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Lengliné E, Baba J, de Boissieu P, Beaufils A, Desbiolles A, Diatta T, Cochat P, Chevret S. Composite event-free-survival as an endpoint in oncology drug evaluation: Review and guidance perspectives from the Haute Autorité de Santé (HAS). Eur J Cancer 2024; 204:114047. [PMID: 38653034 DOI: 10.1016/j.ejca.2024.114047] [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] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 04/04/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND The use of right-censored composite endpoints, such as progression-free survival, has been questioned in haemato-oncology trials due to potential bias in estimated treatment effect. This may impact the accuracy of health technology evaluations. We hypothesized that there is heterogeneity and potential sources of bias in the reporting of composite endpoints to health technology assessment (HTA) bodies. METHODS We reviewed the submissions for reimbursement of oncology drugs in 2021 and 2022 that used a composite endpoint in the pivotal trial, after appraisal by the French HTA body. The retrieved information included the clinical study report, protocol, and statistical analysis plan submitted by the industry. All events of the composite endpoint and all causes of censored observations were measured. The design characteristics and treatment effect estimates were recorded. FINDINGS Seventy-six submissions were selected, including seven without a right-censored endpoint and four evaluating associations, resulting in 65 analysed records: 17 for haematological and 48 for solid tumours. Out these 65 submissions, 47 (72·3%) used a randomized controlled design, and 18 (27·7%) a non-comparative design. The most frequently used composite endpoint was progression-free survival, used in 54 (83·1%) of the submissions. Censoring was possibly informative in 51 (92·7%) cases, mostly due to the onset of new treatment (44/51, 86·3%) and/or discontinuation of follow-up (33/51, 64·7%). In contrast, 38 (58·5%) trials reported a quantification of censored observations, with only 12/51 (23·5%) quantifying the informative ones. The estimated treatment effect on the composite outcome increased with the amount of censoring, suggesting a higher benefit of the drug, but remained below that on survival with poor evidence of surrogacy (R-squared=0·23). INTERPRETATION Clinical study reports should be improved in terms of reporting censoring, while stakeholders should be aware of this potential source of bias. At a minimum, sensitivity analysis that ignores intercurrent events should be requested.
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Affiliation(s)
- Etienne Lengliné
- Hematology department, Hôpital Saint-Louis AP-HP, Paris, France.
| | - Joachim Baba
- Drug evaluation department, Haute Autorité de Santé, Saint Denis Paris France
| | - Paul de Boissieu
- Drug evaluation department, Haute Autorité de Santé, Saint Denis Paris France
| | - Alexandre Beaufils
- Drug evaluation department, Haute Autorité de Santé, Saint Denis Paris France
| | - Alice Desbiolles
- Drug evaluation department, Haute Autorité de Santé, Saint Denis Paris France
| | - Thierno Diatta
- Drug evaluation department, Haute Autorité de Santé, Saint Denis Paris France
| | - Pierre Cochat
- Drug evaluation department, Haute Autorité de Santé, Saint Denis Paris France
| | - Sylvie Chevret
- ECSTRRA Team, Université Paris Cité, UMR1153, INSERM, Paris, France
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Fernandez J, Babin C, Thomassin C, Pelon F, Kelley S, Cochat P, Galbraith M, Berdaï D, Pariente A, Salvo F, Vanier A. Can requests for real-world evidence by the French HTA body be planned? An exhaustive retrospective case-control study of medicinal products appraisals from 2016 to 2021. Int J Technol Assess Health Care 2024:1-25. [PMID: 38757153 DOI: 10.1017/s0266462324000291] [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: 05/18/2024]
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Vanier A, Fernandez J, Kelley S, Alter L, Semenzato P, Alberti C, Chevret S, Costagliola D, Cucherat M, Falissard B, Gueyffier F, Lambert J, Lengliné E, Locher C, Naudet F, Porcher R, Thiébaut R, Vray M, Zohar S, Cochat P, Le Guludec D. Rapid access to innovative medicinal products while ensuring relevant health technology assessment. Position of the French National Authority for Health. BMJ Evid Based Med 2024; 29:1-5. [PMID: 36788020 PMCID: PMC10850619 DOI: 10.1136/bmjebm-2022-112091] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 02/16/2023]
Affiliation(s)
- Antoine Vanier
- Health Technology Assessment Department, Haute Autorité de Santé, La Plaine Saint-Denis, France
- UMR U1246 Sphere, Inserm - Nantes Université - Université de Tours, Nantes, France
| | - Judith Fernandez
- Health Technology Assessment Department, Haute Autorité de Santé, La Plaine Saint-Denis, France
| | - Sophie Kelley
- Health Technology Assessment Department, Haute Autorité de Santé, La Plaine Saint-Denis, France
| | - Lise Alter
- Health Technology Assessment Department, Haute Autorité de Santé, La Plaine Saint-Denis, France
| | - Patrick Semenzato
- Health Technology Assessment Department, Haute Autorité de Santé, La Plaine Saint-Denis, France
| | - Corinne Alberti
- ECEVE, Inserm - Université Paris Cité, Paris, France
- CIC 1426, UEC, Inserm - AP-HP Robert-Debré Mother-Child University Hospital, Paris, France
| | - Sylvie Chevret
- UMR U1153 - ECSTRRA Team, Inserm - Université Paris Cité, Paris, France
| | - Dominique Costagliola
- Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Inserm - Sorbonne Universite, Paris, France
| | - Michel Cucherat
- Pharmacology Department, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Bruno Falissard
- UMR U1018 CESP, Inserm - UVSQ - AP-HP - Université Paris-Saclay, Paris, France
| | - François Gueyffier
- Pôle de Santé Publique - Unité des Bases de Données Cliniques et Epidemiologiques, Hospices Civils de Lyon, Lyon, France
| | - Jérôme Lambert
- UMR U1153 - ECSTRRA Team, Inserm - Université Paris Cité, Paris, France
| | | | - Clara Locher
- CIC 1414 - Service de Pharmacologie Clinique - Irset UMR S1085, Inserm - CHU de Rennes - EHESP - Rennes 1 University, Rennes, France
| | - Florian Naudet
- CIC 1414 - Irset UMR S1085, Inserm - CHU de Rennes - EHESP - Rennes 1 University, Rennes, France
- Institut Universitaire de France, Paris, France
| | - Raphael Porcher
- Centre de Recherche Epidémiologie et Statistiques (CRESS-UMR1153), Inserm - Université Paris Cité, Paris, France
| | - Rodolphe Thiébaut
- Bordeaux Population Health - SISTM - Service d'Information Médicale, Inserm - Inria - Bordeaux 1 University - CHU de Bordeaux, Bordeaux, France
| | - Muriel Vray
- Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur - Inserm, Paris, France
| | - Sarah Zohar
- Centre de Recherche des Cordeliers, Inserm - Université Paris-Cité - Sorbonne Université, Paris, France
- HeKA, Inria, Paris, France
| | - Pierre Cochat
- Scientific Board, Haute Autorité de Santé, La Plaine Saint-Denis, France
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Metry EL, Garrelfs SF, Deesker LJ, Acquaviva C, D’Ambrosio V, Bacchetta J, Beck BB, Cochat P, Collard L, Hogan J, Ferraro PM, Franssen CF, Harambat J, Hulton SA, Lipkin GW, Mandrile G, Martin-Higueras C, Mohebbi N, Moochhala SH, Neuhaus TJ, Prikhodina L, Salido E, Topaloglu R, Oosterveld MJ, Groothoff JW, Peters-Sengers H. Determinants of Kidney Failure in Primary Hyperoxaluria Type 1: Findings of the European Hyperoxaluria Consortium. Kidney Int Rep 2023; 8:2029-2042. [PMID: 37849991 PMCID: PMC10577369 DOI: 10.1016/j.ekir.2023.07.025] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/10/2023] [Accepted: 07/24/2023] [Indexed: 10/19/2023] Open
Abstract
Introduction Primary hyperoxaluria type 1 (PH1) has a highly heterogeneous disease course. Apart from the c.508G>A (p.Gly170Arg) AGXT variant, which imparts a relatively favorable outcome, little is known about determinants of kidney failure. Identifying these is crucial for disease management, especially in this era of new therapies. Methods In this retrospective study of 932 patients with PH1 included in the OxalEurope registry, we analyzed genotype-phenotype correlations as well as the impact of nephrocalcinosis, urolithiasis, and urinary oxalate and glycolate excretion on the development of kidney failure, using survival and mixed model analyses. Results The risk of developing kidney failure was the highest for 175 vitamin-B6 unresponsive ("null") homozygotes and lowest for 155 patients with c.508G>A and c.454T>A (p.Phe152Ile) variants, with a median age of onset of kidney failure of 7.8 and 31.8 years, respectively. Fifty patients with c.731T>C (p.Ile244Thr) homozygote variants had better kidney survival than null homozygotes (P = 0.003). Poor outcomes were found in patients with other potentially vitamin B6-responsive variants. Nephrocalcinosis increased the risk of kidney failure significantly (hazard ratio [HR] 3.17 [2.03-4.94], P < 0.001). Urinary oxalate and glycolate measurements were available in 620 and 579 twenty-four-hour urine collections from 117 and 87 patients, respectively. Urinary oxalate excretion, unlike glycolate, was higher in patients who subsequently developed kidney failure (P = 0.034). However, the 41% intraindividual variation of urinary oxalate resulted in wide confidence intervals. Conclusion In conclusion, homozygosity for AGXT null variants and nephrocalcinosis were the strongest determinants for kidney failure in PH1.
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Affiliation(s)
- Elisabeth L. Metry
- Department of Pediatric Nephrology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Sander F. Garrelfs
- Department of Pediatric Nephrology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lisa J. Deesker
- Department of Pediatric Nephrology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Cecile Acquaviva
- Service de Biochimie et Biologie Moléculaire, UM Pathologies Héréditaires du Métabolisme et du Globule Rouge, Hospices Civils de Lyon, France
| | - Viola D’Ambrosio
- Department of Nephrology, Catholic University of the Sacred Heart, Rome, Italy
| | - Justine Bacchetta
- Centre de Référence des Maladies Rares Néphrogones, Hospices Civils de Lyon et Université Claude-Bernard Lyon 1, Lyon, France
| | - Bodo B. Beck
- Institute of Human Genetics, Center for Molecular Medicine Cologne, University Hospital of Cologne, Cologne, Germany
- Center for Rare and Hereditary Kidney Disease Cologne, University Hospital of Cologne, Cologne, Germany
| | - Pierre Cochat
- Centre de Référence des Maladies Rares Néphrogones, Hospices Civils de Lyon et Université Claude-Bernard Lyon 1, Lyon, France
| | - Laure Collard
- Department of Pediatric Nephrology, Center Hospitalier Universitaire Liège, Liège, Belgium
| | - Julien Hogan
- Department of Pediatric Nephrology, Assistance Publique–Hôpitaux de Paris Robert-Debré, University of Paris, Paris, France
| | | | - Casper F.M. Franssen
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jérôme Harambat
- Department of Pediatrics, Pediatric Nephrology Unit, Bordeaux University Hospital, Bordeaux, France
| | - Sally-Anne Hulton
- Department of Nephrology, Birmingham Women’s and Children’s Hospital NHS Foundation Trust, Birmingham, UK
| | - Graham W. Lipkin
- Department of Nephrology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Giorgia Mandrile
- Genetic Unit and Thalassemia Center, San Luigi University Hospital, Orbassano, Italy
| | - Cristina Martin-Higueras
- Institute of Biomedical Technology, CIBERER, University of Laguna, San Cristóbal de La Laguna, Spain
| | - Nilufar Mohebbi
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
| | | | - Thomas J. Neuhaus
- Department of Pediatrics, Children’s Hospital Lucerne, Lucerne, Switzerland
| | - Larisa Prikhodina
- Department of Inherited and Acquired Kidney Diseases, Veltishev Research and Clinical Institute for Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University, Moscow, Russia
| | - Eduardo Salido
- Department of Pathology, Center for Biomedical Research on Rare Diseases, Hospital Universitario Canarias, Universidad La Laguna, Tenerife, Spain
| | - Rezan Topaloglu
- Division of Pediatric Nephrology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Michiel J.S. Oosterveld
- Department of Pediatric Nephrology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jaap W. Groothoff
- Department of Pediatric Nephrology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Hessel Peters-Sengers
- Center for Experimental and Molecular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Teixeira A, Topaloglu R, Cochat P, Coppo R, Levtchenko E, Haffner D, Mahan JD, Oh J. IPNA-ESPN Junior Master Class-a decade of successful continuing education and training in pediatric nephrology. Pediatr Nephrol 2023; 38:3201-3205. [PMID: 37014529 PMCID: PMC10071458 DOI: 10.1007/s00467-023-05940-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 04/05/2023]
Affiliation(s)
- Ana Teixeira
- Pediatric Nephrology Unit, Pediatrics Department, Centro Hospitalar Universitário Do Porto, Porto, Portugal
| | - Rezan Topaloglu
- Department of Pediatric Nephrology, Hacettepe University School of Medicine, Ankara, Turkey.
