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Duan QL, Nikpoor B, Dubé MP, Molinaro G, Meijer IA, Dion P, Rochefort D, Saint-Onge J, Flury L, Brown NJ, Gainer JV, Rouleau JL, Agostoni A, Cugno M, Simon P, Clavel P, Potier J, Wehbe B, Benarbia S, Marc-Aurèle J, Chanard J, Foroud T, Adam A, Rouleau GA. A variant in XPNPEP2 is associated with angioedema induced by angiotensin I-converting enzyme inhibitors. Am J Hum Genet 2005; 77:617-26. [PMID: 16175507 PMCID: PMC1275610 DOI: 10.1086/496899] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2005] [Accepted: 08/01/2005] [Indexed: 11/04/2022] Open
Abstract
Angiotensin I-converting enzyme inhibitors (ACEi), which are used to treat common cardiovascular diseases, are associated with a potentially life-threatening adverse reaction known as angioedema (AE-ACEi). We have previously documented a significant association between AE-ACEi and low plasma aminopeptidase P (APP) activity. With eight large pedigrees, we hereby demonstrate that this quantitative trait is partially regulated by genetic factors. We tested APP activity using a variance-component QTL analysis of a 10-cM genomewide microsatellite scan enriched with seven markers over two candidate regions. We found significant linkage (LOD = 3.75) to a locus that includes the XPNPEP2 candidate gene encoding membrane-bound APP. Mutation screening of this QTL identified a large coding deletion segregating in one pedigree and an upstream single-nucleotide polymorphism (C-2399A SNP), which segregates in the remaining seven pedigrees. Measured genotype analysis strongly suggests that the linkage signal for APP activity at this locus is accounted for predominantly by the SNP association. In a separate case-control study (20 cases and 60 controls), we found significant association of this SNP to ACEi-induced AE (P=.0364). In conclusion, our findings provide supporting evidence that the C-2399A variant in XPNPEP2 is associated with reduced APP activity and a higher incidence of AE-ACEi.
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Affiliation(s)
- Qing Ling Duan
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Borzoo Nikpoor
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Marie-Pierre Dubé
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Giuseppe Molinaro
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Inge A. Meijer
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Patrick Dion
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Daniel Rochefort
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Judith Saint-Onge
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Leah Flury
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Nancy J. Brown
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - James V. Gainer
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Jean L. Rouleau
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Angelo Agostoni
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Massimo Cugno
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Pierre Simon
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Pierre Clavel
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Jacky Potier
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Bassem Wehbe
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Seddik Benarbia
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Julien Marc-Aurèle
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Jacques Chanard
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Tatiana Foroud
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Albert Adam
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
| | - Guy A. Rouleau
- Centre de recherche du CHUM, Hôpital Notre-Dame, Department of Human Genetics, McGill University, and Department of Medicine, Montreal Heart Institute, and Faculté de Pharmacie, Université de Montréal, Montreal; Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN; Department of Pharmacology, Vanderbilt University, Nashville, TN; Department of Internal Medicine, University of Milan, Milan; Service de Néphrologie, CH La Beauchée, Saint-Brieuc, France; Service de Néphrologie-Hémodialyse, ARPDD, and Service de Néphrologie, CH Universitaire-Reims, Reims, France; Service d’Hémodialyse, CH Louis Pasteur, Cherbourg, France; Service d’Hémodialyse, CH Intercommunal de Cornouaille, and Service de Néphrologie-Hémodialyse, CH Laënnec, Quimper, France; and Hôtel-Dieu de Saint-Jérôme, Saint-Jérôme, Canada
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