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Belmonte R, Silva-Rodriguez M, Barbé F, Bensenane M, Haghenejad V, Vrillon I, Alla A, Flahault A, Kormann R, Corbel A, Aitdjafer Z, Quilliot D, Derain-Dubourg L, Namour F, Guéant JL, Bronowicki JP, Oussalah A. Multiparametric renal function assessment in cirrhotic patients shows high prevalence of medically actionable changes in multiple modules. Hepatol Res 2024. [PMID: 38662338 DOI: 10.1111/hepr.14050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/24/2024] [Accepted: 04/03/2024] [Indexed: 04/26/2024]
Abstract
AIM Renal dysfunction is a common complication of cirrhosis, occurring either as part of multiorgan involvement in acute illness or secondary to advanced liver disease. To date, no study has comprehensively assessed multiple renal function parameters in hospitalized patients with cirrhosis through a multiparametric analysis of renal biochemistry markers. METHODS We conducted a retrospective, observational study including all consecutive patients hospitalized with cirrhosis who underwent a 43-multiparametric renal function assessment between January 1, 2021, and June 30, 2023. RESULTS All patients showed at least one of the following renal abnormalities: Kidney Disease: Improving Global Outcomes stage G2 or higher, sodium and/or chloride excretion fraction <1%, electrolyte-free water clearance <0.4 mL/min, or tubular maximum phosphate reabsorption capacity <0.8 mmol/L. The estimated glomerular filtration rate equations significantly overestimated the measured creatinine clearance with median differences of +14 mL/min/1.73 m2 (95% CI 6-29) and +9 mL/min/1.73 m2 (95% CI 2-15) for European Kidney Function Consortium equations, respectively. Notably, 54% and 39% of patients demonstrated estimated glomerular filtration rates exceeding 30% of the measured creatinine clearance when the Chronic Kidney Disease - Epidemiology Collaboration and European Kidney Function Consortium formulas were employed, respectively. Substantial discrepancies in Kidney Disease: Improving Global Outcomes stage assignments were observed between the estimated glomerular filtration rate- and measured creatinine clearance-based assessments. CONCLUSIONS This study underscores the value of a multiparametric renal function assessment as a routine tool for evaluating renal function in patients with cirrhosis. A high prevalence of medically actionable renal abnormalities spanning multiple renal function modules, including alterations in glomerular function, salt and solute-free water excretion, and proximal tubule phosphate reabsorption, has been demonstrated in hospitalized patients with cirrhosis.
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Affiliation(s)
- Richard Belmonte
- Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, Nancy, France
- Reference Medical Biology Laboratory for Biochemical and Molecular Explorations of Uro-nephrological Diseases, University Hospital of Nancy, Nancy, France
| | - Maël Silva-Rodriguez
- Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, Nancy, France
- Reference Medical Biology Laboratory for Biochemical and Molecular Explorations of Uro-nephrological Diseases, University Hospital of Nancy, Nancy, France
| | - Françoise Barbé
- Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, Nancy, France
- Reference Medical Biology Laboratory for Biochemical and Molecular Explorations of Uro-nephrological Diseases, University Hospital of Nancy, Nancy, France
| | - Mouni Bensenane
- Department of Gastroenterology and Liver Diseases, University Hospital of Nancy, Nancy, France
| | - Vincent Haghenejad
- Department of Gastroenterology and Liver Diseases, University Hospital of Nancy, Nancy, France
- University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, Nancy, France
| | - Isabelle Vrillon
- Pediatric Nephrology Unit, University Hospital of Nancy, Nancy, France
| | - Asma Alla
- Department of Nephrology, University Hospital of Nancy, Nancy, France
| | - Adrien Flahault
- Department of Nephrology, University Hospital of Nancy, Nancy, France
| | - Raphael Kormann
- Department of Nephrology, University Hospital of Nancy, Nancy, France
| | - Alice Corbel
- Department of Nephrology, University Hospital of Nancy, Nancy, France
| | - Zakia Aitdjafer
- Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, Nancy, France
- Reference Medical Biology Laboratory for Biochemical and Molecular Explorations of Uro-nephrological Diseases, University Hospital of Nancy, Nancy, France
| | - Didier Quilliot
- University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, Nancy, France
- Department of Endocrinology Diabetology and Nutrition, University Hospital of Nancy, Nancy, France
| | - Laurence Derain-Dubourg
- Nephrology, Dialysis, Hypertension and Functional Renal Exploration, Edouard Herriot Hospital, Hospices Civils de Lyon and Université Lyon 1, Lyon, France
| | - Farès Namour
- Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, Nancy, France
- Reference Medical Biology Laboratory for Biochemical and Molecular Explorations of Uro-nephrological Diseases, University Hospital of Nancy, Nancy, France
- University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, Nancy, France
- Reference Center for Inborn Errors of Metabolism (ORPHA67872), University Hospital of Nancy, Nancy, France
| | - Jean-Louis Guéant
- Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, Nancy, France
- Reference Medical Biology Laboratory for Biochemical and Molecular Explorations of Uro-nephrological Diseases, University Hospital of Nancy, Nancy, France
- University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, Nancy, France
- Reference Center for Inborn Errors of Metabolism (ORPHA67872), University Hospital of Nancy, Nancy, France
| | - Jean-Pierre Bronowicki
- Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, Nancy, France
- Department of Gastroenterology and Liver Diseases, University Hospital of Nancy, Nancy, France
- University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, Nancy, France
| | - Abderrahim Oussalah
- Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, Nancy, France
- Reference Medical Biology Laboratory for Biochemical and Molecular Explorations of Uro-nephrological Diseases, University Hospital of Nancy, Nancy, France
- University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, Nancy, France
- Reference Center for Inborn Errors of Metabolism (ORPHA67872), University Hospital of Nancy, Nancy, France
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Quinaux T, Tubail Z, Vrillon I, Sartelet H, Savenkoff B. Campylobacter Colitis as a Trigger for Atypical Hemolytic Uremic Syndrome: About One Case. Case Rep Nephrol Dial 2023; 13:113-119. [PMID: 37900922 PMCID: PMC10601843 DOI: 10.1159/000529941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 02/20/2023] [Indexed: 10/31/2023] Open
Abstract
We present the case of a 17-year-old Caucasian male whose condition featured acute renal failure, anemia, and deep thrombocytopenia after five consecutive days of diarrhea. Campylobacter coli was identified in stool cultures and, although the direct role of this germ in the pathogenesis of hemolytic uremic syndrome (HUS) remains uncertain to this day, initial presentation was considered broadly consistent with typical HUS. However, the patient showed no signs of spontaneous recovery over time. While secondary investigations showed no abnormalities in ADAMTS13 activity or in the alternate pathway of complement, patient's condition deteriorated. Worsening kidney failure required emergency renal replacement therapy and was followed by cardiac involvement in the form of acute heart failure. Given this unfavorable development, blood samples were drawn to look for mutations in the alternate complement pathway, and eculizumab therapy was initiated without further delay, allowing prompt improvement of cardiac function and recovery of diuresis. Upon discharge, the patient still had to undergo intermittent dialysis, which would later be withdrawn. Genetic analysis ultimately confirmed the presence of a complement factor H mutation associated with a high risk of disease recurrence, indicating long-term continuation of eculizumab therapy.
