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Noordzij M, Meijers B, Gansevoort RT, Covic A, Duivenvoorden R, Hilbrands LB, Hemmelder MH, Jager KJ, Mjoen G, Nistor I, Parshina E, Pessolano G, Tuglular S, Vart P, Zanoli L, Franssen CFM, van der Net JB, Essig M, du Buf-Vereijken PWG, van Ginneken B, Maas N, van Jaarsveld BC, Bemelman FJ, Klingenberg-Salahova F, Vervloet MG, Nurmohamed A, Vogt L, Abramowicz D, Verhofstede S, Maoujoud O, Malfait T, Fialova J, Lips J, Hengst M, Konings C, Rydzewski A, Oliveira J, Zakharova EV, Lepeytre F, Rabaté C, Rostoker G, Marques S, Azasevac T, Majstorovic GS, Fricke L, Slebe JJP, ElHafeez SA, El-Wakil HS, Verhoeven M, Logan I, Panagoutsos S, Mallamaci F, Postorino A, Cambareri F, Matceac I, Groeneveld JHM, Jousma J, van Buren M, Pereira TA, Arias-Cabrales C, Crespo M, Llinàs-Mallol L, Buxeda A, Tàrrega CB, Redondo-Pachon D, Jimenez MDA, Mendoza-Valderrey A, Martins AC, Mateus C, Alvila G, Laranjinha I, Arroyo D, Castellano S, Rodríguez-Ferrero ML, Lemahieu W, Dirim AB, Demir E, Sever MS, Turkmen A, Şafak S, Hollander DAMJ, Büttner S, Sridharan S, van der Sande FM, Christiaans MHL, Luca MD, Beerenhout C, Adema AY, Stepanov VA, Zulkarnaev AB, Turkmen K, Fliedner A, Åsberg A, Pini S, de Biase C, Kerckhoffs A, van de Logt AE, Maas R, Lebedeva O, Reichert LJM, Verhave J, Marcantoni C, van Gils-Verrij LEA, Battaglia Y, Lentini P, Cabezas-Reina CJ, Roca AM, Nauta F, Goffin E, Kanaan N, Labriola L, Devresse A, Coca A, Naesens M, Kuypers D, Desschans B, Dedinska I, Malik S, Berger SP, Sanders JSF, Özyilmaz A, Ponikvar JB, Pernat AM, Kovac D, Arnol M, Abrahams AC, Molenaar FM, van Zuilen AD, Meijvis SCA, Dolmans H, Esposito P, Krzesinski JM, Barahira JD, Gallieni M, Guglielmetti G, Guzzo G, Luik AJ, van Kuijk WHM, Stikkelbroeck LWH, Hermans MMH, Rimsevicius L, Righetti M, Islam M, Heitink-ter Braak N. Strategies to prevent SARS-CoV-2 transmission in hemodialysis centres across Europe - Lessons for the future. Clin Kidney J 2022; 16:662-675. [PMID: 37007687 PMCID: PMC10061429 DOI: 10.1093/ckj/sfac253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Indexed: 12/04/2022] Open
Abstract
Abstract
Background
Early reports on the pandemic nature of COVID-19 directed the nephrology community to develop infection prevention and control guidance. We aimed to make an inventory of strategies that dialysis centres followed to prevent infection with COVID-19 in the first pandemic wave.
Methods
We analyzed IPC measures taken by hemodialysis centres treating patients presenting with COVID-19 between March 1, 2020 and July 31, 2020 and that completed the European Renal Association COVID-19 Database centre questionnaire. Additionally, we made an inventory of guidelines published in European countries to prevent spread of SARS-CoV-2 in dialysis centres.
