intake, hemodialysis, nutritional intake, protein energy wasting syndrome, Renal Dialysis, Risk Factors, Food and Nutrition, Humans, Diabetic Nephropathies, Geriatric Assessment, Aged, Aged, 80 and over, Hand Strength, perte d'énergie, perte protéique, [SDV] Life Sciences [q-bio], régime alimentaire, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, Cross-Sectional Studies, Nutrition Assessment, Treatment Outcome, Alimentation et Nutrition, Body Composition, Kidney Failure, Chronic, Female, Dietary Proteins, France, Energy Intake, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, diabète
Abstract: The main cause of malnutrition in hemodialysis patients is a spontaneous decline in energy and protein intakes. This study aims to report the dietary energy intake (DEI), dietary protein intake (DPI), and dietary micronutrient intake in a French HD population, to report factors associated with a low DPI and DEI, and to analyze if nutritional intake was correlated with nutritional status., We conducted an observational cross-sectional study in a hemodialysis population of 87 adult patients in July 2014. Daily nutritional oral intake, handgrip strength, body composition measured by bioimpedancemetry, and biological and dialysis parameters were obtained from medical records. Statistical analyses of parameters associated with DEI and DPI were performed., The median age (interquartile range) of the population was 77.3[71.1; 84.8] years, 57.5% were men, and 52.9% had diabetes mellitus. Median weight-adjusted DEI was 18.4[15.7;22.3]kcal/kg/day (1308 [1078; 1569] kcal/day), and median weight-adjusted DPI was 0.80[0.66; 0.96] g/kg/day (57.5[47.1; 66.8] g/day). In multivariate analysis, weight-adjusted DEI was statistically lower in patients with diabetes (coefficient [95%CI] -3.81[-5.21;-2.41] kcal/kg/day; p = 0.01) but was not associated with the others parameters. When DEI was not adjusted for weight, diabetes was no longer associated with DEI, but female gender (-178[-259;-961] kcal/day; p = 0.03) and a higher Charlson comorbidity index (-30[-44;-15]; p = 0.04) were associated with a lower calorie intake. Results for DPI were similar except that the Charlson comorbidity index did not reach significance., Diabetes is an important factor associated with low dietary intake in hemodialysis patients. Restrictive regimens should be prescribed cautiously in hemodialysis patients, especially in those with diabetes.
Published: 2016
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94. Prévention des infections au cours du lupus systémique chez l’adulte et l’adolescent : élaboration de recommandations pour la pratique clinique, à partir d’une analyse de la littérature et de l’avis d’experts

