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Raynaud M, Al-Awadhi S, Juric I, Divard G, Lombardi Y, Basic-Jukic N, Aubert O, Dubourg L, Masson I, Mariat C, Prié D, Pernin V, Le Quintrec M, Larson TS, Stegall MD, Bikbov B, Ruggenenti P, Mesnard L, Ibrahim HN, Nielsen MB, Matas AJ, Nankivell BJ, Benjamens S, Pol RA, Bakker SJL, Jouven X, Legendre C, Kamar N, Smith BH, Wadei HM, Durrbach A, Vincenti F, Remuzzi G, Lefaucheur C, Bentall AJ, Loupy A. Race-free estimated glomerular filtration rate equation in kidney transplant recipients: development and validation study. BMJ 2023; 381:e073654. [PMID: 37257905 PMCID: PMC10231444 DOI: 10.1136/bmj-2022-073654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To compare the performance of a newly developed race-free kidney recipient specific glomerular filtration rate (GFR) equation with the three current main equations for measuring GFR in kidney transplant recipients. DESIGN Development and validation study SETTING: 17 cohorts in Europe, the United States, and Australia (14 transplant centres, three clinical trials). PARTICIPANTS 15 489 adults (3622 in development cohort (Necker, Saint Louis, and Toulouse hospitals, France), 11 867 in multiple external validation cohorts) who received kidney transplants between 1 January 2000 and 1 January 2021. MAIN OUTCOME MEASURE The main outcome measure was GFR, measured according to local practice. Performance of the GFR equations was assessed using P30 (proportion of estimated GFR (eGFR) within 30% of measured GFR (mGFR)) and correct classification (agreement between eGFR and mGFR according to GFR stages). The race-free equation, based on creatinine level, age, and sex, was developed using additive and multiplicative linear regressions, and its performance was compared with the three current main GFR equations: Modification of Diet in Renal Disease (MDRD) equation, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2009 equation, and race-free CKD-EPI 2021 equation. RESULTS The study included 15 489 participants, with 50 464 mGFR and eGFR values. The mean GFR was 53.18 mL/min/1.73m2 (SD 17.23) in the development cohort and 55.90 mL/min/1.73m2 (19.69) in the external validation cohorts. Among the current GFR equations, the race-free CKD-EPI 2021 equation showed the lowest performance compared with the MDRD and CKD-EPI 2009 equations. When race was included in the kidney recipient specific GFR equation, performance did not increase. The race-free kidney recipient specific GFR equation showed significantly improved performance compared with the race-free CKD-EPI 2021 equation and performed well in the external validation cohorts (P30 ranging from 73.0% to 91.3%). The race-free kidney recipient specific GFR equation performed well in several subpopulations of kidney transplant recipients stratified by race (P30 73.0-91.3%), sex (72.7-91.4%), age (70.3-92.0%), body mass index (64.5-100%), donor type (58.5-92.9%), donor age (68.3-94.3%), treatment (78.5-85.2%), creatinine level (72.8-91.3%), GFR measurement method (73.0-91.3%), and timing of GFR measurement post-transplant (72.9-95.5%). An online application was developed that estimates GFR based on recipient's creatinine level, age, and sex (https://transplant-prediction-system.shinyapps.io/eGFR_equation_KTX/). CONCLUSION A new race-free kidney recipient specific GFR equation was developed and validated using multiple, large, international cohorts of kidney transplant recipients. The equation showed high accuracy and outperformed the race-free CKD-EPI 2021 equation that was developed in individuals with native kidneys. TRIAL REGISTRATION ClinicalTrials.gov NCT05229939.
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Affiliation(s)
- Marc Raynaud
- Université de Paris Cité, INSERM, PARCC, Paris Translational Research Centre for Organ Transplantation, F-75015 Paris, France
| | - Solaf Al-Awadhi
- Université de Paris Cité, INSERM, PARCC, Paris Translational Research Centre for Organ Transplantation, F-75015 Paris, France
| | - Ivana Juric
- Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Gillian Divard
- Université de Paris Cité, INSERM, PARCC, Paris Translational Research Centre for Organ Transplantation, F-75015 Paris, France
| | - Yannis Lombardi
- Department of Nephrology and Acute Kidney Intensive Care, Tenon Hospital, Paris, France
| | - Nikolina Basic-Jukic
- Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Olivier Aubert
- Université de Paris Cité, INSERM, PARCC, Paris Translational Research Centre for Organ Transplantation, F-75015 Paris, France
- Department of Nephrology and Kidney Transplantation, Necker Hospital, Paris, France
| | - Laurence Dubourg
- Centre de Référence des Maladies Rénales Rares, Service de Néphrologie et Rhumatologie Pédiatriques, Hospices Civils de Lyon, Lyon, France
| | - Ingrid Masson
- Department of Nephrology, Dialysis and Renal Transplantation, Nord Hospital, Jean Monnet University, Saint-Etienne, France
| | - Christophe Mariat
- Department of Nephrology, Dialysis and Renal Transplantation, Nord Hospital, Jean Monnet University, Saint-Etienne, France
| | - Dominique Prié
- Department of Nephrology and Kidney Transplantation, Necker Hospital, Paris, France
| | - Vincent Pernin
- Department of Nephrology, University Hospital Centre, Montpellier, France
| | - Moglie Le Quintrec
- Department of Nephrology, University Hospital Centre, Montpellier, France
| | - Timothy S Larson
- William J von Liebig Centre for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota, USA
| | - Mark D Stegall
- William J von Liebig Centre for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota, USA
| | - Boris Bikbov
- Department of Health Policy, Instituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Piero Ruggenenti
- Department of Renal Medicine, Clinical Research Centre for Rare Diseases "Aldo e Cele Daccò": Instituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, Bergamo, Italy
- Unit of Nephrology and Dialysis, Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Laurent Mesnard
- Department of Nephrology and Acute Kidney Intensive Care, Tenon Hospital, Paris, France
| | - Hassan N Ibrahim
- University of Texas Health Sciences Centre at Houston, Texas, USA
| | | | - Arthur J Matas
- Division of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Stan Benjamens
- Department of Surgery, University of Groningen and University Medical Centre Groningen, Groningen, Netherlands
| | - Robert A Pol
- Department of Surgery, University of Groningen and University Medical Centre Groningen, Groningen, Netherlands
| | - Stephan J L Bakker
- Division of Nephrology, Department of Internal Medicine, University of Groningen and University Medical Centre Groningen, Groningen, Netherlands
| | - Xavier Jouven
- Université de Paris Cité, INSERM, PARCC, Paris Translational Research Centre for Organ Transplantation, F-75015 Paris, France
| | - Christophe Legendre
- Department of Nephrology and Kidney Transplantation, Necker Hospital, Paris, France
| | - Nassim Kamar
- Department of Nephrology and Organ Transplantation, Paul Sabatier University, INSERM, Toulouse, France
| | - Byron H Smith
- Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, Florida, USA
| | - Hani M Wadei
- Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, Florida, USA
| | - Antoine Durrbach
- Department of Nephrology and Renal Transplantation, Henri-Mondor Hospital, Paris-Saclay University, Creteil, France
| | - Flavio Vincenti
- Department of Surgery, Kidney Transplant Service, University of California San Francisco, San Francisco, California, USA
| | - Giuseppe Remuzzi
- Department of Renal Medicine, Clinical Research Centre for Rare Diseases "Aldo e Cele Daccò": Instituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, Bergamo, Italy
| | - Carmen Lefaucheur
- Department of Kidney Transplantation, Saint Louis University Hospital, Paris, France
| | - Andrew J Bentall
- William J von Liebig Centre for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota, USA
| | - Alexandre Loupy
- Université de Paris Cité, INSERM, PARCC, Paris Translational Research Centre for Organ Transplantation, F-75015 Paris, France
- Department of Nephrology and Kidney Transplantation, Necker Hospital, Paris, France
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Pottel H, Björk J, Rule AD, Ebert N, Eriksen BO, Dubourg L, Vidal-Petiot E, Grubb A, Hansson M, Lamb EJ, Littmann K, Mariat C, Melsom T, Schaeffner E, Sundin PO, Åkesson A, Larsson A, Cavalier E, Bukabau JB, Sumaili EK, Yayo E, Monnet D, Flamant M, Nyman U, Delanaye P. Cystatin C-Based Equation to Estimate GFR without the Inclusion of Race and Sex. N Engl J Med 2023; 388:333-343. [PMID: 36720134 DOI: 10.1056/nejmoa2203769] [Citation(s) in RCA: 50] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The accuracy of estimation of kidney function with the use of routine metabolic tests, such as measurement of the serum creatinine level, has been controversial. The European Kidney Function Consortium (EKFC) developed a creatinine-based equation (EKFC eGFRcr) to estimate the glomerular filtration rate (GFR) with a rescaled serum creatinine level (i.e., the serum creatinine level is divided by the median serum creatinine level among healthy persons to control for variation related to differences in age, sex, or race). Whether a cystatin C-based EKFC equation would increase the accuracy of estimated GFR is unknown. METHODS We used data from patients in Sweden to estimate the rescaling factor for the cystatin C level in adults. We then replaced rescaled serum creatinine in the EKFC eGFRcr equation with rescaled cystatin C, and we validated the resulting EKFC eGFRcys equation in cohorts of White patients and Black patients in Europe, the United States, and Africa, according to measured GFR, levels of serum creatinine and cystatin C, age, and sex. RESULTS On the basis of data from 227,643 patients in Sweden, the rescaling factor for cystatin C was estimated at 0.83 for men and women younger than 50 years of age and 0.83 + 0.005 × (age - 50) for those 50 years of age or older. The EKFC eGFRcys equation was unbiased, had accuracy that was similar to that of the EKFC eGFRcr equation in both White patients and Black patients (11,231 patients from Europe, 1093 from the United States, and 508 from Africa), and was more accurate than the Chronic Kidney Disease Epidemiology Collaboration eGFRcys equation recommended by Kidney Disease: Improving Global Outcomes. The arithmetic mean of EKFC eGFRcr and EKFC eGFRcys further improved the accuracy of estimated GFR over estimates from either biomarker equation alone. CONCLUSIONS The EKFC eGFRcys equation had the same mathematical form as the EKFC eGFRcr equation, but it had a scaling factor for cystatin C that did not differ according to race or sex. In cohorts from Europe, the United States, and Africa, this equation improved the accuracy of GFR assessment over that of commonly used equations. (Funded by the Swedish Research Council.).
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Affiliation(s)
- Hans Pottel
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Jonas Björk
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Andrew D Rule
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Natalie Ebert
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Björn O Eriksen
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Laurence Dubourg
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Emmanuelle Vidal-Petiot
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Anders Grubb
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Magnus Hansson
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Edmund J Lamb
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Karin Littmann
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Christophe Mariat
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Toralf Melsom
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Elke Schaeffner
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Per-Ola Sundin
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Anna Åkesson
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Anders Larsson
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Etienne Cavalier
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Justine B Bukabau
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Ernest K Sumaili
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Eric Yayo
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Dagui Monnet
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Martin Flamant
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Ulf Nyman
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Pierre Delanaye
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
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Delanaye P, Vidal-Petiot E, Björk J, Ebert N, Eriksen BO, Dubourg L, Grubb A, Hansson M, Littmann K, Mariat C, Melsom T, Schaeffner E, Sundin PO, Bökenkamp A, Berg UB, Åsling-Monemi K, Åkesson A, Larsson A, Cavalier E, Dalton RN, Courbebaisse M, Couzi L, Gaillard F, Garrouste C, Jacquemont L, Kamar N, Legendre C, Rostaing L, Stehlé T, Haymann JP, Selistre LDS, Strogoff-de-Matos JP, Bukabau JB, Sumaili EK, Yayo E, Monnet D, Nyman U, Pottel H, Flamant M. Performance of creatinine-based equations to estimate glomerular filtration rate in White and Black populations in Europe, Brazil and Africa. Nephrol Dial Transplant 2023; 38:106-118. [PMID: 36002032 DOI: 10.1093/ndt/gfac241] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [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: 04/01/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND A new Chronic Kidney Disease Epidemiology Collaboration equation without the race variable has been recently proposed (CKD-EPIAS). This equation has neither been validated outside USA nor compared with the new European Kidney Function Consortium (EKFC) and Lund-Malmö Revised (LMREV) equations, developed in European cohorts. METHODS Standardized creatinine and measured glomerular filtration rate (GFR) from the European EKFC cohorts (n = 13 856 including 6031 individuals in the external validation cohort), from France (n = 4429, including 964 Black Europeans), from Brazil (n = 100) and from Africa (n = 508) were used to test the performances of the equations. A matched analysis between White Europeans and Black Africans or Black Europeans was performed. RESULTS In White Europeans (n = 9496), both the EKFC and LMREV equations outperformed CKD-EPIAS (bias of -0.6 and -3.2, respectively versus 5.0 mL/min/1.73 m², and accuracy within 30% of 86.9 and 87.4, respectively, versus 80.9%). In Black Europeans and Black Africans, the best performance was observed with the EKFC equation using a specific Q-value (= concentration of serum creatinine in healthy males and females). These results were confirmed in matched analyses, which showed that serum creatinine concentrations were different in White Europeans, Black Europeans and Black Africans for the same measured GFR, age, sex and body mass index. Creatinine differences were more relevant in males. CONCLUSION In a European and African cohort, the performances of CKD-EPIAS remain suboptimal. The EKFC equation, using usual or dedicated population-specific Q-values, presents the best performance in the whole age range in the European and African populations included in this study.
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Affiliation(s)
- Pierre Delanaye
- Department of Nephrology-Dialysis-Transplantation, University of Liège, Centre Hospitalier Universitaire Sart Tilman, Liège, Belgium.,Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes, France
| | - Emmanuelle Vidal-Petiot
- Assistance Publique-Hôpitaux de Paris, Bichat Hospital, and Université Paris Cité, Paris, France
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.,Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Natalie Ebert
- Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany
| | - Björn O Eriksen
- Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsö, Norway
| | - Laurence Dubourg
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, France
| | - Anders Grubb
- Department of Clinical Chemistry, Skåne University Hospital, Lund, Lund University, Sweden
| | - Magnus Hansson
- Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge and Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Karin Littmann
- Department of Medicine, Karolinska Institute, Huddinge, Sweden
| | - Christophe Mariat
- Service de Néphrologie, Dialyse et Transplantation Rénale, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Etienne, France
| | - Toralf Melsom
- Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsö, Norway
| | - Elke Schaeffner
- Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany
| | - Per-Ola Sundin
- Department of Geriatrics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Arend Bökenkamp
- Department of Paediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ulla B Berg
- Department of Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Kajsa Åsling-Monemi
- Department of Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Anna Åkesson
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.,Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, Centre Hospitalier Universitaire Sart Tilman, Liège, Belgium
| | - R Neil Dalton
- The Wellchild Laboratory, Evelina London Children's Hospital, London, UK
| | - Marie Courbebaisse
- Physiology Department, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris University, Paris, France
| | - Lionel Couzi
- CNRS-UMR Immuno ConcEpT, Nephrologie - Transplantation-Dialyse, Centre Hospitalier Universitaire de Bordeaux, Université de Bordeaux, France
| | - Francois Gaillard
- Service de transplantation et immunologie clinique, Hôpital Edouard Herriot, Hospices civils de Lyon, Lyon, France
| | - Cyril Garrouste
- Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Lola Jacquemont
- Renal Transplantation Department, Centre Hospitalier Universitaire Nantes, Nantes University, Nantes, France
| | - Nassim Kamar
- Department of Nephrology, Dialysis and Organ Transplantation, Centre Hospitalier Universitaire Rangueil, University Paul Sabatier, Toulouse, France
| | - Christophe Legendre
- Hôpital Necker, Assistance Publique Hôpitaux de Paris, Paris University, France
| | - Lionel Rostaing
- Service de Néphrologie, Hémodialyse, Aphérèses et Transplantation Rénale, Hôpital Michallon, Centre Hospitalier Universitaire Grenoble-Alpes, France
| | - Thomas Stehlé
- Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France.,Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire 'Innovative therapy for immune disorders' Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Créteil, France
| | - Jean-Philippe Haymann
- Physiology Department, Assistance Publique- Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Luciano da Silva Selistre
- Ciências da Saúde, Universidade de Caxias do Sul, Hospital Geral de Caxias do Sul, Caxias do Sul, Brazil
| | - Jorge P Strogoff-de-Matos
- Nephrology Division, Department of Medicine, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Justine B Bukabau
- Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Ernest K Sumaili
- Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Eric Yayo
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Côte d'Ivoire
| | - Dagui Monnet
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Côte d'Ivoire
| | - Ulf Nyman
- Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden
| | - Hans Pottel
- Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Martin Flamant
- Cordeliers Research Center, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, and Université Paris Cité, Paris, France
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Nyman U, Björk J, Berg U, Bökenkamp A, Dubourg L, Goffin K, Grubb A, Hansson M, Larsson A, Littmann K, Åsling-Monemi K, Pottel H, Delanaye P. The Modified CKiD Study Estimated GFR Equations for Children and Young Adults Under 25 Years of Age: Performance in a European Multicenter Cohort. Am J Kidney Dis 2022; 80:807-810. [PMID: 35346743 DOI: 10.1053/j.ajkd.2022.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 02/07/2022] [Indexed: 02/02/2023]
Affiliation(s)
- Ulf Nyman
- Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden.