Results
Data from 73 dialysis units located in and bordering Europe were analyzed. All participating centres implemented IPC measures to mitigate the impact of SARS-CoV-2 during the first pandemic wave. Measures mentioned most often included triage with questions before entering the dialysis ward, measuring body temperature, hand disinfection, masking for all patients and staff, and personal protective equipment for staff members. These measures were also recommended in most of the 14 guidelines that were identified in the inventory of national guidelines and were also scored as being among the most important measures by the authors of this paper. Heterogeneity existed between centres and national guidelines regarding the minimal distance between dialysis chairs and recommendations regarding isolation and cohorting.
Conclusions
Although variation existed, measures to prevent transmission of SARS-CoV-2 were relatively similar across centres and national guidelines. Further research is needed to assess causal relationships between measures taken and spread of SARS-CoV-2.
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Affiliation(s)
- Marlies Noordzij
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - Björn Meijers
- Department of Nephrology , UZ Leuven, Leuven , , Immunology and Transplantation, KU Leuven, Leuven , Belgium
- Belgium and Department of Microbiology , UZ Leuven, Leuven , , Immunology and Transplantation, KU Leuven, Leuven , Belgium
| | - Ron T Gansevoort
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - Adrian Covic
- Grigore T Popa University of Medicine and Pharmacy , Iasi , , Iasi , Romania
- Romania / Dr Ci Parhon Hospital , Iasi , , Iasi , Romania
| | - Raphaël Duivenvoorden
- Department of Nephrology, Radboud University Medical Center , Nijmegen , The Netherlands
| | - Luuk B Hilbrands
- Department of Nephrology, Radboud University Medical Center , Nijmegen , The Netherlands
| | - Marc H Hemmelder
- Dept. of Internal Medicine, Div. of Nephrology, Maastricht University Medical Center / CARIM school for cardiovascular disease, University of Maastricht , Maastricht , The Netherlands
| | - Kitty J Jager
- ERA Registry, Amsterdam UMC location University of Amsterdam , Medical Informatics, Amsterdam , The Netherlands
- Amsterdam Public Health Research Institute , Quality of Care, Amsterdam , The Netherlands
| | - Geir Mjoen
- Department of Transplantation, Oslo University Hospital , Norway
| | - Ionut Nistor
- Grigore T Popa University of Medicine and Pharmacy , Iasi , , Iasi , Romania
- Romania / Dr Ci Parhon Hospital , Iasi , , Iasi , Romania
| | - Ekaterina Parshina
- Nephrology and Dialysis Department, Saint Petersburg State University Hospital , Saint-Petersburg, Russia
| | - Giuseppina Pessolano
- Division of Nephrology , Azienda Ospedaliera Universitaria Integrata Verona, Italy
| | - Serhan Tuglular
- Medical Faculty, Department of Internal Medicine, Marmara University , Istanbul , Turkey
| | - Priya Vart
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
- Department of Clinical Pharmacy & Pharmacology, University Medical Center Groningen, University of Groningen , The Netherlands
| | - Luca Zanoli
- Nephrology and dialysis, San Marco Hospital, University of Catania , Catania , Italy
| | - Casper F M Franssen
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
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Bouwmans P, Brandts L, Hilbrands LB, Duivenvoorden R, Vart P, Franssen CFM, Covic A, Islam M, Rabaté C, Jager KJ, Noordzij M, Gansevoort RT, Hemmelder MH. The clinical frailty scale as a triage tool for ICU admission of dialysis patients with COVID-19 - An ERACODA analysis. Nephrol Dial Transplant 2022; 37:2264-2274. [PMID: 36002034 PMCID: PMC9452166 DOI: 10.1093/ndt/gfac246] [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: 05/09/2022] [Indexed: 11/15/2022] Open
Abstract