Author: Mathian, A., Arnaud, L., Adoue, D., Agard, C., Bader-Meunier, B., Baudouin, V., Belizna, C., Bonnotte, B., Boumedine, F., Chaib, A., Chauchard, M., Chiche, L., Daugas, E., Ghali, A., Gobert, P., Gondran, G., Guettrot-Imbert, G., Hachulla, E., Hamidou, M., Haroche, J., Hervier, B., Hummel, A., Jourde-Chiche, N., Korganow, A.S., Kwon, T., Le Guern, V., Le Quellec, A., Limal, N., Magy-Bertrand, N., Marianetti-Guingel, P., Martin, T., Martin Silva, N., Meyer, O., Miyara, M., Morell-Dubois, S., Ninet, J., Pennaforte, J.L., Polomat, K., Pourrat, J., Queyrel, V., Raymond, I., Rémy, P., Sacre, K., Sibilia, J., Viallard, J.-F., Viau Brabant, A., Hanslik, T., Amoura, Zahir, antiphospholipides, le groupe France lupus érythémateux systémique réseau (FLEUR) et les centres de référence et de compétence des lupus et syndromes des, Centre National de Référence du Lupus Systémique, Syndrome des Anticorps Anti-phospholipides et Maladies Auto-immunes Systémiques Rares[CHU Pitié Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Service de médecine interne [CHU Pitié-Salpétrière], Institut E3M [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [APHP], Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Service de médecine interne [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'immuno-hématologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Imagine - Institut des maladies génétiques (IMAGINE - U1163), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP Hôpital universitaire Robert-Debré [Paris], Service de médecine interne et gérontologie clinique [Angers], Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service de médecine interne et immunologie clinique (SOC 1) [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Médecine Interne [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Service de Médecine Interne [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Centre de référence des syndromes drépanocytaires majeurs, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Centre hospitalier d'Avignon, CH Avignon, Service de Médecine interne A et polyclinique médicale [CHU Limoges], CHU Limoges, CHU Clermont-Ferrand, Service de médecine interne [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Lille, Service de néphrologie adultes [CHU Necker], Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), CHU Strasbourg, Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service de médecine interne [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Service de médecine interne [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), CHU de la Martinique [Fort de France], Service de Néphrologie - Immunologie Clinique [Toulouse], CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse]-PRES Université de Toulouse, Centre Hospitalier Universitaire de Nice (CHU Nice), Service de médecine interne et maladies infectieuses [Bordeaux], CHU Bordeaux [Bordeaux]-Groupe hospitalier Saint-André, Institut François Magendie, Service de néphrologie et transplantation, Service de rhumatologie [Strasbourg], CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Hôpital Ambroise Paré, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre National de Référence du Lupus Systémique, Syndrome des Anticorps Anti-phospholipides et Maladies Auto-immunes Systémiques Rares [CHU Pitié Salpêtrière], Service de Médecine Interne 2, maladies auto-immunes et systémiques [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Institut E3M [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine interne [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Centre de référence des syndromes drépanocytaires majeurs, Centre Hospitalier Henri Duffaut (Avignon), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital Ambroise Paré [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-PRES Université de Toulouse, Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de référence des syndromes drépanocytaires majeurs-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Strasbourg (UNISTRA), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut E3M [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)
Subjects: 030203 arthritis & rheumatology, Gynecology, medicine.medical_specialty, business.industry, Recommandations, education, Vaccination, Gastroenterology, Review Literature as Topic, Guidelines, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Systemic lupus erythematosus, Lupus systémique, immune system diseases, Internal Medicine, medicine, 030212 general & internal medicine, business, skin and connective tissue diseases, Infection, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Resume Propos L’objectif de ce travail etait de proposer des recommandations relatives aux modalites des vaccinations, de la prevention de la pneumocystose et du depistage du cancer du col de l’uterus dans le lupus systemique (LS) chez l’adulte et l’adolescent. Methodes Trente-sept experts francais du LS ont pris part a un vote visant a retenir des recommandations preparees par un groupe de travail a partir d’une revue de la litterature. Resultats Les vaccins inactives ou sous-unitaires peuvent etre administres sans danger car le risque de declencher une poussee de LS apres une vaccination n’a jamais ete demontre. Les patients lupiques doivent suivre les recommandations de vaccination et le calendrier vaccinal de la population generale. Il est egalement recommande que tous les patients lupiques soient vaccines contre le pneumocoque et que les patients lupiques immunodeprimes soient vaccines annuellement contre la grippe saisonniere (vaccin inactive). De facon generale, les patients lupiques immunodeprimes ne doivent pas recevoir de vaccin vivant. Cependant, ces vaccins peuvent etre envisages dans certaines situations ou le niveau d’immunosuppression n’est pas trop prononce (par exemple, les patients traites par une posologie ≤ 10 mg/j d’equivalent-prednisone sans immunosuppresseur ni biotherapie) et ou le benefice de la vaccination est plus important que le risque de la maladie infectieuse qui doit etre prevenue. Les experts recommandent que le depistage du cancer du col de l’uterus chez les patientes lupiques immunodeprimees soit realise annuellement par frottis cervico-uterins. Conclusions Ces recommandations devraient aider a homogeneiser la pratique des differents medecins francais impliques dans la prise en charge du LS.
Published: 2016
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95. NATURAL KILLER CELL ACTIVATION IS A POTENT CYTOTOXIC MECHANISM ă SUSTAINING ADVERSE CYTOTOXIC EFFECTS OF DONOR-SPECIFIC ANTIBODIES IN ă SOLID ORGAN TRANSPLANTATION

Author: Pascale Paul, Tristan Legris, Luc Lyonnet, Ă, Dilyana Todorova, Emmanuelle Sampol, Julie Di Cristofaro, Laurent Daniel, Valerie Moal, yvon Berland, Frederic Collart, Ă, Florence Sabatier, Stéphane Burtey, Francoise Dignat-George, Ă, Annick Mouly Bandini, Christophe Picard, Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Physiopathologie de l'Endothelium, Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Etablissement Français du Sang - Alpes-Méditerranée (EFS - Alpes-Méditerranée), Etablissement Français du Sang, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM), Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), INSB-INSB-Centre National de la Recherche Scientifique (CNRS), and COMBE, Isabelle
Subjects: [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, ComputingMilieux_MISCELLANEOUS
Abstract: International audience; no abstract
Published: 2016

96. NATURAL KILLER CELL ACTIVATION IS A POTENT CYTOTOXIC MECHANISM SUSTAINING ADVERSE CYTOTOXIC EFFECTS OF DONOR-SPECIFIC ANTIBODIES IN SOLID ORGAN TRANSPLANTATION