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden; Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden.
| | - Ulla Berg
- Department of Clinical Science, Intervention and Technology, Division of Paediatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Arend Bökenkamp
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Laurence Dubourg
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, and Laboratory of Tissue Biology and Therapeutic Engineering, UMR 5305 CNRS, Université Claude Bernard Lyon 1, Lyon, France
| | - Karolien Goffin
- Department of Nuclear Medicine, University Hospital Leuven, Division of Nuclear Medicine and Molecular Imaging, KU Leuven, Leuven, Belgium
| | - Anders Grubb
- Department of Clinical Chemistry, Skåne University Hospital, Lund University, Lund, Sweden
| | - Magnus Hansson
- Function area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge and Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Karin Littmann
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden and Medical Unit of Endocrinology, Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Kajsa Åsling-Monemi
- Department of Clinical Science, Intervention and Technology, Division of Paediatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Hans Pottel
- Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Pierre Delanaye
- Department of Nephrology-Dialysis-Transplantation, University of Liège (ULg CHU), CHU Sart Tilman, Liège, Belgium; Department of Nephrology-Dialysis-Apheresis, Hopital Universitaire Caremeau, Nimes, France
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5
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Pottel H, Cavalier E, Björk J, Nyman U, Grubb A, Ebert N, Schaeffner E, Eriksen BO, Melsom T, Lamb EJ, Mariat C, Dubourg L, Hansson M, Littmann K, Sundin PO, Åkesson A, Larsson A, Rule A, Delanaye P. Standardization of serum creatinine is essential for accurate use of unbiased estimated GFR equations: evidence from three cohorts matched on renal function. Clin Kidney J 2022; 15:2258-2265. [PMID: 36381377 PMCID: PMC9664577 DOI: 10.1093/ckj/sfac182] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 03/31/2022] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Differences in the performance of estimated glomerular filtration rate (eGFR) equations have been attributed to the mathematical form of the equations and to differences between patient demographics and measurement methods. We evaluated differences in serum creatinine (SCr) and eGFR in cohorts matched for age, sex, body mass index (BMI) and measured GFR (mGFR). METHODS White North Americans from Minnesota (n = 1093) and the Chronic Renal Insufficiency Cohort (CRIC) (n = 1548) and White subjects from the European Kidney Function Consortium (EKFC) cohort (n = 7727) were matched for demographic patient characteristics (sex, age ± 3 years, BMI ± 2.5 kg/m2) and renal function (mGFR ± 3 ml/min/1.73 m2). SCr was measured with isotope dilution mass spectrometry (IDMS)-traceable assays in the Minnesota and EKFC cohorts and with non-standardized SCr assays recalculated to IDMS in the CRIC. The Minnesota cohort and CRIC shared a common method to measure GFR (renal clearance of iothalamate), while the EKFC cohort used a variety of exogenous markers and methods, all with recognized sufficient accuracy. We compared the SCr levels and eGFR predictions [for Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and EKFC equations] of patients fulfilling these matching criteria. RESULTS For 305 matched individuals, mean SCr (mg/dL) was not different between the Minnesota and EKFC cohorts (females 0.83 ± 0.20 versus 0.86 ± 0.23, males 1.06 ± 0.23 versus 1.12 ± 0.37; P > .05) but significantly different from the CRIC [females 1.13 ± 0.23 (P < .0001), males 1.42 ± 0.31 (P < .0001)]. The CKD-EPI equations performed better than the EKFC equation in the CRIC, while the opposite was true in the Minnesota and EKFC cohorts. CONCLUSION Significant differences in SCr concentrations between the Minnesota and EKFC cohorts versus CRIC were observed in subjects with the same level of mGFR and equal demographic characteristics and can be explained by the difference in SCr calibration.
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Affiliation(s)
- Hans Pottel
- Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU Sart Tilman, Liège, Belgium
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
- Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Ulf Nyman
- Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden
| | - Anders Grubb
- Department of Clinical Chemistry, Skåne University Hospital, Lund, Lund University, Sweden
| | - Natalie Ebert
- Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany
| | - Elke Schaeffner
- Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany
| | - Björn O Eriksen
- Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsö, Norway
| | - Toralf Melsom
- Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsö, Norway
| | - Edmund J Lamb
- Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | - Christophe Mariat
- Service de Néphrologie, Dialyse et Transplantation Rénale, Hôpital Nord, CHU de Saint-Etienne, France
| | - Laurence Dubourg
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, France
| | - Magnus Hansson
- Function area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge and Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Karin Littmann
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institute, Huddinge, Sweden
| | - Per-Ola Sundin
- Department of Geriatrics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Anna Åkesson
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
- Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Andrew Rule
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Pierre Delanaye
- Nephrology-Dialysis-Transplantation, University of Liège, CHU Sart Tilman, Liège, Belgium
- Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes, France
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Grocholski C, Chambrier C, Acquaviva-Bourdain C, Bacchetta J, Dubourg L, Lemoine S. Étude OXAGO – mesure de l’oxalate plasmatique au cours de l’hyperoxalurie entérique secondaire au syndrome du grêle court de type 2 et 3. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.384] [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: 10/14/2022]
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7
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Lemoine S, Rouveure AC, Dubourg L, Pelletier S, Marolho C, Decullier E, Laville M. Point of care creatinine derived eGFR measurement in capillary blood for identifying patients at risk. Pract Lab Med 2022; 31:e00296. [PMID: 35860391 PMCID: PMC9289727 DOI: 10.1016/j.plabm.2022.e00296] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/27/2022] [Accepted: 07/08/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction The aim of the study was to assess the clinical reliability of eGFR values estimated with a creatinine measurement from a point of care (StatSensor®) compared with measured GFR (mGFR) by a gold standard method. Methods We prospectively included 113 patients undergoing renal function assessment. We compared eGFR using creatinine from capillary blood or venous blood measured by StatSensor® and measured GFR (mGFR) by Passing Bablok regression. Performance of eGFR was estimated by biais, precision and accuracy. Results A total of 113 subjects were included. Median eGFR values were 59 (10–132), 52 (10–123) and 51 (10–131) ml/min/1.73 m2 for enzymatic, capillary and venous measurements, respectively. There was no difference between P30 and P10 for the three eGFR values (p = 0.11 and p = 0.1 respectively). StatSensor® eGFR tended to be underestimated compared to mGFR. For CKD stage 4/5 patients, concordance was 79 and 84% for eGFR with capillary creatinine and venous creatinine respectively. For mGFR< 60 ml/min/1.73 m2, concordance was 84 and 88% with capillary creatinine and venous creatinine respectively. Conclusion The use of a handheld blood creatinine monitoring system with eGFR calculation provides a good estimation of GFR and allow to identify patients at high risk of acute kidney injury.
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Affiliation(s)
- Sandrine Lemoine
- Department of Nephrology and Renal Function, Edouard Herriot Hospital, Hospices Civils de Lyon, France.,INSERM U1060 CarMeN, Lyon, France
| | | | - Laurence Dubourg
- Department of Nephrology and Renal Function, Edouard Herriot Hospital, Hospices Civils de Lyon, France
| | | | - Christelle Marolho
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, Lyon, France
| | - Evelyne Decullier
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, Lyon, France
| | - Maurice Laville
- Department of Nephrology, Lyon Sud University Hospital, France.,INSERM U1060 CarMeN, Lyon, France
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Bertholet-Thomas A, Portefaix A, Flammier S, Dhelens C, Subtil F, Dubourg L, Laudy V, Le Bouar M, Boussaha I, Ndiaye M, Molin A, Lemoine S, Bacchetta J. Fluconazole in hypercalciuric patients with increased 1,25(OH) 2D levels: the prospective, randomized, placebo-controlled, double-blind FLUCOLITH trial. Trials 2022; 23:499. [PMID: 35710560 PMCID: PMC9204961 DOI: 10.1186/s13063-022-06302-z] [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: 10/21/2021] [Accepted: 04/13/2022] [Indexed: 11/23/2022] Open
Abstract
Background Hypercalciuria is one of the most frequent metabolic disorders associated with nephrolithiasis and/or nephrocalcinosis possibly leading to chronic kidney disease (CKD) and bone complications in adults. Orphan diseases with different underlying primary pathophysiology share inappropriately increased 1,25(OH)2D levels and hypercalciuria, e.g., hypersensitivity to vitamin D and renal phosphate wasting. Their management is challenging, typically based on hyperhydration and dietary advice. The antifungal azoles are known to inhibit the 1α-hydroxylase and therefore decrease 1,25(OH)2D levels; they are commonly used, with well described pharmacokinetic and tolerability data. Fluconazole has been successfully reported to reduce calciuria in patients with CYP24A1 or SLC34A3 mutations, with no safety warnings. Thus, based on these case reports, we hypothesize that fluconazole is effective to decrease and normalize calciuria in patients with hypercalciuria and increased 1,25(OH)2D levels. Methods The FLUCOLITH trial is a prospective, interventional, randomized in parallel groups (1:1), placebo-controlled, double-blind trial. A total of 60 patients (10–60 years) with nephrolithiasis and/or nephrocalcinosis history, hypercalciuria (> 0.1 mmol/kg/day), increased 1,25(OH)2D levels (> 150 pmol/L), and 25-OH-D levels >20 nmol/L will be included. Inclusions will be performed only from mid-September to the beginning of February to avoid bias due to sunlight-induced vitamin D synthesis. The primary endpoint will be the proportion of patients with normalization of 24-h calciuria between baseline and 16 weeks, or with a relative decrease of at least 30% of 24-h calciuria in patients who still display at W16 a 24-h hypercalciuria. Discussion The current challenge is to propose an efficient treatment to patients with hypercalciuria and increased 1,25(OH)2D levels in order to prevent later complications and notably CKD that can ultimately lead to end-stage renal disease. Based on improvement of knowledge in phosphate/calcium metabolism, pathophysiology and genetics, the “off-label” use of fluconazole was recently reported to be useful in hypercalciuric patients with increased 1,25(OH)2D levels. Thus, the FLUCOLITH study is a unique opportunity to develop a new indication of a well-known and not expensive drug in orphan renal diseases, the ultimate objective being the secondary prevention of CKD worsening in these patients. Trial registration ClinicalTrials.gov NCT04495608. Registered on July 23, 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06302-z.
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Affiliation(s)
- Aurélia Bertholet-Thomas
- Centre de Référence des Maladies Rénales Rares, filières maladies rares ORKID and ERK-Net, Service de Néphrologie, Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Boulevard Pinel, 69677, Bron, Cedex, France.,Centre de Référence des Maladies Rares du Calcium et du Phosphate, filière maladies rares OSCAR, Hôpital Femme Mère Enfant, Bron, France.,INSERM 1033, Prévention des Maladies Osseuses, Lyon, France
| | - Aurélie Portefaix
- Centre d'Investigation Clinique, Hôpital Cardiovasculaire Louis Pradel, Inserm 1407, 69500, Bron, France
| | - Sacha Flammier
- Centre de Référence des Maladies Rénales Rares, filières maladies rares ORKID and ERK-Net, Service de Néphrologie, Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Boulevard Pinel, 69677, Bron, Cedex, France.,Centre de Référence des Maladies Rares du Calcium et du Phosphate, filière maladies rares OSCAR, Hôpital Femme Mère Enfant, Bron, France
| | - Carole Dhelens
- Pharmacie, FRIPHARM, Hôpital Edouard Herriot, Lyon, France
| | - Fabien Subtil
- Service de Biostatistique, Hospices Civils de Lyon, Lyon, France.,Université de Lyon, Université Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne, France
| | - Laurence Dubourg
- Néphrologie, Dialyse, Hypertension Artérielle et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Lyon, France.,Faculté de Médecine Lyon Est, Université Lyon 1, Lyon, France
| | - Valérie Laudy
- Centre d'Investigation Clinique, Hôpital Cardiovasculaire Louis Pradel, Inserm 1407, 69500, Bron, France
| | - Myrtille Le Bouar
- Centre d'Investigation Clinique, Hôpital Cardiovasculaire Louis Pradel, Inserm 1407, 69500, Bron, France
| | - Inesse Boussaha
- Centre d'Investigation Clinique, Hôpital Cardiovasculaire Louis Pradel, Inserm 1407, 69500, Bron, France
| | - Marietou Ndiaye
- Centre d'Investigation Clinique, Hôpital Cardiovasculaire Louis Pradel, Inserm 1407, 69500, Bron, France
| | - Arnaud Molin
- Service de Génétique, CHU de Caen, Caen, France.,Centre de Référence des Maladies Rares du Calcium et du Phosphate, filière maladies rares OSCAR Caen, Caen, France
| | - Sandrine Lemoine
- Centre de Référence des Maladies Rénales Rares, filières maladies rares ORKID and ERK-Net, Service de Néphrologie, Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Boulevard Pinel, 69677, Bron, Cedex, France.,Centre de Référence des Maladies Rares du Calcium et du Phosphate, filière maladies rares OSCAR, Hôpital Femme Mère Enfant, Bron, France.,Néphrologie, Dialyse, Hypertension Artérielle et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Lyon, France.,Faculté de Médecine Lyon Est, Université Lyon 1, Lyon, France
| | - Justine Bacchetta
- Centre de Référence des Maladies Rénales Rares, filières maladies rares ORKID and ERK-Net, Service de Néphrologie, Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Boulevard Pinel, 69677, Bron, Cedex, France. .,Centre de Référence des Maladies Rares du Calcium et du Phosphate, filière maladies rares OSCAR, Hôpital Femme Mère Enfant, Bron, France. .,INSERM 1033, Prévention des Maladies Osseuses, Lyon, France. .,Faculté de Médecine Lyon Est, Université Lyon 1, Lyon, France.
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9
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da Silva Selistre L, Renard C, Bacchetta J, Goutagny MP, Hu J, Carla de Souza V, Bertrand Y, Dubourg L, Domenech C. Teenagers and young adults with a past of allogenic hematopoietic stem cell transplantation are at significant risk of chronic kidney disease. Pediatr Nephrol 2022; 37:1365-1375. [PMID: 34735600 DOI: 10.1007/s00467-021-05319-x] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Allogenic hematopoietic stem cell transplantation (aHSCT) remains the treatment of choice for some malignant hemopathies in children, albeit with the risk of long-term consequences, including chronic kidney disease (CKD). METHODS In our single tertiary referral center, we retrospectively assessed the long-term renal outcome in a cohort of children and adolescents who had undergone aHSCT for malignant hemopathies between 2003 and 2017. We distinguished glomerular and tubular dysfunctions and assessed the accuracy of the most common formula(s) to estimate glomerular filtration rate (GFR) during standard clinical follow-up. RESULTS Among the 166 patients who had received aHSCT, 61 underwent kidney functional assessment 1 to 10 years post-transplantation. Twenty-seven patients (44.3%) had a CKD with glomerular impairment, including 20 patients with a GFR < 90 mL/min/1.73 m2, and among these, 5 patients < 60 mL/min/1.73 m2. Patients with tubular signs had a significantly higher baseline GFR: 112 mL/min/1.73 m2 [100; 120] versus 102 [99.0; 112.5] for patients without kidney involvement, and 76 [61; 86] for patients with CKD (p < 0.01). Schwartz, CKiDU25, and EKFC formulas significantly overestimated mGFR, with a P30% ≤ 30%, which could lead to overlooking CKD diagnosis in this population. No patient reached kidney failure. CONCLUSIONS In conclusion, our study shows that CKD represents an important long-term sequela for children and adolescents who undergo aHSCT for malignant hemopathies, either with glomerular dysfunction or with the more insidious tubular dysfunction which could potentially impact growth. These patients could benefit from specialized long-term nephrology follow-up. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Luciano da Silva Selistre
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard-Herriot, Hospices Civils de Lyon, Lyon, France
- Universidade de Caxias Do Sul, Programa de Pós Graduação Em Ciências da Saúde, Caxias do Sul, Brazil
- Hospital Geral de Caxias Do Sul, Caxias do Sul, Brazil
| | - Cécile Renard
- Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Université Lyon 1, 1 place Professeur Joseph Renault, 69008, Lyon, France
| | - Justine Bacchetta
- Centre de Référence Des Maladies Rénales Rares, Service de Néphrologie, Rhumatologie et Dermatologie Pédiatriques, Hospices Civils de Lyon, Université Lyon 1, Lyon, France
- Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France
| | - Marie-Pierre Goutagny
- Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Université Lyon 1, 1 place Professeur Joseph Renault, 69008, Lyon, France
| | - Julie Hu
- Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Université Lyon 1, 1 place Professeur Joseph Renault, 69008, Lyon, France
| | - Vandréa Carla de Souza
- Universidade de Caxias Do Sul, Programa de Pós Graduação Em Ciências da Saúde, Caxias do Sul, Brazil
- Hospital Geral de Caxias Do Sul, Caxias do Sul, Brazil
| | - Yves Bertrand
- Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Université Lyon 1, 1 place Professeur Joseph Renault, 69008, Lyon, France
- Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France
| | - Laurence Dubourg
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard-Herriot, Hospices Civils de Lyon, Lyon, France
- Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France
| | - Carine Domenech
- Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Université Lyon 1, 1 place Professeur Joseph Renault, 69008, Lyon, France.
- Faculté de Médecine Et de Maïeutique Lyon Sud, Université Claude Bernard Lyon 1, Lyon, France.
- Centre de Recherche en Cancérologie de Lyon, UMR INSERM 1052, CNRS 5286, Université Lyon 1, Lyon, France.
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Lemoine S, Dang J, Dubourg L. MO095: Normocalcaemic Hyperparathyroidia Diagnosed by Calcium Load. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac065.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Calcium load is usually used in clinical practice to diagnose a normocalcaemic hyperparathyroidia in stone disease. However, the calcium load developed by Pak and colleagues has been described in very few patients. We aimed to provide data about calcium load in a bigger cohort of patients.
METHOD
We included retrospectively 115 patients who underwent a calcium load for stone disease or hypercalciuria with a basal increased PTH. At basal state, ionized calcium (iCa2+), PTH, phosphate urinary Calcium to creatinine ratio (UCa/creat), 25 OHvit D and 1–25 OHvit D were measured. Patients ingested 1g of calcium and iCa2+ PTH, phosphate and UCa/creat were measured after 2 h and 4. Calcium load was interpreted based on Pak's publications. Normocalcaemic hyperparathyroidia was defined by fasting urinary calcium/creatinine ratio >0.35 mmol/mmol associated with a non-adapted PTH to ionized calcium (iCa2+) after calcium load and absorptive hypercalciuria. Renal hypercalciuria is defined by fasting and absorptive hypercalciuria with an adapted decrease of PTH to iCa2+.