| | | | - Rosanna Coppo
- Fondazione Ricerca Molinette, Regina Margherita Hospital, Turin, Italy
| | - Elena Levtchenko
- Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - John D Mahan
- Division of Pediatric Nephrology, The Ohio State University College of Medicine, Columbus, OH, 43209, USA
| | - Jun Oh
- Department of Pediatric Nephrology, University Medical Center Hamburg/Eppendorf, Hamburg, Germany
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Bacchetta J, Cochat P. [Revolution in the field of primary and secondary hyperoxalurias: Stay tuned!]. Med Sci (Paris) 2023; 39:262-264. [PMID: 36943123 DOI: 10.1051/medsci/2023024] [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: 03/23/2023] Open
Affiliation(s)
- Justine Bacchetta
- Service de néphrologie, rhumatologie et dermatologie pédiatriques, Centre de référence des maladies rénales rares, Filières maladies rares ORKID et ERK-Net, Service de néphrologie, rhumatologie et dermatologie pédiatriques, Hôpital femme mère enfant, boulevard Pinel, 69500 Bron Cedex, France - Inserm 1033, 69008 Lyon, France
| | - Pierre Cochat
- Service de néphrologie, rhumatologie et dermatologie pédiatriques, Centre de référence des maladies rénales rares, Filières maladies rares ORKID et ERK-Net, Service de néphrologie, rhumatologie et dermatologie pédiatriques, Hôpital femme mère enfant, boulevard Pinel, 69500 Bron Cedex, France - Inserm 1033, 69008 Lyon, France
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Alfadhel M, Umair M, Alghamdi MA, Al Fakeeh K, Al Qahtani AT, Farahat A, Shalaby MA, Kari JA, Raina R, Cochat P, Alhasan KA. Clinical and molecular characterization of a large primary hyperoxaluria cohort from Saudi Arabia: a retrospective study. Pediatr Nephrol 2022; 38:1801-1810. [PMID: 36409364 PMCID: PMC10154271 DOI: 10.1007/s00467-022-05784-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/25/2022] [Accepted: 09/28/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Primary hyperoxalurias (PHs) constitute rare disorders resulting in abnormal glyoxalate metabolism. PH-associated phenotypes range from progressive nephrocalcinosis and/or recurrent urolithiasis to early kidney failure. METHODS A retrospective study was conducted for patients with confirmed PH diagnoses from three tertiary centers in Saudi Arabia. Detailed clinical molecular diagnosis was performed for 25 affected individuals. Whole exome sequencing (WES)-based molecular diagnosis was performed for all affected individuals. RESULTS The male:female ratio was 52% male (n = 13) and 48% female (n = 12), and consanguinity was present in 88%. Nephrolithiasis and/or nephrocalcinosis were present in all patients. Kidney stones were present in 72%, nephrocalcinosis in 60%, hematuria in 32%, proteinuria in 16%, abdominal pain in 36%, developmental delay in 8%, and chronic kidney disease stage 5 (CKD stage 5) was observed in 28% of the patients. The most common PH disorder was type I caused by variants in the AGXT gene, accounting for 56%. The GRHPR gene variants were identified in 4 patients, 16% of the total cases. Seven patients did not reveal any associated variants. Missense variants were the most commonly observed variants (48%), followed by frame-shift duplication variants (28%). CONCLUSIONS Characterization of the genetic and clinical aspects of PH in this unique population provides direction for improved patient management and further research. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Majid Alfadhel
- Genetics and Precision Medicine Department (GPM), King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNG-HA), Riyadh, Saudi Arabia. .,Medical Genomic Research Department, King Abdullah International Medical Research Center(KAIMRC), King Saud Bin Abdulaziz University for Health Sciences(KSAU-HS), Ministry of National Guard Health Affairs (MNG-HA), Riyadh, Saudi Arabia.
| | - Muhammad Umair
- Medical Genomic Research Department, King Abdullah International Medical Research Center(KAIMRC), King Saud Bin Abdulaziz University for Health Sciences(KSAU-HS), Ministry of National Guard Health Affairs (MNG-HA), Riyadh, Saudi Arabia
| | - Malak A Alghamdi
- Medical Genetic Division, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Al Fakeeh
- Nephrology Division, Department of Pediatrics, King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs (MNG-HA), Riyadh, Saudi Arabia
| | - Abdullah T Al Qahtani
- Nephrology Division, Department of Pediatrics, King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs (MNG-HA), Riyadh, Saudi Arabia
| | - Afrah Farahat
- Division of Nephrology, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mohamed A Shalaby
- Pediatric Nephrology Center of Excellence, King Abdulaziz University Hospital, Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jameela A Kari
- Pediatric Nephrology Center of Excellence, King Abdulaziz University Hospital, Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rupesh Raina
- Department of Nephrology, Cleveland Clinic Akron General and Akron Childrens Hospital, Akron, OH, USA
| | - Pierre Cochat
- Centre de Référence Des Maladies Rénales Rares Néphrogones, Hospices Civils de Lyon & Université Claude-Bernard Lyon 1, Lyon, France
| | - Khalid A Alhasan
- Division of Nephrology, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Division of Pediatric Kidney Transplant, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Ghuysen MS, Cochat P. Jean-Pierre Guignard. Pediatr Nephrol 2022; 37:1939-1940. [PMID: 35585369 DOI: 10.1007/s00467-022-05593-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 04/19/2022] [Indexed: 11/29/2022]
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Deesker LJ, Garrelfs SF, Mandrile G, Oosterveld MJ, Cochat P, Deschênes G, Harambat J, Hulton SA, Gupta A, Hoppe B, Beck BB, Collard L, Topaloglu R, Prikhodina L, Salido E, Neuhaus T, Groothoff JW, Bacchetta J. Improved Outcome of Infantile Oxalosis Over Time in Europe: Data From the OxalEurope Registry. Kidney Int Rep 2022; 7:1608-1618. [PMID: 35812297 PMCID: PMC9263236 DOI: 10.1016/j.ekir.2022.04.012] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Infantile oxalosis is the most severe form of primary hyperoxaluria type 1 (PH1), with onset of end-stage kidney disease (ESKD) during infancy. We aimed to analyze the outcome of these patients as our current understanding is limited owing to a paucity of reports. METHODS A retrospective registry study was conducted using data from the OxalEurope registry. All PH1 patients with ESKD onset at age <1 year were analyzed. RESULTS We identified 95 patients born between 1980 and 2018 with infantile oxalosis. Median (interquartile range [IQR]) age at ESKD was 0.4 (0.3-0.5) year. There were 4 patients diagnosed by family screening who developed ESKD despite early diagnosis. There were 11 patients who had biallelic missense mutations associated with vitamin B6 responsiveness. Of 89 patients, 27 (30%) died at a median age of 1.4 (0.6-2.0) years (5-year patient survival of 69%). Systemic oxalosis was described in 54 of 56 screened patients (96%). First transplantation was performed at a median age of 1.7 (1.3-2.9) years. In 42 cases, this procedure was a combined liver-kidney transplantation (LKTx), and in 23 cases, liver transplantations (LTx) was part of a sequential procedure. Survival rates of both strategies were similar. Patient survival was significantly higher in patients born after 2000. Intrafamilial phenotypic variability was present in 14 families of patients with infantile oxalosis. CONCLUSION Nearly all screened patients with infantile oxalosis developed systemic disease. Mortality is still high but has significantly improved over time and might further improve under new therapies. The intrafamilial phenotypic variability warrants further investigation.
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Affiliation(s)
- Lisa J. Deesker
- Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Correspondence: Lisa J. Deesker, Department of Pediatric Nephrology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Sander F. Garrelfs
- Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Giorgia Mandrile
- Medical Genetics Unit, San Luigi University Hospital, University of Torino, Orbassano (TO), Italy
- Thalassemia Center, San Luigi University Hospital, University of Torino, Orbassano (TO), Italy
| | - Michiel J.S. Oosterveld
- Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Pierre Cochat
- Department of Pediatric Nephrology, Hospices Civils de Lyon and University de Lyon, Lyon, France
| | - Georges Deschênes
- Department of Pediatric Nephrology, Paris University Hospital Robert Debré, Paris, France
| | - Jérôme Harambat
- Department of Pediatrics, Pediatric Nephrology Unit, Bordeaux University Hospital, Bordeaux, France
| | - Sally-Anne Hulton
- Department of Nephrology, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | - Asheeta Gupta
- Department of Nephrology, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | - Bernd Hoppe
- Department of Pediatric Nephrology, Children’s Hospital of the University of Bonn, Bonn, Germany
| | - Bodo B. Beck
- Institute of Human Genetics, Center for Molecular Medicine Cologne, University Hospital of Cologne, Cologne, Germany
- Center for Rare and hereditary Kidney Disease, Cologne, University Hospital of Cologne, Cologne, Germany
| | - Laure Collard
- Pediatric Nephrology unit, Department of Pediatrics, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Rezan Topaloglu
- Department of Pediatric Nephrology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Larisa Prikhodina
- Department of Inherited and Acquired Kidney Diseases, Research and Clinical Institute for Pediatrics, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Eduardo Salido
- Department of Pathology, Centre for Biomedical Research on Rare Diseases, Hospital Universitario Canarias, Universidad La Laguna, Tenerife, Spain
| | - Thomas Neuhaus
- Department of Pediatrics, Children's Hospital Lucerne, Lucerne, Switzerland
| | - Jaap W. Groothoff
- Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Justine Bacchetta
- Department of Pediatric Nephrology, Hospices Civils de Lyon and University de Lyon, Lyon, France
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Ndongo A, Ranchin B, Cartier R, Bertholet-Thomas A, Bacchetta J, Cochat P. Are plasma proteins a valid alternative for assessing nephrotic syndrome in children from low-income countries? Arch Pediatr 2022; 29:263-266. [DOI: 10.1016/j.arcped.2022.02.009] [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] [Received: 09/12/2021] [Revised: 01/31/2022] [Accepted: 02/20/2022] [Indexed: 12/23/2022]
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Metry EL, Garrelfs SF, Peters-Sengers H, Hulton SA, Acquaviva C, Bacchetta J, Beck BB, Collard L, Deschênes G, Franssen C, Kemper MJ, Lipkin GW, Mandrile G, Mohebbi N, Moochhala SH, Oosterveld MJ, Prikhodina L, Hoppe B, Cochat P, Groothoff JW. Long-Term Transplantation Outcomes in Patients With Primary Hyperoxaluria Type 1 Included in the European Hyperoxaluria Consortium (OxalEurope) Registry. Kidney Int Rep 2021; 7:210-220. [PMID: 35155860 PMCID: PMC8821040 DOI: 10.1016/j.ekir.2021.11.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/28/2021] [Accepted: 11/01/2021] [Indexed: 12/20/2022] Open
Abstract
Introduction In primary hyperoxaluria type 1 (PH1), oxalate overproduction frequently causes kidney stones, nephrocalcinosis, and kidney failure. As PH1 is caused by a congenital liver enzyme defect, combined liver–kidney transplantation (CLKT) has been recommended in patients with kidney failure. Nevertheless, systematic analyses on long-term transplantation outcomes are scarce. The merits of a sequential over combined procedure regarding kidney graft survival remain unclear as is the place of isolated kidney transplantation (KT) for patients with vitamin B6-responsive genotypes. Methods We used the OxalEurope registry for retrospective analyses of patients with PH1 who underwent transplantation. Analyses of crude Kaplan–Meier survival curves and adjusted relative hazards from the Cox proportional hazards model were performed. Results A total of 267 patients with PH1 underwent transplantation between 1978 and 2019. Data of 244 patients (159 CLKTs, 48 isolated KTs, 37 sequential liver–KTs [SLKTs]) were eligible for comparative analyses. Comparing CLKTs with isolated KTs, adjusted mortality was similar in patients with B6-unresponsive genotypes but lower after isolated KT in patients with B6-responsive genotypes (adjusted hazard ratio 0.07, 95% CI: 0.01–0.75, P = 0.028). CLKT yielded higher adjusted event-free survival and death-censored kidney graft survival in patients with B6-unresponsive genotypes (P = 0.025, P < 0.001) but not in patients with B6-responsive genotypes (P = 0.145, P = 0.421). Outcomes for 159 combined procedures versus 37 sequential procedures were comparable. There were 12 patients who underwent pre-emptive liver transplantation (PLT) with poor outcomes. Conclusion The CLKT or SLKT remains the preferred transplantation modality in patients with PH1 with B6-unresponsive genotypes, but isolated KT could be an alternative approach in patients with B6-responsive genotypes.