Background Several guidelines recommend using the Clinical Frailty Scale (CFS) for triage of critically ill coronavirus disease 2019 (COVID-19) patients. This study evaluates the impact of CFS on intensive care unit (ICU) admission rate and hospital and ICU mortality rates in hospitalized dialysis patients with COVID-19. Methods We analysed data of dialysis patients diagnosed with COVID-19 from the European Renal Association COVID-19 Database. The primary outcome was ICU admission rate and secondary outcomes were hospital and ICU mortality until 3 months after COVID-19 diagnosis. Cox regression analyses were performed to assess associations between CFS and outcomes. Results A total of 1501 dialysis patients were hospitalized due to COVID-19, of whom 219 (15%) were admitted to an ICU. The ICU admission rate was lowest (5%) in patients >75 years of age with a CFS of 7–9 and highest (27%) in patients 65–75 years of age with a CFS of 5. A CFS of 7–9 was associated with a lower ICU admission rate than a CFS of 1–3 [relative risk 0.49 (95% confidence interval 0.27–0.87)]. Overall, mortality at 3 months was 34% in hospitalized patients, 65% in ICU-admitted patients and highest in patients >75 years of age with a CFS of 7–9 (69%). Only 9% of patients with a CFS ≥6 survived after ICU admission. After adjustment for age and sex, each CFS category ≥4 was associated with higher hospital and ICU mortality compared with a CFS of 1–3. Conclusions Frail dialysis patients with COVID-19 were less frequently admitted to the ICU. Large differences in mortality rates between fit and frail patients suggest that the CFS may be a useful complementary triage tool for ICU admission in dialysis patients with COVID-19.
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Affiliation(s)
- Pim Bouwmans
- Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center, Maastricht, The Netherlands. CARIM School for Cardiovascular Disease, University of Maastricht, Maastricht, The Netherlands
| | - Lloyd Brandts
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Luuk B Hilbrands
- Department of Nephrology, Radboud University Medical Center. Nijmegen, The Netherlands
| | - Raphaël Duivenvoorden
- Department of Nephrology, Radboud University Medical Center. Nijmegen, The Netherlands
| | - Priya Vart
- Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands.,Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, The Netherlands
| | - Casper F M Franssen
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, The Netherlands
| | - Adrian Covic
- Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania / Dr Ci Parhon Hospital, Iasi, Romania
| | - Mahmud Islam
- Zonguldak Ataturk state hospital, Zonguldak, Turkey
| | | | - Kitty J Jager
- ERA Registry, Amsterdam UMC location University of Amsterdam, Medical Informatics, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, The Netherlands
| | - Marlies Noordzij
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, The Netherlands
| | - Ron T Gansevoort
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, The Netherlands
| | - Marc H Hemmelder
- Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center, Maastricht, The Netherlands. CARIM School for Cardiovascular Disease, University of Maastricht, Maastricht, The Netherlands
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Rostoker G, Senet P, Lepeytre F, Griuncelli M, Loridon C, Rabaté C, Cohen Y. Analysis of liver iron concentration in an elderly female undergoing hemodialysis with calcific uremic arteriolopathy does not support the role of iron overload in calciphylaxis: lesson for the clinical nephrologist. J Nephrol 2021; 34:1547-1551. [PMID: 33484427 PMCID: PMC8494698 DOI: 10.1007/s40620-020-00904-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/04/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Guy Rostoker
- Division of Nephrology and Dialysis, Ramsay Santé, Hôpital Privé Claude Galien, 20 Route de Boussy-Saint-Antoine, 91480, Quincy-Sous-Sénart, France.
- Collège de Médecine des Hôpitaux de Paris, 10 Rue des Fossés Saint-Marcel, 75005, Paris, France.