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Affiliation(s)
- Thomas Quinaux
- Nephrology, dialysis and therapeutic apheresis department, Centre Hospitalier Régional Metz-Thionville, Metz, France
| | - Zead Tubail
- Nephrology, dialysis and therapeutic apheresis department, Centre Hospitalier Régional Metz-Thionville, Metz, France
| | - Isabelle Vrillon
- Pediatric nephrology, dialysis and transplantation department, Centre Hospitalier Régional Universitaire de Nancy - Hôpital Brabois Enfants, Nancy, France
| | - Hervé Sartelet
- Pathology department, Centre Hospitalier Régional Universitaire de Nancy, Nancy, France
| | - Benjamin Savenkoff
- Nephrology, dialysis and therapeutic apheresis department, Centre Hospitalier Régional Metz-Thionville, Metz, France
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3
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Madden I, Baudouin V, Charbit M, Ranchin B, Roussey G, Novo R, Garaix F, Decramer S, Fila M, Merieau E, Vrillon I, Zaloszyc A, Hogan J, Harambat J. National survey of prevention and management of CMV infection in pediatric kidney transplantation in comparison to clinical practice guidelines. Front Pediatr 2022; 10:1057352. [PMID: 36589153 PMCID: PMC9800817 DOI: 10.3389/fped.2022.1057352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Cytomegalovirus (CMV) is one of the most frequent opportunistic infections in kidney transplant (KT) recipients and is a risk factor for patient and graft survival after KT. Center-to-center variation, optimal prevention and treatment strategies in pediatric KT are currently unknown. This survey aimed to assess current CMV prevention and treatment strategies used among French pediatric KT centers. METHODS A web-based survey was sent to all 13 French pediatric kidney transplantation centers. RESULTS Twelve (92%) centers responded to the survey. All centers used prophylaxis for the donor-positive/recipient-negative (D+/R-) group. For R + patients, 54% used prophylaxis, 37% used a pre-emptive strategy. In the low-risk group, D-/R-, 50% used a pre-emptive approach and 50% had no specific prevention strategy. The antiviral used by all centers for prophylaxis was valganciclovir (VGCV). The duration of prophylaxis varied from 3 to 7 months and the duration of viral load monitoring varied from 6 months to indefinitely. No center used a hybrid/sequential approach. For the treatment of CMV DNAemia, VGCV or intravenous GCV were used. Therapeutic drug monitoring of VGCV was performed in 5 centers (42%). Five centers reported drug resistance. Eight centers (67%) administered VGCV during the treatment of acute graft rejection. CONCLUSIONS There is uniformity in CMV management in some areas among pediatric KT centers in France but not in others which remain diverse and are not up to date with current guidelines, suggesting unnecessary variation which could be reduced with better evidence to inform practice.
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Affiliation(s)
- Iona Madden
- Pediatric Nephrology Unit, Bordeaux University Hospital, Bordeaux, France
| | | | - Marina Charbit
- Pediatric Nephrology Unit, Hôpital Necker Enfants Malades, APHP, Paris, France
| | - Bruno Ranchin
- Pediatric Nephrology Unit, Hospices Civils de Lyon, Lyon, France
| | - Gwenaëlle Roussey
- Pediatric Nephrology Unit, Nantes University Hospital, Nantes, France
| | - Robert Novo
- Pediatric Nephrology Unit, Lille University Hospital, Lille, France
| | - Florentine Garaix
- Pediatric Nephrology Unit, AP-Hôpitaux de Marseille, Marseille, France
| | - Stéphane Decramer
- Pediatric Nephrology Unit, Toulouse University Hospital, Toulouse, France
| | - Marc Fila
- Pediatric Nephrology Unit, Montpellier University Hospital, Montpellier, France
| | - Elodie Merieau
- Pediatric Nephrology Unit, Tours University Hospital, Tours, France
| | - Isabelle Vrillon
- Pediatric Nephrology Unit, Nancy University Hospital, Nancy, France
| | - Ariane Zaloszyc
- Pediatric Nephrology Unit, Strasbourg University Hospital, Strasbourg, France
| | - Julien Hogan
- Pediatric Nephrology Unit, Robert Debré Hospital, APHP, Paris, France
| | - Jérôme Harambat
- Pediatric Nephrology Unit, Bordeaux University Hospital, Bordeaux, France
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Dumangin G, Brenkman M, Pape E, Kolodziej A, Gambier N, Vrillon I, Charmillon A, Scala-Bertola J. Temocillin dosage adjustment in a preterm infant with severe renal disease: a case report. J Antimicrob Chemother 2021; 75:3652-3655. [PMID: 32814946 DOI: 10.1093/jac/dkaa356] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/16/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Temocillin is a carboxypenicillin antibiotic indicated in complicated urinary tract infections due to susceptible ESBL-producing Enterobacteriaceae. While temocillin therapeutic schemes for adult patients with normal or impaired renal function are evidence based, little is known in paediatric populations. OBJECTIVES We report herein the management of temocillin treatment in a preterm infant with end-stage renal disease. PATIENTS AND METHODS The patient was a 7-month-old preterm infant born at 35 weeks gestation and treated by temocillin for 10 days for a bacteraemic urinary tract infection due to a susceptible ESBL-producing Enterobacter cloacae complex strain. Temocillin was administered by continuous infusion using a loading dose of 25 mg followed by a maintenance dose of 70 mg daily. Determination of MIC and temocillin plasma and urinary concentration was performed. RESULTS Clinical improvement was observed 24 h after the initiation of temocillin treatment. Temocillin concentrations ranged between 21.6 and 35.5 mg/L in urine between the first and the sixth day of treatment and between 47.0 and 61.8 mg/L in plasma after 6 and 10 days of treatment, respectively. Temocillin concentrations were found to be above the determined MIC of 6 mg/L. From the measured concentrations, we can postulate that 100%fT>MIC was achieved in urine and at least equal to 40% in plasma. CONCLUSIONS Temocillin dosing adjustment performed in the present reported case allowed safe and effective treatment. The strategy described herein could be used as a basis for further clinical studies relative to temocillin use in a paediatric population with renal impairment.