RESULTS
At a basal state, PTH was 88 (±19) ng/L, calcium was 2.36 (±0.14) mmol/L, iCa 1.23 (±0.08) mmol/L, calcium excretion fraction was 1.5 (0.85)% and phosphataemia was 0.88 (±0.14) mmol/L. The mean fasting Ca/creat ratio was 0.4 mmol/mmol. A total of 21% were hypercalcemic (iCa > 1.30 mmol/L). iCa2+ was 1.28 (±0.07) 2 h after calcium load (H2) and was 1.27 (±0.07) mmol/L 4 h after calcium load (H4). The mean decrease in PTH was 32% after H2 and 44% after H4. Urinary Ca/creat was 0.55 and 0.73 mmol/mmol after H2 and H4, respectively. A total of 27% of patients had a UCa/creat increase of >0.5 mmol/mmol after H2, and 47% after H4. A total of 72% had a calcium excretion fraction of >1%.
Normocalcaemic hyperparathyroidia was diagnosed in 64% of these patients. In Normocalcaemic hyperparathyroidia, mean PTH was 91 (±21) ng/L, the mean decrease of PTH was 35% and 27% after H2 and H4, respectively. The mean iCa2+ increased from 1.24 (±0.07) to 1.28 (±0.07) mmol/L. UCa/creat increased from 0.45 (±1.26) to 0.71 (±1.26) and 0.81 (±1.26) after H2 and H4, respectively. The 1–25 OH vit D was 159 (±55) pmol/L.
In renal hypercalciuria, mean PTH was 66 (±26) ng/L, 42 (±20) after H2 and 30 (±13) after H4. The mean decrease in PTH was 65% after H4. Mean iCa2+ increased from 1.24 (±0.07) to 1.27 (±0.07) mmol/L. UCa/creat increased from 0.33 (±0.19) to 0.37 (±0.25) and 0.68 (±0.44) mmol/mmol after H2 and H4, respectively. The 1–25 OH vit D was 130 (±67) pmol/L.
Basal PTH is significantly higher in normocalcaemic hyperparathyroidia compared with renal hypercalciuria, but there is no difference in fasting UCa/creatinine ratio between both group. The 1–25 OHvit D level was significantly increased in normocalcaemic hyperparathyroidia.
CONCLUSION
Calcium load allows to discriminate patients with basal increased PTH between normocalcaemic hyperparathyroidia and renal hypercalciuria. We provide new data to help physicians in clinical practice.
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Affiliation(s)
- Sandrine Lemoine
- Hospices civils de Lyon, Nephrology, Université de Lyon, Lyon, France
| | - Julien Dang
- Hospices civils de Lyon, Nephrology, Université de Lyon, Lyon, France
| | - Laurence Dubourg
- Hospices civils de Lyon, Nephrology, Université de Lyon, Lyon, France
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11
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Delanaye P, Bjork J, Vidal-Petiot E, Ebert N, Odvar Eriksen B, Dubourg L, Grubb A, Hansson M, Lamb E, Littman K, Mariat C, Melsom T, Schaeffner E, Sundin PO, Bokenkamp A, Berg U, Asling-Monemi K, Åkesson A, Larsson A, Cavalier E, Dalton N, Courbebaisse M, Couzi L, Gaillard F, Garrouste C, Jacquemont L, Kamar N, Legendre C, Rostaing L, Stehlé T, Haymann JP, Selistre L, Strogoff-de-Matos J, Bukabau J, Sumaili E, Yayo E, Monnet D, Nyman U, Pottel H, Flamant M. MO385: Performance of Creatinine-Based Equations to Estimate Glomerular Filtration Rate in White and Black Subjects From Europe, Brazil and Africa. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac069.018] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Current Glomerular filtration rate (GFR) estimating equations based on serum creatinine are facing increased criticism due to the inclusion of a race correction in black Americans with the CKD-EPI equation (CKD-EPIASR, A = Age, S = Sex, R = Race). A new equation without race (CKD-EPIAS) has been proposed. However, this equation was developed mainly from US cohorts. The performance of this new equation has been poorly compared with current European-developed creatinine-based equations, i.e. the Lund-Malmö Revised (LMR), and the new European Kidney Function Consortium (EKFC)
METHOD
Data from subjects over 18 years, representing 11 cohorts from Europe (previously described as the EKFC dataset, n = 13 856), and enhanced with data from Brazil (n = 100), France (n = 4429) and Africa [Democratic Republic of Congo (DRC) and Côte d'Ivoire, n = 508] were considered (n = 18 893 for the whole cohort). The EKFC cohort was considered as non-black population. All data from Africa derived from black individuals. From France, 964 subjects were self-reported as black (=Blacks from Paris). Measured GFR as a reference method and IDMS creatinine results were available. Median bias (eGFR—mGFR) with 95% confidence intervals (CI), imprecision (interquartile range: IQR), and P30 accuracy (percentage of eGFR-values within ± 30% of mGFR) with 95% CI were calculated.
RESULTS
Results are summarized in Table.
CONCLUSION
The new CKD-EPIAS has been launched in the USA for societal reasons and is now recommended by US guidelines. However, in Europe and Africa, its performance was suboptimal. The EKFC equation, using the usual Q values, or population-specific Q values (when available), displays the best performance over the whole age range for populations in Europe and Africa.
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12
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Lemoine S, Figueres L, Bacchetta J, Frey S, Dubourg L. Calcium homeostasis pathologies in hyperparathyroidism: nephrologic and endocrinologic points of view. Annales d'Endocrinologie 2022; 83:237-243. [DOI: 10.1016/j.ando.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Stämmler F, Grassi M, Meeusen JW, Lieske JC, Dasari S, Dubourg L, Lemoine S, Ehrich J, Schiffer E. Estimating Glomerular Filtration Rate from Serum Myo-Inositol, Valine, Creatinine and Cystatin C. Diagnostics (Basel) 2021; 11:2291. [PMID: 34943527 PMCID: PMC8700166 DOI: 10.3390/diagnostics11122291] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 10/21/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 11/22/2022] Open
Abstract
Assessment of renal function relies on the estimation of the glomerular filtration rate (eGFR). Existing eGFR equations, usually based on serum levels of creatinine and/or cystatin C, are not uniformly accurate across patient populations. In the present study, we expanded a recent proof-of-concept approach to optimize an eGFR equation targeting the adult population with and without chronic kidney disease (CKD), based on a nuclear magnetic resonance spectroscopy (NMR) derived 'metabolite constellation' (GFRNMR). A total of 1855 serum samples were partitioned into development, internal validation and external validation datasets. The new GFRNMR equation used serum myo-inositol, valine, creatinine and cystatin C plus age and sex. GFRNMR had a lower bias to tracer measured GFR (mGFR) than existing eGFR equations, with a median bias (95% confidence interval [CI]) of 0.0 (-1.0; 1.0) mL/min/1.73 m2 for GFRNMR vs. -6.0 (-7.0; -5.0) mL/min/1.73 m2 for the Chronic Kidney Disease Epidemiology Collaboration equation that combines creatinine and cystatin C (CKD-EPI2012) (p < 0.0001). Accuracy (95% CI) within 15% of mGFR (1-P15) was 38.8% (34.3; 42.5) for GFRNMR vs. 47.3% (43.2; 51.5) for CKD-EPI2012 (p < 0.010). Thus, GFRNMR holds promise as an alternative way to assess eGFR with superior accuracy in adult patients with and without CKD.
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Affiliation(s)
- Frank Stämmler
- Department of Research and Development, numares AG, 93053 Regensburg, Germany; (F.S.); (M.G.)
| | - Marcello Grassi
- Department of Research and Development, numares AG, 93053 Regensburg, Germany; (F.S.); (M.G.)
| | - Jeffrey W. Meeusen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; (J.W.M.); (J.C.L.)
| | - John C. Lieske
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; (J.W.M.); (J.C.L.)
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USA
| | - Surendra Dasari
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN 55905, USA;
| | - Laurence Dubourg
- Service d’Explorations Fonctionnelles Rénales et Métaboliques, Hôpital Edouard Herriot, 69437 Lyon, France; (L.D.); (S.L.)
| | - Sandrine Lemoine
- Service d’Explorations Fonctionnelles Rénales et Métaboliques, Hôpital Edouard Herriot, 69437 Lyon, France; (L.D.); (S.L.)
| | - Jochen Ehrich
- Children’s Hospital, Hannover Medical School, 30625 Hannover, Germany;
| | - Eric Schiffer
- Department of Research and Development, numares AG, 93053 Regensburg, Germany; (F.S.); (M.G.)
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14
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Fonseca GDSD, Souza VCD, Bilibio SA, Carobin V, Facin L, Koch K, Machado M, Dubourg L, Selistre LDS. Performance of creatinine-based equations for estimating glomerular filtration rate compared to endogenous creatinine clearance. J Bras Nefrol 2021; 44:179-186. [PMID: 34874985 PMCID: PMC9269182 DOI: 10.1590/2175-8239-jbn-2021-0109] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/27/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction: The guidelines recommend estimating the glomerular filtration rate using serum creatinine-based equations as a predictor of kidney disease, preferably adjusted for local population groups. Methods: Cross-sectional study that evaluated the performance of four equations used for estimating GFR compared to endogenous creatinine clearance (ClCr) in 1,281 participants. Modification of Diet equations in Renal Disease Study Group (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), CKD-EPI with adjustment for local population (CKD-EPI local) and Full Age Spectrum (FAS) in comparison with endogenous creatinine clearance (ClCr). We used the Quantile Regression to calculate the median bias, interquartile range (IQR), Bland-Altman agreement analysis and 30% margin of error (P30). Results: The mean age of participants was 52.5 ± 16.5 years with 466 women (38%), median ClCr[IQR] of 92.0 [58.0; 122.0] mL/min/1.73 m2, with 320 (25%) participants presenting ClCr < 60 mL/min/1.73 m2. The performance of the local CKD-EPI and FAS equations were superior to MDRD and CKD-EPI in relation to variability (0.92 [0.89; 0.94]) and P30 (90.5% [88.7; 92, 0]). In the group with ClCr < 60 mL/min/1.73 m2, the local CKD-EPI and FAS equations showed less variability than the CKD-EPI and MDRD (0.90 [0.86; 0.98] and 1.05 [0.97; 1.09] vs. 0.63 [0.61; 0.68] and 0.65 [0.62; 0.70], P < 0.01) and best P30 (85.5) % [81.0; 90.0], 88.0% [84.0; 92.0] vs. 52.0% (46.0; 58.0) and 53.0% [47.0; 58 .5], P < 0.01). Conclusion: Local CKD-EPI and FAS equations performed better than CKD-EPI and MDRD when compared to ClCr.
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Affiliation(s)
- Gisele da Silva da Fonseca
- Universidade de Caxias do Sul, Programa de Pós-Graduação em Ciências da Saúde Brasil, Caxias do Sul, RS, Brasil
| | - Vandréa Carla de Souza
- Universidade de Caxias do Sul, Programa de Pós-Graduação em Ciências da Saúde Brasil, Caxias do Sul, RS, Brasil.,Hospital Geral de Caxias do Sul, Caxias do Sul, RS, Brasil
| | | | | | - Lígia Facin
- Hospital Geral de Caxias do Sul, Caxias do Sul, RS, Brasil
| | - Ketelly Koch
- Universidade de Caxias do Sul, Caxias do Sul, RS, Brasil
| | | | | | - Luciano da Silva Selistre
- Universidade de Caxias do Sul, Programa de Pós-Graduação em Ciências da Saúde Brasil, Caxias do Sul, RS, Brasil.,Hospital Geral de Caxias do Sul, Caxias do Sul, RS, Brasil
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Rauturier C, Machon C, Demède D, Dubourg L, Bacchetta J, Bertholet-Thomas A. Composition of urinary stones in children: clinical and metabolic determinants in a French tertiary care center. Eur J Pediatr 2021; 180:3555-3563. [PMID: 34165592 DOI: 10.1007/s00431-021-04151-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 12/23/2022]
Abstract
As the epidemiology of urolithiasis is constantly evolving, analyzing the composition of stones is crucial to better understand the determinants of lithogenesis. The aim of this study was to describe the composition of stones of pediatric patients in a tertiary center. Clinical and metabolic data from all pediatric patients with at least one stone that was analyzed by Fourier transformed infrared spectroscopy (FTIR) in the Hospices Civils de Lyon between 2013 and 2017 were retrospectively collected. A total of 111 patients (sex ratio 1.4:1) were included; their median ([IQR]) age was 7.5 (3.1-10.5) years. The main component of stones was calcium oxalate (weddellite for 34 (31%) stones, whewellite 23 (21%)), calcium phosphate (carbapatite 32 (29%), brushite 6 (5%), amorphous calcium phosphate 3 (3%)), struvite 5 (5%), cystine 4 (4%), uric acid 2 (2%), and ammonium acid urate 2 (2%). A total of 20 (18%) stones were pure and 24 (22%) were infectious. Carbapatite stones were the most frequent in patients < 2 years and calcium oxalate stones in patients > 2 years old. Metabolic abnormalities (most frequently hypercalciuria) were found in 50% of tested patients and in 54% of patients with infectious stones. Congenital anomalies of the kidney and/or urinary tract (CAKUT) or neurogenic bladder were present in 9/24 (38%) patients with infectious stones and 12/16 (76%) patients with bladder stones.Conclusion: This study confirms that calcium oxalate stones are the most frequent among pediatric patients, which could reflect the nutritional habits of predisposed patients. In contrast, infectious stones are less frequent and occur mostly in association with anatomic or metabolic favoring factors.
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Affiliation(s)
- Camille Rauturier
- Centre de Référence des Maladies Rénales Rares, Centre de Référence des Maladies Rares du Calcium et du Phosphore, Service de Néphrologie, Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Boulevard Pinel, 69500, Bron Cedex, France.
| | - Christelle Machon
- Laboratoire de Biochimie, Hôpital Lyon Sud, Hospices Civils de Lyon, Cedex, 69495, Pierre-Bénite, France
| | - Delphine Demède
- Urologie pédiatrique, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500, Bron, France
| | - Laurence Dubourg
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69008, Lyon, France
- Faculté de Médecine Lyon Est, Université de Lyon, 69008, Lyon, France
| | - Justine Bacchetta
- Centre de Référence des Maladies Rénales Rares, Centre de Référence des Maladies Rares du Calcium et du Phosphore, Service de Néphrologie, Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Boulevard Pinel, 69500, Bron Cedex, France
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69008, Lyon, France
- INSERM 1033, Prévention des Maladies Osseuses, 69008, Lyon, France
| | - Aurélia Bertholet-Thomas
- Centre de Référence des Maladies Rénales Rares, Centre de Référence des Maladies Rares du Calcium et du Phosphore, Service de Néphrologie, Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Boulevard Pinel, 69500, Bron Cedex, France
- INSERM 1033, Prévention des Maladies Osseuses, 69008, Lyon, France
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16
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Delanaye P, Björk J, Courbebaisse M, Couzi L, Ebert N, Eriksen BO, Dalton RN, Dubourg L, Gaillard F, Garrouste C, Grubb A, Jacquemont L, Hansson M, Kamar N, Lamb EJ, Legendre C, Littmann K, Mariat C, Melsom T, Rostaing L, Rule AD, Schaeffner E, Sundin PO, Berg U, Åsling-Monemi K, Selistre L, Åkesson A, Larsson A, Bökenkamp A, Pottel H, Nyman U. Performance of creatinine-based equations to estimate glomerular filtration rate with a methodology adapted to the context of drug dosage adjustment. Br J Clin Pharmacol 2021; 88:2118-2127. [PMID: 34709683 DOI: 10.1111/bcp.15132] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 06/24/2021] [Revised: 10/04/2021] [Accepted: 10/19/2021] [Indexed: 11/27/2022] Open
Abstract
AIM The Cockcroft-Gault (CG) creatinine-based equation is still used to estimate glomerular filtration rate (eGFR) for drug dosage adjustment. Incorrect eGFR may lead to hazardous over- or underdosing METHODS: In a cross-sectional analysis, CG was validated against measured GFR (mGFR) in 14,804 participants and compared with the Modification-of-Diet-in-Renal-Diseases (MDRD), Chronic-Kidney-Disease-Epidemiology (CKD-EPI), Lund-Malmö-Revised (LMR), and European-Kidney-Function-Consortium (EKFC) equations. Validation focused on bias, imprecision, and accuracy (percentage of estimates within ±30% of mGFR, P30), overall and stratified for mGFR, age, and body mass index at mGFR <60 mL/min, as well as classification in mGFR stages. RESULTS The CG equation performed worse than the other equations, overall and in mGFR, age and BMI subgroups in terms of bias (systematic overestimation), imprecision and accuracy except for patients ≥65 years where bias and P30 were similar to MDRD and CKD-EPI, but worse than LMR and EKFC. In subjects with mGFR<60 mL/min and at BMI [18.5-25[kg/m2 , all equations performed similarly and for BMI<18.5kg/m2 CG and LMR had the best results though all equations had poor P30-accuracy. At BMI≥25kg/m2 the bias of the CG increased with increasing BMI (+17.2mL/min at BMI≥40kg/m2 ). The four more recent equations also classified mGFR stages better than CG. CONCLUSIONS The CG equation showed poor ability to estimate GFR overall and in analyses stratified for GFR, age, and BMI. CG was inferior to correctly classify the patients in the mGFR staging compared to more recent creatinine-based equations.
