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Leroyer A, Anfosso F, Lacroix R, Sabatier F, Simoncini S, Njock S, Jourde N, Brunet P, Camoin-Jau L, Sampol J, Dignat-George F. Endothelial-derived microparticles: Biological conveyors at the crossroad of inflammation, thrombosis and angiogenesis. Thromb Haemost 2017; 104:456-63. [DOI: 10.1160/th10-02-0111] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Accepted: 04/15/2010] [Indexed: 11/05/2022]
Abstract
SummaryEndothelial microparticles (EMP) are complex vesicular structures that can be shed by activated or apoptotic endothelial cells. EMP are composed of a phospholipid bilayer that exposes transmembrane proteins and receptors and encloses cytosolic components such as enzymes, transcription factors and mRNA derived from their parent cells. Thus, EMP behave as biological conveyors playing a key role in the tuning of vascular homeostasis. This review focuses on the multifaceted roles of EMP, notably in coagulation, inflammation and angiogenesis and also on the mechanisms that trigger their formation. In this context, EMP could compromise vascular homeostasis and then represent key players in the pathogenesis of several inflammatory and thrombotic diseases. Consequently, elucidating their role and their mechanisms of formation will bring new insights into the understanding of endothelial-associated diseases. Moreover, in the future, it can open novel therapeutic perspectives based on the inhibition of EMP release.
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Vairo D, Bruzzese L, Marlinge M, Fuster L, Adjriou N, Kipson N, Brunet P, Cautela J, Jammes Y, Mottola G, Burtey S, Ruf J, Guieu R, Fenouillet E. Towards Addressing the Body Electrolyte Environment via Sweat Analysis:Pilocarpine Iontophoresis Supports Assessment of Plasma Potassium Concentration. Sci Rep 2017; 7:11801. [PMID: 28924220 PMCID: PMC5603548 DOI: 10.1038/s41598-017-12211-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 08/30/2017] [Indexed: 12/17/2022] Open
Abstract
Electrolyte concentration in sweat depends on environmental context and physical condition but also on the pathophysiological status. Sweat analyzers may be therefore the future way for biological survey although how sweat electrolyte composition can reflect plasma composition remains unclear. We recruited 10 healthy subjects and 6 patients to have a broad range of plasma electrolyte concentrations (chloride, potassium and sodium) and pH. These variables were compared to those found in sweat produced following cycling exercise or pilocarpine iontophoresis, a condition compatible with operating a wearable device. We found no correlation between plasma and sweat parameters when exercise-induced sweat was analyzed, and we could identify a correlation only between plasma and sweat potassium concentration (R = 0.78, p < 0.01) when sweat was induced using pilocarpine iontophoresis. We tested measurement repeatability in sweat at 24hr-interval for 3 days in 4 subjects and found a great intra-individual variability regarding all parameters in exercise-induced sweat whereas similar electrolyte levels were measured in pilocarpine-induced sweat. Thus, electrolyte concentration in sweat sampled following physical activity does not reflect concentration in plasma while pilocarpine iontophoresis appears to be promising to reproducibly address sweat electrolytes, and to make an indirect evaluation of plasma potassium concentration in chronic kidney disease and arrhythmia.