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Affiliation(s)
- Guillaume Dumangin
- Université de Lorraine, CHRU-Nancy, Department of Clinical Pharmacology and Toxicology, F-54000 Nancy, France
| | - Matthieu Brenkman
- Université de Lorraine, CHRU-Nancy, Department of Clinical Pharmacology and Toxicology, F-54000 Nancy, France
| | - Elise Pape
- Université de Lorraine, CHRU-Nancy, Department of Clinical Pharmacology and Toxicology, F-54000 Nancy, France.,Université de Lorraine, CNRS, IMoPA, F-54000 Nancy, France
| | - Allan Kolodziej
- Université de Lorraine, CHRU-Nancy, Department of Clinical Pharmacology and Toxicology, F-54000 Nancy, France
| | - Nicolas Gambier
- Université de Lorraine, CHRU-Nancy, Department of Clinical Pharmacology and Toxicology, F-54000 Nancy, France.,Université de Lorraine, CNRS, IMoPA, F-54000 Nancy, France
| | - Isabelle Vrillon
- CHRU-Nancy, Department of Pediatric Nephrology, F-54000 Nancy, France
| | - Alexandre Charmillon
- CHRU-Nancy, Department of Infectious and Tropical Diseases, F-54000 Nancy, France
| | - Julien Scala-Bertola
- Université de Lorraine, CHRU-Nancy, Department of Clinical Pharmacology and Toxicology, F-54000 Nancy, France.,Université de Lorraine, CNRS, IMoPA, F-54000 Nancy, France
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5
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Hogan J, Perez A, Sellier-Leclerc AL, Vrillon I, Broux F, Nobili F, Harambat J, Bessenay L, Audard V, Faudeux C, Morin D, Pietrement C, Tellier S, Djeddi D, Eckart P, Lahoche A, Roussey-Kesler G, Ulinski T, Boyer O, Plaisier E, Cloarec S, Jolivot A, Guigonis V, Guilmin-Crepon S, Baudouin V, Dossier C, Deschênes G. Efficacy and safety of intravenous immunoglobulin with rituximab versus rituximab alone in childhood-onset steroid-dependent and frequently relapsing nephrotic syndrome: protocol for a multicentre randomised controlled trial. BMJ Open 2020; 10:e037306. [PMID: 32967877 PMCID: PMC7513594 DOI: 10.1136/bmjopen-2020-037306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Guidelines for the treatment of steroid-dependent nephrotic syndrome (SDNS) and frequently relapsing nephrotic syndrome (FRNS) are lacking. Given the substantial impact of SDNS/FRNS on quality of life, strategies aiming to provide long-term remission while minimising treatment side effects are needed. Several studies confirm that rituximab is effective in preventing early relapses in SDNS/FRNS; however, the long-term relapse rate remains high (~70% at 2 years). This trial will assess the association of intravenous immunoglobulins (IVIgs) to rituximab in patients with SDNS/FRNS and inform clinicians on whether IVIg's immunomodulatory properties can alter the course of the disease and reduce the use of immunosuppressive drugs and their side effects. METHODS AND ANALYSIS We conduct an open-label multicentre, randomised, parallel group in a 1:1 ratio, controlled, superiority trial to assess the safety and efficacy of a single infusion of rituximab followed by IVIg compared with rituximab alone in childhood-onset FRNS/SDNS. The primary outcome is the occurrence of first relapse within 24 months. Patients are allocated to receive either rituximab alone (375 mg/m²) or rituximab followed by IVIg, which includes an initial Ig dose of 2 g/kg, followed by 1.5 g/kg injections once a month for the following 5 months (maximum dose: 100 g). ETHICS AND DISSEMINATION The study has been approved by the ethics committee (Comité de Protection des Personnes) of Ouest I and authorised by the French drug regulatory agency (Agence Nationale de Sécurité du Médicament et des Produits de Santé). Results of the primary study and the secondary aims will be disseminated through peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT03560011.
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Affiliation(s)
- Julien Hogan
- Department of Pediatric Nephrology, Robert Debré Hospital, APHP, Paris, France
- Department of Surgery, Emory University, Atlanta, Georgia, USA
| | - Aubriana Perez
- Department of Surgery, Emory University, Atlanta, Georgia, USA
| | | | - Isabelle Vrillon
- Department of Pediatric Nephrology, Hopital Brabois enfants, Vandoeuvre-les-Nancy, France
| | - Francoise Broux
- Department of Pediatric Nephrology, University Hospital Centre Rouen, Rouen, France
| | - Francois Nobili
- Department of Pediatric Nephrology, University Hospital Centre Besancon, Besancon, France
| | - Jerome Harambat
- Department of Pediatric Nephrology, Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, Bordeaux, France
| | - Lucie Bessenay
- Department of Pediatric Nephrology, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - V Audard
- Department of Nephrology and Transplantation, Henri Mondor Hospital, APHP, Université Paris-Est, Créteil, France
| | - Camille Faudeux
- Department of Pediatric Nephrology, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Denis Morin
- Department of Pediatric Nephrology, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Christine Pietrement
- Department of Pediatric Nephrology, Centre Hospitalier Universitaire de Reims Hôpital d'enfants, Reims, France
| | - Stephanie Tellier
- Department of Pediatric Nephrology, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Djamal Djeddi
- Department of Paediatrics, Amiens University Hospital and University of Amiens, Amiens, France
| | - Philippe Eckart
- Department of Pediatric Nephrology, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
| | - Annie Lahoche
- Department of Pediatric Nephrology, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - G Roussey-Kesler
- Department of Pediatric Nephrology, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Tim Ulinski
- Department of Pediatric Nephrology, Hopital Trousseau la Roche-Guyon, Paris, France
| | - Olivia Boyer
- Department of Pediatric Nephrology, Hopital Necker-Enfants Malades, Paris, France
| | | | - Sylvie Cloarec
- Department of Pediatric Nephrology, Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | - Anne Jolivot
- Department of Nephrology, Groupement Hospitalier Edouard Herriot, Lyon, France
| | - Vincent Guigonis
- Department of Pediatric Nephrology, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | | | - Veronique Baudouin
- Department of Pediatric Nephrology, Robert Debré Hospital, APHP, Paris, France
| | - Claire Dossier
- Department of Pediatric Nephrology, Robert Debré Hospital, APHP, Paris, France
| | - Georges Deschênes
- Department of Pediatric Nephrology, Robert Debré Hospital, APHP, Paris, France
- Université Sorbonne Paris Cité, Paris, France
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Robert S, Nisse YE, Henn-Ménétré S, Vrillon I, Demoré B. [Case report of an infant hyperkalemia: Suggestion of a hospital procedure for the milk pretreatment with sodium polystyrene sulfonate resin]. Ann Pharm Fr 2020; 78:287-293. [PMID: 32439127 DOI: 10.1016/j.pharma.2020.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 10/24/2022]
Abstract
Sodium polystyrene sulfonate (SPS) is used to reduce intestinal potassium absorption in hyperkalemia during conservative management of chronic renal failure in infants. Milk can be pretreated by SPS to reduce the risk of enteropathy associated with oral or rectal administration. We report the case of an infant for whom this pre-treatment has been implemented. The objective of this work was to define the hospital procedure for the pre-treatment of milk by the SPS. This pre-treatment involves both a drug and infant milk. Each product has its own regulation and their processes do not normally cross each other. The roles of each contributor were therefore defined: prescription of pre-treated milk (dose of SPS and volume of milk) by the physician, dispensing of SPS by the pharmacist, delivery of milk by the milk kitchen staff, pre-treatment by a nurse and administration by a nursing auxiliary. The preparation of the bottles is as follows: placing approximately 1g of SPS per 100mL of milk in contact, stirring, resting in the refrigerator for one hour, taking the supernatant to be administered. In the reported case, serum potassium levels were reduced from 5.57mmol/L before treatment to 4.53mmol/L after treatment, in line with the 20% decrease found in the literature. This method of administration is beneficial in terms of tolerance and acceptability. The preparation is simple and allows going back home under treatment.
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Affiliation(s)
- S Robert
- Pôle pharmacie stérilisation, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France
| | - Y-E Nisse
- Pôle pharmacie stérilisation, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France
| | - S Henn-Ménétré
- Pôle pharmacie stérilisation, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France.
| | - I Vrillon
- Médecine infantile, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France
| | - B Demoré
- Pôle pharmacie stérilisation, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France; APEMAC, université de Lorraine, 54000 Nancy, France
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7
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Boyer O, Baudouin V, Bérard É, Biebuyck-Gougé N, Dossier C, Guigonis V, Audard V, Klifa R, Leroy V, Ranchin B, Roussey G, Samaille C, Tellier S, Vrillon I. [Vaccine recommendations for children with idiopathic nephrotic syndrome]. Nephrol Ther 2020; 16:177-183. [PMID: 32278737 DOI: 10.1016/j.nephro.2019.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/17/2019] [Indexed: 11/16/2022]
Abstract
The specific treatment of idiopathic nephrotic syndrome is based on corticosteroid therapy and/or steroid-sparing immunosuppressive agents in children who are steroid-dependant or frequent relapsers (60-70 %). Patients have an increased infectious risk not only related to the disease during relapses (hypogammaglobulinemia and urinary leakage of opsonins) but also to treatments (corticosteroids or immunosuppressive agents) in period of remission. Vaccination is therefore particularly recommended in these patients. Potential vaccine risks are ineffectiveness, induction of vaccine disease and relapse of idiopathic nephrotic syndrome. Only live vaccines expose to the risk of vaccine disease: they are in general contra-indicated under immunosuppressive treatment. The immunogenicity of inactivated vaccines is reduced but persists. The immunogenic stimulus of vaccination may in theory trigger a relapse of the nephrotic syndrome. Nevertheless, this risk is low in the literature, and even absent in some studies. The benefit-risk ratio is therefore in favor of vaccination with respect to the vaccination schedule for inactivated vaccines, with wide vaccination against pneumococcus and influenza annually. Depending on the context and after expert advice, immunization with live vaccines could be discussed if residual doses/levels of immunosuppressive treatments are moderate and immunity preserved.