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Affiliation(s)
- Pierre Delanaye
- Department of Nephrology-Dialysis-Transplantation, University of Liège (ULg CHU), CHU Sart Tilman, Liège, Belgium.,Department of Nephrology-Dialysis-Apheresis, Hopital Universitaire Caremeau, Nimes, France
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.,Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Marie Courbebaisse
- Physiology Department, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris Descartes University, INSERM U1151-CNRS UMR8253, Paris, France
| | - Lionel Couzi
- CHU de Bordeaux, Nephrologie - Transplantation - Dialyse, Université de Bordeaux, CNRS-UMR 5164 Immuno ConcEpT, France
| | - Natalie Ebert
- Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany
| | - Björn O Eriksen
- Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsö, Norway
| | - R Neil Dalton
- The Wellchild Laboratory, Evelina London Children's Hospital, London, United Kingdom
| | - Laurence Dubourg
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, France
| | - Francois Gaillard
- Renal Transplantation Department, Assistance Publique-Hôpitaux de Paris (AP-HP), France
| | - Cyril Garrouste
- Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Anders Grubb
- Department of Clinical Chemistry, Skåne University Hospital, Lund, Lund University, Sweden
| | - Lola Jacquemont
- Renal Transplantation Department, CHU Nantes, Nantes University, Nantes, France
| | - Magnus Hansson
- Function area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge and Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Nassim Kamar
- Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, INSERM U1043, IFR -BMT, University Paul Sabatier, Toulouse, France
| | - Edmund J Lamb
- Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom
| | | | - Karin Littmann
- Department of Medicine Huddinge (MedH), Karolinska Institute, Huddinge, Sweden
| | - Christophe Mariat
- Service de Néphrologie, Dialyse et Transplantation Rénale, Hôpital Nord, CHU de Saint-Etienne, France
| | - Toralf Melsom
- Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsö, Norway
| | - Lionel Rostaing
- Service de Néphrologie, Hémodialyse, Aphérèses et Transplantation Rénale, Hôpital Michallon, CHU Grenoble-Alpes, France
| | - Andrew D Rule
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Elke Schaeffner
- Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany
| | - Per-Ola Sundin
- Department of Geriatrics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Ulla Berg
- Department of Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Kajsa Åsling-Monemi
- Department of Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Luciano Selistre
- Mestrado em Ciências da Saúde -Universidade Caxias do Sul Foundation CAPES, Brazil
| | - Anna Åkesson
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.,Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Arend Bökenkamp
- Department of Paediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hans Pottel
- Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Ulf Nyman
- Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden
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17
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Delanaye P, Gaillard F, van der Weijden J, Mjøen G, Ferhman-Ekholm I, Dubourg L, Ebert N, Schaeffner E, Åkerfeldt T, Goffin K, Couzi L, Garrouste C, Rostaing L, Courbebaisse M, Legendre C, Hourmant M, Kamar N, Cavalier E, Weekers L, Bouquegneau A, de Borst MH, Mariat C, Pottel H, van Londen M. Age-adapted percentiles of measured glomerular filtration in healthy individuals: extrapolation to living kidney donors over 65 years. Clin Chem Lab Med 2021; 60:401-407. [PMID: 34670031 DOI: 10.1515/cclm-2021-1011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/11/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Most data on glomerular filtration rate (GFR) originate from subjects <65 years old, complicating decision-making in elderly living kidney donors. In this retrospective multi-center study, we calculated percentiles of measured GFR (mGFR) in donors <65 years old and extrapolated these to donors ≥65 years old. METHODS mGFR percentiles were calculated from a development cohort of French/Belgian living kidney donors <65 years (n=1,983), using quantiles modeled as cubic splines (two linear parts joining at 40 years). Percentiles were extrapolated and validated in an internal cohort of donors ≥65 years (n=147, France) and external cohort of donors and healthy subjects ≥65 years (n=329, Germany, Sweden, Norway, France, The Netherlands) by calculating percentages within the extrapolated 5th-95th percentile (P5-P95). RESULTS Individuals in the development cohort had a higher mGFR (99.9 ± 16.4 vs. 86.4 ± 14 and 82.7 ± 15.5 mL/min/1.73 m2) compared to the individuals in the validation cohorts. In the internal validation cohort, none (0%) had mGFR below the extrapolated P5, 12 (8.2%) above P95 and 135 (91.8%) between P5-P95. In the external validation cohort, five subjects had mGFR below the extrapolated P5 (1.5%), 25 above P95 (7.6%) and 299 (90.9%) between P5-P95. CONCLUSIONS We demonstrate that extrapolation of mGFR from younger donors is possible and might aid with decision-making in elderly donors.
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Affiliation(s)
- Pierre Delanaye
- Department of Nephrology-Dialysis-Transplantation, University of Liège (ULiege), CHU Sart Tilman, Liège, Belgium.,Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes, France
| | - François Gaillard
- Department of Nephrology, Bichat Hospital and University of Paris, Paris, France
| | - Jessica van der Weijden
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Geir Mjøen
- Department of Transplant Medicine, Section of Nephrology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Ingela Ferhman-Ekholm
- Department of Transplantation Surgery, Karolinska University Hospital, Huddinge, Sweden
| | - Laurence Dubourg
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Natalie Ebert
- Institute of Public Health, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Elke Schaeffner
- Institute of Public Health, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Torbjörn Åkerfeldt
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Karolien Goffin
- Department of Nuclear Medicine, University Hospital Leuven, Leuven, Belgium.,Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Lionel Couzi
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
| | - Cyril Garrouste
- Nephrology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Lionel Rostaing
- Nephrology, Hemodialysis, Apheresis, and Kidney Transplantation Department, CHU Grenoble-Alpes, Grenoble, France
| | - Marie Courbebaisse
- Physiology Department and INSERM, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Christophe Legendre
- Nephrolgy and Renal Transplantation Department, Necker Hospital and University of Paris, Paris, France
| | - Maryvonne Hourmant
- Nephrology and Transplantation Department, Centre Hospitalier Universitaire, Nantes, France
| | - Nassim Kamar
- Departments of Clinical Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège (ULiege), CHU Sart Tilman, Liège, Belgium
| | - Laurent Weekers
- Department of Nephrology-Dialysis-Transplantation, University of Liège (ULiege), CHU Sart Tilman, Liège, Belgium
| | - Antoine Bouquegneau
- Department of Nephrology-Dialysis-Transplantation, University of Liège (ULiege), CHU Sart Tilman, Liège, Belgium
| | - Martin H de Borst
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Christophe Mariat
- Service de Néphrologie, Dialyse et Transplantation Rénale, Hôpital Nord, CHU de Saint-Etienne, Saint-Etienne, France
| | - Hans Pottel
- Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Marco van Londen
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
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18
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Delanaye P, Melsom T, Cavalier E, Pottel H, Eriksen BO, Dubourg L. Iohexol Plasma Clearance: Impact of Weighing the Syringe. Kidney Int Rep 2021; 6:2478-2480. [PMID: 34514209 PMCID: PMC8418941 DOI: 10.1016/j.ekir.2021.05.038] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/26/2021] [Accepted: 05/31/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Pierre Delanaye
- Department of Nephrology-Dialysis-Transplantation, University of Liège (ULiège CHU), Liège, Belgium.,Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nimes, France
| | - Toralf Melsom
- Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsö, Norway
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège (ULiège CHU), Liège, Belgium
| | - Hans Pottel
- Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Björn O Eriksen
- Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsö, Norway
| | - Laurence Dubourg
- Néphrologie, Dialyse, Hypertension artérielle et Exploration fonctionnelle rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France
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19
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Gaillard F, Courbebaisse M, Couzi L, Dubourg L, Garrouste C, Hourmant M, Kamar N, Rostaing L, Mariat C, Delanaye P. Age-adapted percentiles for older candidates to living kidney donation. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.310] [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: 11/17/2022]
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20
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Paul A, Duncan A, Bacchetta J, Dubourg L, Marec-Bérard P, Tanné C. Chronic kidney disease consecutive to chemotherapy for chondroblastic osteosarcoma: A report on 6 pediatric cases. Nephrol Ther 2021; 17:543-546. [PMID: 34229968 DOI: 10.1016/j.nephro.2021.05.004] [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: 10/04/2020] [Revised: 05/19/2021] [Accepted: 05/27/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The management of osteosarcoma in children and adolescents is based on poly-chemotherapy including several nephrotoxic drugs (e.g. ifosfamide, methotrexate, and cisplatinum). Chronic renal toxicity is a frequent complication but stage 5 chronic kidney disease requiring dialysis is rare. We report here a series of six pediatric patients with osteosarcoma displaying chronic kidney disease after chemotherapy. CASE-DIAGNOSIS/TREATMENT We retrospectively reviewed the medical charts, mainly for clinical history, timing between chemotherapy and development of tubulopathy and CKD, type of therapies and global evolution (chronic dialysis and further renal transplantation, n=2; death, n=1). Notably, all patients suffered from chondroblastic osteosarcoma. CONCLUSIONS Advanced chronic kidney disease can be a complication of osteosarcoma management that could more frequently lead to dialysis and further transplantation. It would be interesting to identify specific risk factors of such renal toxicity. The chondroblastic sub-type may be associated with such susceptibility, but this needs to be confirmed.
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Affiliation(s)
- Alice Paul
- Centre de référence des maladies rénales rares, Service de néphrologie rhumatologie dermatologie pédiatriques, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, 59, Boulevard Pinel, 69500 Bron, France.
| | - Anita Duncan
- Centre de référence des maladies rénales rares, Service de néphrologie rhumatologie dermatologie pédiatriques, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, 59, Boulevard Pinel, 69500 Bron, France
| | - Justine Bacchetta
- Centre de référence des maladies rénales rares, Service de néphrologie rhumatologie dermatologie pédiatriques, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, 59, Boulevard Pinel, 69500 Bron, France; Faculté de médecine Lyon Est, Université Lyon 1, Lyon, France
| | - Laurence Dubourg
- Faculté de médecine Lyon Est, Université Lyon 1, Lyon, France; Service d'exploration fonctionnelle rénale, Groupement hospitalier Édouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Perrine Marec-Bérard
- Institut d'hématologie et d'oncologie pédiatrique (IHOPe), Centre Léon Bérard, Lyon, France
| | - Corentin Tanné
- Service de pédiatrie et néonatologie, Hôpitaux du Pays du Mont Blanc, Sallanches, France
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21
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Gaillard F, Delanaye P, Van Der Weijden J, Mjøen G, Fehrman-Ekholm I, Dubourg L, Ebert N, Schaeffner E, Akerfeldt T, Goffin K, Couzi L, Garrouste C, Rostaing L, Courbebaisse M, Legendre C, HOURMANT M, Kamar N, Weekers L, Bouquegneau A, De Borst M, Mariat C, Pottel H, Van Londen M. FC 055PERCENTILES OF NORMAL MEASURED GLOMERULAR FILTRATION RATE BASED ON DATA FROM LIVING KIDNEY DONORS. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab130.003] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Studies of healthy individuals or candidates for living kidney donation, in various geographical areas and ethnic groups, describe a decline of glomerular filtration rate (GFR) with age. Most data on GFR are obtained from subjects in the general population or from candidates for kidney donation who are younger than 65 years. It is currently unknown whether the definition of normal GFR in subjects older than 65 years is similar to the definition in those younger than 65 years. Because the age of candidates for living kidney donation is increasing worldwide, lack of GFR references for older donors complicates the selection process. Moreover, older individuals are most likely to have a mildly decreased GFR that may be misinterpreted as chronic kidney disease. In this study, we calculated percentiles of measured GFR (mGFR) from a large cohort of effective kidney donors (EKD) younger than 65 years, and extrapolated them to subjects older than 65 years. Additionnaly, we collected mGFR data from different centers within Europe from EKD and/or healthy people (HP) from the general population older than 65 years. We tested if the distribution of mGFR of these older subjects fitted with the extrapolated percentiles.
Method
In this retrospective, observational, multi-center study, percentiles of mGFR in EKD were calculated from a development cohort of French and Belgian EKD younger than 65 years (n=1983). From the French kidney donor study, 147 EKD older than 65 years were considered as the internal validation cohort. In an external validation cohort, data on mGFR of subjects older than 65 years, either EKD or HP from the general population (from Germany, Sweden (2), Norway, Netherlands and France, n=2459) were included. Data were fully anonymized and this retrospective study was approved by the respective ethics committees. Percentiles were derived for the development database, using quantiles modeled as cubic splines with two linear parts joining at one age-knot of 40 years. The median quantile had a constant first part (slope of zero) and a second part with a negative slope of -0.88235 mL/min/1.73m² per year. To maintain consistency, all quantiles were adjusted to show the same shape as the medium quantile. Above 65 years, the percentile values were extrapolated using the same mathematical model. We then calculated the percentage of results from the internal and external validation cohorts that were within the 5th extrapolated percentile (P5) and 95th percentile (P95). A sensitivity analysis including the EKD only was performed.
Results
Individuals in the development cohort were younger than in the internal or external validation cohort (47.3±10.5 years vs. 68.8±2.9 years and 71.4±6.4 years; respectively, both p<0.001). Individuals in the development cohort had a higher mGFR than in the internal or external validation cohort (99.9±16.4 mL/min/1.73m2 vs. 86.4±14 mL/min/1.73m2 and 82.7±15.5 mL/min/1.73m2; respectively, both p < 0.001). Among the 147 EKD from the internal validation cohort, none (0%) had mGFR below the extrapolated P5 and12 (8.1%) had mGFR higher than the extrapolated P95. Consequently, 135/147 (91.2%) of subjects were between P5-P95. (Figure 1). Considering the whole external validation cohort (n=329), 5 subjects had mGFR lower than extrapolated P5 (1.5%), 25 were above P95, leaving 299 (90.9%) with mGFR between P5 and the extrapolated P95.
Conclusion
We demonstrate that extrapolated percentiles of mGFR (calculated in individuals younger than 65) fits well with the distribution of mGFR in individuals older than 65. Extrapolation of percentiles to individuals older than 65 is useful to define age-adapted GFR thresholds for older individuals.
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Affiliation(s)
- François Gaillard
- Assistance Publique Hopitaux de Paris - Bichat Hospital, Nephrology, Paris, France
- Université de Paris, Paris, France
| | - Pierre Delanaye
- Chu De Liège, Liège, Belgium
- University Hospital of Nimes, Nephrology, Nîmes, France
| | | | - Geir Mjøen
- Oslo universitetssykehus Rikshospitalet, Nephrology, Oslo, Norway
| | | | | | - Natalie Ebert
- Charité – Universitätsmedizin Berlin, Public health, Berlin, Germany
| | - Elke Schaeffner
- Charité – Universitätsmedizin Berlin, Public health, Berlin, Germany
| | | | | | - Lionel Couzi
- Hospital Center University De Bordeaux, Nephrology, Bordeaux, France
| | | | | | | | | | | | - Nassim Kamar
- Hospital Center University De Toulouse, Nephrology and renal transplantation, Toulouse, France
| | | | | | | | | | - Hans Pottel
- KU Leuven Campus Kulak Kortrijk, Public health, Kortrijk, Belgium
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22
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Brito Dos Santos S, Bertholet-Thomas A, Butin M, Dubourg L, Fouilhoux A, Bacchetta J. Tyrosinemia type 1 in pediatric nephrology: Not always straightforward. Arch Pediatr 2021; 28:338-341. [PMID: 33858731 DOI: 10.1016/j.arcped.2021.03.002] [Citation(s) in RCA: 1] [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] [Received: 11/30/2020] [Revised: 03/07/2021] [Accepted: 03/16/2021] [Indexed: 11/29/2022]
Abstract
The main clinical features of tyrosinemia type 1 usually appear in the first months of life, including fever, diarrhea, vomiting, liver involvement, growth failure, and renal proximal tubulopathy with subsequent hypophosphatemic rickets. An early diagnosis is crucial in order to provide specific management and to prevent complications. Here, we report on two cases referred primarily to pediatric nephrologists for the diagnosis of "neonatal tubulopathy" and management of "X-linked hypophosphatemia (XLH)," respectively. Our aim is to emphasize that (1) even a mixed tubulopathy can reveal tyrosinemia, and (2) tyrosinemia is a classic differential diagnosis of XLH that should not be forgotten, especially in the era of the anti-FGF23 burosumab.
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Affiliation(s)
- Sissa Brito Dos Santos
- Centre de Référence des Maladies Rénales Rares, Filières de santé maladies rares ORKID et ERK-Net, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Aurélia Bertholet-Thomas
- Centre de Référence des Maladies Rénales Rares, Filières de santé maladies rares ORKID et ERK-Net, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Marine Butin
- Service de Néonatologie, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France; Centre International de Recherche en Infectiologie. Unité INSERMI U1111 CNRS UMR5308 ENS de Lyon, Lyon, France
| | - Laurence Dubourg
- Departament de Néphrologie, Service d'Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot Lyon, Lyon, France; Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France
| | - Alain Fouilhoux
- Centre de Référence de Maladies Héréditaires du Métabolisme, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Justine Bacchetta
- Centre de Référence des Maladies Rénales Rares, Filières de santé maladies rares ORKID et ERK-Net, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France; Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France; INSERM, UMR 1033, Faculté de Medecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France.