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Sallée M, Santana Machado T, Mckay N, Mallmann C, Bouchouareb D, Brunet P, Burtey S. Impact de l’alimentation sur les taux de toxines urémiques. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bataille S, Pelletier M, Sallée M, Berland Y, Mckay N, Duval-Sabatier A, Gentile S, Mouelhi Y, Brunet P, Burtey S. L’indole-3-acétique acide, l’indoxyl sulfate et le para-cresyl sulfate ne sont pas corrélés aux marqueurs de l’anémie des patients hémodialysés chroniques. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Fages L, Moal V, Boucekine M, Brunet P, Moussi-Francès J, Legris T, Purgus R, Daniel L, Burtey S, Dussol B, Berland Y, Vacher-Coponat H. Suivi à 10 ans d’un essai thérapeutique en transplantation rénale comparant deux stratégies immunosuppressives avec corticoïdes et globuline anti-thymocytes : ciclosporine/azathioprine contre tacrolimus/mycophénolate mofétil. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bataille S, Pelletier M, Sallée M, Berland Y, McKay N, Duval A, Gentile S, Mouelhi Y, Brunet P, Burtey S. Indole 3-acetic acid, indoxyl sulfate and paracresyl-sulfate do not influence anemia parameters in hemodialysis patients. BMC Nephrol 2017; 18:251. [PMID: 28747155 PMCID: PMC5530556 DOI: 10.1186/s12882-017-0668-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 07/14/2017] [Indexed: 12/16/2022] Open
Abstract
Background The main reason for anemia in renal failure patients is the insufficient erythropoietin production by the kidneys. Beside erythropoietin deficiency, in vitro studies have incriminated uremic toxins in the pathophysiology of anemia but clinical data are sparse. In order to assess if indole 3-acetic acid (IAA), indoxyl sulfate (IS), and paracresyl sulfate (PCS) -three protein bound uremic toxins- are clinically implicated in end-stage renal disease anemia we studied the correlation between IAA, IS and PCS plasmatic concentrations with hemoglobin and Erythropoietin Stimulating Agents (ESA) use in hemodialysis patients. Methods Between June and July 2014, we conducted an observational cross sectional study in two hemodialysis center. Three statistical approaches were conducted. First, we compared patients treated with ESA and those not treated. Second, we performed linear regression models between IAA, IS, and PCS plasma concentrations and hemoglobin, the ESA dose over hemoglobin ratio (ESA/Hemoglobin) or the ESA resistance index (ERI). Third, we used a polytomous logistic regression model to compare groups of patients with no/low/high ESA dose and low/high hemoglobin statuses. Results Overall, 240 patients were included in the study. Mean age ± SD was 67.6 ± 16.0 years, 55.4% were men and 42.5% had diabetes mellitus. When compared with ESA treated patients, patients with no ESA had higher hemoglobin (mean 11.4 ± 1.1 versus 10.6 ± 1.2 g/dL; p <0.001), higher transferrin saturation (TSAT, 31.1 ± 16.3% versus 23.1 ± 11.5%; p < 0.001), less frequently an IV iron prescription (52.1 versus 65.7%, p = 0.04) and were more frequently treated with hemodiafiltration (53.5 versus 36.7%). In univariate analysis, IAA, IS or PCS plasma concentrations did not differ between the two groups. In the linear model, IAA plasma concentration was not associated with hemoglobin, but was negatively associated with ESA/Hb (p = 0.02; R = 0.18) and with the ERI (p = 0.03; R = 0.17). IS was associated with none of the three anemia parameters. PCS was positively associated with hemoglobin (p = 0.03; R = 0.14), but negatively with ESA/Hb (p = 0.03; R = 0.17) and the ERI (p = 0.02; R = 0.19). In multivariate analysis, the association of IAA concentration with ESA/Hb or ERI was not statistically significant, neither was the association of PCS with ESA/Hb or ERI. Identically, in the subgroup of 76 patients with no inflammation (CRP <5 mg/L) and no iron deficiency (TSAT >20%) linear regression between IAA, IS or PCS and any anemia parameter did not reach significance. In the third model, univariate analysis showed no intergroup significant differences for IAA and IS. Regarding PCS, the Low Hb/High ESA group had lower concentrations. However, when we compared PCS with the other significant characteristics of the five groups to the Low Hb/high ESA (our reference group), the polytomous logistic regression model didn’t show any significant difference for PCS. Conclusions In our study, using three different statistical models, we were unable to show any correlation between IAA, IS and PCS plasmatic concentrations and any anemia parameter in hemodialysis patients. Indolic uremic toxins and PCS have no or a very low effect on anemia parameters.
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Sallee M, Mc Kay N, Santana T, Jourde-Chiche N, Bouchouareb D, Dou L, Brunet P, Burtey S. MP731VARIABILITY OF UREMIC BOUND TOXINS IN HEMODIALYSED PATIENTS OVER A YEAR. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx180.mp731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ficheux A, Gayrard N, Szwarc I, Duranton F, Vetromile F, Brunet P, Jankowski J, Servel MF, Kerr P, Argiles A. SP470INTRADIALYSER PRESSURES: LIMITS, MEASUREMENT PITFALLS AND INFLUENCE OF SURFACE AREA. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx150.sp470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Habib A, Durand AC, Brunet P, Duval-Sabatier A, Moranne O, Bataille S, Benhaim L, Bargas É, Gentile S. Facteurs influençant le choix de la dialyse péritonéale : le point de vue des patients et des néphrologues. Nephrol Ther 2017; 13:93-102. [DOI: 10.1016/j.nephro.2016.07.451] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/21/2016] [Accepted: 07/08/2016] [Indexed: 11/25/2022]
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Gayrard N, Ficheux A, Duranton F, Guzman C, Szwarc I, Vetromile F, Cazevieille C, Brunet P, Servel MF, Argilés À, Le Quintrec M. Consequences of increasing convection onto patient care and protein removal in hemodialysis. PLoS One 2017; 12:e0171179. [PMID: 28166268 PMCID: PMC5293266 DOI: 10.1371/journal.pone.0171179] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 01/17/2017] [Indexed: 11/24/2022] Open
Abstract
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 (p<0.001 for N >56,000 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<0.001 compared to lower convection volumes). Optimal convection volumes as assessed by GKD-UF-max were 20.6 ± 0.4 L/session, whilst 4 supplementary litres were obtained in the maximum situation (24.5 ± 0.6 L/session) but the proportion of sessions achieving the prescribed convection volume decreased from 94% to only 33% (p<0.001). Convection increased high molecular weight compound removal and shifted the membrane cut-off towards the higher molecular weight range. CONCLUSIONS Reaching high convection volumes as recommended by the recent RCTs (> 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.