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12
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Halfon M, Cochat P, Kissling S, Dattner N, de Leval L, Fakhouri F, Pruijm M, Bonny O. A stone in the bone. JIMD Rep 2021; 62:6-8. [PMID: 34765391 PMCID: PMC8574174 DOI: 10.1002/jmd2.12246] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 12/03/2022] Open
Abstract
Primary hyperoxaluria (PH) is a group of diseases due to mutations in genes coding for enzymes involved in oxalate metabolism. Three types of PH are identified depending on the gene mutated. Type 1 is the most frequent with 80% of the cases, while PH2 and PH3 are rarer. The severity of renal involvement varies between the three types. Indeed, between 60% and 80% of PH1 but only 20% of PH2 patients will reach end-stage kidney disease. In PH3 patients, dialysis is uncommon. Because oxalate clearance is impaired in CKD patients, oxalate can precipitate in various organs leading to systemic oxalosis. We report an uncommon presentation of bone oxalosis associated with hypercalcemia in a dialyzed patient. This report emphasizes the difficulties to diagnose primary hyperoxaluria and the challenge of treating dialyzed patients.
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Affiliation(s)
- Matthieu Halfon
- Service of NephrologyLausanne University HospitalLausanneSwitzerland
| | - Pierre Cochat
- Centre de référence des maladies rénales rares, Hospices Civils de LyonLyonFrance
| | | | - Nicolas Dattner
- Department of Laboratory Medicine and PathologyInstitute of Pathology, Lausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Laurence de Leval
- Department of Laboratory Medicine and PathologyInstitute of Pathology, Lausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Fadi Fakhouri
- Service of NephrologyLausanne University HospitalLausanneSwitzerland
| | - Menno Pruijm
- Service of NephrologyLausanne University HospitalLausanneSwitzerland
| | - Olivier Bonny
- Service of NephrologyLausanne University HospitalLausanneSwitzerland
- Department of Biomedical SciencesUniversity of LausanneLausanneSwitzerland
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13
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Lengliné E, Peron J, Vanier A, Gueyffier F, Kouzan S, Dufour P, Guillot B, Blondon H, Clanet M, Cochat P, Degos F, Chevret S, Grande M, Putzolu J. Basket clinical trial design for targeted therapies for cancer: a French National Authority for Health statement for health technology assessment. Lancet Oncol 2021; 22:e430-e434. [PMID: 34592192 DOI: 10.1016/s1470-2045(21)00337-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 11/16/2022]
Abstract
During the past decade, health technology assessment bodies have faced new challenges in establishing the benefits of new drugs for individuals and health-care systems. A topic of increasing importance to the field of oncology is the so-called agnostic regulatory approval of targeted therapies for cancer (independent of tumour location and histology) granted on the basis of basket trials. Basket trials in oncology offer the advantage of simultaneously evaluating treatments for multiple tumours, even rare cancers, in a single clinical trial. To address the novel challenges introduced by these trials, an interdisciplinary panel was convened on behalf of the Transparency Committee of the French National Authority for Health to clarify an approach designed to guarantee a transparent, reproducible, and fair assessment of histology-agnostic treatments for reimbursement by the French National Health Insurance Fund. The requirements of this approach include the need for randomisation, clinically relevant endpoints, appropriate correction for multiple significance testing, characterisation of subgroup heterogeneity, and validation of underlying biomarker assays. A prospectively designated external control is encouraged when the implementation of a direct comparison is deemed infeasible. We also underline the importance of recording outcomes from basket trials in a registry for use as future external controls.
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Affiliation(s)
| | - Julien Peron
- Medical Oncology Department, Cancer Institute of the Hospices Civils of Lyon, Lyon, France
| | - Antoine Vanier
- Unit of Methodology Biostatistics and Data Management, INSERM CIC1415, University Hospital of Tours, Tours, France
| | - François Gueyffier
- UMR 5558 CNRS Lyon, Claude Bernard University Lyon 1, Lyon, France; Public Health Department, Lyon University Hospitals, Lyon, France
| | - Serge Kouzan
- Pulmonary Department, Centre Regional Hospital, Chambery, France
| | - Patrick Dufour
- Medical and Surgical Division of Digestive Pathology, Hautepierre Hospital, Louis Pasteur University, Strasbourg, France
| | - Bernard Guillot
- Dermatology Department, Saint Eloi University Hospital, Montpellier, France
| | - Hugues Blondon
- Department of Gastroenterology and Hepatology, Versailles Hospital, Le Chesnay, France
| | - Michel Clanet
- Pharmaceuticals Assessment Department, French National Authority for Health, Saint-Denis, France
| | - Pierre Cochat
- Pharmaceuticals Assessment Department, French National Authority for Health, Saint-Denis, France
| | - Françoise Degos
- Pharmaceuticals Assessment Department, French National Authority for Health, Saint-Denis, France
| | - Sylvie Chevret
- Biostatistics Department, Saint-Louis Hospital, Paris, France
| | - Mathilde Grande
- Pharmaceuticals Assessment Department, French National Authority for Health, Saint-Denis, France
| | - Jade Putzolu
- Pharmaceuticals Assessment Department, French National Authority for Health, Saint-Denis, France.
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14
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Hoppe B, Koch A, Cochat P, Garrelfs SF, Baum MA, Groothoff JW, Lipkin G, Coenen M, Schalk G, Amrite A, McDougall D, Barrios K, Langman CB. Safety, pharmacodynamics, and exposure-response modeling results from a first-in-human phase 1 study of nedosiran (PHYOX1) in primary hyperoxaluria. Kidney Int 2021; 101:626-634. [PMID: 34481803 DOI: 10.1016/j.kint.2021.08.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/27/2021] [Accepted: 08/06/2021] [Indexed: 12/18/2022]
Abstract
Primary hyperoxaluria (PH) is a family of ultra-rare autosomal recessive inherited disorders of hepatic glyoxylate metabolism characterized by oxalate overproduction. Nedosiran is an RNA interference agent that inhibits hepatic lactate dehydrogenase, the enzyme responsible for the common, final step of oxalate production in all three genetic subtypes of PH. Here, we assessed in a two-part, randomized, single-ascending-dose, phase 1 study (PHYOX1) the safety, pharmacokinetics, pharmacodynamics, and exposure-response of subcutaneous nedosiran in 25 healthy participants (Group A) and 18 patients with PH1 or PH2 (Group B). Group A received nedosiran (0.3, 1.5, 3.0, 6.0, then 12.0 mg/kg) or placebo, and Group B received open-label nedosiran (1.5, 3.0, or 6.0 mg/kg). No significant safety concerns were identified. Injection site reactions (four or more hours post dose) occurred in 13.3% of participants in Group A and 27.8% of participants in Group B. Mean maximum reduction in 24-hour urinary oxalate excretion from baseline to day 57 (end of study) across Group B dose cohorts was 55% (range: 22%-100%) after single-dose nedosiran, with 33% participants reaching normal 24-hour urinary oxalate excretion. Based on the available modeling and simulation data, a fixed monthly dose of nedosiran 160 mg (free acid; equivalent to 170 mg sodium salt) in adults was associated with the highest proportion of simulated individuals achieving normal or near-normal 24-hour urinary oxalate excretion and fewest fluctuations in urinary oxalate response. Thus, single-dose nedosiran demonstrated acceptable safety and evidence of a pharmacodynamic effect in both PH1 and PH2 subpopulations consistent with its mechanism of action.
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Affiliation(s)
- Bernd Hoppe
- Department of Pediatrics, Division of Pediatric Nephrology, University Hospital Bonn, Bonn, Germany; Dicerna Pharmaceuticals, Inc., Lexington, Massachusetts, USA
| | - Annelize Koch
- Clinical Pharmacology Unit, Simbec Research Ltd., Merthyr Tydfil, UK
| | - Pierre Cochat
- Center for Rare Renal Diseases and Inserm Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon, France
| | - Sander F Garrelfs
- Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
| | - Michelle A Baum
- Division of Pediatric Nephrology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Jaap W Groothoff
- Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
| | - Graham Lipkin
- Department of Nephrology, Queen Elizabeth Hospital, Birmingham, UK
| | - Martin Coenen
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Bonn, Germany
| | - Gesa Schalk
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Bonn, Germany
| | | | - David McDougall
- Model Answers, a Parexel Company, Brisbane, Queensland, Australia
| | - Kelly Barrios
- Dicerna Pharmaceuticals, Inc., Lexington, Massachusetts, USA
| | - Craig B Langman
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Division of Kidney Diseases, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
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15
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Frishberg Y, Deschênes G, Groothoff JW, Hulton SA, Magen D, Harambat J, van’t Hoff WG, Lorch U, Milliner DS, Lieske JC, Haslett P, Garg PP, Vaishnaw AK, Talamudupula S, Lu J, Habtemariam BA, Erbe DV, McGregor TL, Cochat P. Phase 1/2 Study of Lumasiran for Treatment of Primary Hyperoxaluria Type 1: A Placebo-Controlled Randomized Clinical Trial. Clin J Am Soc Nephrol 2021; 16:1025-1036. [PMID: 33985991 PMCID: PMC8425611 DOI: 10.2215/cjn.14730920] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [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: 09/11/2020] [Accepted: 03/22/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVES In the rare disease primary hyperoxaluria type 1, overproduction of oxalate by the liver causes kidney stones, nephrocalcinosis, kidney failure, and systemic oxalosis. Lumasiran, an RNA interference therapeutic, suppresses glycolate oxidase, reducing hepatic oxalate production. The objective of this first-in-human, randomized, placebo-controlled trial was to evaluate the safety, pharmacokinetic, and pharmacodynamic profiles of lumasiran in healthy participants and patients with primary hyperoxaluria type 1. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS This phase 1/2 study was conducted in two parts. In part A, healthy adults randomized 3:1 received a single subcutaneous dose of lumasiran or placebo in ascending dose groups (0.3-6 mg/kg). In part B, patients with primary hyperoxaluria type 1 randomized 3:1 received up to three doses of lumasiran or placebo in cohorts of 1 or 3 mg/kg monthly or 3 mg/kg quarterly. Patients initially assigned to placebo crossed over to lumasiran on day 85. The primary outcome was incidence of adverse events. Secondary outcomes included pharmacokinetic and pharmacodynamic parameters, including measures of oxalate in patients with primary hyperoxaluria type 1. Data were analyzed using descriptive statistics. RESULTS Thirty-two healthy participants and 20 adult and pediatric patients with primary hyperoxaluria type 1 were enrolled. Lumasiran had an acceptable safety profile, with no serious adverse events or study discontinuations attributed to treatment. In part A, increases in mean plasma glycolate concentration, a measure of target engagement, were observed in healthy participants. In part B, patients with primary hyperoxaluria type 1 had a mean maximal reduction from baseline of 75% across dosing cohorts in 24-hour urinary oxalate excretion. All patients achieved urinary oxalate levels ≤1.5 times the upper limit of normal. CONCLUSIONS Lumasiran had an acceptable safety profile and reduced urinary oxalate excretion in all patients with primary hyperoxaluria type 1 to near-normal levels. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER Study of Lumasiran in Healthy Adults and Patients with Primary Hyperoxaluria Type 1, NCT02706886.