- Service de Néphrologie et de Dialyse, Ramsay Santé, HP Claude Galien, 20 Route de Boussy-Saint-Antoine, 91480, Quincy-Sous-Sénart, France.
| | - Patricia Senet
- Division of Dermatology and Allergology, Assistance Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 Rue de la Chine, 75020, Paris, France
| | - Fanny Lepeytre
- Division of Nephrology and Dialysis, Ramsay Santé, Hôpital Privé Claude Galien, 20 Route de Boussy-Saint-Antoine, 91480, Quincy-Sous-Sénart, France
| | - Mireille Griuncelli
- Division of Nephrology and Dialysis, Ramsay Santé, Hôpital Privé Claude Galien, 20 Route de Boussy-Saint-Antoine, 91480, Quincy-Sous-Sénart, France
| | - Christelle Loridon
- Division of Nephrology and Dialysis, Ramsay Santé, Hôpital Privé Claude Galien, 20 Route de Boussy-Saint-Antoine, 91480, Quincy-Sous-Sénart, France
| | - Clémentine Rabaté
- Division of Nephrology and Dialysis, Ramsay Santé, Hôpital Privé Claude Galien, 20 Route de Boussy-Saint-Antoine, 91480, Quincy-Sous-Sénart, France
| | - Yves Cohen
- Division of Radiology, Ramsay Santé, Hôpital Privé Claude Galien, 20 Route de Boussy-Saint-Antoine, 91480, Quincy-Sous-Sénart, France
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Anglicheau D, Tinel C, Canaud G, Loupy A, Zuber J, Delville M, Rabaté C, Scemla A, Snanoudj R, Sberro-Soussan R, Mamzer-Bruneel MF, Bererhi L, Martinez F, Timsit MO, Rabant M, Correas JM, Bienaimé F, Duong JP, Hélénon O, Prié D, Méjean A, Legendre C. [Renal transplantation: Procedure and early follow-up]. Nephrol Ther 2019; 15:469-484. [PMID: 31640943 DOI: 10.1016/j.nephro.2019.09.001] [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] [Indexed: 10/25/2022]
Abstract
More than fifty years after the success of the two first renal transplantations in Boston and in Necker hospital in Paris, renal transplantation became the treatment of choice of end stage renal failure, because it improves not only the quality of life of the patients but also their long-term survival. In France, more than 3,700 kidney transplantations are performed every year and more than 40,000 patients are living with a functioning kidney allograft. This treatment of end stage renal disease requires a fine-tuned pre-transplant evaluation and a multidisciplinary post-transplant care in order to prevent, to detect and to treat comorbidities and complications of immunosuppression. The ambition of this manuscript is not to describe in an exhaustive way all the aspects of renal transplantation but starting from the experience of a team, recently published data, and national and international guidelines, to try to provide a synthetic and chronological view of the early post-transplant monitoring.
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Affiliation(s)
- Dany Anglicheau
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France; Service de néphrologie et transplantation adulte, hôpital Necker, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
| | - Claire Tinel
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France; Service de néphrologie et transplantation adulte, hôpital Necker, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - Guillaume Canaud
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France; Service de néphrologie et transplantation adulte, hôpital Necker, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - Alexandre Loupy
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France; Service de néphrologie et transplantation adulte, hôpital Necker, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - Julien Zuber
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France; Service de néphrologie et transplantation adulte, hôpital Necker, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - Marianne Delville
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France; Service de néphrologie et transplantation adulte, hôpital Necker, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - Clémentine Rabaté
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France; Service de néphrologie et transplantation adulte, hôpital Necker, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - Anne Scemla
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France
| | - Renaud Snanoudj
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France