Author: Pascale Paul, Tristan Legris, Luc Lyonnet, Dilyana Todorova, Emmanuelle Sampol, Julie Di Cristofaro, Laurent Daniel, Valérie Moal, yvon Berland, Frederic Collart, Florence Sabatier, Stéphane Burtey, Francoise Dignat-George, Annick Mouly Bandini, Christophe Picard, Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Etablissement Français du Sang - Alpes-Méditerranée (EFS - Alpes-Méditerranée), Etablissement Français du Sang, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Héritages et Constructions dans le Texte et l'Image (HCTI), Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Institut Brestois des Sciences de l'Homme et de la Société (IBSHS), Université de Brest (UBO), Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Assistance Publique - Hôpitaux de Marseille (APHM), COMBE, Isabelle, Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), and Université de Brest (UBO)-Université de Brest (UBO)
Subjects: [SDV] Life Sciences [q-bio], [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV]Life Sciences [q-bio], [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, ComputingMilieux_MISCELLANEOUS
Abstract: International audience; no abstract
Published: 2016

97. Indoxyl Sulfate Upregulates Liver P-Glycoprotein Expression and Activity through Aryl Hydrocarbon Receptor Signaling

Author: Annick Mouly-Bandini, Pascale Paul, Philippe Brunet, Stéphane Burtey, Noémie Jourde-Chiche, Rosalinde Masereeuw, Stéphane Poitevin, Nathalie McKay, Claire Cerini, Tristan Legris, Tacy Santana Machado, Françoise Dignat-George, Afd Pharmacology, Pharmacology, Vascular research center of Marseille (VRCM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Ministry of Education [Brazil], Centre recherche en CardioVasculaire et Nutrition (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), and Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)
Subjects: Male, 0301 basic medicine, ATP Binding Cassette Transporter, Subfamily B, SLC47A1, [SDV]Life Sciences [q-bio], Gene Expression, Renal function, Pharmacology, Mice, 03 medical and health sciences, Downregulation and upregulation, Albumins, Animals, Humans, RNA, Messenger, cyclosporine, Renal Insufficiency, Chronic, ComputingMilieux_MISCELLANEOUS, P-glycoprotein, SLC10A1, biology, Chemistry, Multidrug resistance-associated protein 2, Hep G2 Cells, General Medicine, Middle Aged, Aryl hydrocarbon receptor, Kidney Transplantation, Multidrug Resistance-Associated Protein 2, drug transporter, Up-Regulation, Disease Models, Animal, Basic Research, 030104 developmental biology, Liver, Receptors, Aryl Hydrocarbon, Nephrology, biology.protein, Heart Transplantation, Female, Efflux, ABC transporter, Indican, Immunosuppressive Agents, chronic kidney disease, Signal Transduction
Abstract: In patients with CKD, not only renal but also, nonrenal clearance of drugs is altered. Uremic toxins could modify the expression and/or activity of drug transporters in the liver. We tested whether the uremic toxin indoxyl sulfate (IS), an endogenous ligand of the transcription factor aryl hydrocarbon receptor, could change the expression of the following liver transporters involved in drug clearance: SLC10A1, SLC22A1, SLC22A7, SLC47A1, SLCO1B1, SLCO1B3, SLCO2B1, ABCB1, ABCB11, ABCC2, ABCC3, ABCC4, ABCC6, and ABCG2. We showed that IS increases the expression and activity of the efflux transporter P-glycoprotein (P-gp) encoded by ABCB1 in human hepatoma cells (HepG2) without modifying the expression of the other transporters. This effect depended on the aryl hydrocarbon receptor pathway. Presence of human albumin at physiologic concentration in the culture medium did not abolish the effect of IS. In two mouse models of CKD, the decline in renal function associated with the accumulation of IS in serum and the specific upregulation of Abcb1a in the liver. Additionally, among 109 heart or kidney transplant recipients with CKD, those with higher serum levels of IS needed higher doses of cyclosporin, a P-gp substrate, to obtain the cyclosporin target blood concentration. This need associated with serum levels of IS independent of renal function. These findings suggest that increased activity of P-gp could be responsible for increased hepatic cyclosporin clearance. Altogether, these results suggest that uremic toxins, such as IS, through effects on drug transporters, may modify the nonrenal clearance of drugs in patients with CKD.
Published: 2018
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98. The 'Dose-Effect' Relationship Between 25-Hydroxyvitamin D and Muscle Strength in Hemodialysis Patients Favors a Normal Threshold of 30 ng/mL for Plasma 25-Hydroxyvitamin D