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Ficheux A, Gayrard N, Duranton F, Guzman C, Szwarc I, Vetromile F, Brunet P, Servel M, Argilés A. A reliable method to assess the water permeability of a dialysis system: the global ultrafiltration coefficient. Nephrol Dial Transplant 2017; 32:364-370. [PMID: 28186570 PMCID: PMC5837204 DOI: 10.1093/ndt/gfw370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 09/12/2016] [Indexed: 12/25/2022] Open
Abstract
Background Recent randomized controlled trials suggest that sufficiently high convection post-dilutional haemodiafiltration (HC-HDF) improves survival in dialysis patients, consequently this technique is increasingly being adopted. However, when performing HC-HDF, rigorous control systems of the ultrafiltration setting are required. Assessing the global ultrafiltration coefficient of the dialysis system [GKD-UF; defined as ultrafiltration rate (QUF)/transmembrane pressure] or water permeability may be adapted to the present dialysis settings and be of value in clinics. Methods GKD-UF was determined and its reproducibility, variability and influencing factors were specifically assessed in 15 stable patients routinely treated by high-flux haemodialysis or HC-HDF in a single unit. Results GKD-UF invariably followed a parabolic function with increasing QUF in dialysis and both pre- and post-dilution HC-HDF (R2 constantly >0.96). The vertex of the parabola, GKD-UF-max and related QUF were very reproducible per patient (coefficient of variation 3.9 ± 0.6 and 3.3 ± 0.3%, respectively) and they greatly varied across patients (31–42 mL/h−1/mmHg and 82–100 mL/min, respectively). GKD-UF-max and its associated QUF decreased during dialysis treatment (P < 0.01). The GKD-UF-max decrease was related to weight loss (R2 = 0.66; P = 0.0015). Conclusions GKD-UF is a reliable and accurate method to assess the water permeability of a system in vivo. It varies according to dialysis setting and patient-related factors. It is an objective parameter evaluating the forces driving convection and identifies any diversion of the system during the treatment procedure. It is applicable to low- or high-flux dialysis as well as pre- or post-dilution HDF. Thus, it may be used to describe the characteristics of a dialysis system, is suitable for clinical use and may be of help for personalized prescription.
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Brunet P. Producing Innovations: A Low-Key Science Policy on Embryonic Stem Cells. JOURNAL OF INNOVATION ECONOMICS & MANAGEMENT 2017. [DOI: 10.3917/jie.pr1.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Brunet P, Fartoux L. Débat sur l’évaluation de la surcharge hydro-sodée : la clinique est suffisante. Nephrol Ther 2016; 12:S12-S13. [DOI: 10.1016/s1769-7255(17)30021-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Laforêt M, Von Kotze C, Perrin J, Brunet P, Dou L, Burtey S. La toxine urémique indoxyl sulfate induit l’expression du facteur tissulaire endothélial en conditions de flux par un mécanisme dépendant d’aryl hydrocarbon receptor. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pelletier M, Dou L, Sallée M, Bataille S, Brunet P, Burtey S. Activation d’aryl hydrocabon receptor et risque hémorragique dans une cohorte de patients hémodialysés. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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91
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Sallée M, Mckay N, Dou L, Pelletier M, Bouchouareb D, Brunet P, Burtey S. Variabilité des taux de toxines urémiques. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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93
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Bussonnière A, Baudoin M, Brunet P, Matar OB. Dynamics of sessile and pendant drops excited by surface acoustic waves: Gravity effects and correlation between oscillatory and translational motions. Phys Rev E 2016; 93:053106. [PMID: 27300977 DOI: 10.1103/physreve.93.053106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Indexed: 06/06/2023]
Abstract
When sessile droplets are excited by ultrasonic traveling surface acoustic waves (SAWs), they undergo complex dynamics with both oscillations and translational motion. While the nature of the Rayleigh-Lamb quadrupolar drop oscillations has been identified, their origin and their influence on the drop mobility remains unexplained. Indeed, the physics behind this peculiar dynamics is complex with nonlinearities involved both at the excitation level (acoustic streaming and radiation pressure) and in the droplet response (nonlinear oscillations and contact line dynamics). In this paper, we investigate the dynamics of sessile and pendant drops excited by SAWs. For pendant drops, so-far unreported dynamics are observed close to the drop detachment threshold with the suppression of the translational motion. Away from this threshold, the comparison between pendant and sessile drop dynamics allows us to identify the role played by gravity or, more generally, by an initial or dynamically induced stretching of the drop. In turn, we elucidate the origin of the resonance frequency shift, as well as the origin of the strong correlation between oscillatory and translational motion. We show that for sessile drops, the velocity is mainly determined by the amplitude of oscillation and that the saturation observed is due to the nonlinear dependence of the drop response frequency on the dynamically induced stretching.