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Affiliation(s)
- Yaacov Frishberg
- Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Georges Deschênes
- Department of Pediatric Nephrology, Hôpital Robert Debré, Paris, France
| | - Jaap W. Groothoff
- Department of Pediatric Nephrology, University of Amsterdam, Amsterdam, The Netherlands
| | - Sally-Anne Hulton
- Department of Nephrology, Birmingham Women’s and Children’s Hospital, Birmingham, United Kingdom
| | - Daniella Magen
- Pediatric Nephrology Institute, Ruth Children's Hospital, Haifa, Israel
| | - Jérôme Harambat
- Pediatric Nephrology Unit, Bordeaux University Hospital, Bordeaux, France
| | - William G. van’t Hoff
- Department of Paediatric Nephrology, Great Ormond Street Hospital, London, United Kingdom
| | - Ulrike Lorch
- Richmond Pharmacology Ltd., London, United Kingdom
| | - Dawn S. Milliner
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota
| | - John C. Lieske
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota
| | | | | | | | | | - Jiandong Lu
- Alnylam Pharmaceuticals, Cambridge, Massachusetts
| | | | | | | | - Pierre Cochat
- Center for Rare Renal Diseases and Institut National de la Santé et de la Recherche Médicale Pediatric Clinical Investigation Center, Hospices Civils de Lyon, Lyon, France,Université de Lyon, Lyon, France
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16
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McCarthy F, Cochat P, Alhasan K, Bonilla-Felix M. Living well with kidney disease. Pediatr Nephrol 2021; 36:1035-1036. [PMID: 33646396 DOI: 10.1007/s00467-021-05011-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 02/15/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Florencio McCarthy
- Hospital del Niño Dr. José Renán Esquivel, Calle 34 Este, Panamá City, Panama.
| | - Pierre Cochat
- Centre de référence des maladies rénales rares Néphrogones, Hospices Civils de Lyon & Université Claude-Bernard Lyon 1, Lyon, France
| | - Khalid Alhasan
- Pediatrics Department, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Melvin Bonilla-Felix
- Department of Pediatrics, University of Puerto Rico, Medical Sciences Campus, PO Box 365067, San Juan, 00936-5067, Puerto Rico
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17
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Cochat P, Sellier-Leclerc AL, Bertholet-Thomas A, Bacchetta J. [Interferent RNA treatment: Example of primary hyperoxaluria]. Nephrol Ther 2021; 17S:S23-S26. [PMID: 33910694 DOI: 10.1016/j.nephro.2020.02.002] [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] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 02/03/2020] [Indexed: 11/20/2022]
Abstract
Primary hyperoxalurias are rare disease with autosomal recessive inheritance; they often lead to kidney failure and can lead to life-threatening conditions, especially in early onset forms. There are three types, responding to distinct enzyme deficits. Type 1 represents 85% of cases and results from an enzyme deficiency (alanine-glyoxylate aminotransferase) in the peroxisomes of the liver, causing hyperoxaluria leading to urolithiasis with or without nephrocalcinosis. As glomerular filtration decreases, a systemic overload appears and spares no organ. Treatment has hitherto been based on combined liver and kidney transplantation, with significant mortality and morbidity. The recent introduction of interfering RNA treatments opens up new perspectives. By blocking an enzymatic synthesis (glycolate oxidase or lacticodehydrogenase a) upstream of the deficit that causes the disease, oxaluria normalizes and the tolerance of the drug (administered by injection every 1 to 3 months) is good. This strategy will help prevent kidney failure in patients treated early and avoid liver transplantation in those who are diagnosed at an advanced stage of kidney failure.
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Affiliation(s)
- Pierre Cochat
- Centre de référence des maladies rénales rares, hôpital Femme-Mère-Enfant, 59 boulevard Pinel, 69677 Bron cedex, France; Service de néphrologie rhumatologie dermatologie pédiatriques, hôpital Femme-Mère-Enfant, 59 boulevard Pinel, 69677 Bron cedex, France; Université Claude-Bernard Lyon-1, 8, avenue Rockefeller, 69008 Lyon, France.
| | - Anne-Laure Sellier-Leclerc
- Centre de référence des maladies rénales rares, hôpital Femme-Mère-Enfant, 59 boulevard Pinel, 69677 Bron cedex, France; Service de néphrologie rhumatologie dermatologie pédiatriques, hôpital Femme-Mère-Enfant, 59 boulevard Pinel, 69677 Bron cedex, France
| | - Aurélia Bertholet-Thomas
- Centre de référence des maladies rénales rares, hôpital Femme-Mère-Enfant, 59 boulevard Pinel, 69677 Bron cedex, France; Service de néphrologie rhumatologie dermatologie pédiatriques, hôpital Femme-Mère-Enfant, 59 boulevard Pinel, 69677 Bron cedex, France
| | - Justine Bacchetta
- Centre de référence des maladies rénales rares, hôpital Femme-Mère-Enfant, 59 boulevard Pinel, 69677 Bron cedex, France; Service de néphrologie rhumatologie dermatologie pédiatriques, hôpital Femme-Mère-Enfant, 59 boulevard Pinel, 69677 Bron cedex, France; Université Claude-Bernard Lyon-1, 8, avenue Rockefeller, 69008 Lyon, France
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18
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Kaboré R, Ferrer L, Couchoud C, Hogan J, Cochat P, Dehoux L, Roussey-Kesler G, Novo R, Garaix F, Brochard K, Fila M, Parmentier C, Fournier MC, Macher MA, Harambat J, Leffondré K. Dynamic prediction models for graft failure in paediatric kidney transplantation. Nephrol Dial Transplant 2021; 36:927-935. [PMID: 32989448 DOI: 10.1093/ndt/gfaa180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Several models have been proposed to predict kidney graft failure in adult recipients but none in younger recipients. Our objective was to propose a dynamic prediction model for graft failure in young kidney transplant recipients. METHODS We included 793 kidney transplant recipients waitlisted before the age of 18 years who received a first kidney transplantation before the age of 21 years in France in 2002-13 and survived >90 days with a functioning graft. We used a Cox model including baseline predictors only (sex, age at transplant, primary kidney disease, dialysis duration, donor type and age, human leucocyte antigen matching, cytomegalovirus serostatus, cold ischaemia time and delayed graft function) and two joint models also accounting for post-transplant estimated glomerular filtration rate (eGFR) trajectory. Predictive performances were evaluated using a cross-validated area under the curve (AUC) and R2 curves. RESULTS When predicting the risk of graft failure from any time within the first 7 years after paediatric kidney transplantation, the predictions for the following 3 or 5 years were accurate and much better with the joint models than with the Cox model (AUC ranged from 0.83 to 0.91 for the joint models versus 0.56 to 0.64 for the Cox model). CONCLUSION Accounting for post-transplant eGFR trajectory strongly increased the accuracy of graft failure prediction in young kidney transplant recipients.
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Affiliation(s)
- Rémi Kaboré
- INSERM, Bordeaux Population Health Research Center, University of Bordeaux, UMR1219, Bordeaux, France
| | - Loïc Ferrer
- INSERM, Bordeaux Population Health Research Center, University of Bordeaux, UMR1219, Bordeaux, France
| | - Cécile Couchoud
- Agence de la Biomédecine, REIN Registry, La Plaine-Saint Denis, France
| | - Julien Hogan
- Pediatric Nephrology Unit, Robert Debré Hospital, Centre de Référence Maladies Rénales Rares Marhea, APHP, Paris, France
| | - Pierre Cochat
- Pediatric Nephrology Unit, Femme-Mère-Enfant Hospital, Lyon University Hospital, Centre de Référence Maladies Rénales Rares Nephrogones, Bron, France
| | - Laurène Dehoux
- Pediatric Nephrology Unit, Necker Enfants-Malades Hospital, Centre de Référence Maladies Rénales Rares Marhea, APHP, Paris Descartes University, Paris, France
| | - Gwenaelle Roussey-Kesler
- Pediatric Nephrology Unit, Femme-Enfant-Adolescent Hospital, Nantes University Hospital, Nantes, France
| | - Robert Novo
- Pediatric Nephrology Unit, Jeanne de Flandre Hospital, Lille University Hospital, Lille, France
| | - Florentine Garaix
- Pediatric Nephrology Unit, Timone-Enfants Hospital, Marseille University Hospital, Marseille, France
| | - Karine Brochard
- Pediatric Nephrology Unit, Children's Hospital, Toulouse University Hospital, Centre de Référence Maladies Rénales Rares Sorare, Toulouse, France
| | - Marc Fila
- Pediatric Nephrology Unit, Arnaud de Villeneuve Hospital, Montpellier University Hospital, Centre de Référence Maladies Rénales Rares Sorare, Montpellier, France
| | - Cyrielle Parmentier
- Pediatric Nephrology Unit, Trousseau Hospital, Centre de Référence Maladies Rénales Rares Marhea, APHP, Paris, France
| | | | - Marie-Alice Macher
- Agence de la Biomédecine, REIN Registry, La Plaine-Saint Denis, France.,Pediatric Nephrology Unit, Robert Debré Hospital, Centre de Référence Maladies Rénales Rares Marhea, APHP, Paris, France
| | - Jérôme Harambat
- INSERM, Bordeaux Population Health Research Center, University of Bordeaux, UMR1219, Bordeaux, France.,Pediatric Nephrology Unit, Pellegrin-Enfants Hospital, Bordeaux University Hospital, Centre de Référence Maladies Rénales Rares Sorare, Bordeaux, France.,INSERM, Clinical Investigation Center-Clinical Epidemiology-CIC-1401, Bordeaux, France
| | - Karen Leffondré
- INSERM, Bordeaux Population Health Research Center, University of Bordeaux, UMR1219, Bordeaux, France.,INSERM, Clinical Investigation Center-Clinical Epidemiology-CIC-1401, Bordeaux, France
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19
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Lemoine S, Radenac J, Baudouin V, Belaiche S, Bertholet-Thomas A, Buebuyck N, Broux F, Burtey S, Champion G, Charbit M, Cochat P, De Parscau L, Delmas Y, Dunand O, Essig M, Guebre-Egziabher F, Langellier-Bellevue B, Leclerc AL, Merieau É, Moulin B, Perrin J, Rousiot D, Sartoris B, Servais A, Nagra A, Novo R. [Recommendations for management of patients from pediatrics unit to adult unit: Transition and transfer program]. Nephrol Ther 2021; 17:137-142. [PMID: 33531259 DOI: 10.1016/j.nephro.2020.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/20/2020] [Accepted: 10/26/2020] [Indexed: 11/20/2022]
Affiliation(s)
- Sandrine Lemoine
- Service de néphrologie et d'exploration fonctionnelle rénale, centre de référence maladies rénales rares néphrogones, hôpital Édouard-Herriot, hospices civils de Lyon, filière ORKiD, Lyon, France
| | | | - Véronique Baudouin
- Service de néphrologie pédiatrique, centre hospitalo-universitaire Robert-Debré, Assistance publique-Hôpitaux de Paris, Paris, France
| | | | - Aurélia Bertholet-Thomas
- Service de néphrologie pédiatrique, hospices civils de Lyon, et centre de référence maladies rénales rares-néphrogones, filière ORKiD, Lyon, France
| | - Nathalie Buebuyck
- Service de néphrologie pédiatrique, hôpital Necker, centre de référence MARHEA, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, Paris, France
| | - Françoise Broux
- Service de néphrologie et d'hémodialyse pédiatrique, hôpital Charles-Nicolle, CHU de Rouen, Rouen, France
| | - Stéphane Burtey
- Centre de néphrologie et transplantation rénale, hôpital de la Conception, Marseille, France
| | - Gérard Champion
- Service de néphrologie pédiatrique, CHU d'Angers, Angers, France
| | - Marina Charbit
- Service de néphrologie pédiatrique, hôpital Necker, centre de référence MARHEA, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, Paris, France
| | - Pierre Cochat
- Service de néphrologie pédiatrique, hospices civils de Lyon, et centre de référence maladies rénales rares-néphrogones, filière ORKiD, Lyon, France
| | | | - Yahsou Delmas
- Service de néphrologie transplantation dialyse, CHU de Bordeaux, centre de référence SORARE, Bordeaux, France
| | - Olivier Dunand
- Service de néphrologie pédiatrique, CHU F-Guyon, Saint-Denis de La Réunion, La Réunion
| | - Marie Essig
- Service de néphrologie, hôpital Ambroise Paré, Paris, France
| | - Fitsum Guebre-Egziabher
- Service de néphrologie et d'exploration fonctionnelle rénale, centre de référence maladies rénales rares néphrogones, hôpital Édouard-Herriot, hospices civils de Lyon, filière ORKiD, Lyon, France
| | | | - Anne-Laure Leclerc
- Service de néphrologie pédiatrique, hospices civils de Lyon, et centre de référence maladies rénales rares-néphrogones, filière ORKiD, Lyon, France
| | - Élodie Merieau
- Service de néphrologie, hôpital Clocheville, Tours, France
| | - Bruno Moulin
- Service de néphrologie et transplantation, Nouvel Hôpital Civil, Strasbourg, France
| | - Justine Perrin
- Centre de néphrologie et transplantation rénale, hôpital de la Conception, Marseille, France
| | | | | | - Aude Servais
- Service de néphrologie et transplantation, hôpital Necker-Enfants malades, centre de référence MARHEA, Paris, France
| | - Arvind Nagra
- Service de néphrologie, Southampton Children's Hôpital, Southampton, Royaume-Uni
| | - Robert Novo
- Service de néphrologie pédiatrique, hôpital Jeanne-de-Flandre, CHU de Lille, filière ORKiD, Lille, France.