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23
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Matrat L, Ruiz M, Ecochard-Dugelay E, Loras-Duclaux I, Marotte S, Heissat S, Poinsot P, Sellier-Leclerc AL, Bacchetta J, Dubourg L, Peretti N. Combined use of creatinine and cystatin C improves the detection of renal dysfunction in children undergoing home parenteral nutrition. JPEN J Parenter Enteral Nutr 2021; 46:180-189. [PMID: 33733460 DOI: 10.1002/jpen.2108] [Citation(s) in RCA: 1] [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: 12/16/2022]
Abstract
BACKGROUND Renal dysfunction can complicate home parenteral nutrition (HPN). The aims were, in the context of pediatric HPN, to assess renal function using the measured glomerular filtration rate (mGFR), determine the most accurate formula(s) to estimate GFR, and identify possible underlying mechanisms of renal impairment. METHODS A retrospective study was performed in 2 centers. Patients receiving HPN and aged 2-16 years without medical history of nephropathy were included. GFR was measured using iohexol clearance. Estimated GFR (eGFR) was calculated using creatinine, cystatin C-based, and combined (eGFRcr+cyst ) Schwartz formulas. RESULTS A total of 36 patients (18 females) were included; they received HPN for 8 (2-16) years. The primary digestive disease was short-bowel syndrome for 16 (44%) patients, gastrointestinal motility disorder for 10 (28%), or congenital diarrhea for 10 (28%). The median (range) mGFR was 99 (33-136) ml/min/1.73 m2 ; 9 (25%) patients had mildly decreased mGFR (<90 and ≥60 ml/min/1.73 m2 ), and 2 (6%) had mildly to severely decreased mGFR (<60 ml/min/1.73 m2 ). The eGFRcr+cyst formula was the most accurate and precise to estimate GFR. A significant negative correlation between mGFR and PN duration was found for patients receiving PN for 6-7/7 days (P = .008). Activation of the renin-angiotensin system was identified in 15 of 36 (42%) patients. CONCLUSION Renal dysfunction was frequent and correlated with the duration of PN only for patients with the most severe intestinal failure. The use of eGFRcr+cyst improves its detection in these patients. Chronic dehydration may be an underlying mechanism.
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Affiliation(s)
- Lucie Matrat
- Pediatric Gastroenterology Hepatology and Nutrition Department, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.,Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Pierre-Bénite, France
| | - Mathias Ruiz
- Pediatric Gastroenterology Hepatology and Nutrition Department, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | | | - Irène Loras-Duclaux
- Pediatric Gastroenterology Hepatology and Nutrition Department, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Stéphanie Marotte
- Pediatric Gastroenterology Hepatology and Nutrition Department, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Sophie Heissat
- Pediatric Gastroenterology Hepatology and Nutrition Department, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Pierre Poinsot
- Pediatric Gastroenterology Hepatology and Nutrition Department, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.,Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Pierre-Bénite, France.,CarMeN Laboratory, INRAE, INSERM, UMR1060, University Lyon 1, Pierre-Bénite, France
| | - Anne-Laure Sellier-Leclerc
- Centre de Référence des Maladies Rénales Rares, Service de Néphrologie, Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Justine Bacchetta
- Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Pierre-Bénite, France.,Centre de Référence des Maladies Rénales Rares, Service de Néphrologie, Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Laurence Dubourg
- Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Pierre-Bénite, France.,Centre de Référence des Maladies Rénales Rares, Service de Néphrologie, Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.,Service d'Exploration Fonctionnelle Rénale, Département de Néphrologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Bron, France
| | - Noël Peretti
- Pediatric Gastroenterology Hepatology and Nutrition Department, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.,Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Pierre-Bénite, France.,CarMeN Laboratory, INRAE, INSERM, UMR1060, University Lyon 1, Pierre-Bénite, France
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24
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Ehrich J, Dubourg L, Hansson S, Pape L, Steinle T, Fruth J, Höckner S, Schiffer E. Serum Myo-Inositol, Dimethyl Sulfone, and Valine in Combination with Creatinine Allow Accurate Assessment of Renal Insufficiency-A Proof of Concept. Diagnostics (Basel) 2021; 11:234. [PMID: 33546466 PMCID: PMC7913668 DOI: 10.3390/diagnostics11020234] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 12/21/2020] [Revised: 01/15/2021] [Accepted: 01/29/2021] [Indexed: 12/11/2022] Open
Abstract
Evaluation of renal dysfunction includes estimation of glomerular filtration rate (eGFR) as the initial step and subsequent laboratory testing. We hypothesized that combined analysis of serum creatinine, myo-inositol, dimethyl sulfone, and valine would allow both assessment of renal dysfunction and precise GFR estimation. Bio-banked sera were analyzed using nuclear magnetic resonance spectroscopy (NMR). The metabolites were combined into a metabolite constellation (GFRNMR) using n = 95 training samples and tested in n = 189 independent samples. Tracer-measured GFR (mGFR) served as a reference. GFRNMR was compared to eGFR based on serum creatinine (eGFRCrea and eGFREKFC), cystatin C (eGFRCys-C), and their combination (eGFRCrea-Cys-C) when available. The renal biomarkers provided insights into individual renal and metabolic dysfunction profiles in selected mGFR-matched patients with otherwise homogenous clinical etiology. GFRNMR correlated better with mGFR (Pearson correlation coefficient r = 0.84 vs. 0.79 and 0.80). Overall percentages of eGFR values within 30% of mGFR for GFRNMR matched or exceeded those for eGFRCrea and eGFREKFC (81% vs. 64% and 74%), eGFRCys-C (81% vs. 72%), and eGFRCrea-Cys-C (81% vs. 81%). GFRNMR was independent of patients' age and sex. The metabolite-based NMR approach combined metabolic characterization of renal dysfunction with precise GFR estimation in pediatric and adult patients in a single analytical step.
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Affiliation(s)
- Jochen Ehrich
- Department of Pediatric Kidney-, Liver- and Metabolic Diseases, Children’s Hospital, Hannover Medical School, 30625 Hannover, Germany;
| | - Laurence Dubourg
- Service d’Explorations Fonctionnelles Rénaleset Métaboliques, Hôpital Edouard Herriot, 69437 Lyon, France;
| | - Sverker Hansson
- Department of Pediatrics, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden;
| | - Lars Pape
- Department of Pediatrics II, University Hospital Essen, 45147 Essen, Germany;
| | - Tobias Steinle
- Department of Research and Development, numaresAG, 93053 Regensburg, Germany; (T.S.); (J.F.); (S.H.)
| | - Jana Fruth
- Department of Research and Development, numaresAG, 93053 Regensburg, Germany; (T.S.); (J.F.); (S.H.)
| | - Sebastian Höckner
- Department of Research and Development, numaresAG, 93053 Regensburg, Germany; (T.S.); (J.F.); (S.H.)
| | - Eric Schiffer
- Department of Research and Development, numaresAG, 93053 Regensburg, Germany; (T.S.); (J.F.); (S.H.)
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Pottel H, Björk J, Courbebaisse M, Couzi L, Ebert N, Eriksen BO, Dalton RN, Dubourg L, Gaillard F, Garrouste C, Grubb A, Jacquemont L, Hansson M, Kamar N, Lamb EJ, Legendre C, Littmann K, Mariat C, Melsom T, Rostaing L, Rule AD, Schaeffner E, Sundin PO, Turner S, Bökenkamp A, Berg U, Åsling-Monemi K, Selistre L, Åkesson A, Larsson A, Nyman U, Delanaye P. Development and Validation of a Modified Full Age Spectrum Creatinine-Based Equation to Estimate Glomerular Filtration Rate : A Cross-sectional Analysis of Pooled Data. Ann Intern Med 2021; 174:183-191. [PMID: 33166224 DOI: 10.7326/m20-4366] [Citation(s) in RCA: 141] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The Chronic Kidney Disease in Children Study (CKiD) equation for children and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for adults are recommended serum creatinine (SCr)-based calculations for estimating glomerular filtration rate (GFR). However, these equations, as well as their combination, have limitations, notably the problem of implausible changes in GFR during the transition from adolescence to adulthood and overestimation of GFR in young adults. The full age spectrum (FAS) equation addresses these issues but overestimates GFR when SCr levels are low. OBJECTIVE To develop and validate a modified FAS SCr-based equation combining design features of the FAS and CKD-EPI equations. DESIGN Cross-sectional analysis with separate pooled data sets for development and validation. SETTING Research and clinical studies (n = 13) with measured GFR available. PATIENTS 11 251 participants in 7 studies (development and internal validation data sets) and 8378 participants in 6 studies (external validation data set). MEASUREMENTS Clearance of an exogenous marker (reference method), SCr level, age, sex, and height were used to develop a new equation to estimate GFR. RESULTS The new European Kidney Function Consortium (EKFC) equation is a FAS equation with low bias (-1.2 mL/min/1.73 m2 [95% CI, -2.7 to 0.0 mL/min/1.73 m2] in children and -0.9 mL/min/1.73 m2 [CI, -1.2 to -0.5 mL/min/1.73 m2] in adults) across the FAS (2 to 90 years) and SCr range (40 to 490 µmol/L [0.45 to 5.54 mg/dL]) and with fewer estimation errors exceeding 30% (6.5% [CI, 3.8% to 9.1%] in children and 3.1% [CI, 2.5% to 3.6%] in adults) compared with the CKiD and CKD-EPI equations. LIMITATION No Black patients were included. CONCLUSION The new EKFC equation shows improved accuracy and precision compared with commonly used equations for estimating GFR from SCr levels. PRIMARY FUNDING SOURCE Swedish Research Council (Vetenskapsrådet).
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Affiliation(s)
- Hans Pottel
- KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium (H.P.)
| | - Jonas Björk
- Lund University and Skåne University Hospital, Lund, Sweden (J.B., A.Å.)
| | - Marie Courbebaisse
- Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Paris Descartes University, INSERM U1151-CNRS UMR8253, Paris, France (M.C.)
| | - Lionel Couzi
- CHU de Bordeaux, Université de Bordeaux, CNRS-UMR 5164 Immuno ConcEpT, Bordeaux, France (L.C.)
| | - Natalie Ebert
- Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.)
| | - Björn O Eriksen
- UiT The Arctic University of Norway, Tromsö, Norway (B.O.E., T.M.)
| | - R Neil Dalton
- Evelina London Children's Hospital, London, United Kingdom (R.N.D.)
| | - Laurence Dubourg
- Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France (L.D.)
| | | | - Cyril Garrouste
- Clermont-Ferrand University Hospital, Clermont-Ferrand, France (C.G.)
| | - Anders Grubb
- Skåne University Hospital and Lund University, Lund, Sweden (A.G.)
| | | | - Magnus Hansson
- Karolinska University Hospital Huddinge and Karolinska Institute, Stockholm, Sweden (M.H.)
| | - Nassim Kamar
- CHU Rangueil, INSERM U1043, IFR-BMT, University Paul Sabatier, Toulouse, France (N.K.)
| | - Edmund J Lamb
- East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.)
| | - Christophe Legendre
- Hôpital Necker, Assistance Publique Hôpitaux de Paris (AP-HP)and Université Paris Descartes, Paris, France (C.L.)
| | | | | | - Toralf Melsom
- UiT The Arctic University of Norway, Tromsö, Norway (B.O.E., T.M.)
| | - Lionel Rostaing
- Hôpital Michallon, CHU Grenoble-Alpes, La Tronche, France (L.R.)
| | | | - Elke Schaeffner
- Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.)
| | | | | | - Arend Bökenkamp
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands (A.B.)
| | - Ulla Berg
- Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden (U.B., K.Å.)
| | - Kajsa Åsling-Monemi
- Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden (U.B., K.Å.)
| | - Luciano Selistre
- Mestrado em Ciências da Saúde-Universidade Caxias do Sul Foundation CAPES, Caxias do Sul, Brazil (L.S.)
| | - Anna Åkesson
- Lund University and Skåne University Hospital, Lund, Sweden (J.B., A.Å.)
| | - Anders Larsson
- Skåne University Hospital, Lund, Sweden; Uppsala University, Uppsala, Sweden (A.L.)
| | - Ulf Nyman
- Lund University, Malmö, Sweden (U.N.)
| | - Pierre Delanaye
- University of Liège (ULg CHU), CHU Sart Tilman, Liège, Belgium, and Hôpital Universitaire Carémeau, Nîmes, France (P.D.)
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Matrat L, Ruiz M, Dugelay E, Loras-Duclaux I, Marotte S, Heissat S, Sellier-Leclerc AL, Bacchetta J, Dubourg L, Peretti N. Alteration of renal function in children with long-term parenteral nutrition. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.499] [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: 11/24/2022]
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Florens N, Dubourg L, Bitker L, Kalbacher E, Philit F, Mornex JF, Parant F, Guebre-Egziabher F, Juillard L, Lemoine S. Measurement of glomerular filtration rate in lung transplant recipients highlights a dramatic loss of renal function after transplantation. Clin Kidney J 2020; 13:828-833. [PMID: 33123359 PMCID: PMC7577765 DOI: 10.1093/ckj/sfaa053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 09/23/2019] [Accepted: 03/16/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) after lung transplantation (LT) is underestimated. The aim of the present study was to measure the loss of glomerular filtration rate (GFR) 1 year after LT and to identify the risk factors for developing Stage ≥3 CKD. METHODS LT patients in the University Hospital of Lyon had a pre- and post-transplantation measurement of their GFR (mGFR), and GFR was also estimated using the Chronic Kidney Disease Epidemiology Collaboration equation. RESULTS During the study period, 111 patients were lung transplant candidates, of which 91 had a pre-transplantation mGFR, and 29 had a mGFR at 1 year after LT. Six patients underwent maintenance haemodialysis after transplantation. Mean mGFR was 106 mL/min/1.73 m2 before LT and 58 mL/min/1.73 m2 1 year after LT (P < 0.05) with a mean loss of 48 mL/min/1.73 m2 per patient. The risk of developing Stage ≥3 CKD after LT was higher in patients with lower pre-LT mGFR (odds ratio for each 1 mL/min/1.73 m2 increase: 0.94, 95% confidence interval 0.88-0.99). Receiver operator characteristics curves for the sensitivity and specificity of eGFR and mGFR for the prediction of CKD Stage ≥3 after LT found that pre-LT mGFR of 101 mL/min/1.73 m2 and pre-LT eGFR of 124 mL/min/1.73 m2 were the optimal thresholds for predicting Stage ≥3 CKD after LT. CONCLUSION The present study underlines the value of mGFR in the pre-LT stage and found major renal function loss after LT, and consequently two-thirds of patients have Stage ≥3 CKD at 1 year. All patients with a pre-LT mGFR <90 mL/min/1.73 m2 warrant particular attention.
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Affiliation(s)
- Nans Florens
- Université de Lyon, CarMeN, INSERM U1060, INSA de Lyon, Université Claude Bernard Lyon 1, INRA U1397, Villeurbanne, France.,Hospices Civils de Lyon, Service de Néphrologie, Hôpital E. Herriot, Lyon, France
| | - Laurence Dubourg
- Hospices Civils de Lyon, Service de Néphrologie, Hôpital E. Herriot, Lyon, France
| | - Laurent Bitker
- Hospices Civils de Lyon, Service de Néphrologie, Hôpital E. Herriot, Lyon, France
| | - Emilie Kalbacher
- Hospices Civils de Lyon, Service de Néphrologie, Hôpital E. Herriot, Lyon, France
| | - François Philit
- Hospices Civils de Lyon, Hôpital L. Pradel, Bron, F-69500, France.,UMR754 INRA Université Lyon 1, Université de Lyon, Lyon, France
| | - Jean François Mornex
- Hospices Civils de Lyon, Hôpital L. Pradel, Bron, F-69500, France.,UMR754 INRA Université Lyon 1, Université de Lyon, Lyon, France
| | - François Parant
- Department of Pharmacology, Hospices Civils de Lyon, Hôpital Lyon Sud, Lyon, France
| | - Fitsum Guebre-Egziabher
- Université de Lyon, CarMeN, INSERM U1060, INSA de Lyon, Université Claude Bernard Lyon 1, INRA U1397, Villeurbanne, France.,Hospices Civils de Lyon, Service de Néphrologie, Hôpital E. Herriot, Lyon, France
| | - Laurent Juillard
- Université de Lyon, CarMeN, INSERM U1060, INSA de Lyon, Université Claude Bernard Lyon 1, INRA U1397, Villeurbanne, France.,Hospices Civils de Lyon, Service de Néphrologie, Hôpital E. Herriot, Lyon, France
| | - Sandrine Lemoine
- Université de Lyon, CarMeN, INSERM U1060, INSA de Lyon, Université Claude Bernard Lyon 1, INRA U1397, Villeurbanne, France.,Hospices Civils de Lyon, Service de Néphrologie, Hôpital E. Herriot, Lyon, France
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28
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Dubourg L, Lemoine S, Joannard B, Chardon L, de Souza V, Cochat P, Iwaz J, Rabilloud M, Selistre L. Comparison of iohexol plasma clearance formulas vs. inulin urinary clearance for measuring glomerular filtration rate. Clin Chem Lab Med 2020; 59:571-579. [PMID: 33068376 DOI: 10.1515/cclm-2020-0770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/28/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The one-compartment iohexol plasma clearance has been proposed as a reliable alternative to renal inulin clearance. However, this method's performance depends on the formula used to calculate glomerular filtration rate (GFR). This study reports on performance comparisons between various mathematical formulas proposed for iohexol plasma clearance vs. inulin urinary clearance. METHODS GFR was simultaneously determined by inulin and iohexol clearance in 144 participants (age: 10-84 years; glomerular filtration rate: 15-169 mL/min/1.73 m2). A retrospective cross-sectional study evaluated the performance of four formulas proposed to calculate plasma iohexol clearance (Brøchner-Mortensen, Fleming et al., Jødal-Brøchner-Mortensen, and Ng-Schwartz-Munoz). The performance of each formula was assessed using bias, precision (standard deviation of the bias), accuracy (percentage iohexol within 5, 10, and 15%), root mean square error, and concordance correlation coefficient vs. renal inulin clearance as reference. RESULTS Regarding accuracy, there was no difference in root mean square error (RMSE), P5, P10, or P15 between the four formulas. The four concordance correlation coefficients (CCC) between the value from each formula and in-GFR were high and not significantly different. At in-GFR ≥90 mL/min/1.73 m2, Ng-Schwartz-Munoz formula performed slightly better than other formulas regarding median bias (-0.5; 95% CI [-3.0 to 2.0] and accuracy P15 (95.0; 95% CI [88.0-100.0]). CONCLUSIONS The studied formulas were found equivalent in terms of precision and accuracy, but the Ng-Schwartz-Munoz formula improved the accuracy at higher levels of in-GFR.