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Affiliation(s)
- Olivia Boyer
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Necker-Enfants-malades, institut Imagine, université de Paris, 149, rue de Sèvres, 75015 Paris, France.
| | - Véronique Baudouin
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Robert-Debré, institut Imagine, université de Paris, 48, boulevard Sérurier, 75935 Paris cedex 19, France
| | - Étienne Bérard
- Service de néphrologie pédiatrique, CHU de Nice, Archet 2, 151, route Saint-Antoine de Ginestière, CS 23079, 06202 Nice cedex 3, France
| | - Nathalie Biebuyck-Gougé
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Necker-Enfants-malades, institut Imagine, université de Paris, 149, rue de Sèvres, 75015 Paris, France
| | - Claire Dossier
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Robert-Debré, institut Imagine, université de Paris, 48, boulevard Sérurier, 75935 Paris cedex 19, France
| | - Vincent Guigonis
- Département de pédiatrie, hôpital Mère-Enfant, 8, avenue Dominique-Larrey, 87042 Limoges cedex, France
| | - Vincent Audard
- Inserm U955, service de néphrologie et transplantation, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, université Paris-Est Créteil, CHU Henri Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - Roman Klifa
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Necker-Enfants-malades, institut Imagine, université de Paris, 149, rue de Sèvres, 75015 Paris, France
| | - Valérie Leroy
- Service de néphrologie pédiatrique, CHU La Réunion, Site Félix Guyon, allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion
| | - Bruno Ranchin
- Service de néphrologie pédiatrique, centre de référence néphrogone, CHU de Lyon, 59, boulevard Pinel, 69500 Bron, France
| | - Gwenaëlle Roussey
- Clinique médicale pédiatrique, CHU de Nantes, 5, allée de l'Île Gloriette, 44093 Nantes, France
| | - Charlotte Samaille
- Service de néphrologie pédiatrique, hôpital Jeanne de Flandre, centre hospitalo-universitaire de Lille, avenue Eugène-Avinée, 59000 Lille, France
| | - Stéphanie Tellier
- Service de néphrologie-rhumatologie-médecine interne pédiatrique, centre de référence des Maladies rénales rares du Sud-Ouest (SORARE), hôpital des enfants, 330, avenue de Grande-Bretagne, 31300 Toulouse, France
| | - Isabelle Vrillon
- Service de médecine infantile, secteur de néphrologie pédiatrique, hôpital d'Enfants de Brabois, CHRU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
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Preka E, Bonthuis M, Harambat J, Jager KJ, Groothoff JW, Baiko S, Bayazit AK, Boehm M, Cvetkovic M, Edvardsson VO, Fomina S, Heaf JG, Holtta T, Kis E, Kolvek G, Koster-Kamphuis L, Molchanova EA, Muňoz M, Neto G, Novljan G, Printza N, Sahpazova E, Sartz L, Sinha MD, Vidal E, Vondrak K, Vrillon I, Weber LT, Weitz M, Zagozdzon I, Stefanidis CJ, Bakkaloglu SA. Association between timing of dialysis initiation and clinical outcomes in the paediatric population: an ESPN/ERA-EDTA registry study. Nephrol Dial Transplant 2019; 34:1932-1940. [PMID: 31038179 DOI: 10.1093/ndt/gfz069] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 03/13/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is no consensus regarding the timing of dialysis therapy initiation for end-stage kidney disease (ESKD) in children. As studies investigating the association between timing of dialysis initiation and clinical outcomes are lacking, we aimed to study this relationship in a cohort of European children who started maintenance dialysis treatment. METHODS We used data on 2963 children from 21 different countries included in the European Society of Pediatric Nephrology/European Renal Association-European Dialysis and Transplant Association Registry who started renal replacement therapy before 18 years of age between 2000 and 2014. We compared two groups according to the estimated glomerular filtration rate (eGFR) at start: eGFR ≥8 mL/min/1.73 m2 (early starters) and eGFR <8 mL/min/1.73 m2 (late starters). The primary outcomes were patient survival and access to transplantation. Secondary outcomes were growth and cardiovascular risk factors. Sensitivity analyses were performed to account for selection- and lead time-bias. RESULTS The median eGFR at the start of dialysis was 6.1 for late versus 10.5 mL/min/1.73 m2 for early starters. Early starters were older [median: 11.0, interquartile range (IQR): 5.7-14.5 versus 9.4, IQR: 2.6-14.1 years]. There were no differences observed between the two groups in mortality and access to transplantation at 1, 2 and 5 years of follow-up. One-year evolution of height standard deviation scores was similar among the groups, whereas hypertension was more prevalent among late initiators. Sensitivity analyses resulted in similar findings. CONCLUSIONS We found no evidence for a clinically relevant benefit of early start of dialysis in children with ESKD. Presence of cardiovascular risk factors, such as high blood pressure, should be taken into account when deciding to initiate or postpone dialysis in children with ESKD, as this affects the survival.