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Garrelfs SF, Frishberg Y, Hulton SA, Koren MJ, O'Riordan WD, Cochat P, Deschênes G, Shasha-Lavsky H, Saland JM, Van't Hoff WG, Fuster DG, Magen D, Moochhala SH, Schalk G, Simkova E, Groothoff JW, Sas DJ, Meliambro KA, Lu J, Sweetser MT, Garg PP, Vaishnaw AK, Gansner JM, McGregor TL, Lieske JC. Lumasiran, an RNAi Therapeutic for Primary Hyperoxaluria Type 1. N Engl J Med 2021; 384:1216-1226. [PMID: 33789010 DOI: 10.1056/nejmoa2021712] [Citation(s) in RCA: 227] [Impact Index Per Article: 75.7] [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] [Indexed: 11/19/2022]
Abstract
BACKGROUND Primary hyperoxaluria type 1 (PH1) is a rare genetic disease caused by hepatic overproduction of oxalate that leads to kidney stones, nephrocalcinosis, kidney failure, and systemic oxalosis. Lumasiran, an investigational RNA interference (RNAi) therapeutic agent, reduces hepatic oxalate production by targeting glycolate oxidase. METHODS In this double-blind, phase 3 trial, we randomly assigned (in a 2:1 ratio) patients with PH1 who were 6 years of age or older to receive subcutaneous lumasiran or placebo for 6 months (with doses given at baseline and at months 1, 2, 3, and 6). The primary end point was the percent change in 24-hour urinary oxalate excretion from baseline to month 6 (mean percent change across months 3 through 6). Secondary end points included the percent change in the plasma oxalate level from baseline to month 6 (mean percent change across months 3 through 6) and the percentage of patients with 24-hour urinary oxalate excretion no higher than 1.5 times the upper limit of the normal range at month 6. RESULTS A total of 39 patients underwent randomization; 26 were assigned to the lumasiran group and 13 to the placebo group. The least-squares mean difference in the change in 24-hour urinary oxalate excretion (lumasiran minus placebo) was -53.5 percentage points (P<0.001), with a reduction in the lumasiran group of 65.4% and an effect seen as early as month 1. The between-group differences for all hierarchically tested secondary end points were significant. The difference in the percent change in the plasma oxalate level (lumasiran minus placebo) was -39.5 percentage points (P<0.001). In the lumasiran group, 84% of patients had 24-hour urinary oxalate excretion no higher than 1.5 times the upper limit of the normal range at month 6, as compared with 0% in the placebo group (P<0.001). Mild, transient injection-site reactions were reported in 38% of lumasiran-treated patients. CONCLUSIONS Lumasiran reduced urinary oxalate excretion, the cause of progressive kidney failure in PH1. The majority of patients who received lumasiran had normal or near-normal levels after 6 months of treatment. (Funded by Alnylam Pharmaceuticals; ILLUMINATE-A ClinicalTrials.gov number, NCT03681184.).
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Affiliation(s)
- Sander F Garrelfs
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Yaacov Frishberg
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Sally A Hulton
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Michael J Koren
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - William D O'Riordan
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Pierre Cochat
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Georges Deschênes
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Hadas Shasha-Lavsky
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Jeffrey M Saland
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - William G Van't Hoff
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Daniel G Fuster
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Daniella Magen
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Shabbir H Moochhala
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Gesa Schalk
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Eva Simkova
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Jaap W Groothoff
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - David J Sas
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Kristin A Meliambro
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Jiandong Lu
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Marianne T Sweetser
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Pushkal P Garg
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Akshay K Vaishnaw
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - John M Gansner
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - Tracy L McGregor
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
| | - John C Lieske
- From the Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam (S.F.G., J.W.G.); the Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem (Y.F.); the Department of Nephrology, Birmingham Women's and Children's Hospital, Birmingham (S.A.H.), and the Department of Paediatric Nephrology, Great Ormond Street Hospital (W.G.H.), and UCL Department of Renal Medicine, Royal Free Hospital (S.H.M.), London - both in the United Kingdom; Jacksonville Center for Clinical Research, Jacksonville, FL (M.J.K.); eStudySite, San Diego, CA (W.D.O.); Center for Rare Renal Diseases and INSERM Pediatric Clinical Investigation Center-Hospices Civils de Lyon and Université de Lyon, Lyon (P.C.), and the Department of Pediatric Nephrology, Hôpital Robert-Debré, Paris (G.D.) - both in France; the Pediatric Nephrology Unit, Galilee Medical Center, Nahariya (H.S.-L.), and the Pediatric Nephrology Institute, Rambam Health Care Campus, Haifa (D.M.) - both in Israel; the Icahn School of Medicine at Mount Sinai, New York (J.M.S., K.A.M.); the Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (D.G.F.); the University of Bonn, Bonn, Germany (G.S.); Al Jalila Children's Hospital, Dubai, United Arab Emirates (E.S.); the Divisions of Pediatric Nephrology and Hypertension (D.J.S.) and Nephrology and Hypertension (J.C.L.), Mayo Clinic, Rochester, MN; and Alnylam Pharmaceuticals, Cambridge, MA (J.L., M.T.S., P.P.G., A.K.V., J.M.G., T.L.M.)
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Gaillard S, Roche L, Lemoine S, Deschênes G, Morin D, Vianey-Saban C, Acquaviva-Bourdain C, Ranchin B, Bacchetta J, Kassai B, Nony P, Bodénan E, Laudy V, Rouges C, Zarrabian S, Subtil F, Mercier C, Cochat P, Bertholet-Thomas A. Adherence to cysteamine in nephropathic cystinosis: A unique electronic monitoring experience for a better understanding. A prospective cohort study: CrYSTobs. Pediatr Nephrol 2021; 36:581-589. [PMID: 32901297 DOI: 10.1007/s00467-020-04722-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/22/2020] [Accepted: 07/23/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION In nephropathic cystinosis (NC), adherence to cysteamine remains challenging; poor adherence is worsening the disease progression with a decline of kidney function and increase of extrarenal morbidities. Our objective was to describe adherence to cysteamine in NC patients, using electronic monitoring systems. METHODS Patients with confirmed NC, aged > 4 years and receiving oral cysteamine (short acting or delayed release formulation as standard of care) from 3 French reference centers, were included. Adherence to treatment was primarily assessed as the percentage of days with a good adherence score, adherence score rating from 0 (poor) to 2 (good). A descriptive analysis was performed after 1-year follow-up. RESULTS Seventeen patients (10 girls, median age: 13.9 (5.4-33.0) years) were included. Median age at diagnosis was 17.0 (3.0-76.9) months and age at start of cysteamine was 21.0 (15.5-116.3) months. Median daily dose of cysteamine was 1.05 (0.55-1.63) g/m2/day. Over the year, the median percentage of days with a good adherence score was 80 (1-99)% decreasing to 68 (1-99)% in patients > 11 years old. The median of average number of hours covered by treatment in a day was 22.5 (6.1-23.9) versus 14.9 (9.2-20.5) hours for delayed release versus short acting cysteamine. CONCLUSION Our data are the first describing a rather good adherence to cysteamine, decreasing in adolescents and adults. We described a potential interest of the delayed release formulation. Our data highlight the need for a multidisciplinary approach including therapeutic education and individualized approaches in NC patients transitioning to adulthood. Graphical abstract.