| | - Rébecca Sberro-Soussan
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France
| | | | - Lynda Bererhi
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France
| | - Frank Martinez
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France
| | - Marc-Olivier Timsit
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France; Service d'urologie, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - Marion Rabant
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France; Service d'anatomie pathologique, hôpital Necker, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - Jean-Michel Correas
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France; Service de radiologie adulte, hôpital Necker, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - Frank Bienaimé
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France; Service d'exploration fonctionnelle, hôpital Necker, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - Jean-Paul Duong
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France; Service d'anatomie pathologique, hôpital Necker, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - Olivier Hélénon
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France; Service de radiologie adulte, hôpital Necker, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - Dominique Prié
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France; Service d'exploration fonctionnelle, hôpital Necker, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - Arnaud Méjean
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France; Service d'urologie, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - Christophe Legendre
- Faculté de médecine, université Paris-Descartes, Université de Paris, 75006 Paris, France; Service de néphrologie et transplantation adulte, hôpital Necker, AP-HP, 149, rue de Sèvres, 75015 Paris, France
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Rostoker G, Loridon C, Griuncelli M, Rabaté C, Lepeytre F, Ureña-Torres P, Issad B, Ghali N, Cohen Y. Liver Iron Load Influences Hepatic Fat Fraction in End-Stage Renal Disease Patients on Dialysis: A Proof of Concept Study. EBioMedicine 2018; 39:461-471. [PMID: 30502056 PMCID: PMC6354439 DOI: 10.1016/j.ebiom.2018.11.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 10/11/2018] [Revised: 11/08/2018] [Accepted: 11/12/2018] [Indexed: 12/13/2022] Open
Abstract
Background Nonalcoholic fatty liver disease (NAFLD) is a spectrum of diseases including steatosis, nonalcoholic steatohepatitis (NASH), cirrhosis, and end-stage liver failure. Hepatic iron accumulation has been linked to hepatic fibrosis severity in NASH and NAFLD. Iron overload induced by parenteral (IV) iron therapy is a potential clinical problem in dialysis patients. We analyzed the hypothetical triggering and aggravating role of iron on NAFLD in patients on dialysis. Methods Liver iron concentration (LIC) and hepatic proton density fat fraction (PDFF) were analyzed prospectively in 68 dialysis patients by magnetic resonance imaging (MRI). Follow up of LIC and PDFF was performed in 17 dialysis patients during iron therapy. Findings PDFF differed significantly among dialysis patients classified according to LIC: patients with moderate or severe iron overload had increased fat fraction (PDFF: 7.9% (0.5–14.8%)) when compared to those with normal LIC (PDFF: 5% (0.27–11%)) or mild iron overload (PDFF: 5% (0.30–11.6%); P = 0.0049). PDFF correlated with LIC, and ferritin and body mass index. In seven patients monitored during IV iron therapy, LIC and PDFF increased concomitantly (PDFF: initial 2.5%, final 8%, P = 0.0156; LIC: initial 20 μmol/g, final 160 μmol/g: P = 0.0156), whereas in ten patients with iron overload, PDFF decreased after IV iron withdrawal or major dose reduction (initial: 8%, final: 4%; P = 0.0098) in parallel with LIC (initial: 195 μmol/g, final: 45 μmol/g; P = 0.002). Interpretation Liver iron load influences hepatic fat fraction in dialysis patients. Iron overload induced by iron therapy may aggravate or trigger NAFLD in dialysis patients. Trial registration number (ISRCTN) 80100088.
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Affiliation(s)
- Guy Rostoker
- Division of Nephrology and Dialysis, Ramsay Générale de Santé, Hôpital Privé Claude Galien, Quincy-Sous-Sénart, France.