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Duranton F, Duny Y, Szwarc I, Deleuze S, Rouanet C, Selcer I, Maurice F, Rivory JP, Servel MF, Jover B, Brunet P, Daurès JP, Argilés À. Early changes in body weight and blood pressure are associated with mortality in incident dialysis patients. Clin Kidney J 2016; 9:287-94. [PMID: 26985382 PMCID: PMC4792627 DOI: 10.1093/ckj/sfv153] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 12/18/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND While much research is devoted to identifying novel biomarkers, addressing the prognostic value of routinely measured clinical parameters is of great interest. We studied early blood pressure (BP) and body weight (BW) trajectories in incident haemodialysis patients and their association with all-cause mortality. METHODS In a cohort of 357 incident patients, we obtained all records of BP and BW during the first 90 days on dialysis (over 12 800 observations) and analysed trajectories using penalized B-splines and mixed linear regression models. Baseline comorbidities and all-cause mortality (median follow-up: 2.2 years) were obtained from the French Renal Epidemiology and Information Network (REIN) registry, and the association with mortality was assessed by Cox models adjusting for baseline comorbidities. RESULTS During the initial 90 days on dialysis, there were non-linear decreases in BP and BW, with milder slopes after 15 days [systolic BP (SBP)] or 30 days [diastolic BP (DBP) and BW]. SBP or DBP levels at dialysis initiation and changes in BW occurring in the first month or during the following 2 months were significantly associated with survival. In multivariate models adjusting for baseline comorbidities and prescriptions, higher SBP value and BW slopes were independently associated with a lower risk of mortality. Hazard ratios of mortality and 95% confidence intervals were 0.92 (0.85-0.99) for a 10 mmHg higher SBP and 0.76 (0.66-0.88) for a 1 kg/month higher BW change on Days 30-90. CONCLUSIONS BW loss in the first weeks on dialysis is a strong and independent predictor of mortality. Low BP is also associated with mortality and is probably the consequence of underlying cardiovascular diseases. These early markers appear to be valuable prognostic factors.