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Affiliation(s)
- Segolene Gaillard
- Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Department of Clinical Epidemiology, CHU-Lyon, F-69677, Bron, France. .,Université de Lyon, F-69000, Lyon, Université Lyon 1; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France.
| | - Laurent Roche
- Université de Lyon, F-69000, Lyon, Université Lyon 1; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France.,Hospices Civils de Lyon, Service de Biostatistique, F-69324, Lyon, France
| | - Sandrine Lemoine
- Service de Néphrologie, Dialyse, Hypertension artérielle, Hôpital Edouard Herriot, Hospices Civils de Lyon, Université de Lyon, Lyon, France
| | - Georges Deschênes
- APHP, Hôpital Robert Debré, Service de néphrologie pédiatrique, Paris, France
| | - Denis Morin
- CHU Montpellier, Service de néphrologie et endocrinologie pédiatrique, Montpellier, France
| | - Christine Vianey-Saban
- Hospices Civils de Lyon, Service Biochimie et Biologie Moléculaire, UF Maladies Héréditaires du Métabolisme, F-69500, Bron, France
| | - Cécile Acquaviva-Bourdain
- Hospices Civils de Lyon, Service Biochimie et Biologie Moléculaire, UF Maladies Héréditaires du Métabolisme, F-69500, Bron, France
| | - Bruno Ranchin
- Hospices Civils de Lyon, Service de Néphrologie Pédiatrique, et centre de référence maladies rénales et phosphocalciques rares- Néphrogones- Filière ORKiD -69500, Bron, France
| | - Justine Bacchetta
- Hospices Civils de Lyon, Service de Néphrologie Pédiatrique, et centre de référence maladies rénales et phosphocalciques rares- Néphrogones- Filière ORKiD -69500, Bron, France
| | - Behrouz Kassai
- Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Department of Clinical Epidemiology, CHU-Lyon, F-69677, Bron, France.,Université de Lyon, F-69000, Lyon, Université Lyon 1; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France
| | - Patrice Nony
- Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Department of Clinical Epidemiology, CHU-Lyon, F-69677, Bron, France.,Université de Lyon, F-69000, Lyon, Université Lyon 1; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France
| | - Eurielle Bodénan
- Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Department of Clinical Epidemiology, CHU-Lyon, F-69677, Bron, France
| | - Valérie Laudy
- Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Department of Clinical Epidemiology, CHU-Lyon, F-69677, Bron, France.,Université de Lyon, F-69000, Lyon, Université Lyon 1; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France
| | - Cécile Rouges
- CHU Montpellier, Centre d'Investigation Clinique, Inserm CIC 1411, F-69500, Bron, Montpellier, France
| | - Setareh Zarrabian
- Centre d'Investigation Clinique - CIC 1426 Hôpital Robert Debre - Assistance Publique - Hopitaux de Paris (AP-HP), Paris, France
| | - Fabien Subtil
- Université de Lyon, F-69000, Lyon, Université Lyon 1; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France.,Hospices Civils de Lyon, Service de Biostatistique, F-69324, Lyon, France
| | - Catherine Mercier
- Université de Lyon, F-69000, Lyon, Université Lyon 1; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France.,Hospices Civils de Lyon, Service de Biostatistique, F-69324, Lyon, France
| | - Pierre Cochat
- Hospices Civils de Lyon, Service de Néphrologie Pédiatrique, et centre de référence maladies rénales et phosphocalciques rares- Néphrogones- Filière ORKiD -69500, Bron, France
| | - Aurélia Bertholet-Thomas
- Hospices Civils de Lyon, Service de Néphrologie Pédiatrique, et centre de référence maladies rénales et phosphocalciques rares- Néphrogones- Filière ORKiD -69500, Bron, France
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Devresse A, Cochat P, Godefroid N, Kanaan N. Transplantation for Primary Hyperoxaluria Type 1: Designing New Strategies in the Era of Promising Therapeutic Perspectives. Kidney Int Rep 2020; 5:2136-2145. [PMID: 33305106 PMCID: PMC7710835 DOI: 10.1016/j.ekir.2020.09.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 12/13/2022] Open
Abstract
Primary hyperoxaluria type 1 (PH1) is an autosomal recessive disease caused by the functional defect of alanine-glyoxylate aminotransferase that results in the overproduction of oxalate. It can be devastating especially for kidneys, leading to end-stage renal disease (ESRD) during the first 2 to 3 decades of life in most patients. Consequently, many PH1 patients need kidney transplantation. However, because PH1 is caused by a liver enzyme deficiency, the only cure of the metabolic defect is liver transplantation. Thus, current transplant strategies to treat PH1 patients with ESRD include dual liver-kidney transplantation. However, the morbidity and mortality associated with liver transplantation make these strategies far from optimal. Fortunately, a therapeutic revolution is looming. Indeed, innovative drugs are being currently tested in clinical trials, and preliminary data show impressive efficacy to reduce the hepatic overproduction of oxalate. Hopefully, with these therapies, liver transplantation will no longer be necessary. However, some patients with progressing renal disease or those who will be diagnosed with PH1 at an advanced stage of chronic kidney disease will ultimately need kidney transplantation. Here we review the current knowledge on this subject and discuss the future of kidney transplant management in PH1 patients in the era of novel therapies.
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Affiliation(s)
- Arnaud Devresse
- Division of Nephrology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Pierre Cochat
- Service de Néphrologie Rhumatologie Dermatologie Pédiatriques, Centre de Référence des Maladies Rénales Rares, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon et Université Claude-Bernard Lyon 1, Lyon, France
- EPICIME Epidémiologie Pharmacologie Investigation Clinique Information Médicale de l'Enfant, Hospices Civils de Lyon, Lyon, France
| | - Nathalie Godefroid
- Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
- Division of Pediatric Nephrology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Nada Kanaan
- Division of Nephrology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
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23
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Dachy A, Bacchetta J, Sellier-Leclerc AL, Bertholet-Thomas A, Demède D, Cochat P, Nobili F, Ranchin B. Long-term outcomes of peritoneal dialysis started in infants below 6 months of age: An experience from two tertiary centres. Nephrol Ther 2020; 16:424-430. [PMID: 33177015 DOI: 10.1016/j.nephro.2020.08.002] [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: 05/26/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Little data are available for infants who started renal replacement therapy before 6 months of age. Because of extra-renal comorbidities and uncertain outcomes, whether renal replacement therapy in neonates is justified remains debatable. METHODS We performed a retrospective analysis of all patients who began chronic peritoneal dialysis below 6 months between 2007 and 2017 in two tertiary centres. Results are presented as median (min;max). RESULTS Seventeen patients (10 boys) were included (8 prenatal diagnoses, 6 premies), with the following diagnoses: congenital anomalies of kidney and urinary tract (n=9), oxalosis (n=5), congenital nephrotic syndrome (n=2) and renal vein thrombosis (n=1). Five patients had associated comorbidities. At peritoneal dialysis initiation, age was 2.6 (0.1;5.9) months, height-standard deviation score (SDS) -1.3 (-5.7;1.6) and weight-SDS -1.4 (-3.6;0.6). Peritoneal dialysis duration was 12 (2;32) months, and at peritoneal dialysis discontinuation height-SDS was -1.0 (-4.3;0.7) weight-SDS -0.7 (-3.2;0.2), parathyroid hormone 123 (44;1540) ng/L, and hemoglobin 110 (73;174) g/L. During the first 6 months of peritoneal dialysis, the median time of hospitalisation stay was 69 (15;182) days. Ten patients presented a total of 27 peritonitis episodes. Reasons for peritoneal dialysis discontinuation were switch to hemodialysis (n=6), transplantation (n=6), recovery of renal function (n=2) and death (n=1). After a follow-up of 4.3 (1.7;10.3) years, 12 patients were transplanted, 2 patients were still on peritoneal dialysis, 2 patients were dialysis free with severe chronic kidney disease and 1 patient had died. Seven patients displayed neurodevelopmental delay, of whom five needed special schooling. CONCLUSION We confirm that most infants starting peritoneal dialysis before 6 months of age will be successfully transplanted and will have a favourable growth outcome. Their quality of life will be impacted by recurrent hospitalisations and neurodevelopmental delay is frequent.
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Affiliation(s)
- Angélique Dachy
- Centre de référence des maladies rénales rares, hôpital femme-mère-enfant, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France
| | - Justine Bacchetta
- Centre de référence des maladies rénales rares, hôpital femme-mère-enfant, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France; Inserm, UMR 1033, faculté de médecine Lyon est, université Claude-Bernard Lyon 1, 43, boulevard du 11-novembre-1918, 69622 Villeurbanne cedex, France; Faculté de médecine Lyon est, université de Lyon, Lyon, France
| | - Anne-Laure Sellier-Leclerc
- Centre de référence des maladies rénales rares, hôpital femme-mère-enfant, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France
| | - Aurélia Bertholet-Thomas
- Centre de référence des maladies rénales rares, hôpital femme-mère-enfant, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France
| | - Delphine Demède
- Service de chirurgie pédiatrique, hôpital femme-mère-enfant, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France
| | - Pierre Cochat
- Centre de référence des maladies rénales rares, hôpital femme-mère-enfant, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France; Inserm, UMR 1033, faculté de médecine Lyon est, université Claude-Bernard Lyon 1, 43, boulevard du 11-novembre-1918, 69622 Villeurbanne cedex, France; Faculté de médecine Lyon est, université de Lyon, Lyon, France
| | - François Nobili
- Service de néphrologie pédiatrique, centre hospitalier régional universitaire de Besançon, Besançon, France
| | - Bruno Ranchin
- Centre de référence des maladies rénales rares, hôpital femme-mère-enfant, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France.
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24
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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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Rãchişan AL, Dubois V, Ranchin B, Sellier-Leclerc AL, Bertholet Thomas A, Cochat P, Bacchetta J. Eplet incompatibility in pediatric renal transplantation. Pediatr Transplant 2020; 24:e13721. [PMID: 32388894 DOI: 10.1111/petr.13721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 03/26/2019] [Revised: 08/13/2019] [Accepted: 04/05/2020] [Indexed: 11/29/2022]
Abstract
Eplet incompatibility appears to be a better predictor of the de novo appearance of DSA post-Tx than HLA antigen matching in adults. We evaluated the HLA Matchmaker® software (version 2.1) in our pediatric cohort to predict the appearance of DSA post-Tx. We included 70 pediatric patients (26 girls, 10 living donors, mean age 11.2 ± 3.9 years) after a first R-Tx (January 2010-August 2016), without prior immunization, having complete HLA typing (A, B, C, DRB1 and DQB1) and DSA follow-up for at least one year. The mean of HLA and eplet incompatibilities was 4.7 ± 1.3 and 15.5 ± 6.1, respectively, with a correlation coefficient r2 between these two variables of 0.34 (P < .001). The eplet load was 12.8 ± 5.0 in living donors vs 15.9 ± 6.2 in deceased donors (P = NS), 12.6 ± 6.1 in preemptive R-Tx (n = 14) vs 16.3 ± 5.9 for non-preemptive R-Tx (P = .04). Seven patients (10%) developed DSA during the 3.5 ± 1.2 years post-Tx. The eplet load was 13.7 ± 5.5 for those who developed DSA vs 15.7 ± 6.1 for the others (P = NS). In our single-center series of pediatric R-Tx with good HLA matching and lower eplet load than previously published series, eplet incompatibilities do not predict the development of DSA. The question of the HLA matching requirement and the daily interest of the HLA Matchmaker® software to help select the grafts remain open.
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Affiliation(s)
- Andreea Liana Rãchişan
- Department of Pediatrics II, University of Medicine & Pharmacy «Iuliu Hatieganu», Cluj-Napoca, Romania
| | - Valerie Dubois
- Department of Immunology, Hospice Civils de Lyon, Lyon, France
| | - Bruno Ranchin
- Department of Pediatric Nephrology, Hopital Femme-Mere-Enfant, Lyon, France
| | | | | | - Pierre Cochat
- Department of Pediatric Nephrology, Hopital Femme-Mere-Enfant, Lyon, France
| | - Justine Bacchetta
- Department of Pediatric Nephrology, Hopital Femme-Mere-Enfant, Lyon, France
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26
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Garrelfs S, Frishberg Y, Hulton S, Koren M, O’Riordan W, Cochat P, Deschenes G, Shasha-Lavsky H, Saland J, van’t Hoff W, Fuster D, Magen D, Moochhala S, Schalk G, Simkova E, Groothoff J, Sas D, Meliambro K, Lu J, Garg P, Gansner J, McGregor T, Lieske J. ILLUMINATE-A, une étude de phase 3 du lumasiran, un ARNi thérapeutique expérimental, chez les enfants et les adultes atteints d’hyperoxalurie primaire de type 1. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.036] [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: 10/23/2022]
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27
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Garrelfs S, Frishberg Y, Hulton S, Koren M, O'Riordan W, Cochat P, Deschenes G, Shasha-Lavsky H, Saland J, Van't Hoff W, Fuster DG, Magen D, Moochhala S, Schalk G, Simkova E, Groothoff J, Sas D, Meliambro K, Lu J, Garg P, Gansner J, McGregor T, Lieske J. LB002ILLUMINATE-A, A PHASE 3 STUDY OF LUMASIRAN, AN INVESTIGATIONAL RNAI THERAPEUTIC, IN CHILDREN AND ADULTS WITH PRIMARY HYPEROXALURIA TYPE 1 (PH1). Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa146.lb002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
PH1 is a rare genetic disorder characterized by hepatic oxalate overproduction, leading to recurrent kidney stones, nephrocalcinosis, progressive kidney failure, and multiorgan damage from systemic oxalosis. There are no approved pharmacologic therapies for PH1. Lumasiran is a subcutaneously-administered investigational RNAi therapeutic that targets glycolate oxidase to reduce hepatic oxalate production. We report the first results from the six-month, double-blind period of ILLUMINATE-A, a randomized, placebo-controlled Phase 3 study to evaluate lumasiran in patients with PH1.