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Affiliation(s)
- Evgenia Preka
- Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Marjolein Bonthuis
- ESPN/ERA-EDTA Registry, Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Jerome Harambat
- Department of Pediatrics, Bordeaux University Hospital, Bordeaux, France
| | - Kitty J Jager
- ESPN/ERA-EDTA Registry, Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Jaap W Groothoff
- Amsterdam UMC, University of Amsterdam, Department of Paediatric Nephrology, Emma Children's Academic Medical Center, Amsterdam, The Netherlands
| | - Sergey Baiko
- Department of Pediatrics, Belarusian State Medical University, Minsk, Belarus
| | - Aysun K Bayazit
- Department of Pediatric Nephrology, School of Medicine, Cukurova University, Adana, Turkey
| | - Michael Boehm
- Department of Pediatric Nephrology, University Children's Hospital, Vienna, Austria
| | - Mirjana Cvetkovic
- Nephrology Department, University Children's Hospital, Belgrade, Serbia
| | - Vidar O Edvardsson
- Children's Medical Center, Landspitali-The National University Hospital of Iceland, and Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Svitlana Fomina
- Department of Pediatric Nephrology, National Academy of Medical Sciences of Ukraine, Kiev, Ukraine
| | - James G Heaf
- Department of Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Tuula Holtta
- Children's Hospital, University of Helsinki, Helsinki, Finland
| | - Eva Kis
- Gottsegen György Hungarian Institute of Cardiology, Budapest, Hungary
| | - Gabriel Kolvek
- Pediatric Department, Faculty of Medicine, Safarik University, Kosice, Slovakia
| | - Linda Koster-Kamphuis
- Department of Pediatric Nephrology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Elena A Molchanova
- Department of Kidney Transplantation, Russian Children's Clinical Hospital, Moscow, Russia
| | - Marina Muňoz
- Department of Pediatric Nephrology, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Gisela Neto
- Paediatric Nephrology Unit, Hospital de Dona Estefânia, Lisbon, Portugal
| | - Gregor Novljan
- Department of Pediatric Nephrology, University Medical Center Ljubjana, Faculty of Medicine, University of Ljubjana, Slovenia
| | - Nikoleta Printza
- 1st Pediatric Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Lisa Sartz
- Department of Clinical Sciences, Pediatric Nephrology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Manish D Sinha
- Department of Paediatric Nephrology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Enrico Vidal
- Pediatric Nephrology, Dialysis and Transplantation Unit, Department of Woman's and Child's Health, University Hospital of Padua, Padua, Italy
| | - Karel Vondrak
- Department of Pediatrics, University Hospital Motol, Prague, Czech Republic
| | - Isabelle Vrillon
- Pediatric Nephrology Department, Nancy University Hospital, Nancy, France
| | - Lutz T Weber
- Pediatric Nephrology, Childreńs and Adolescents` Hospital, University Hospital of Cologne, Cologne, Germany
| | - Marcus Weitz
- Pediatric Nephrology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Ilona Zagozdzon
- Department of Pediatrics, Nephrology and Hypertension, Medical University of Gdansk, Gdansk, Poland
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Quinaux T, Pongas M, Guissard E, Ait-Djafer Z, Camoin-Schweitzer MC, Vrillon I. FP831COMPARISON BETWEEN CITRATE AND ACETATE DIALYSATE IN CHRONIC HEMODIALYSIS: A SHORT-TERM PROSPECTIVE STUDY IN PEDIATRIC SETTINGS. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz106.fp831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Thomas Quinaux
- Nancy University Hospital - Children's Hospital, Vandoeuvre-lès-Nancy, France
| | - Marios Pongas
- Nancy University Hospital - Children's Hospital, Vandoeuvre-lès-Nancy, France
| | - Elodie Guissard
- Nancy University Hospital - Children's Hospital, Vandoeuvre-lès-Nancy, France
| | - Zakia Ait-Djafer
- Nancy University Hospital - Children's Hospital, Vandoeuvre-lès-Nancy, France
| | | | - Isabelle Vrillon
- Nancy University Hospital - Children's Hospital, Vandoeuvre-lès-Nancy, France
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10
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Clavé S, Tsimaratos M, Boucekine M, Ranchin B, Salomon R, Dunand O, Garnier A, Lahoche A, Fila M, Roussey G, Broux F, Harambat J, Cloarec S, Menouer S, Deschenes G, Vrillon I, Auquier P, Berbis J. Quality of life in adolescents with chronic kidney disease who initiate haemodialysis treatment. BMC Nephrol 2019; 20:163. [PMID: 31088395 PMCID: PMC6515621 DOI: 10.1186/s12882-019-1365-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 04/30/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND To describe the quality of life of adolescents initiating haemodialysis, to determine the factors associated with quality of life, and to assess coping strategies and their impact on quality of life. METHODS All adolescents initiating haemodialysis between September 2013 and July 2015 in French paediatric haemodialysis centres were included. Quality of life data were collected using the "Vécu et Santé Perçue de l'Adolescent et l'Enfant" questionnaire, and coping data were collected using the Kidcope questionnaire. Adolescent's quality of life was compared with age- and sex-matched French control. RESULTS Thirty-two adolescents were included. Their mean age was 13.9 ± 2.0 years. The quality of life score was lowest in leisure activities and highest in relationships with medical staff. Compared with the French control, index, energy-vitality, relationships with friends, leisure activities and physical well-being scores were significantly lower in haemodialysis population. In multivariate analyses, active coping was positively associated with quality of life and especially with energy-vitality, relationships with parents and teachers, and school performance. In contrast, avoidant and negative coping were negatively associated with energy-vitality, psychological well-being and body image for avoidant coping, and body image and relationships with medical staff for negative coping. CONCLUSIONS The quality of life of haemodialysis adolescents, and mainly the dimensions of leisure activities, physical well-being, relationships with friends and energy-vitality, were significantly altered compared to that of the French population. The impact of coping strategies on quality of life seems to be important. Given the importance of quality of life and coping strategies in adolescents with chronic disease, health care professionals should integrate these aspects into care management.
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Affiliation(s)
- Stéphanie Clavé
- Department of Multidisciplinary Pediatrics, Hôpital de la Timone Enfant, Assistance Publique des Hôpitaux de Marseille, Marseille, France. .,Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279: - CEReSS Health Service Research and Quality of Life Center, Marseille, France.
| | - Michel Tsimaratos
- Department of Multidisciplinary Pediatrics, Hôpital de la Timone Enfant, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | - Mohamed Boucekine
- Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279: - CEReSS Health Service Research and Quality of Life Center, Marseille, France
| | - Bruno Ranchin
- Department of Pediatric Nephrology, Hôpital Femme Mere Enfant, Hospices Civils de Lyon, Lyon, France
| | - Rémi Salomon
- Department of Pediatric Nephrology, Assistance Publique des Hôpitaux de Paris, University Hospital Necker-Enfants Malades, Paris, France
| | - Olivier Dunand
- Department of Pediatrics, Hôpital Félix Guyon, University Hospital La Réunion, Saint-Denis, La Réunion, France
| | - Arnaud Garnier
- Department of Pediatric Nephrology, Children Hospital Toulouse, Toulouse, France
| | - Annie Lahoche
- Department of Pediatric Nephrology, Jeanne de Flandre Hospital, University Hospital of Lille, Lille, France
| | - Marc Fila
- Department of Pediatric Nephrology, hôpital Arnaud-de-Villeneuve, University Hospital of Montpellier, Montpellier, France
| | - Gwenaelle Roussey
- Department of Pediatrics, University Hospital of Nantes, Nantes, France
| | - Francoise Broux
- Department of Pediatrics, Pediatric Nephrology and Hemodialysis Unit, University Hospital Charles Nicolle, Rouen, France
| | - Jérome Harambat
- Department of Pediatrics, Hôpital Pellegrin-Enfants, University Hospital of Bordeaux, Bordeaux, France
| | - Sylvie Cloarec
- Department of Pediatric Nephrology and Hemodialysis, Clocheville Hospital, University Hospital of Tours, Tours, France
| | - Soraya Menouer
- Department of Pediatrics 1, University Hospital of Strasbourg, Hôpital de Hautepierre, Strasbourg, France