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Laforet M, Jourde-Chiche N, Haddad F, Sallee M, Stoppa AM, Brunet P, Dussol B, Burtey S, Gondouin B. Evolution in the treatment of multiple myeloma and impact on dialysis independence: data from a French cohort from 1999 to 2014. Blood Cancer J 2016; 6:e409. [PMID: 27015286 PMCID: PMC4817100 DOI: 10.1038/bcj.2016.17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Decourt A, Gondouin B, Delaroziere JC, Brunet P, Sallée M, Burtey S, Dussol B, Ivanov V, Costello R, Couchoud C, Jourde-Chiche N. Trends in Survival and Renal Recovery in Patients with Multiple Myeloma or Light-Chain Amyloidosis on Chronic Dialysis. Clin J Am Soc Nephrol 2016; 11:431-41. [PMID: 26728585 DOI: 10.2215/cjn.06290615] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 11/17/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Monoclonal gammopathies (MGs) with renal involvement can lead to ESRD caused by myeloma cast nephropathy (MCN), immunoglobulin light chain amyloidosis (ALA), or light-chain deposition disease (LCDD). Few studies have focused on the prognosis of patients with MG on chronic dialysis. We evaluated the outcomes of patients with MG incident on chronic dialysis in France. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS All incident patients registered in the Renal Epidemiology and Information Network Registry between 2002 and 2011 with ESRD caused by ALA, LCDD, or MCN were included. Patient's survival, censored for renal transplantation, renal recovery, and loss to follow-up, as well as renal outcomes were analyzed and compared with a control group. Risk factors and causes of death were analyzed. RESULTS We included 1459 patients, comprising 265 (18%) patients with ALA, 334 (23%) patients with LCDD, and 861 (59%) patients with MCN. Median age was 72 years, and 56% were men. Median follow-up was 13.1 months. Renal recovery was observed in 9.1% of patients and more frequent after 2006. Kidney transplantation was rare in this population (2.3%). Among 1272 patients who remained on dialysis, 67% died. Median survival on dialysis was 18.3 months. Main causes of death were malignancies (34.4%), cardiovascular diseases (18%), infections (13.3%), and cachexia (5.2%). Independent risk factors of death were age (hazard ratio [HR], 1.03 per year increase; 95% confidence interval [95% CI], 1.02 to 1.03), frailty (HR, 1.93; 95% CI, 1.58 to 2.36), congestive heart failure (HR, 1.54; 95% CI, 1.23 to 1.93), and dialysis initiation on a central catheter (HR, 1.40; 95% CI, 1.11 to 1.75). Factors associated with a lower risk of death were year of dialysis initiation (HR, 0.95 per year increase; 95% CI, 0.91 to 0.99) and high BP (HR, 0.80; 95% CI, 0.67 to 0.97). CONCLUSIONS Survival of patients with ALA, LCDD, or MCN on chronic dialysis is poor but has improved over time. Progressive malignancy is the main cause of death in this population. Renal recovery has increased since 2006.
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Gondouin B, Jourde-Chiche N, Sallee M, Dou L, Cerini C, Loundou A, Morange S, Berland Y, Burtey S, Brunet P, Guieu R, Dussol B. Plasma Xanthine Oxidase Activity Is Predictive of Cardiovascular Disease in Patients with Chronic Kidney Disease, Independently of Uric Acid Levels. Nephron Clin Pract 2015; 131:167-74. [PMID: 26426087 DOI: 10.1159/000441091] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 09/09/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is associated with increased cardiovascular morbidity and mortality. Oxidative stress seems to play a pivotal role in this process, and purine metabolism may be involved in CKD-related oxidative stress. Xanthine oxidase (XO) is an enzyme involved in purine metabolism and is also responsible for the production of reactive oxygen species. METHODS This prospective study aimed to analyze the relation between plasma dosages of molecules involved in redox balance, purine metabolism and cardiovascular events in patients with non-diabetic CKD stages 3-5 or on chronic hemodialysis (HD). CKD (n = 51) and HD (n = 50) patients were compared to matched healthy controls (n = 38) and followed-up for 3 years. RESULTS Both CKD and HD patients had decreased plasma levels of antioxidants (selenium, zinc, vitamin C). HD patients had decreased levels of the antioxidant enzyme superoxide dismutase and increased levels of oxidation products (ischemia-modified albumin, malondialdehyde [MDA]). The following substrates and enzymes involved in purine metabolism were increased in the HD cohort: adenosine, adenosine deaminase and the pro-oxidant XO. XO activity was negatively correlated with super oxide dismutase and positively with MDA. Interestingly, XO activity was an independent predictor of cardiovascular events in CKD and HD patients, regardless of uric acid levels. Uric acid was not predictive of events. CONCLUSION This highlights a possible role of XO itself in CKD-related cardiovascular disease (CVD) and raises the hypothesis that beneficial effects observed with XO inhibitors on CVD in CKD may also be due to the reduction of oxidative stress.
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Duval-Sabatier A, Martin N, Laforet M, Bouchouareb D, Ramananarivo P, Sallée M, Brunet P. Mise en place du dialyseur Evodial en centre d’hémodialyse. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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99
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Decourt A, Bataille S, Bardin N, Frere C, Gondouin B, Jourde-Chiche N, Duval A, Sallée M, Brunet P, Burtey S. Les anticorps IgA anti-β2 glycoprotéine I ne sont pas un facteur indépendant de mortalité chez le patient en hémodialyse chronique. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Dou L, Addi T, Sallée M, Gondouin B, Jourde-Chiche N, Brunet P, Cerini C, Burtey S. Aryl hydrocarbon receptor est activé in vivo au cours de l’insuffisance rénale chronique. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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