Method
Key inclusion criteria: age≥6 years, 24hr urinary oxalate (UOx)≥0.70 mmol/24hr/1.73m2, confirmed PH1 diagnosis, eGFR≥30 mL/min/1.73m2. Randomization: 2:1; lumasiran (n=26), placebo (n=13). Dosing: 3 mg/kg monthly×3, then quarterly. Primary endpoint: percent change in 24hr UOx excretion from baseline to month (M) 6. Primary comparison: least square (LS) mean treatment difference in percent change from baseline (average of M3-6).
Results
Lumasiran led to a statistically significant percent reduction in 24hr UOx excretion compared to placebo: the LS mean change from baseline to M6 (average of M3-6) was −65.4% with lumasiran and −11.8% with placebo (LS mean difference: −53.5%; p=1.7 × 10−14). Subgroup analyses of the primary endpoint showed a consistent effect of lumasiran across age, baseline UOx, eGFR, and concomitant pyridoxine use. Lumasiran led to statistically significant improvements in all hierarchically tested secondary endpoints, including: proportion of lumasiran-treated patients that achieved normalization or near-normalization of 24hr UOx at M6 (84% vs 0% of placebo-treated patients, p=8.3 × 10−7), and percent change in plasma oxalate from baseline to M6 (average of months 3-6) (-39.5%, p=2.9 × 10−8). There were no serious or severe adverse events. The most common adverse events related to lumasiran were mild, transient injection site reactions.
Conclusion
Lumasiran resulted in clinically meaningful, rapid, sustained, and statistically significant reductions in urinary and plasma oxalate levels compared to placebo during the six-month double-blind period. Lumasiran has a favorable safety profile.
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Affiliation(s)
- Sander Garrelfs
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam
| | - Yaacov Frishberg
- Division of Pediatric Nephrology, Shaare Zedek Medical Center, Israel
| | - Sally Hulton
- Birmingham Children's Hospital, Birmingham, United Kingdom
| | - Michael Koren
- Jacksonville Center for Clinical Research, Jacksonville, FL, United States of America
| | | | - Pierre Cochat
- Hospices Civils de Lyon, Université de Lyon, Lyon, France
| | | | | | - Jeffrey Saland
- Icahn School of Medicine, New York, NY, United States of America
| | | | - Daniel Guido Fuster
- Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Daniella Magen
- Pediatric Nephrology Institute, Rambam Health Care Campus, Technion Faculty of Medicine, Haifa, Israel
| | | | | | - Eva Simkova
- Al Jalila Children’s Hospital, Dubai, United Arab Emirates
| | - Jaap Groothoff
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam
| | - David Sas
- Mayo Clinic, Rochester, MN, United States of America
| | | | - Jiandong Lu
- Alnylam Pharmaceuticals, Cambridge, MA, United States of America
| | - Pushkal Garg
- Alnylam Pharmaceuticals, Cambridge, MA, United States of America
| | - John Gansner
- Alnylam Pharmaceuticals, Cambridge, MA, United States of America
| | - Tracy McGregor
- Alnylam Pharmaceuticals, Cambridge, MA, United States of America
| | - John Lieske
- Mayo Clinic, Rochester, MN, United States of America
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Bertholet-Thomas A, Guittet C, Manso-Silván MA, Navas Serrano V, Granier LA, Cochat P. P0003ADHERENCE BENEFITS OF ADV7103, AN INNOVATIVE PROLONGED-RELEASE ORAL COMBINATION PRODUCT, IN PATIENTS WITH DISTAL RENAL TUBULAR ACIDOSIS. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0003] [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: 11/12/2022] Open
Abstract
Abstract
Background and Aims
Distal renal tubular acidosis (dRTA) is a rare disorder leading to impaired net acid excretion by the kidney inducing hyperchloremic metabolic acidosis and hypokalemia. The therapeutic effect of the standard of care is of short duration and requires multiple day and night administrations; it is also often accompanied by gastrointestinal discomfort and poor palatability impacting medication adherence. ADV7103, the first advanced therapy for dRTA, consists of a combination of prolonged-release potassium citrate and prolonged-release potassium bicarbonate granules providing round-the-clock alkali and potassium coverage with twice daily administration. Long-term adherence with ADV7103 is reported, along with acceptability of the product.
Method
B22CS is a multicentre, open-label long-term extension study, evaluating safety, tolerability, acceptability and efficacy of ADV7103 in adult and paediatric patients with dRTA. Adherence was assessed at each study visit up to 24 months, based on accountability of study drug retrieval, laboratory results, and interview of the patients in a diary and expressed as the proportion of patients that presented adherence lower than 50%, between 50% and 74%, between 75 and 90%, and higher than to 90%. Treatment acceptability as well as quality of life of the patients and their parents were assessed using a 100-mm visual analogue scales (VAS).
Results
Table 1 shows the evolution of compliance between Month 6 and Month 24. Overall, of the 29 patients remaining in the study after 24 months, 18 (62%) had adherence rates >90%, 5 (17%) had adherence rates of 75-90%, 6 (21%) had adherence rates of 50-74%, and there were no patients with adherence <50%. Adherence was good in all age groups, with rates of ≥75% in 100% of adults, 63% of adolescents 85% of children, and 67% of infants and toddlers.
Compared to the alkalising treatments they had before the study, more than 80% of the patients perceived both the improvement of the formulation and of the number of daily doses at scores ≥ 75 mm. The overall improvement of quality of life reported by the patients was of 89 ± 19 mm and that reported by their parents was of 90 ± 14 mm after 24 months of treatment.
Conclusion
Adherence to treatment was maintained at a high level throughout the 24 months of the study confirming the good acceptance of ADV7103 therapy.
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Affiliation(s)
- Aurélia Bertholet-Thomas
- Centre de référence des Maladies rénales rares – Néphrogones – Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | | | | | | | | | - Pierre Cochat
- Centre de référence des Maladies rénales rares – Néphrogones – Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
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Gaillard S, Roche L, Deschênes G, Morin D, Vianey-Saban C, Acquaviva-Bourdain C, Nony P, Subtil F, Mercier C, Cochat P, Bertholet-Thomas A, Cornu C, Kassai B. Collaboration between academics, small pharmaceutical company and patient organizations in the development of a new formulation of cysteamine in nephropathic cystinosis: A successful story. Therapie 2020; 75:169-173. [PMID: 32248985 DOI: 10.1016/j.therap.2020.02.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/15/2019] [Indexed: 11/19/2022]
Abstract
Rare diseases usually concern small and disseminated population. Implementing clinical research with the right design, outcomes measures and the recruitment of patients are challenges. Collaborations, training and multidisciplinary approach are often required. In this article, we provide an overview of a successful collaboration in nephropathic cystinosis (NC), focusing on what was the key of success, the interactions between academics, the pharmaceutical company and patients organizations. NC is considered as a very rare disease. In 2010, a new formulation of cysteamine, the only available treatment to improve renal outcome of the disease, was proposed by a small American company. Studies were implemented in France under the coordination of an expert of the disease and the clinical investigation center of Lyon. The collaboration resulted in a good recruitment and retention of the patients in the study and most of all in the availability of the new formulation in France. Patients could have facilitated the research by being involved in the early stages of the studies. Involving patients and public early in the process is particularly important in rare diseases as the patient is a great source of knowledge and has his own expectations. Priorities of research, design, conduct and reporting of clinical trials can be defined in collaboration with adults but also with young patients or public, the first concerned in rare diseases. This concept is still to be developed and improved especially with paediatric patients.
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Affiliation(s)
- Ségolène Gaillard
- Hospices civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, department of clinical epidemiology, CHU-Lyon, 69677 Bron, France; Université de Lyon 1, 69000 Lyon, France.
| | - Laurent Roche
- Université de Lyon 1, 69000 Lyon, France; CNRS, UMR 5558, laboratoire de biométrie et biologie évolutive, 69622 Villeurbanne, France; Hospices civils de Lyon, service de biostatistiques, 69324 Lyon, France
| | - Georges Deschênes
- AP-HP, hôpital Robert-Debré, service de néphrologie pédiatrique, 75019 Paris, France
| | - Denis Morin
- CHU Montpellier, service de néphrologie et endocrinologie pédiatrique, 34295 Montpellier, France
| | - Christine Vianey-Saban
- Hospices civils de Lyon, service biochimie et biologie moléculaire, UF maladies héréditaires du métabolisme, 69500 Bron, France
| | - Cécile Acquaviva-Bourdain
- Hospices civils de Lyon, service biochimie et biologie moléculaire, UF maladies héréditaires du métabolisme, 69500 Bron, France
| | - Patrice Nony
- Hospices civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, department of clinical epidemiology, CHU-Lyon, 69677 Bron, France; Université de Lyon 1, 69000 Lyon, France
| | - Fabien Subtil
- Université de Lyon 1, 69000 Lyon, France; Hospices civils de Lyon, service de biostatistiques, 69324 Lyon, France
| | - Catherine Mercier
- Université de Lyon 1, 69000 Lyon, France; Hospices civils de Lyon, service de biostatistiques, 69324 Lyon, France
| | - Pierre Cochat
- Hospices civils de Lyon, service de néphrologie pédiatrique, et centre de référence maladies rénales et phosphocalciques rares - Néphrogones - Filière ORKiD, 69500 Bron, France
| | - Aurélia Bertholet-Thomas
- Hospices civils de Lyon, service de néphrologie pédiatrique, et centre de référence maladies rénales et phosphocalciques rares - Néphrogones - Filière ORKiD, 69500 Bron, France
| | - Catherine Cornu
- Hospices civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, department of clinical epidemiology, CHU-Lyon, 69677 Bron, France; Université de Lyon 1, 69000 Lyon, France
| | - Behrouz Kassai
- Hospices civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, department of clinical epidemiology, CHU-Lyon, 69677 Bron, France; Université de Lyon 1, 69000 Lyon, France
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Curie A, Touil N, Gaillard S, Galanaud D, Leboucq N, Deschênes G, Morin D, Abad F, Luauté J, Bodenan E, Roche L, Acquaviva C, Vianey-Saban C, Cochat P, Cotton F, Bertholet-Thomas A. Neuropsychological and neuroanatomical phenotype in 17 patients with cystinosis. Orphanet J Rare Dis 2020; 15:59. [PMID: 32102670 PMCID: PMC7045592 DOI: 10.1186/s13023-019-1271-6] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 12/03/2019] [Indexed: 01/19/2023] Open
Abstract
Background Cystinosis is a rare autosomal recessive disorder caused by intracellular cystine accumulation. Proximal tubulopathy (Fanconi syndrome) is one of the first signs, leading to end-stage renal disease between the age of 12 and 16. Other symptoms occur later and encompass endocrinopathies, distal myopathy and deterioration of the central nervous system. Treatment with cysteamine if started early can delay the progression of the disease. Little is known about the neurological impairment which occurs later. The goal of the present study was to find a possible neuroanatomical dysmorphic pattern that could help to explain the cognitive profile of cystinosis patients. We also performed a detailed review of the literature on neurocognitive complications associated with cystinosis. Methods 17 patients (mean age = 17.6 years, [5.4–33.3]) with cystinosis were included in the study. Neuropsychological assessment was performed including intelligence (Intelligence Quotient (IQ) with Wechsler’s scale), memory (Children Memory Scale and Wechsler Memory Scale), visuo-spatial (Rey’s figure test) and visuo-perceptual skills assessments. Structural brain MRI (3 T) was also performed in 16 out of 17 patients, with high resolution 3D T1-weighted, 3D FLAIR and spectroscopy sequences. Results Intellectual efficiency was normal in patients with cystinosis (mean Total IQ = 93). However the Perceptual Reasoning Index (mean = 87, [63–109]) was significantly lower than the Verbal Comprehension Index (mean = 100, [59–138], p = 0.003). Memory assessment showed no difference between visual and verbal memory. But the working memory was significantly impaired in comparison with the general memory skills (p = 0.003). Visuospatial skills assessment revealed copy and reproduction scores below the 50th percentile rank in more than 70% of the patients. Brain MRI showed cortical and sub-cortical cerebral atrophy, especially in the parieto-occipital region and FLAIR hypersignals in parietal, occipital and brain stem/cerebellum. Patients with atrophic brain had lower Total IQ scores compared to non-atrophic cystinosis patients. Conclusions Patients with cystinosis have a specific neuropsychological and neuroanatomical profile. We suggest performing a systematic neuropsychological assessment in such children aiming at considering adequate management.