| | - Georges Deschenes
- Department of Pediatric Nephrology, Assistance publique des Hôpitaux de Paris, University Hospital Robert Debré, Paris, France
| | - Isabelle Vrillon
- Department of Pediatric Nephrology, Hôpital d'Enfants Brabois, Nancy, France
| | - Pascal Auquier
- Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279: - CEReSS Health Service Research and Quality of Life Center, Marseille, France
| | - Julie Berbis
- Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279: - CEReSS Health Service Research and Quality of Life Center, Marseille, France
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Hogan J, Bacchetta J, Charbit M, Roussey G, Novo R, Tsimaratos M, Terzic J, Ulinski T, Garnier A, Merieau E, Harambat J, Vrillon I, Dunand O, Morin D, Berard E, Nobili F, Couchoud C, Macher MA. Patient and transplant outcome in infants starting renal replacement therapy before 2 years of age. Nephrol Dial Transplant 2018; 33:1459-1465. [DOI: 10.1093/ndt/gfy040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 01/21/2018] [Indexed: 01/16/2023] Open
Affiliation(s)
- Julien Hogan
- Pediatric Nephrology Department, Robert Debré University Hospital, APHP, Paris, France
- Agence de la Biomédecine, La Plaine Saint-Denis, France
| | - Justine Bacchetta
- Pediatric Nephrology Department, HFME, Lyon University Hospital, Bron, France
| | - Marina Charbit
- Pediatric Nephrology Department, Necker University Hospital, APHP, Paris, France
| | - Gwenaelle Roussey
- Pediatric Nephrology Department, Nantes University Hospital, Nantes, France
| | - Robert Novo
- Pediatric Nephrology Department, Jeanne de Flandre University Hospital, Lille, France
| | - Michel Tsimaratos
- Pediatric Nephrology Department, La Timone University Hospital, Marseille, France
| | - Joelle Terzic
- Pediatric Nephrology Department, Hautepierre University Hospital, Strasbourg, France
| | - Tim Ulinski
- Pediatric Nephrology Department, Armand Trousseau University Hospital, APHP, Paris, France
| | - Arnaud Garnier
- Pediatric Nephrology Department, Children University Hospital, Toulouse, France
| | - Elodie Merieau
- Pediatric Nephrology Department, Tours University Hospital, Tours, France
| | - Jérôme Harambat
- Pediatric Nephrology Department, Pellegrin University Hospital, Bordeaux, France
| | - Isabelle Vrillon
- Pediatric Nephrology Department, Nancy University Hospital, Nancy, France
| | - Olivier Dunand
- Pediatric Nephrology Department, Felix Guyon University Hospital, Saint-Denis de la Réunion, France
| | - Denis Morin
- Pediatric Nephrology Department, Montpellier University Hospital, Montpellier, France
| | - Etienne Berard
- Pediatric Nephrology Department, Lenval University Hospital, Nice, France
| | - Francois Nobili
- Pediatric Nephrology Department, Saint Jacques University Hospital, Besançon, France
| | | | - Marie-Alice Macher
- Pediatric Nephrology Department, Robert Debré University Hospital, APHP, Paris, France
- Agence de la Biomédecine, La Plaine Saint-Denis, France
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12
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Legrand A, Treard C, Roncelin I, Dreux S, Bertholet-Thomas A, Broux F, Bruno D, Decramer S, Deschenes G, Djeddi D, Guigonis V, Jay N, Khalifeh T, Llanas B, Morin D, Morin G, Nobili F, Pietrement C, Ryckewaert A, Salomon R, Vrillon I, Blanchard A, Vargas-Poussou R. Prevalence of Novel MAGED2 Mutations in Antenatal Bartter Syndrome. Clin J Am Soc Nephrol 2018; 13:242-250. [PMID: 29146702 PMCID: PMC5967426 DOI: 10.2215/cjn.05670517] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 10/02/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Mutations in the MAGED2 gene, located on the X chromosome, have been recently detected in males with a transient form of antenatal Bartter syndrome or with idiopathic polyhydramnios. The aim of this study is to analyze the proportion of the population with mutations in this gene in a French cohort of patients with antenatal Bartter syndrome. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS The French cohort of patients with antenatal Bartter syndrome encompasses 171 families. Mutations in genes responsible for types 1-4 have been detected in 75% of cases. In patients without identified genetic cause (n=42), transient antenatal Bartter syndrome was reported in 12 cases. We analyzed the MAGED2 gene in the entire cohort of negative cases by Sanger sequencing and retrospectively collected clinical data regarding pregnancy as well as the postnatal outcome for positive cases. RESULTS We detected mutations in MAGED2 in 17 patients, including the 12 with transient antenatal Bartter syndrome, from 16 families. Fifteen different mutations were detected (one whole deletion, three frameshift, three splicing, three nonsense, two inframe deletions, and three missense); 13 of these mutations had not been previously described. Interestingly, two patients are females; in one of these patients our data are consistent with selective inactivation of chromosome X explaining the severity. The phenotypic presentation in our patients was variable and less severe than that of the originally described cases. CONCLUSIONS MAGED2 mutations explained 9% of cases of antenatal Bartter syndrome in a French cohort, and accounted for 38% of patients without other characterized mutations and for 44% of male probands of negative cases. Our study confirmed previously published data and showed that females can be affected. As a result, this gene must be included in the screening of the most severe clinical form of Bartter syndrome.
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Affiliation(s)
- Anne Legrand
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
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Reydit M, Salomon R, Macher MA, Ranchin B, Roussey G, Garaix F, Lahoche A, Decramer S, Fila M, Dunand O, Cloarec S, Vrillon I, Zaloszyc A, Ulinski T, Bérard E, Couchoud C, Leffondré K, Harambat J. Pre-emptive kidney transplantation is associated with improved graft survival in children: Data from the French renal replacement therapy registry. Arch Pediatr 2017. [DOI: 10.1016/j.arcped.2017.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Boyer O, Baudouin V, Bérard E, Dossier C, Audard V, Guigonis V, Vrillon I. [Idiopathic nephrotic syndrome]. Arch Pediatr 2017; 24:1338-1343. [PMID: 29169714 DOI: 10.1016/j.arcped.2017.09.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 08/02/2017] [Accepted: 09/15/2017] [Indexed: 10/18/2022]
Abstract
Nephrotic syndrome (NS) is defined by massive proteinuria and hypoalbuminemia, with resulting hyperlipidemia and edema. The most common cause of NS in children is idiopathic nephrotic syndrome (INS), also called nephrosis. Its annual incidence has been estimated to 1-4 per 100,000 children and varies with age, race, and geography. Many agents or conditions have been reported to be associated with INS such as infectious diseases, drugs, allergy, vaccinations, and malignancies. The disease may occur during the 1st year of life, but it usually starts between the ages of 2 and 7 years. INS is characterized by a sudden onset, edema being the major presenting symptom, but may rarely be discovered during a routine urine analysis. The disease may also be revealed by a complication such as hypovolemia, infection (pneumonia and peritonitis due to Streptococcus pneumoniae), deep-vein or arterial thromboses, and pulmonary embolism. Renal biopsy is usually not indicated in a child aged 1-10 years with typical symptoms and a complete remission with corticosteroids. Conversely, it is indicated in children under 1 year in case of macroscopic hematuria, hypertension, low C3 levels, persistent renal failure, or steroid resistance. Steroid therapy is applied in all children whatever the histopathology. Initial prednisone therapy in France consists of 60mg/m2 administered daily for 4 weeks (maximum dose, 60mg/day), followed by alternate-day prednisone with tapering doses. Eight-five to 90 % patients are steroid-responsive and may relapse, but the majority still responds to steroids over the subsequent courses. Only 1-3 % of patients who are initially steroid-sensitive subsequently become steroid-resistant. Children with primary or secondary steroid-resistance are at risk of end-stage kidney disease. Symptomatic treatment includes salt restriction, fluid restriction when natremia is less than 125 meq/L, reduction of saturated fat and carbohydrates, calcium and vitamin D supplements, anticoagulation, and vaccination. Albumin infusions are only indicated in case of complications. Diuretics should be restricted to cases of severe edema, after hypovolemia has been corrected.