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Affiliation(s)
- Laurence Dubourg
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, CNRS UMR 5305/Université Lyon 1, Lyon, France
| | - Sandrine Lemoine
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire CarMeN, INSERM 1060, Lyon, France
| | - Brune Joannard
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Laurence Chardon
- Laboratoire de biochimie, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France
| | - Vandréa de Souza
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Universidade de Caxias do Sul, Programa de Pós-graduação em Ciências da Saúde, Caxias do Sul, Brazil.,CAPES Foundation, Ministry of Education of Brazil, Brasilia, Brazil.,Hospital Geral de Caxias do Sul, Caxias do Sul, Brasil
| | - Pierre Cochat
- Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, CNRS UMR 5305/Université Lyon 1, Lyon, France.,Centre de Référence des Maladies Rénales et Phosphocalciques Rares, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France
| | - Jean Iwaz
- Université Claude Bernard Lyon 1, Lyon, France.,Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,CNRS UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
| | - Muriel Rabilloud
- Université Claude Bernard Lyon 1, Lyon, France.,Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,CNRS UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
| | - Luciano Selistre
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Universidade de Caxias do Sul, Programa de Pós-graduação em Ciências da Saúde, Caxias do Sul, Brazil.,CAPES Foundation, Ministry of Education of Brazil, Brasilia, Brazil.,Hospital Geral de Caxias do Sul, Caxias do Sul, Brasil
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Björk J, Nyman U, Courbebaisse M, Couzi L, Dalton RN, Dubourg L, Ebert N, Eriksen BO, Gaillard F, Garrouste C, Grubb A, Hansson M, Jacquemont L, Jones I, Kamar N, Lamb EJ, Legendre C, Littmann K, Mariat C, Melsom T, Rostaing L, Rule AD, Schaeffner E, Sundin PO, Turner S, Åkesson A, Delanaye P, Pottel H. Prospects for improved glomerular filtration rate estimation based on creatinine-results from a transnational multicentre study. Clin Kidney J 2020; 13:674-683. [PMID: 32905314 PMCID: PMC7467594 DOI: 10.1093/ckj/sfaa039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 03/04/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation is routinely used to assess renal function but exhibits varying accuracy depending on patient characteristics and clinical presentation. The overall aim of the present study was to assess if and to what extent glomerular filtration rate (GFR) estimation based on creatinine can be improved. METHODS In a cross-sectional analysis covering the years 2003-17, CKD-EPI was validated against measured GFR (mGFR; using various tracer methods) in patients with high likelihood of chronic kidney disease (CKD; five CKD cohorts, n = 8365) and in patients with low likelihood of CKD (six community cohorts, n = 6759). Comparisons were made with the Lund-Malmö revised equation (LMR) and the Full Age Spectrum equation. RESULTS 7In patients aged 18-39 years old, CKD-EPI overestimated GFR with 5.0-16 mL/min/1.73 m2 in median in both cohort types at mGFR levels <120 mL/min/1.73 m2. LMR had greater accuracy than CKD-EPI in the CKD cohorts (P30, the percentage of estimated GFR within 30% of mGFR, 83.5% versus 76.6%). CKD-EPI was generally the most accurate equation in the community cohorts, but all three equations reached P30 above the Kidney Disease Outcomes Quality Initiative benchmark of 90%. CONCLUSIONS None of the evaluated equations made optimal use of available data. Prospects for improved GFR estimation procedures based on creatinine exist, particularly in young adults and in settings where patients with suspected or manifest CKD are investigated.
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Affiliation(s)
- Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
- Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Ulf Nyman
- Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden
| | - Marie Courbebaisse
- Physiology Department, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris Descartes University, INSERM U1151-CNRS UMR8253, Paris, France
| | - Lionel Couzi
- CHU de Bordeaux, Nephrologie–Transplantation–Dialyse, Université de Bordeaux, CNRS-UMR 5164 Immuno ConcEpT, Bordeaux, France
| | - R Neil Dalton
- The Wellchild Laboratory, Evelina London Children’s Hospital, London, UK
| | - Laurence Dubourg
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Natalie Ebert
- Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany
| | - Björn O Eriksen
- Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsö, Norway
| | - Francois Gaillard
- Renal Transplantation Department, Necker Hospital, Assistance Publique–Hôpitaux de Paris (AP-HP), Paris, France
| | - Cyril Garrouste
- Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Anders Grubb
- Department of Clinical Chemistry, Skåne University Hospital Lund, Lund University, Lund, Sweden
| | - Magnus Hansson
- Function area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Lola Jacquemont
- Renal Transplantation Department, CHU Nantes, Nantes University, Nantes, France
| | - Ian Jones
- Department of Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Nassim Kamar
- Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, INSERM U1043, IFR–BMT, University Paul Sabatier, Toulouse, France
| | - Edmund J Lamb
- Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | | | - Karin Littmann
- Function area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Christophe Mariat
- Service de Néphrologie, Dialyse et Transplantation Rénale, Hôpital Nord, CHU de Saint-Etienne, France
| | - Toralf Melsom
- Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsö, Norway
| | - Lionel Rostaing
- Service de Néphrologie, Hémodialyse, Aphérèses et Transplantation Rénale, Hôpital Michallon, CHU Grenoble-Alpes, La Tronche, France
| | - Andrew D Rule
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Elke Schaeffner
- Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany
| | - Per-Ola Sundin
- Department of Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Stephen Turner
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Anna Åkesson
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
- Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Pierre Delanaye
- Department of Nephrology-Dialysis-Transplantation, University of Liège (ULg CHU), CHU Sart Tilman, Liège, Belgium
| | - Hans Pottel
- Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
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Lemoine S, Eladari D, Juillard L, Bonnefond A, Froguel P, Dubourg L. The Case | Hypokalemia and severe renal loss of sodium. Kidney Int 2020; 97:1305-1306. [DOI: 10.1016/j.kint.2019.12.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 12/17/2019] [Accepted: 12/30/2019] [Indexed: 11/29/2022]
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Selistre LDS, Lemoine S, Dantec A, Buron F, de Souza VC, Bertoldo M, Poli-de-Figueiredo CE, Rimmelé T, Thaunat O, Badet L, Morelon E, Sicard A, Dubourg L. Comparison of creatinine-based equations for estimating glomerular filtration rate in deceased donor renal transplant recipients. PLoS One 2020; 15:e0231873. [PMID: 32343691 PMCID: PMC7188287 DOI: 10.1371/journal.pone.0231873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/26/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Estimating glomerular filtration rate (GFR) is important for clinical management in kidney transplantation recipients (KTR). However, very few studies have evaluated the performance of the new GFR estimating equations (Lund-Malmö Revised-LMR, and Full Age Spectrum-FAS) in KTR. METHODS GFR was estimated (eGFR) using CKD-EPI, MDRD, LMR, and FAS equations and compared to GFR measurement (mGFR) by reference methods (inuline urinary and iohexol plasma clearance) in 395 deceased-donor KTR without corticosteroids. The equations performance was assessed using bias (mean difference of eGFR and mGFR), precision (standard deviation of the difference), accuracy (concordance correlation coefficient-CCC), and agreements (total deviation index-TDI). The area under receiver operating characteristic curves (ROC) and the likelihood ratio for a positive result were calculated. RESULTS In the total population, the performance of the CKD-EPI, MDRD and FAS equations was significantly lower than the LMR equation regarding the mean [95%CI] difference in bias (-2.0 [-4.0; -1.5] versus 9.0 [7.5; 10.0], 5.0 [3.5; 6.0] and 10.0 [8.5; 11.0] mL/min/1.73m2, P<0.005) and TDI (17.10 [16.41; 17.88], 25.91 [24.66; 27.16], 21.23 [19.48; 23.13] and 25.84 [24.16; 27.57], respectively). Concerning the CCC, all equation had poor agreement (<0.800) without statically difference between them. However, all equations had excellent area under the ROC curve (>0.900), and LMR equation had the best ability to correctly predict KTR with mGFR<45 mL/min/1.73 m2 (positive likelihood ratio: 8.87 [5.79; 13.52]). CONCLUSION Among a referral group of subjects KTR, LMR equation had the best mean bias and TDI, but with no significant superiority in other agreement tools. Caveat is required in the use and interpretation of PCr-based equations in this specific population.
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Affiliation(s)
- Luciano da Silva Selistre
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- Universidade de Caxias do Sul—Programa de Pós-Graduação em Ciências da Saúde, Caxias do Sul, Brazil
- Hospital Geral de Caxias do Sul, Caxias do Sul, Brazil
| | - Sandrine Lemoine
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- Université Lyon 1, Lyon, France
- CarMeN: Cardiovasculaire, Métabolisme, Diabétologie & Nutrition-INSERM U1060/Lyon 1, Lyon, France
| | - Allyriane Dantec
- Service de Transplantation, Néphrologie et Immunologie Clinique, Hôpital Edouard Herriot, Lyon, France
| | - Fanny Buron
- Service de Transplantation, Néphrologie et Immunologie Clinique, Hôpital Edouard Herriot, Lyon, France
| | - Vandréa Carla de Souza
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- Universidade de Caxias do Sul—Programa de Pós-Graduação em Ciências da Saúde, Caxias do Sul, Brazil
- Hospital Geral de Caxias do Sul, Caxias do Sul, Brazil
| | - Mariana Bertoldo
- Universidade de Caxias do Sul—Programa de Pós-Graduação em Ciências da Saúde, Caxias do Sul, Brazil
| | | | - Thomas Rimmelé
- CarMeN: Cardiovasculaire, Métabolisme, Diabétologie & Nutrition-INSERM U1060/Lyon 1, Lyon, France
- Service d'anesthésie-réanimation, hôpital Edouard-Herriot, Lyon, France
| | - Olivier Thaunat
- Université Lyon 1, Lyon, France
- Service de Transplantation, Néphrologie et Immunologie Clinique, Hôpital Edouard Herriot, Lyon, France
- Unité INSERM U1111, Lyon, France
| | - Lionel Badet
- Université Lyon 1, Lyon, France
- Service d’Urologie et Transplantation, Hôpital Edouard Herriot, Lyon, France
| | - Emmanuel Morelon
- Université Lyon 1, Lyon, France
- Service de Transplantation, Néphrologie et Immunologie Clinique, Hôpital Edouard Herriot, Lyon, France
- Unité INSERM U1111, Lyon, France
| | - Antoine Sicard
- Université Lyon 1, Lyon, France
- Unité INSERM U1111, Lyon, France
| | - Laurence Dubourg
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- Université Lyon 1, Lyon, France
- Laboratoire de Biologie Tissulaire et d’ingénierie Thérapeutique (LBTI), UMR 5305 CNRS, Université Claude Bernard Lyon 1, Lyon, France
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Roger C, Abid N, Dubourg L, Auvergnon C, Lemoine S, Machon C. Composition of urinary calculi: Lessons from a French epidemiologic retrospective study. Prog Urol 2020; 30:339-345. [PMID: 32312624 DOI: 10.1016/j.purol.2020.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 01/10/2020] [Revised: 03/06/2020] [Accepted: 03/06/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Urolithiasis is a common urological disease whose incidence increases in developed countries. We studied relations between composition of urinary calculi, age and gender. MATERIAL An epidemiologic study was conducted in a French population of patients encountered analysis of urinary calculi between 2013 and 2017. This retrospective cohort study was performed from urinary calculi samples analysed in a clinical biochemistry laboratory of University Hospital of Lyon in France. A total of 5782 samples were included. Data, according to stone composition, presence of a papillary umbilication and a Randall's plaque, age and gender, were investigated. Statistical analyses used the Chi2 test (R software). RESULTS The overall male to female sex ratio was equal to 1.76. The average and the median of age were 52.1 and 53.0 years, respectively. Whewellite was the most frequent main component in our population (44.4%). Carbapatite, weddellite and uric acid represented the main component in 14.0%, 13.4% and 13.0% of samples, respectively. Differences between genders were shown. Whewellite and uric acid were more frequent in men (P<0.001), while carbapatite and struvite were predominant in women (P<0.001). CONCLUSIONS Our study provided recent data on the composition of urinary calculi in a French population and the relations between composition of urinary calculi and age and gender. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- C Roger
- Service de biochimie et biologie moléculaire, Centre De Biologie Sud, Hospices Civils de Lyon, hôpital Lyon Sud, Lyon, France
| | - N Abid
- Service d'urologie, groupement hospitalier Edouard-Herriot, Hospices Civils de Lyon, Lyon, France
| | - L Dubourg
- Exploration fonctionnelle Rénale, groupement hospitalier Edouard-Herriot, Hospices Civils de Lyon, Lyon, France
| | - C Auvergnon
- Service de biochimie et biologie moléculaire, Centre De Biologie Sud, Hospices Civils de Lyon, hôpital Lyon Sud, Lyon, France
| | - S Lemoine
- Exploration fonctionnelle Rénale, groupement hospitalier Edouard-Herriot, Hospices Civils de Lyon, Lyon, France
| | - C Machon
- Service de biochimie et biologie moléculaire, Centre De Biologie Sud, Hospices Civils de Lyon, hôpital Lyon Sud, Lyon, France.
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Guebre-Egziabher F, Brunelle C, Thomas J, Pelletier CC, Normand G, Juillard L, Dubourg L, Lemoine S. Estimated Glomerular Filtration Rate Bias in Participants with Severe Obesity Regardless of Deindexation. Obesity (Silver Spring) 2019; 27:2011-2017. [PMID: 31579999 DOI: 10.1002/oby.22574] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/23/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Morbid obesity is associated with a higher independent risk of chronic kidney disease (CKD). Estimated glomerular filtration rate (eGFR) has been evaluated in a limited number of study participants with severe obesity. METHODS A total of 706 measured GFR (mGFR) results from 598 participants with obesity (BMI ≥ 35 kg/m2 ) were retrospectively collected. The performance of the Modification of Diet in Renal Disease (MDRD) equation, Chronic Kidney Disease-Epidemiology (CKD-EPI) equation, and deindexed eGFR were compared with mGFR from the gold standard technique (inuline or iohexol), adjusted (mGFRr) or nonadjusted (mGFR) to body surface area. Absolute bias, precision, and accuracy were calculated. RESULTS Mean mGFRr (58 ± 31 mL/min/1.73 m2 ) was significantly different from CKD-EPI and MDRD (P < 0.001). Mean mGFR (nonindexed) (70 ± 40 mL/min) was significantly higher than mGFRr (P < 0.001). eGFR showed important biases and low accuracies for CKD-EPI and MDRD (10.7 ± 10.7 and 12.2 ± 13.7 mL/min/1.73 m2 ; 78% vs. 75% respectively). Deindexation worsened bias and accuracy 30% (percentage of GFR estimates within 30% of mGFRr or mGFR) between eGFR and mGFR. CONCLUSIONS eGFR overestimates mGFR and is associated with important biases and inaccuracies in patients with severe obesity, and deindexing eGFR worsens the overestimation. These findings may have important implications in examining kidney function in patients with obesity.
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Affiliation(s)
- Fitsum Guebre-Egziabher
- Nephrology and Renal Function Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
- Faculté de Médecine Lyon Est, Université Lyon-1 Claude Bernard, Lyon, France
- INSERM U1060, CarMeN Laboratory, Lyon, France
- Federation Hospitalo-Universitaire FHU-DO-IT, Lyon, France
| | - Charlotte Brunelle
- Nephrology and Renal Function Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
- INSERM U1060, CarMeN Laboratory, Lyon, France
| | - Jouve Thomas
- Nephrology Unit, Centre Hospitalo Universitaire Grenoble Alpes, La Tronche, France
| | - Caroline C Pelletier
- Nephrology and Renal Function Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
- INSERM U1060, CarMeN Laboratory, Lyon, France
| | - Gabrielle Normand
- Nephrology and Renal Function Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
- Faculté de Médecine Lyon Est, Université Lyon-1 Claude Bernard, Lyon, France
- INSERM U1060, CarMeN Laboratory, Lyon, France
| | - Laurent Juillard
- Nephrology and Renal Function Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
- Faculté de Médecine Lyon Est, Université Lyon-1 Claude Bernard, Lyon, France
- INSERM U1060, CarMeN Laboratory, Lyon, France
- Federation Hospitalo-Universitaire FHU-DO-IT, Lyon, France
| | - Laurence Dubourg
- Nephrology and Renal Function Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
- Faculté de Médecine Lyon Est, Université Lyon-1 Claude Bernard, Lyon, France
- UMR 5305 CNRS, Université Lyon 1, Université de Lyon, Biologie tissulaire et ingénierie thérapeutique, Lyon, France
| | - Sandrine Lemoine
- Nephrology and Renal Function Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
- Faculté de Médecine Lyon Est, Université Lyon-1 Claude Bernard, Lyon, France
- INSERM U1060, CarMeN Laboratory, Lyon, France
- Federation Hospitalo-Universitaire FHU-DO-IT, Lyon, France
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Bacchetta J, Ginhoux T, Bernoux D, Dubourg L, Ranchin B, Roger C. Assessment of mineral and bone biomarkers highlights a high frequency of hypercalciuria in asymptomatic healthy teenagers. Acta Paediatr 2019; 108:2253-2260. [PMID: 31215071 DOI: 10.1111/apa.14907] [Citation(s) in RCA: 8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/27/2019] [Accepted: 06/17/2019] [Indexed: 11/30/2022]
Abstract
AIM Assessment of mineral metabolism is complex in paediatrics. METHODS We assessed the evolution of the main mineral and bone biomarkers (total/bone alkaline phosphatase ALP/BAP, β-crosslaps, osteocalcin, sclerostin, C-terminal and intact FGF23) in 100 healthy teenagers (10-18 years, 50 boys). RESULTS At a mean age of 13.7 ± 2.2 years, phosphatemia, tubular phosphate reabsorption, ALP and BAP significantly decreased along puberty in both genders, whilst parathyroid hormone (PTH), 25-vitamin D (25D), FGF23, plasma calcium and urinary calcium were not modified. In girls, osteocalcin, β-crosslaps and sclerostin significantly decreased at the end of puberty. Calciuria above the crystallisation threshold (>3.8 mmol/L) and urinary calcium/creatinine ratio >0.7 mmol/mmol were found in 39% and 6% of subjects, respectively. Multivariable analyses showed that renal function and PTH were significant predictors of calciuria and urinary calcium/creatinine, whilst 25D remained a predictor only of urinary calcium/creatinine ratio. CONCLUSION Using the most recent assays, this study provides data for mineral/bone biomarkers across puberty and highlights the risk of hyper-calciuria in apparent asymptomatic healthy teenagers, not related to calcium intake but rather to 25D. Future studies are required to dissect the underlying mechanisms increasing calciuria and prevent nephrolithiasis as early as during childhood.