Author: Jacques Ollier, Philippe Giaime, Julien Astier, Marianne Serveaux, Jean-François Landrier, Jérôme Sampol, Jean Gugliotta, Julien Cohen, Patrice Darmon, Hélène Sichez, Stanislas Bataille, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Nutrition humaine et lipides : Biodisponibilité, métabolisme et régulation, Université de la Méditerranée - Aix-Marseille 2-Institut National de la Recherche Agronomique (INRA)-Université de Provence - Aix-Marseille 1-IFR125-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, obésité et risque thrombotique (NORT), Aix Marseille Université (AMU)-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), and Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM)
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Population, 030232 urology & nephrology, Nutritional Status, Medicine (miscellaneous), Body Mass Index, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Renal Dialysis, Internal medicine, Hand strength, medicine, Vitamin D and neurology, Humans, Prealbumin, 030212 general & internal medicine, Vitamin D, education, ComputingMilieux_MISCELLANEOUS, Aged, Aged, 80 and over, Creatinine, education.field_of_study, Nutrition and Dietetics, Dose-Response Relationship, Drug, Hand Strength, business.industry, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, Dose–response relationship, Cross-Sectional Studies, Nutrition Assessment, Endocrinology, chemistry, Nephrology, Dietary Supplements, Body Composition, Linear Models, Muscle strength, Female, Hemodialysis, business, Body mass index, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Objective: Muscle strength is weakened in maintenance hemodialysis patients. Strength is both a measure of a functional parameter and of frailty as it is independently associated with mortality. In the general population, observational studies show that plasma 25-hydroxyvitamin D (25[OH]D) is positively correlated with muscle strength and function. We analyzed the determinants of muscle strength measured by handgrip and 25(OH)D in a maintenance hemodialysis population. Methods: In this observational cross-sectional study, data from all hemodialysis patients from our nephrology department were recorded in July 2014. Daily nutritional oral intake, handgrip strength, body composition measured by bioimpedancemetry analysis, as well as biological and dialysis parameters, were obtained from medical files. We used a linear regression model to assess nutritional, biological, and dialysis parameters as well as body composition associated with handgrip strength. Results: The median age (interquartile range) of the 130 included patients was 77.3 (69.5-84.7) years, 57.7% were men, and 50.8% had diabetes mellitus. Median handgrip strength value (interquartile range) was 14.3 (10.6-22.2) kg. In univariate analyses, the factors associated with handgrip strength were age, gender, albumin, transthyretin, predialysis creatinine and urea, normalized protein nitrogen appearance, lean mass, and muscle mass measured by bioimpedancemetry analysis as well as phase angle, and 25(OH)D. In multivariate analyses, lower age, male gender, higher albumin, higher muscle mass, and 25(OH)D level >= 30 ng/mL were independently correlated with muscle strength measured by handgrip. Conclusions: This study found a positive correlation between plasma 25(OH)D and muscle strength measured by handgrip in hemodialysis patients. We report a "dose-effect'' relationship between 25(OH)D and handgrip strength under 30 ng/mL, which is no more present above 30 ng/mL. Prospective randomized studies are needed to prove that supplementation with cholecalciferol, leading to 25(OH)D levels >= 30 ng/mL, improves muscle strength in hemodialysis patients. (
Published: 2016
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99. Enhanced Natural Killer Responsiveness Is a Potent Cytotoxic Mechanism Associating to Kidney Allograft Dysfunction and Pathogenic Effects of Donor-Specific Antibodies (DSA)

Author: Paul, P., Legris, T., Picard, C., Todorova, D., Lyonnet, L., Daniel, L., Dussol, B., Moal, V., Coponat, H. V., Berland, Y., Françoise DIGNAT-GEORGE, Burtey, S., DIGNAT-GEORGE, Françoise, Vascular research center of Marseille (VRCM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Physiopathologie de l'Endothelium, Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Laboratoire d'Immunologie [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Centre National de la Recherche Scientifique (CNRS), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: [SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2016

100. PREDICTION OF CV EVENT IN DIABETIC NEPHROPATHY

Author: Fauvel, J., Joly, D., Choukroun, Gabriel, Dussol, B., Fiquet, B., Halimi, J. -M., Quere, S., Combe, C., Ducher, M., Institut des Sciences Chimiques de Rennes (ISCR), Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Ecole Nationale Supérieure de Chimie de Rennes (ENSCR)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Pharmaceut, Med & Sci Affairs, Novartis, Diagnostics et imageries des procédés industriels (ENISE-DIPI), Ecole Nationale d'Ingénieurs de Saint Etienne (ENISE), Hospices Civils de Lyon (HCL), Ciblage thérapeutique en Oncologie (EA3738), Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon
Subjects: [SDV]Life Sciences [q-bio], ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2016
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