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Affiliation(s)
- O Boyer
- Service de néphrologie pédiatrique, centre de référence syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Necker-Enfants-Malades, institut Imagine, université Paris-Descartes, Assistance publique-Hôpitaux de Paris, 75015 Paris, France.
| | - V Baudouin
- Service de néphrologie pédiatrique, centre de référence syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Robert-Debré, institut Imagine, université Paris-Diderot, Assistance publique-Hôpitaux de Paris, 75019 Paris, France
| | - E Bérard
- Service de néphrologie pédiatrique, CHU de Nice, Archet 2, 06200 Nice, France
| | - C Dossier
- Service de néphrologie pédiatrique, centre de référence syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Robert-Debré, institut Imagine, université Paris-Diderot, Assistance publique-Hôpitaux de Paris, 75019 Paris, France
| | - V Audard
- Service de néphrologie et transplantation, centre de référence syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Henri-Mondor, Inserm U955, université Paris-Est-Créteil, 94010 Créteil, France
| | - V Guigonis
- Département de pédiatrie, hôpital Mère-Enfant, 87000 Limoges, France
| | - I Vrillon
- Service de pédiatrie, hôpital d'enfants, CHRU de Nancy, 54511 Vandœuvre-lès-Nancy, France
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Couderc A, Bérard E, Guigonis V, Vrillon I, Hogan J, Audard V, Baudouin V, Dossier C, Boyer O. [Treatments of steroid-dependent nephrotic syndrome in children]. Arch Pediatr 2017; 24:1312-1320. [PMID: 29146214 DOI: 10.1016/j.arcped.2017.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 07/06/2017] [Accepted: 09/27/2017] [Indexed: 11/18/2022]
Abstract
Primary nephrotic syndrome (NS) is the most common glomerular disease in children. It is characterized by massive proteinuria and hypoalbuminemia. It typically has a sudden onset and more than 70% of patients will experience at least one relapse. An immunological origin has long been postulated, although the precise molecular mechanisms underlying the disease remain debated. Steroids are the first-line therapy with cumulative dose and duration of initial treatment varying among countries. Steroid-sparing agents may be indicated in case of steroid-dependency or frequent relapses. However, no consensus exists regarding the different treatment options. These treatments are mostly suspensive and therefore, need to be prolonged for several months. Levamisole, an antihelminthic drug, also has an immunomodulatory function, and alone or in combination with steroids, it can decrease cumulative steroid dose and relapses. It is usually well tolerated, and its principal side effects are cytopenia and elevated liver enzymes. Mycophenolate mofetil is an immunosuppressive agent whose reported side effects are cytopenia and diarrhea. Calcineurin inhibitors (cyclosporine or tacrolimus) have long been used in steroid-dependent patients. Their major side effects are hirsutism, gum hypertrophy, and nephrotoxicity, leading to interstitial kidney fibrosis and chronic kidney disease. Cyclophosphamide is an efficient treatment but its gonadal toxicity is a major drawback to its use. More recent drugs such as rituximab are very effective but require hospitalization for the infusion and induce an increased risk of opportunistic infection, prolonged neutropenia, and anaphylaxis. In this review, we present the available treatments, their indications, and the side effects.
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Affiliation(s)
- A Couderc
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique, université Paris Diderot, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 48, boulevard Serrurier, 75019 Paris, France.
| | - E Bérard
- Service de néphrologie pédiatrique, CHU de Nice, Archet 2, 151, route St-Antoine, 06200 Nice, France
| | - V Guigonis
- Département de pédiatrie, hôpital Mère-Enfant, 8, avenue Dominique-Larrey, 87042 Limoges cedex, France
| | - I Vrillon
- Département de pédiatrie, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France
| | - J Hogan
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique, université Paris Diderot, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 48, boulevard Serrurier, 75019 Paris, France
| | - V Audard
- Service de néphrologie et transplantation, centre de référence du syndrome néphrotique idiopathique, institut francilien de recherche en néphrologie et transplantation, hôpital Henri-Mondor, Assistance publique-Hôpitaux de Paris, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - V Baudouin
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique, université Paris Diderot, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 48, boulevard Serrurier, 75019 Paris, France
| | - C Dossier
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique, université Paris Diderot, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 48, boulevard Serrurier, 75019 Paris, France
| | - O Boyer
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique, institut Imagine, université Paris Descartes, hôpital Necker-Enfants-Malades, Assistance publique-Hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France
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Seys E, Andrini O, Keck M, Mansour-Hendili L, Courand PY, Simian C, Deschenes G, Kwon T, Bertholet-Thomas A, Bobrie G, Borde JS, Bourdat-Michel G, Decramer S, Cailliez M, Krug P, Cozette P, Delbet JD, Dubourg L, Chaveau D, Fila M, Jourde-Chiche N, Knebelmann B, Lavocat MP, Lemoine S, Djeddi D, Llanas B, Louillet F, Merieau E, Mileva M, Mota-Vieira L, Mousson C, Nobili F, Novo R, Roussey-Kesler G, Vrillon I, Walsh SB, Teulon J, Blanchard A, Vargas-Poussou R. Clinical and Genetic Spectrum of Bartter Syndrome Type 3. J Am Soc Nephrol 2017; 28:2540-2552. [PMID: 28381550 DOI: 10.1681/asn.2016101057] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 02/27/2017] [Indexed: 12/30/2022] Open
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.
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Affiliation(s)
- Elsa Seys
- Pediatric Nephrology Unit, American Memorial Hospital, Reims University Hospital, Reims, France
| | - Olga Andrini
- Unité Mixte de Recherche en Santé 1138, Team 3, Université Pierre et Marie Curie, Paris, France.,Faculté de Médecine, Université Paris Descartes, Paris, France
| | - Mathilde Keck
- Unité Mixte de Recherche en Santé 1138, Team 3, Université Pierre et Marie Curie, Paris, France.,Institut National de la Santé et la Recherche Médicale, Unité Mixte de Recherche en Santé 872, Paris, France
| | | | - Pierre-Yves Courand
- Centre d'Investigation Clinique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France.,Cardiology Department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé; Centre National de la Recherche Scientifique Unité Mixte de Recherche 5220; Institut National de la Santé et la Recherche Médicale, Unité 1044; Institut National de Sciences Appliquées-Lyon; Université Claude Bernard Lyon 1, France
| | | | - Georges Deschenes
- Pediatric Nephrology Unit, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France.,Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte, Paris, France
| | - Theresa Kwon
- Pediatric Nephrology Unit, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France.,Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte, Paris, France
| | - Aurélia Bertholet-Thomas
- Néphrogones, Centre de Référence des Maladies Rénales Rares, Pediatric Nephrology, Rhumatology and Dermatology Unit, Hôpital Femme-Mère-Enfant and
| | - Guillaume Bobrie
- Nephrology Unit, Clinique du Vert Galant, Tremblay-en-France, France
| | | | | | | | - Mathilde Cailliez
- Pediatric Nephrology Unit, Hôpital de la Timone, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | - Pauline Krug
- Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte, Paris, France.,Pediatric Nephrology Unit and
| | - Paul Cozette
- Nephrology Unit, Centre Hospitalier du Pays d'Aix, Aix-en-Provence, France
| | - Jean Daniel Delbet