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Affiliation(s)
- Justine Bacchetta
- Centre de Référence des Maladies Rares du Calcium et du Phosphore Service de Néphrologie Rhumatologie et Dermatologie Pédiatriques Hôpital Femme Mère Enfant Bron France
- Faculté de Médecine Lyon Est Université Claude Bernard Lyon 1 Lyon France
- INSERM UMR 1033 Lyon France
| | - Tiphanie Ginhoux
- EPICIME‐CIC 1407 de Lyon, Inserm Service de Pharmacotoxicologie CHU‐Lyon Bron France
| | - Delphine Bernoux
- EPICIME‐CIC 1407 de Lyon, Inserm Service de Pharmacotoxicologie CHU‐Lyon Bron France
- Service d'Endocrinologie, Diabétologie et Métabolisme pédiatriques Hôpital Femme Mère Enfant Bron France
| | - Laurence Dubourg
- Faculté de Médecine Lyon Est Université Claude Bernard Lyon 1 Lyon France
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale Groupement Hospitalier Edouard Herriot Hospices Civils de Lyon Lyon France
- Laboratory of Tissue Biology and Therapeutic Engineering UMR 5305 CNRS University Lyon 1 Lyon France
| | - Bruno Ranchin
- Centre de Référence des Maladies Rares du Calcium et du Phosphore Service de Néphrologie Rhumatologie et Dermatologie Pédiatriques Hôpital Femme Mère Enfant Bron France
| | - Christelle Roger
- Laboratoire de Biochimie et Biologie Moléculaire Groupe Hospitalier Sud Hospices Civils de Lyon Lyon France
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Turer CB, Baum M, Dubourg L, Selistre LS, Skinner AC. Prevalence of hyperfiltration among US youth/young adults with overweight and obesity: A population-based association study. Obes Sci Pract 2019; 5:570-580. [PMID: 31890248 PMCID: PMC6934429 DOI: 10.1002/osp4.365] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/22/2019] [Accepted: 07/25/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Determine prevalence of hyperfiltration (high estimated glomerular filtration rate "eGFR" >95th percentile for age/sex) among youth and association with BMI classification. METHODS With the use of 1999 to 2016 National Health and Nutrition Examination Survey data from 12- to 29-year-olds, data for serum creatinine and thresholds for high eGFR were normed using a metabolically healthy subsample (no albuminuria, healthy weights, normal blood pressures, blood glucoses, lipids, and liver enzymes). Logistic regression examined the association of BMI classification (healthy weight, overweight, and obesity classes 1-3) with hyperfiltration (eGFR > 95th percentile for age/sex), adjusted for diabetes and other covariates. RESULTS Of 12- to 29-year-olds (N = 18 698), 27.4% (n = 5493) met criteria for entry into the "healthy subsample" and contributed data to derive normative values for serum creatinine/hyperfiltration thresholds. In the full sample, hyperfiltration prevalence in 12- to 29-year-olds classified as healthy-weight, overweight, and obesity classes 1 to 3 was 4.9%, 4.7%, 6.5%, 8.7%, and 11.8%, respectively (P < .001). In multivariable analysis, obesity classes 2 and 3 were associated with greater likelihood of hyperfiltration (adjusted ORs for class 2: 1.5, 95% CI, 1.1-2.1; and for class 3, 2.1, 95% CI, 1.5-2.9). Diabetes also was associated with hyperfiltration (AOR, 4.0; 95% CI, 2.2-7.4). CONCLUSION Obesity classes 2 to 3 are associated with hyperfiltration in youth. Age/sex-specific norms for creatinine and hyperfiltration thresholds may aid recognition of kidney dysfunction early.
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Affiliation(s)
- Christy B. Turer
- Departments of Pediatrics and Internal MedicineUniversity of Texas Southwestern and Children's Medical CenterDallasTexasUSA
| | - Michel Baum
- Departments of Pediatrics and Internal MedicineUniversity of Texas Southwestern and Children's Medical CenterDallasTexasUSA
| | - Laurence Dubourg
- Néphrologie, Dialyse, Hypertension Artérielle et Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard HerriotHospices Civils de LyonLyonFrance
- Université Claude BernardLyonFrance
| | - Luciano S. Selistre
- Néphrologie, Dialyse, Hypertension Artérielle et Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard HerriotHospices Civils de LyonLyonFrance
- Universidade de Caxias do SulCaxias do SulBrazil
- Coordenação de Aperfeiçoamento do Pessoal de Nível Superior (CAPES)BrasiliaBrazil
| | - Asheley C. Skinner
- Department of Population Health Sciences and Duke Clinical Research InstituteDuke University School of MedicineDurhamNorth CarolinaUSA
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Cochat P, Febvey O, Bacchetta J, Bérard E, Cabrera N, Dubourg L. Towards adulthood with a solitary kidney. Pediatr Nephrol 2019; 34:2311-2323. [PMID: 30276534 DOI: 10.1007/s00467-018-4085-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 08/03/2018] [Accepted: 09/10/2018] [Indexed: 02/07/2023]
Abstract
Around 1/1000 people have a solitary kidney. Congenital conditions mainly include multicystic dysplastic kidney and unilateral renal aplasia/agenesis; acquired conditions are secondary to nephrectomy performed because of urologic structural abnormalities, severe parenchymal infection, renal trauma, and renal or pararenal tumors. Children born with congenital solitary kidney have a better long-term glomerular filtration rate than those with solitary kidney secondary to nephrectomy later in life. Acute and chronic adaptation processes lead to hyperfiltration followed by fibrosis in the remnant kidney, with further risk of albuminuria, arterial hypertension, and impaired renal function. Protective measures rely on non-pharmacological renoprotection (controlled protein and sodium intake, avoidance/limitation of nephrotoxic agents, keeping normal body mass index, and limitation of tobacco exposure). Lifelong monitoring should include blood pressure and albuminuria assessment, completed by glomerular filtration rate (GFR) estimation in case of abnormal values. In the absence of additional risk factors to solitary kidney, such assessment can be proposed every 5 years. There is no current consensus for indication and timing of pharmacological intervention.
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Affiliation(s)
- Pierre Cochat
- Centre de référence des maladies rénales rares Néphrogones, Hospices Civils de Lyon, Lyon, France.
- EPICIME Epidémiologie Pharmacologie Investigation Clinique Information Médicale de l'Enfant, Hospices Civils de Lyon, Lyon, France.
- Université Claude-Bernard Lyon 1, Lyon, France.
- Service de Néphrologie Rhumatologie Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69677, Bron Cedex, France.
| | - Olivia Febvey
- EPICIME Epidémiologie Pharmacologie Investigation Clinique Information Médicale de l'Enfant, Hospices Civils de Lyon, Lyon, France
| | - Justine Bacchetta
- Centre de référence des maladies rénales rares Néphrogones, Hospices Civils de Lyon, Lyon, France
- EPICIME Epidémiologie Pharmacologie Investigation Clinique Information Médicale de l'Enfant, Hospices Civils de Lyon, Lyon, France
- Université Claude-Bernard Lyon 1, Lyon, France
| | | | - Natalia Cabrera
- Centre de référence des maladies rénales rares Néphrogones, Hospices Civils de Lyon, Lyon, France
| | - Laurence Dubourg
- Centre de référence des maladies rénales rares Néphrogones, Hospices Civils de Lyon, Lyon, France
- Université Claude-Bernard Lyon 1, Lyon, France
- Exploration fonctionnelle rénale, Hospices Civils de Lyon, Lyon, France
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Delanaye P, Flamant M, Dubourg L, Vidal-Petiot E, Lemoine S, Cavalier E, Schaeffner E, Ebert N, Pottel H. Single- versus multiple-sample method to measure glomerular filtration rate. Nephrol Dial Transplant 2019; 33:1778-1785. [PMID: 29319814 DOI: 10.1093/ndt/gfx345] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 11/12/2017] [Indexed: 01/09/2023] Open
Abstract
Background There are many different ways to measure glomerular filtration rate (GFR) using various exogenous filtration markers, each having their own strengths and limitations. However, not only the marker, but also the methodology may vary in many ways, including the use of urinary or plasma clearance, and, in the case of plasma clearance, the number of time points used to calculate the area under the concentration-time curve, ranging from only one (Jacobsson method) to eight (or more) blood samples. Methods We collected the results obtained from 5106 plasma clearances (iohexol or 51Cr-ethylenediaminetetraacetic acid (EDTA)) using three to four time points, allowing GFR calculation using the slope-intercept method and the Bröchner-Mortensen correction. For each time point, the Jacobsson formula was applied to obtain the single-sample GFR. We used Bland-Altman plots to determine the accuracy of the Jacobsson method at each time point. Results The single-sample method showed within 10% concordances with the multiple-sample method of 66.4%, 83.6%, 91.4% and 96.0% at the time points 120, 180, 240 and ≥300 min, respectively. Concordance was poorer at lower GFR levels, and this trend is in parallel with increasing age. Results were similar in males and females. Some discordance was found in the obese subjects. Conclusion Single-sample GFR is highly concordant with a multiple-sample strategy, except in the low GFR range (<30 mL/min).
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Affiliation(s)
- Pierre Delanaye
- Department of Nephrology, Dialysis, Transplantation, University of Liège (CHU ULg), Liège, Belgium
| | - Martin Flamant
- Department of Renal Physiology, DHU-FIRE, Hôpital Bichat, AP-HP, Inserm U1149, and Paris Diderot University, Sorbonne Paris-Cité, Paris, France
| | - Laurence Dubourg
- Néphrologie, Dialyse, Hypertension artérielle et Exploration fonctionnelle rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Laboratory of Tissue Biology and Therapeutic Engineering, UMR 5305 CNRS, University Claude Bernard Lyon 1, Lyon, France
| | - Emmanuelle Vidal-Petiot
- Department of Renal Physiology, DHU-FIRE, Hôpital Bichat, AP-HP, Inserm U1149, and Paris Diderot University, Sorbonne Paris-Cité, Paris, France
| | - Sandrine Lemoine
- Néphrologie, Dialyse, Hypertension artérielle et Exploration fonctionnelle rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège (CHU ULg), Liège, Belgium
| | - Elke Schaeffner
- Charité University Hospital, Institute of Public Health, Berlin, Germany
| | - Natalie Ebert
- Charité University Hospital, Institute of Public Health, Berlin, Germany
| | - Hans Pottel
- Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
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Delanaye P, Jager KJ, Bökenkamp A, Christensson A, Dubourg L, Eriksen BO, Gaillard F, Gambaro G, van der Giet M, Glassock RJ, Indridason OS, van Londen M, Mariat C, Melsom T, Moranne O, Nordin G, Palsson R, Pottel H, Rule AD, Schaeffner E, Taal MW, White C, Grubb A, van den Brand JAJG. CKD: A Call for an Age-Adapted Definition. J Am Soc Nephrol 2019; 30:1785-1805. [PMID: 31506289 PMCID: PMC6779354 DOI: 10.1681/asn.2019030238] [Citation(s) in RCA: 166] [Impact Index Per Article: 33.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Current criteria for the diagnosis of CKD in adults include persistent signs of kidney damage, such as increased urine albumin-to-creatinine ratio or a GFR below the threshold of 60 ml/min per 1.73 m2 This threshold has important caveats because it does not separate kidney disease from kidney aging, and therefore does not hold for all ages. In an extensive review of the literature, we found that GFR declines with healthy aging without any overt signs of compensation (such as elevated single-nephron GFR) or kidney damage. Older living kidney donors, who are carefully selected based on good health, have a lower predonation GFR compared with younger donors. Furthermore, the results from the large meta-analyses conducted by the CKD Prognosis Consortium and from numerous other studies indicate that the GFR threshold above which the risk of mortality is increased is not consistent across all ages. Among younger persons, mortality is increased at GFR <75 ml/min per 1.73 m2, whereas in elderly people it is increased at levels <45 ml/min per 1.73 m2 Therefore, we suggest that amending the CKD definition to include age-specific thresholds for GFR. The implications of an updated definition are far reaching. Having fewer healthy elderly individuals diagnosed with CKD could help reduce inappropriate care and its associated adverse effects. Global prevalence estimates for CKD would be substantially reduced. Also, using an age-specific threshold for younger persons might lead to earlier identification of CKD onset for such individuals, at a point when progressive kidney damage may still be preventable.
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Affiliation(s)
- Pierre Delanaye
- Department of Nephrology, Dialysis, Transplantation, University of Liège, Centre Hospitalier Universitaire Sart Tilman, ULg CHU, Liège, Belgium;
| | - Kitty J Jager
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Arend Bökenkamp
- Emma Children's Hospital, Amsterdam UMC, Vrije University Amsterdam, Amsterdam, The Netherlands
| | - Anders Christensson
- Department of Nephrology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Laurence Dubourg
- Nephrology, Dialysis, Hypertension and Functional Renal Exploration, Edouard Herriot Hospital, Hospices Civils de Lyon and Université Lyon 1, Lyon, France
| | - Bjørn Odvar Eriksen
- Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway
- Section of Nephrology, Clinic of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - François Gaillard
- Renal Transplantation Department, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France, Paris Sud University, Orsay, France
| | - Giovanni Gambaro
- Division of Nephrology and Dialysis, Department of Medicine, University of Verona, Verona, Italy
| | - Markus van der Giet
- Department of Nephrology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Richard J Glassock
- Department of Medicine, Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Olafur S Indridason
- Division of Nephrology, National University Hospital of Iceland, Reykavik, Iceland
| | - Marco van Londen
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Christophe Mariat
- Nephrology, Dialysis and Renal Transplantation Department, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Etienne, Jean Monnet University, Communauté d'universités et Etablissements Université de Lyon, Lyon, France
| | - Toralf Melsom
- Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway
- Section of Nephrology, Clinic of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Olivier Moranne
- Nephrology, Dialysis, Apheresis Unit, Centre Hospitalier Universitaire Caremeau Nimes, University of Montpellier, Montpellier, France
| | | | - Runolfur Palsson
- Division of Nephrology, National University Hospital of Iceland, Reykavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Hans Pottel
- Department of Public Health and Primary Care, Katholieke Universiteit Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Andrew D Rule
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota
| | - Elke Schaeffner
- Charité - Universitätsmedizin Berlin, corporate member of Free University of Berlin, Humboldt University of Berlin, and Berlin Institute of Health, Institute of Public Health, Berlin, Germany
| | - Maarten W Taal
- Centre for Kidney Research and Innovation, Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, UK
| | - Christine White
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Anders Grubb
- Department of Clinical Chemistry and Pharmacology, Laboratory Medicine, Skåne University Hospital, Lund University, Lund, Sweden; and
| | - Jan A J G van den Brand
- Department of Nephrology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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Lauverjat M, Ait S, Bergoin C, Koppe L, Barnoud D, Dubourg L, Chambrier C. SUN-PO133: Assessment of Renal Function in Home Parenteral Nutrition Patients for Intestinal Failure. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32767-0] [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: 11/26/2022]
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Blanchard A, Vallet M, Dubourg L, Hureaux M, Allard J, Haymann JP, de la Faille R, Arnoux A, Dinut A, Bergerot D, Becker PH, Courand PY, Baron S, Houillier P, Tack I, Devuyst O, Jeunemaitre X, Azizi M, Vargas-Poussou R. Resistance to Insulin in Patients with Gitelman Syndrome and a Subtle Intermediate Phenotype in Heterozygous Carriers: A Cross-Sectional Study. J Am Soc Nephrol 2019; 30:1534-1545. [PMID: 31285285 DOI: 10.1681/asn.2019010031] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [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: 01/14/2019] [Accepted: 05/24/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Gitelman syndrome is a salt-losing tubulopathy caused by mutations in the SLC12A3 gene, which encodes the thiazide-sensitive sodium-chloride cotransporter. Previous studies suggested an intermediate phenotype for heterozygous carriers. METHODS To evaluate the phenotype of heterozygous carriers of pathogenic SLC12A3 mutations, we performed a cross-sectional study of patients with Gitelman syndrome, heterozygous carriers, and healthy noncarriers. Participants measured their BP at home for three consecutive days before hospital admission for blood and urine sampling and an oral glucose tolerance test. RESULTS We enrolled 242 participants, aged 18-75 years, including 81 heterozygous carriers, 82 healthy noncarriers, and 79 patients with Gitelman syndrome. The three groups had similar age, sex ratio, and body mass index. Compared with healthy noncarriers, heterozygous carriers showed significantly higher serum calcium concentration (P=0.01) and a trend for higher plasma aldosterone (P=0.06), but measures of home BP, plasma and urine electrolytes, renin, parathyroid hormone, vitamin D, and response to oral glucose tolerance testing were similar. Patients with Gitelman syndrome had lower systolic BP and higher heart rate than noncarriers and heterozygote carriers; they also had significantly higher fasting serum glucose concentration, higher levels of markers of insulin resistance, and a three-fold higher sensitivity to overweight. According to oral glucose tolerance testing, approximately 14% of patients with Gitelman syndrome were prediabetic, compared with 5% of heterozygous carriers and 4% of healthy noncarriers. CONCLUSIONS Heterozygous carriers had a weak intermediate phenotype, between that of healthy noncarriers and patients with Gitelman syndrome. Moreover, the latter are at risk for development of type 2 diabetes, indicating the heightened importance of body weight control in these patients.