| | - Christelle Loridon
- Division of Nephrology and Dialysis, Ramsay Générale de Santé, Hôpital Privé Claude Galien, Quincy-Sous-Sénart, France
| | - Mireille Griuncelli
- Division of Nephrology and Dialysis, Ramsay Générale de Santé, Hôpital Privé Claude Galien, Quincy-Sous-Sénart, France
| | - Clémentine Rabaté
- Division of Nephrology and Dialysis, Ramsay Générale de Santé, Hôpital Privé Claude Galien, Quincy-Sous-Sénart, France
| | - Fanny Lepeytre
- Division of Nephrology and Dialysis, Ramsay Générale de Santé, Hôpital Privé Claude Galien, Quincy-Sous-Sénart, France
| | - Pablo Ureña-Torres
- Division of Dialysis, Ramsay Générale de Santé, Clinique du Landy, Saint-Ouen, France
| | - Belkacem Issad
- Division of Nephrology and Dialysis, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Nasredine Ghali
- Division of Nephrology and Dialysis, Centre Hospitalier Marc Jacquet, Melun, France
| | - Yves Cohen
- Division of Radiology, Ramsay Générale de Santé, Hôpital Privé Claude Galien, Quincy-Sous-Sénart, France
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6
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Bohelay G, Arzouk N, Lévy P, Rabaté C, Le Cleach L, Barete S, Barrou B, Matignon MB, Euvrard S, Lebbé C, Francès C. Outcome of second kidney transplantation in patients with previous post-transplantation Kaposi's sarcoma: A French retrospective study. Clin Transplant 2017; 31. [DOI: 10.1111/ctr.13091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Gérôme Bohelay
- Department of Dermatology and Allergology; University Paris VI; Hôpital Tenon; Paris France
| | - Nadia Arzouk
- Department of Urology; University Paris VI; Hôpital Pitié Salpêtrière; Paris France
| | - Pierre Lévy
- Department of Public Health; Hôpital Tenon; APHP; University Paris VI; and Institut National de la Santé et de la Recherche Médicale; UMR-S 1136; Paris France
| | - Clémentine Rabaté
- Department of Nephrology; University Paris V; Hôpital Necker; Paris France
| | - Laurence Le Cleach
- Department of Dermatology; AP-HP; Hôpitaux Universitaires Henri Mondor; Créteil France
- EA EpiDermE; INSERM Créteil; Créteil France
| | - Stéphane Barete
- Department of Dermatology and Allergology; University Paris VI; Hôpital Tenon; Paris France
| | - Benoît Barrou
- Department of Urology; University Paris VI; Hôpital Pitié Salpêtrière; Paris France
| | - Marie-Benedicte Matignon
- Department of Nephrology and Transplantation; Assistance Publique-Hôpitaux de Paris; Groupe Henri Mondor-Albert Chenevier; Centre d'Investigation Clinique-BioThérapies 504; Institut National de la Santé et de la Recherche Médicale U955; Paris XII University; Créteil France
| | - Sylvie Euvrard
- Department of Dermatology; Hôpital Edouard Herriot; Hospices Civils de Lyon; Lyon France
| | - Céleste Lebbé
- Department of Dermatology; APHP, University Paris VII; Hôpital Saint-Louis; Paris France
| | - Camille Francès
- Department of Dermatology and Allergology; University Paris VI; Hôpital Tenon; Paris France
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7
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Rostoker G, Laroudie M, Blanc R, Galet B, Rabaté C, Griuncelli M, Cohen Y. Signal-intensity-ratio MRI accurately estimates hepatic iron load in hemodialysis patients. Heliyon 2017; 3:e00226. [PMID: 28124030 PMCID: PMC5220226 DOI: 10.1016/j.heliyon.2016.e00226] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 07/30/2016] [Revised: 11/02/2016] [Accepted: 12/22/2016] [Indexed: 12/22/2022] Open
Abstract
Background Iron overload, diagnosed by means of magnetic resonance imaging (MRI), is an increasingly recognized disorder in hemodialysis patients. Specific MRI protocols have been shown to provide a reliable estimation of tissue iron content in non-renal patient populations but have not been validated in dialysis patients. Such validation studies require liver biopsy for histological comparison, but this invasive and risky procedure raises ethical concerns, especially regarding frail patients with end-stage renal disease. Materials and methods We compared in a pilot study Scheuer’s histological classification and Deugnier and Turlin’s histological classification of iron overload (Perls staining) with signal-intensity-ratio MRI values obtained with the Rennes University algorithm in 11 hemodialysis patients in whom liver biopsy was formally indicated for their medical follow-up. Results For Scheuer’s histological classification, the Wilcoxon non-parametric matched-pairs test showed no significant difference in the ranking of iron overload by the two methods eg histology and MRI (sum of ranks = 1.5; p = 1). The MRI and Scheuer’s histological classifications were tightly correlated (rho = 0.866, p = 0.0035, Spearman’s coefficient), as were the absolute liver iron concentrations (LIC) at MRI (rho = 0.860, p = 0.0013, Spearman’s coefficient). The absolute liver iron concentrations at MRI were also highly correlated with Deugnier and Turlin’s histological scoring (rho = 0.841, p = 0.0033, Spearman’s coefficient). Conclusions This pilot study shows that liver iron determination based on signal-intensity-ratio MRI (Rennes University algorithm) very accurately identifies iron load in hemodialysis patients, by comparison with liver histology.