- Pediatric Nephrology Unit, Hôpital Trousseau, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Laurence Dubourg
- Exploration Fonctionnelle Rénale et Métabolique, Groupement Hospitalier est Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Dominique Chaveau
- Departement of Nephrology, Centre de Référence des Maladies Rénales Rares du Sud-Ouest, Hôpital de Toulouse, Université Paul Sabatier, Toulouse, France
| | - Marc Fila
- Pediatric Nephrology Unit, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Noémie Jourde-Chiche
- Faculté de Médecine, Centre de Référence des Maladies Rénales Rares du Sud-Ouest, Aix-MarseilleUniversité-Vascular Research Center of Marseille, Marseille, France.,Nephrology Unit, Hôpital de la Conception, Assistance Publique des Hopitaux de Marseille, Marseille,France
| | - Bertrand Knebelmann
- Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte, Paris, France.,Department of Nephrology, Hôpital Necker-Enfants-malades, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Marie-Pierre Lavocat
- Departement of Pediatrics, Hôpital Nord, Centre Hospitalier Universitaire de Saint Etienne, Saint Etienne, France
| | - Sandrine Lemoine
- Exploration Fonctionnelle Rénale et Métabolique, Groupement Hospitalier est Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Djamal Djeddi
- Department of Pediatrics and Adolescent Medicine, Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | - Brigitte Llanas
- Service de Néphrologie Pédiatrique, Groupement Hospitalier Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Centre de Référence des Maladies Rénales Rares du Sud-Ouest, Bordeaux, France
| | - Ferielle Louillet
- Department of Pediatrics, Centre Hospitalier Universitaire Charles Nicolle, Rouen, France
| | - Elodie Merieau
- Nephrology Unit,Centre Hospitalier Universitaire Tours, Tours, France
| | - Maria Mileva
- Department of Pediatrics, Centre Hospitalier Pierre Oudot de Bourgoin-Jallieu, Bourgoin-Jallieu, France
| | - Luisa Mota-Vieira
- Molecular Genetics Unit, Hospital do Divino Espírito Santo de Ponta Delgada, Entidade Pública Empresarial Regional, Açores, Portugal
| | - Christiane Mousson
- Nephrology Unit, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - François Nobili
- Pediatric Nephrology Unit, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Robert Novo
- Pediatric Nephrology Unit, Hôpital Jeanne de Flandre, Centre Hospitalier Universitaire de Lille, Lille, France
| | | | - Isabelle Vrillon
- Pediatric Nephrology Unit, Hôpitaux de Brabois, Centre Hospitalier Universitaire de Nancy, Vandoeuvre Les Nancy, France
| | - Stephen B Walsh
- Centre for Nephrology, University College London, London, UK; and
| | - Jacques Teulon
- Unité Mixte de Recherche en Santé 1138, Team 3, Université Pierre et Marie Curie, Paris, France.,Institut National de la Santé et la Recherche Médicale, Unité Mixte de Recherche en Santé 872, Paris, France
| | - Anne Blanchard
- Faculté de Médecine, Université Paris Descartes, Paris, France.,Cardiology Department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte, Paris, France.,Institut National de la Santé et la Recherche Médicale, Unité Mixte de Recherche en Santé 970, Paris-Cardiovascular Research Center, Paris, France
| | - Rosa Vargas-Poussou
- Department of Genetics and.,Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte, Paris, France.,Institut National de la Santé et la Recherche Médicale, Unité Mixte de Recherche en Santé 970, Paris-Cardiovascular Research Center, Paris, France
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Hogan J, Ranchin B, Fila M, Harambat J, Krid S, Vrillon I, Roussey G, Fischbach M, Couchoud C. Effect of center practices on the choice of the first dialysis modality for children and young adults. Pediatr Nephrol 2017; 32:659-667. [PMID: 27844146 DOI: 10.1007/s00467-016-3538-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 10/06/2016] [Accepted: 10/07/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Peritoneal dialysis (PD) remains the modality of choice in children, but there is no clear evidence to support a better outcome in children treated with PD. We aimed to assess factors that have an impact on the choice of dialysis modality in children and young adults in France and sought to determine the roles of medical factors and center practices. METHODS We included all patients aged <20 years at the start of renal replacement therapy (RRT), recorded in the French RRT Registry between 2002 and 2013. Hierarchical logistic regression models were used to study the association between the patient/center characteristics and the probability of receiving PD as the first dialysis modality. RESULTS We included 806 patients starting RRT in 177 centers, 23 of which were specialized pediatric centers. Six hundred and one patients (74.6 %) started with hemodialysis (HD), whereas 205 (25.4 %) started with PD. A greater probability of PD was found in younger children, whereas starting the treatment in an emergency setting was associated with a low use of PD. We found a significant variability among centers that accounted for 43 % of the total variability. The probability of PD was higher in adult centers and was proportional to the rate of PD in the center. CONCLUSIONS Center practices are a major factor in the choice of dialysis modality. This raises concerns about patient and family choices and to what extent doctors may influence the final decision. Further pediatric studies focusing on children's and parents' wishes are needed to provide care as close as possible to patients' and families' expectations.
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Affiliation(s)
- Julien Hogan
- Pediatric Nephrology Unit, Robert Debré Hospital APHP, 48 bld Serurier, 75019, Paris, France. .,REIN Registry, Agence de la biomédecine, Saint-Denis, La Plaine, France.
| | - Bruno Ranchin
- Pediatric Nephrology Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Marc Fila
- Pediatric Nephrology Unit, Arnaud de Villeneuve Hospital, Montpellier, France
| | - Jérome Harambat
- Pediatric Nephrology Unit, Bordeaux University Hospital, Bordeaux, France
| | - Saoussen Krid
- Pediatric Nephrology Unit, Necker Hospital, Paris, France
| | - Isabelle Vrillon
- Pediatric Nephrology Unit, Hôpital d'Enfants Brabois, Nancy, France
| | - Gwenaelle Roussey
- Pediatric Nephrology Unit, Nantes University Hospital, Nantes, France
| | - Michel Fischbach
- Pediatric Nephrology Unit, Hautepierre University Hospital, Strasbourg, France
| | - Cécile Couchoud
- REIN Registry, Agence de la biomédecine, Saint-Denis, La Plaine, France
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Berte N, Vrillon I, Ayav C, Lemelle J. SFCP CO-46 - Pronostic rénal des uropathies obstructives sous vésicales congénitales. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71684-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Yosypiv I, Song R, Preston G, Van Eerde AM, Van Binsbergen E, Konijnenberg Y, Maiburg MC, Lichtenbelt K, Nikkels PGJ, Vd Smagt J, Renkema KY, Giltay JC, De Jong TPVM, Lilien MR, Knoers NVAM, Gueydan C, Serena G, Stephan G, Koesters R, Zeineb B, Laure D, Catherine A, Marie-Therese B, Gauguier D, Lelongt B, Moon SH, Park HC, Lee HY, Hwang JH, Jeong JC, Park JY, Lee SW, Hwang YH, Kang KW, Ahn C, Gattone V, Carr A, Crosler-Roberts R, Wang X, Liu Y, Shen J, Wuthrich R, Serra A, Mei C, Tuta L, Botea F, Guigonis V, Rodier N, Bahans C, Decramer S, Bertholet-Thomas A, Heidet L, Eckart P, Lavocat MP, Vrillon I, Cloarec S, Lahoche A, Bessenay L, Louillet F, Roussey G, Rousset-Riviere C, Dunand O, Baudouin V, Nobili F, Pietrement C, De Parscau L, Gajdos V, Morin D, Laffargue F, Laffargue F, Llanas B, Baudouin V, Lahoche A, Palcoux JB, Morin D, De Parscau L, Bahans C, Delrue MA, Dizier E, Taupiac E, Rodier N, Laroche C, Lacombe B, Bourthoumieu S, Guigonis V, El-Meanawy A, El-Meanawy A, Rufanova V, Stelloh C. Renal development / Cystic diseases. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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