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Affiliation(s)
- Anne Blanchard
- Clinical Investigations Center.,Faculty of Medicine, Paris Descartes Université, Sorbonne Paris Cité, Paris, France.,Clinical Investigations Center-1418, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Marion Vallet
- Department of Physiological Functional Investigations, Université Paul Sabatier, CHU de Toulouse, Toulouse, France
| | - Laurence Dubourg
- Department of Physiological Functional Investigations, Hospital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Marguerite Hureaux
- Faculty of Medicine, Paris Descartes Université, Sorbonne Paris Cité, Paris, France.,Department of Genetics
| | - Julien Allard
- Department of Nephrology, Hôpital Dupuytren, Centre Hospitalier Universitaire de Limoges, Limoges, France.,Clinical Investigations Center-1435, Institut National de la Santé et de la Recherche Médicale, Limoges, France
| | - Jean-Philippe Haymann
- Department of Physiological Functional Investigations, Hôpital Tenon, Assistance Publique Hôpitaux des Hôpitaux de Paris, Paris, France.,Faculty of Medicine, Université Pierre et Marie Curie, Paris, France.,Unité Mixte de Recherche_S 1155, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Renaud de la Faille
- Department of Nephrology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Armelle Arnoux
- Clinical Investigations Center-1418, Institut National de la Santé et de la Recherche Médicale, Paris, France.,Clinical Research Unit, and
| | - Aurelie Dinut
- Clinical Investigations Center-1418, Institut National de la Santé et de la Recherche Médicale, Paris, France.,Clinical Research Unit, and
| | - Damien Bergerot
- Clinical Investigations Center.,Faculty of Medicine, Paris Descartes Université, Sorbonne Paris Cité, Paris, France.,Clinical Investigations Center-1418, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Pierre-Hadrien Becker
- Department of Biochemistry, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France
| | - Pierre-Yves Courand
- Clinical Investigations Center.,Department of Cardiology, Croix-Rousse and Lyon-Sud Hospital, Hospices Civils de Lyon, Lyon, France
| | - Stéphanie Baron
- Faculty of Medicine, Paris Descartes Université, Sorbonne Paris Cité, Paris, France.,Department of Physiological Functional Investigations, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Pascal Houillier
- Faculty of Medicine, Paris Descartes Université, Sorbonne Paris Cité, Paris, France.,Department of Physiological Functional Investigations, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Ivan Tack
- Department of Physiological Functional Investigations, Université Paul Sabatier, CHU de Toulouse, Toulouse, France
| | - Olivier Devuyst
- Institute of Physiology, University of Zurich, Zurich, Switzerland.,Division of Nephrology, Catholic University of Louvain Medical School, Brussels, Belgium; and
| | - Xavier Jeunemaitre
- Faculty of Medicine, Paris Descartes Université, Sorbonne Paris Cité, Paris, France.,Department of Genetics.,Unité Mixte de Recherche_970, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Michel Azizi
- Clinical Investigations Center.,Faculty of Medicine, Paris Descartes Université, Sorbonne Paris Cité, Paris, France.,Clinical Investigations Center-1418, Institut National de la Santé et de la Recherche Médicale, Paris, France
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da Silva Selistre L, Rech DL, de Souza V, Iwaz J, Lemoine S, Dubourg L. Diagnostic Performance of Creatinine-Based Equations for Estimating Glomerular Filtration Rate in Adults 65 Years and Older. JAMA Intern Med 2019; 179:796-804. [PMID: 31034005 PMCID: PMC6547158 DOI: 10.1001/jamainternmed.2019.0223] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 01/20/2019] [Indexed: 12/27/2022]
Abstract
Importance Estimating glomerular filtration rate (GFR) is useful in many clinical conditions. However, very few studies have evaluated the performance of GFR-estimating equations in older adults at various degrees of kidney impairment. Objective To determine the performance of plasma-creatinine-based equations Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI), Lund-Malmö Revised, (LMR), full age spectrum (FAS), and Berlin Initiative Study (BIS) 1 in older adults across a broad spectrum of GFRs. Design, Setting, and Participants Single-center cross-sectional study performed in France including 2247 participants aged 65 to 90 years who underwent inulin GFR measurements from July 1, 2003, to July 30, 2017, for suspected or established renal dysfunction, for renal risk, before kidney donation, or after kidney transplant. Main Outcomes and Measures The main outcome measure was GRF measured by inulin clearance. Equation performance criteria considered bias (difference between estimated and measured GFR), precision (interquartile range of the median difference), and accuracy P30 (percentage of estimated GFRs lying between [measured GFR - 30% of measured GFR] and [measured GFR + 30% of measured GFR]). Results The mean (SD) age of the 2247 participants was 71.5 (5) years and 1192 (53.0%) were male. The difference in median (95% CI) bias was significant between CKD-EPI vs LMR (-4.0 [-4.0 to -3.5 mL/min/1.73 m2; P < .001]) and CKD-EPI vs FAS (-2.0 [-3.5 to -2.5] mL/min/1.73 m2, P < .001) but not significant between CKD-EPI vs BIS 1 (0.0 [-1.5 to 0.5], P = .07, Mood test). In patients aged 65 to 74 years with measured GFR<45 mL/min/1.73 m2, the difference in median P30 (95% CI) was not significant between CKD-EPI vs LMR (P = .08) and CKD-EPI vs FAS (P = .48) but significant vs BIS 1 (P = .004, McNemar test). In subjects 75 years and older, with measured GFR less than 45 mL/min/1.73 m2, LMR and BIS 1 were more accurate than CKD-EPI and FAS (P30 = 74.5 [70.0-79.5] and 73.0 [68.0-78.0] vs 69.0 [64.5-74.0] and 69.0 [65.5-72.0]). In all patients, despite small statistical differences, the performance of CKD-EPI equation was not clinically different from that of LMR, FAS, or BIS 1. Conclusions and Relevance In a referral group of patients 65 years and older who had GFR estimated using CDK-EPI, LMR, BIS 1, and FAS equations, a comparison with renal inulin clearance found that none of the equations had a superior diagnostic performance. Each had limitations regarding accuracy.
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Affiliation(s)
- Luciano da Silva Selistre
- Service de Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- Programa de Pós-graduação em Ciências da Saúde Universidade de Caxias do Sul, Caxias do Sul, Brazil
- CAPES Foundation, Ministry of Education of Brazil, Brasilia
- Núcleo de Apoio à Pesquisa–COEDI, Hospital Geral de Caxias do Sul, Caxias do Sul, Brasil
| | - Dener L. Rech
- Programa de Pós-graduação em Ciências da Saúde Universidade de Caxias do Sul, Caxias do Sul, Brazil
| | - Vandréa de Souza
- Service de Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- Programa de Pós-graduação em Ciências da Saúde Universidade de Caxias do Sul, Caxias do Sul, Brazil
- Núcleo de Apoio à Pesquisa–COEDI, Hospital Geral de Caxias do Sul, Caxias do Sul, Brasil
| | - Jean Iwaz
- Université Claude Bernard Lyon 1, Lyon, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
| | - Sandrine Lemoine
- Service de Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
- Laboratoire CarMeN, Institution National de la Santé et de la Recherche Médicale 1060Université Lyon 1, Lyon, France
| | - Laurence Dubourg
- Service de Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- Programa de Pós-graduação em Ciências da Saúde Universidade de Caxias do Sul, Caxias do Sul, Brazil
- Université Claude Bernard Lyon 1, Lyon, France
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique (UMR 5305 CNRS/Université Claude Bernard, Lyon 1), Lyon, France
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Ehrich JHH, Dubourg L, Hansson S, Ebert N, Schaeffner E, Steinle T, Fruth J, Hoeckner S, Schiffer E. SP278A NUCLEAR MAGNETIC RESONANCE-BASED METHOD FOR ACCURATE ASSESSMENT OF GLOMERULAR FILTRATION RATE. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz103.sp278] [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: 11/13/2022] Open
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Dubourg L, LUCIANO DASILVASELISTRE, De Souza V, Iwaz J, Lemoine S, Rabilloud M, Chardon L. SP281ONE-COMPARTMENT IOHEXOL PLASMA CLEARANCE: VALIDATION OF CORRECTION FORMULAS. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz103.sp281] [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: 11/13/2022] Open
Affiliation(s)
| | | | | | - Jean Iwaz
- Université Lyon 1, Villeurbanne, France
| | | | | | - Laurence Chardon
- Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France
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LUCIANO DASILVASELISTRE, Rabilloud M, De Souza V, Poli-De-Figueiredo CE, Figueiredo AE, Da Silva Fonseca G, Juillard L, Lemoine S, Dubourg L, Cochat P. FP183Averange Creatinine-Urea Clearance: Revival of an Old Analytical Technique? Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz106.fp183] [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: 11/13/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Pierre Cochat
- Claude Bernard University Lyon 1, Villeurbanne, France
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Bertholet-Thomas A, Tram N, Dubourg L, Lemoine S, Molin A, Bacchetta J. Fluconazole as a New Therapeutic Tool to Manage Patients With NPTIIc (SLC34A3) Mutation: A Case Report. Am J Kidney Dis 2019; 73:886-889. [DOI: 10.1053/j.ajkd.2018.12.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 12/06/2018] [Indexed: 11/11/2022]
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Gaillard F, Courbebaisse M, Kamar N, Rostaing L, Jacquemont L, Hourmant M, Del Bello A, Couzi L, Merville P, Malvezzi P, Janbon B, Moulin B, Maillard N, Dubourg L, Lemoine S, Garrouste C, Pottel H, Legendre C, Delanaye P, Mariat C. Impact of estimation versus direct measurement of predonation glomerular filtration rate on the eligibility of potential living kidney donors. Kidney Int 2019; 95:896-904. [DOI: 10.1016/j.kint.2018.11.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/30/2018] [Accepted: 11/08/2018] [Indexed: 10/27/2022]
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Lauverjat M, Dubourg L, Ait S, Barnoud D, Bergoin C, Peraldi C, Chambrier C. Évaluation de la fonction rénale chez les patients en nutrition parentérale pour insuffisance intestinale. NUTR CLIN METAB 2019. [DOI: 10.1016/j.nupar.2019.01.250] [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: 11/17/2022]
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Pottel H, Björk J, Bökenkamp A, Berg U, Åsling-Monemi K, Selistre L, Dubourg L, Hansson M, Littmann K, Jones I, Sjöström P, Nyman U, Delanaye P. Estimating glomerular filtration rate at the transition from pediatric to adult care. Kidney Int 2019; 95:1234-1243. [PMID: 30922665 DOI: 10.1016/j.kint.2018.12.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 09/26/2018] [Revised: 12/07/2018] [Accepted: 12/13/2018] [Indexed: 01/11/2023]
Abstract
The current Kidney Disease Improving Global Outcomes (KDIGO) guidelines recommend the use of the bedside creatinine-based Chronic Kidney Disease in Children (CKiD) equation to estimate glomerular filtration rate (GFR) in children and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation in adults. However, this approach causes implausible changes in estimated GFR (eGFR) at the transition from pediatric to adult care. We investigated the performance of the KDIGO strategy and various creatinine-based eGFR equations in a cross-sectional dataset of 5,764 subjects (age 10-30 years), using directly measured GFR (mGFR) as reference. We also evaluated longitudinal GFR slopes in 136 subjects who transitioned to adult care. Implausible changes in eGFR resulted from the large overestimation (bias=+21 mL/min/1.73m2) and poor precision of the CKD-EPI equation in the 18-20 year age group, compared to CKiD in the 16-18 year age group (bias=-2.7 mL/min/1.73m2), resulting in a mean change of 23 mL/min/1.73m2 at the transition to adult care. Averaging the CKiD and CKD-EPI estimates in young adults only partially mitigated this issue. The Full Age Spectrum equation (with and without height), the Lund-Malmö Revised equation, and an age-dependent weighted average of CKiD and CKD-EPI resulted in much smaller changes in eGFR at the transition (change of 0.6, -2.1, -0.9 and -1.8 mL/min/1.73m2, respectively). The longitudinal analysis revealed a significant difference in average GFR slope between mGFR and the KDIGO strategy (-2.2 vs. +2.9 mL/min/1.73 m2/year), which was not observed with the other approaches. These results suggest that the KDIGO recommendation for GFR estimation at the pediatric-adult care transition should be revisited.
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Affiliation(s)
- Hans Pottel
- Department of Public Health and Primary Care, Katholieke Universiteit Leuven Campus Kulak Kortrijk, Kortrijk, Belgium.
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden; Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Arend Bökenkamp
- Emma Children's Hospital, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ulla Berg
- Department of Clinical Science, Intervention, and Technology, Division of Pediatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Kajsa Åsling-Monemi
- Department of Clinical Science, Intervention, and Technology, Division of Pediatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Luciano Selistre
- Mestrado em Ciências da Saúde-Universidade Caxias do Sul Foundation, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Brazil
| | - Laurence Dubourg
- Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Magnus Hansson
- Department of Laboratory Medicine, Division of Clinical Chemistry, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Karin Littmann
- Department of Laboratory Medicine, Division of Clinical Chemistry, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Ian Jones
- Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden
| | - Per Sjöström
- Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden
| | - Ulf Nyman
- Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden
| | - Pierre Delanaye
- Nephrology-Dialysis-Transplantation, University of Liège, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
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49
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Bruel A, Bacchetta J, Ginhoux T, Rodier-Bonifas C, Sellier-Leclerc AL, Fromy B, Cochat P, Sigaudo-Roussel D, Dubourg L. Skin microvascular dysfunction as an early cardiovascular marker in primary hyperoxaluria type I. Pediatr Nephrol 2019; 34:319-327. [PMID: 30276532 DOI: 10.1007/s00467-018-4081-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 04/17/2018] [Revised: 08/03/2018] [Accepted: 09/03/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Primary hyperoxaluria type 1 (PH1) is an orphan inborn error of oxalate metabolism leading to hyperoxaluria, progressive renal failure, oxalate deposition, and increased cardiovascular complications. As endothelial dysfunction and arterial stiffness are early markers of cardiovascular risk, we investigated early endothelial and vascular dysfunction in young PH1 patients either under conservative treatment (PH1-Cons) or after combined kidney liver transplantation (PH1-T) in comparison to healthy controls (Cont-H) and patients with a past of renal transplantation (Cont-T). METHODS Skin microvascular function was non-invasively assessed by laser Doppler flowmetry before and after stimulation by current, thermal, or pharmacological (nitroprussiate (SNP) or acetylcholine (Ach)) stimuli in young PH1 patients and controls. RESULTS Seven PH1-Cons (6 F, median age 18.2) and 6 PH1-T (2 F, median age 13.3) were compared to 96 Cont-H (51 F, median age 14.2) and 6 Cont-T (4 F, median age 14.5). The endothelium-independent vasodilatation (SNP) was severely decreased in PH1-T compared to Cont-H. Ach, current-induced vasodilatation (CIV), and thermal response was increased in PH1-Cons and Cont-T compared to controls. CONCLUSIONS PH1-T patients displayed severely decreased smooth muscle capacity to vasodilate. An exacerbated endothelial-dependent vasodilation suggests a role for silent inflammation in the early dysfunction of microcirculation observed in PH1-Cons and Cont-T.
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Affiliation(s)
- Alexandra Bruel
- Centre de Référence des Maladies Rénales Rares, Service de Néphrologie et Rhumatologie Pédiatriques, Hospices Civils de Lyon, Lyon, France.,Service de Pédiatrie, Hôpital Mère et Enfants, Centre hospitalo-universitaire de Nantes, Nantes, France
| | - Justine Bacchetta
- Centre de Référence des Maladies Rénales Rares, Service de Néphrologie et Rhumatologie Pédiatriques, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France
| | - Tiphanie Ginhoux
- EPICIME-CIC 1407 de Lyon, Inserm, Service de Pharmacologie Clinique, CHU-Lyon, Lyon, France
| | - Christelle Rodier-Bonifas
- Service d'ophtalmologie, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Anne-Laure Sellier-Leclerc
- Centre de Référence des Maladies Rénales Rares, Service de Néphrologie et Rhumatologie Pédiatriques, Hospices Civils de Lyon, Lyon, France
| | - Bérengère Fromy
- Laboratory of Tissue Biology and Therapeutic Engineering, UMR 5305 CNRS, University Claude Bernard Lyon 1, Villeurbanne, France
| | - Pierre Cochat
- Centre de Référence des Maladies Rénales Rares, Service de Néphrologie et Rhumatologie Pédiatriques, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Laboratory of Tissue Biology and Therapeutic Engineering, UMR 5305 CNRS, University Claude Bernard Lyon 1, Villeurbanne, France
| | - Dominique Sigaudo-Roussel
- Laboratory of Tissue Biology and Therapeutic Engineering, UMR 5305 CNRS, University Claude Bernard Lyon 1, Villeurbanne, France
| | - Laurence Dubourg
- Centre de Référence des Maladies Rénales Rares, Service de Néphrologie et Rhumatologie Pédiatriques, Hospices Civils de Lyon, Lyon, France. .,Université Claude Bernard Lyon 1, Lyon, France. .,Laboratory of Tissue Biology and Therapeutic Engineering, UMR 5305 CNRS, University Claude Bernard Lyon 1, Villeurbanne, France. .,Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
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50
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Abid N, Lemoine S, Molin A, Normand G, Bertholet-Thomas A, Bacchetta J, Juillard L, Badet L, Dubourg L. Une nouvelle étiologie dans la lithiase calcique récidivante : la mutation hétérozygote du gène de la 24 hydroxylase. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.214] [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: 11/15/2022]
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