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Affiliation(s)
- Guy Rostoker
- Division of Nephrology and Dialysis (Service Néphrologie et de Dialyse), Ramsay-Générale de Santé, Hôpital Privé Claude Galien, Quincy sous Sénart, France
- Corresponding author.
| | - Mireille Laroudie
- Histopathology laboratory ACP Bievres (Laboratoire d’Anatomie et de Cytologie Pathologiques (ACP) Bièvres), 7 avenue du Hoggar, 91940 les Ulis, France
| | - Raphaël Blanc
- Division of Angiography (Service de radiologie interventionnelle), Ramsay Générale de Santé, Hôpital Privé Claude Galien, Quincy sous Sénart, France
| | - Bernard Galet
- Histopathology laboratory ACP Bievres (Laboratoire d’Anatomie et de Cytologie Pathologiques (ACP) Bièvres), 7 avenue du Hoggar, 91940 les Ulis, France
| | - Clémentine Rabaté
- Division of Nephrology and Dialysis (Service Néphrologie et de Dialyse), Ramsay-Générale de Santé, Hôpital Privé Claude Galien, Quincy sous Sénart, France
| | - Mireille Griuncelli
- Division of Nephrology and Dialysis (Service Néphrologie et de Dialyse), Ramsay-Générale de Santé, Hôpital Privé Claude Galien, Quincy sous Sénart, France
| | - Yves Cohen
- Division of Radiology (Service de Radiologie), Ramsay Générale de Santé, Hôpital Privé Claude Galien, Quincy sous Sénart, France
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Amrouche L, Desbuissons G, Rabant M, Sauvaget V, Nguyen C, Benon A, Barre P, Rabaté C, Lebreton X, Gallazzini M, Legendre C, Terzi F, Anglicheau D. MicroRNA-146a in Human and Experimental Ischemic AKI: CXCL8-Dependent Mechanism of Action. J Am Soc Nephrol 2016; 28:479-493. [PMID: 27444565 DOI: 10.1681/asn.2016010045] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [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: 01/13/2016] [Accepted: 05/31/2016] [Indexed: 12/19/2022] Open
Abstract
AKI leads to tubular injury and interstitial inflammation that must be controlled to avoid the development of fibrosis. We hypothesized that microRNAs are involved in the regulation of the balance between lesion formation and adaptive repair. We found that, under proinflammatory conditions, microRNA-146a (miR-146a) is transcriptionally upregulated by ligands of IL-1 receptor/Toll-like receptor family members via the activation of NF-κB in cultured renal proximal tubular cells. In vivo, more severe renal ischemia-reperfusion injury (IRI) associated with increased expression of miR-146a in both allografts and urine of human kidney transplant recipients, and unilateral IRI in mice induced miR-146a expression in injured kidneys. After unilateral IRI, miR-146a-/- mice exhibited more extensive tubular injury, inflammatory infiltrates, and fibrosis than wild-type mice. In vitro, overexpression or downregulation of miR-146a diminished or enhanced, respectively, IL-1 receptor-associated kinase 1 expression and induced similar effects on C-X-C motif ligand 8 (CXCL8)/CXCL1 expression by injured tubular cells. Moreover, inhibition of CXCL8/CXCL1 signaling prevented the development of inflammation and fibrosis after IRI in miR-146a-/- mice. In conclusion, these results indicate that miR-146a is a key mediator of the renal tubular response to IRI that limits the consequences of inflammation, a key process in the development of AKI and CKD.
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Affiliation(s)
- Lucile Amrouche
- Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France.,Paris Descartes, Sorbonne Paris Cité University, Paris, France.,Department of Nephrology and Kidney Transplantation
| | - Geoffroy Desbuissons
- Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France
| | - Marion Rabant
- Paris Descartes, Sorbonne Paris Cité University, Paris, France.,Department of Pathology, and
| | - Virginia Sauvaget
- Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France
| | - Clément Nguyen
- Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France
| | - Aurélien Benon
- Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France
| | - Pauline Barre
- Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France
| | - Clémentine Rabaté
- Paris Descartes, Sorbonne Paris Cité University, Paris, France.,Department of Nephrology and Kidney Transplantation
| | | | - Morgan Gallazzini
- Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France
| | - Christophe Legendre
- Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France.,Paris Descartes, Sorbonne Paris Cité University, Paris, France.,Department of Nephrology and Kidney Transplantation.,Réseau Thématique de Recherche et de Soins Centaure, Labex Transplantex, Necker Hospital, Paris, France
| | - Fabiola Terzi
- Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France
| | - Dany Anglicheau
- Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France; .,Paris Descartes, Sorbonne Paris Cité University, Paris, France.,Department of Nephrology and Kidney Transplantation.,Réseau Thématique de Recherche et de Soins Centaure, Labex Transplantex, Necker Hospital, Paris, France
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9
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Legendre C, Loupy A, Rabant M, Aubert O, Rabaté C, Delville M, Tinel C, Amrouche L, Martinez F, Snanoudj R, Bererhi L, Scemla A, Sberro-Soussan R, Duong JP, Suberbielle C, Anglicheau D. [Current aspects of acute humoral rejection]. Nephrol Ther 2014; 10:479-83. [PMID: 25440942 DOI: 10.1016/j.nephro.2014.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Acute clinical antibody-mediated rejection is currently defined by (1), an acute renal failure occurring during the first months following transplantation, (2), at least a microcirculation inflammation (glomerulitis and peritubular capillaritis) on kidney biopsy and (3), the presence in peripheral blood of donor specific antibodies, mostly anti-human leukocyte antigen (HLA) antibodies. The prognosis of this rejection is scored using the severity of vascular lesions and the positivity of C4d on peritubular capillaries. Recently, a subclinical variety of antibody-mediated rejection was recognized as an entity because, as the clinical rejection, it leads to chronic antibody-mediated rejection, currently the most frequent cause of graft loss. The description of these various aspects of antibody-mediated rejection allowed a better understanding of its pathophyiology that may lead in a near future to a more specific treatment.
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Affiliation(s)
- Christophe Legendre
- Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France.
| | - Alexandre Loupy
- Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France
| | - Marion Rabant
- Service d'anatomie pathologique, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France
| | - Olivier Aubert
- Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France
| | - Clémentine Rabaté
- Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France
| | - Marianne Delville
- Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France
| | - Claire Tinel
- Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France
| | - Lucile Amrouche
- Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France
| | - Frank Martinez
- Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France
| | - Renaud Snanoudj
- Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France
| | - Lynda Bererhi
- Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France
| | - Anne Scemla
- Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France
| | - Rébecca Sberro-Soussan
- Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France
| | - Jean-Paul Duong
- Service d'anatomie pathologique, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France
| | - Caroline Suberbielle
- Laboratoire d'histocompatibilité, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Dany Anglicheau
- Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France
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10
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Bohelay G, Rabaté C, Le Cleach L, Barete S, Euvrard S, Lebbé C, Francès C. Nouvelle transplantation rénale après maladie de Kaposi du transplanté. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.139] [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: 10/24/2022]
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