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Affiliation(s)
- Aurore Curie
- Service de neuropédiatrie Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS UMR 5304, 67 boulevard Pinel, 69675, Bron, France. .,Institut des Sciences Cognitives Marc Jeannerod, CNRS UMR 5304, L2C2, Bron, France. .,Faculté de médecine Lyon Est, Université Claude-Bernard Lyon 1, Lyon, France. .,EPICIME-CIC 1407/Inserm, UMR5558, Université de Lyon, Hospices Civils de Lyon, Bron, France.
| | - Nathalie Touil
- EPICIME-CIC 1407/Inserm, UMR5558, Université de Lyon, Hospices Civils de Lyon, Bron, France
| | - Ségolène Gaillard
- EPICIME-CIC 1407/Inserm, UMR5558, Université de Lyon, Hospices Civils de Lyon, Bron, France
| | - Damien Galanaud
- Service de neuroradiologie, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
| | - Nicolas Leboucq
- Service de neuroradiologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Georges Deschênes
- Service de néphropédiatrie, Hôpital Robert-Debré, AP-HP, Paris, France
| | - Denis Morin
- Service de néphrologie et diabétologie pédiatrique, Service de pédiatrie I, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Fanny Abad
- EPICIME-CIC 1407/Inserm, UMR5558, Université de Lyon, Hospices Civils de Lyon, Bron, France
| | - Jacques Luauté
- Service de rééducation fonctionnelle, Hôpital neurologique, Hospices Civils de Lyon, Bron, France
| | - Eurielle Bodenan
- EPICIME-CIC 1407/Inserm, UMR5558, Université de Lyon, Hospices Civils de Lyon, Bron, France
| | - Laurent Roche
- Service de biostatistiques, Hospices Civils de Lyon, Bron, France
| | - Cécile Acquaviva
- Service maladies héréditaires du métabolisme et dépistage néonatal, Centre de Biologie et Pathologie Est, Groupement Hospitalier Est (GHE), Hospices Civils de Lyon, Bron, France
| | - Christine Vianey-Saban
- Service maladies héréditaires du métabolisme et dépistage néonatal, Centre de Biologie et Pathologie Est, Groupement Hospitalier Est (GHE), Hospices Civils de Lyon, Bron, France
| | - Pierre Cochat
- Faculté de médecine Lyon Est, Université Claude-Bernard Lyon 1, Lyon, France.,Centre de référence des maladies rénales rares - Néphrogones - Filière ORKiD, Bron, France
| | - François Cotton
- Faculté de médecine Lyon Est, Université Claude-Bernard Lyon 1, Lyon, France.,Service de radiologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre Bénite, France.,CREATIS, CNRS UMR5220, INSERM U1044, Université Lyon 1, INSA Lyon, Villeurbanne, France
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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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van't Hoff W, Cochat P, Groothoff J, Harambat J, Frishberg Y, Hulton S, Magen D, Hoppe B, Lieske J, Milliner D, Deschenes G. SUN-325 SAFETY AND EFFICACY OF LUMASIRAN, AN INVESTIGATIONAL RNA INTERFERENCE (RNAi) THERAPEUTIC, IN ADULT AND PEDIATRIC PATIENTS WITH PRIMARY HYPEROXALURIA TYPE 1. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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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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Kassai B, Bouyé P, Gilbert-Dussardier B, Godart F, Thambo JB, Rossi M, Cochat P, Chirossel P, Luong S, Serusclat A, Canterino I, Mercier C, Rabilloud M, Pivot C, Pirot F, Ginhoux T, Coopman S, Grenet G, Gueyffier F, Di-Fillippo S, Bertholet-Thomas A. Minoxidil versus placebo in the treatment of arterial wall hypertrophy in children with Williams Beuren Syndrome: a randomized controlled trial. BMC Pediatr 2019; 19:170. [PMID: 31138170 PMCID: PMC6537216 DOI: 10.1186/s12887-019-1544-1] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 05/20/2019] [Indexed: 01/03/2023] Open
Abstract
Background Insufficient elastin synthesis leads to vascular complications and arterial hypertension in children with Williams-Beuren syndrome. Restoring sufficient quantity of elastin should then result in prevention or inhibition of vascular malformations and improvement in arterial blood pressure. Methods The aim of this study was to assess the efficacy and safety of minoxidil on Intima Media Thickness (IMT) on the right common carotid artery after twelve-month treatment in patient with Williams-Beuren syndrome. We performed a randomized placebo controlled double blind trial. All participants were treated for 12 months and followed for 18 months. The principal outcome was assessed by an independent adjudication committee blinded to the allocated treatment groups. Results The principal outcome was available for 9 patients in the placebo group and 8 patients in the minoxidil group. After 12-month treatment, the IMT in the minoxidil group increased by 0.03 mm (95% CI -0.002, 0.06) compared with 0.01 mm (95%CI - 0.02, 0.04 mm) in the placebo group (p = 0.4). Two serious adverse events unrelated to the treatment occurred, one in the minoxidil and 1 in the placebo group. After 18 months, the IMT increased by 0.07 mm (95% CI 0.04, 0.10 mm) in the minoxidil compared with 0.01 mm (95% CI -0.02, 0.04 mm) in the placebo group (p = 0.008). Conclusion Our results suggest a slight increase after 12 and 18-month follow-up in IMT. More understanding of the biological changes induced by minoxidil should better explain its potential role on elastogenesis in Williams-Beuren syndrome. Trials registration US National Institutes of Health Clinical Trial Register (NCT00876200). Registered 3 April 2009 (retrospectively registered). Electronic supplementary material The online version of this article (10.1186/s12887-019-1544-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Behrouz Kassai
- Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Service de Pharmacotoxicologie, CHU-Lyon, F-69677, Bron, France.
| | - Philippe Bouyé
- CHU d'Angers, department of Vascular Studies, Centre de Recherche Clinique Angers, Angers, France
| | | | - François Godart
- CHRU de Lille, université Lille 2, EA 2693, service de cardiologie infantile et congénitale, Nord de France, hôpital cardiologique, F-59000, Lille, France
| | - Jean-Benoit Thambo
- CHU de Bordeaux, université de Bordeaux, service des cardiopathies congénitales, hôpital cardiologique du Haut-Lévêque, Inserm U-1045, LIRYC, institut de rythmologie et modélisation cardiaque, Bordeaux, France
| | - Massimiliano Rossi
- Hospices Civils de Lyon, Service de génétique médicale, INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, GENDEV Team, F-69500, Bron, France
| | - Pierre Cochat
- Hospices Civils de Lyon, Service de Néphrologie Pédiatrique, et centre de référence maladies rénales rares- Néphrogones, Filière ORKiD, -69500, Bron, France
| | - Pierre Chirossel
- Hospices Civils de Lyon, Service d'exploration fonctionnelle vasculaire, hôpital Louis Pradel, F-69500, Bron, France
| | - Stephane Luong
- Hospices Civils de Lyon, Service d'exploration fonctionnelle vasculaire, hôpital Louis Pradel, F-69500, Bron, France
| | - André Serusclat
- Hospices Civils de Lyon, Service d'exploration fonctionnelle vasculaire, hôpital Louis Pradel, F-69500, Bron, France
| | | | - Catherine Mercier
- Université de Lyon, F-69000, Lyon, France ; Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France.,Hospices Civils de Lyon, Service de Biostatistique, F-69324, Lyon, France
| | - Muriel Rabilloud
- Université de Lyon, F-69000, Lyon, France ; Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France.,Hospices Civils de Lyon, Service de Biostatistique, F-69324, Lyon, France
| | - Christine Pivot
- Hospices Civils de Lyon, Pharmacie à Usage Intérieur, plateforme Fripharm, F-69437, Lyon, France
| | - Fabrice Pirot
- Université de Lyon, F-69000, Lyon, France ; Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France.,Hospices Civils de Lyon, Pharmacie à Usage Intérieur, plateforme Fripharm, F-69437, Lyon, France
| | - Tiphanie Ginhoux
- Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Service de Pharmacotoxicologie, CHU-Lyon, F-69677, Bron, France
| | - Stéphanie Coopman
- Lille University Hospital, Centre d'Investigation Clinique, CIC-1403-Inserm-CH&U, F-59000, Lille, France
| | - Guillaume Grenet
- Université de Lyon, F-69000, Lyon, France ; Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France
| | - François Gueyffier
- Université de Lyon, F-69000, Lyon, France ; Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France
| | - Sylvie Di-Fillippo
- Hospices Civils de Lyon, Service de cardiologie pédiatrique, F-69500, Bron, France
| | - Aurélia Bertholet-Thomas
- Hospices Civils de Lyon, Service de Néphrologie Pédiatrique, et centre de référence maladies rénales rares- Néphrogones, Filière ORKiD, -69500, Bron, France
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Prot-Bertoye C, Lebbah S, Daudon M, Tostivint I, Jais JP, Lillo-Le Louët A, Pontoizeau C, Cochat P, Bataille P, Bridoux F, Brignon P, Choquenet C, Combe C, Conort P, Decramer S, Doré B, Dussol B, Essig M, Frimat M, Gaunez N, Joly D, Le Toquin-Bernard S, Méjean A, Meria P, Morin D, N'Guyen HV, Normand M, Pietak M, Ronco P, Saussine C, Tsimaratos M, Friedlander G, Traxer O, Knebelmann B, Courbebaisse M. Adverse events associated with currently used medical treatments for cystinuria and treatment goals: results from a series of 442 patients in France. BJU Int 2019; 124:849-861. [PMID: 30801923 DOI: 10.1111/bju.14721] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 12/20/2022]
Abstract
OBJECTIVE To evaluate medical treatments, in terms of adverse events (AEs) and therapeutic goals, in a large series of patients with cystinuria. PATIENTS AND METHODS Data from 442 patients with cystinuria were recorded retrospectively. Crystalluria was studied in 89 patients. A mixed-effects logistic regression model was used to estimate how urine pH, specific gravity and cysteine-binding thiols (CBT) correlate with risk of cystine crystalluria. RESULTS Alkalizing agents and CBT agents were given to 88.8% (n = 381) and 55.3% (n = 238) of patients, respectively. Gastrointestinal AEs were reported in 12.3%, 10.4% and 2.6% of patients treated with potassium bicarbonate, potassium citrate and sodium bicarbonate, respectively (P = 0.008). The percentages of patients who experienced at least one AE with tiopronin (24.6%) and with D-penicillamine (29.5%) were similar (P = 0.45). Increasing urine pH and decreasing urine specific gravity significantly reduced the risk of cystine crystalluria, whereas D-penicillamine and tiopronin treatments did not reduce this risk (odds ratio [OR] 1 for pH ≤6.5; OR 0.52 [95% confidence interval {95% CI} 0.28-0.95] for 7.0 <pH ≤7.5, P = 0.03; OR 0.26 [95% CI 0.13-0.53] for 7.5 < pH ≤8.0, P <0.001; OR 1 for specific gravity ≤1.005 OR 5.76 [95% CI 1.45-22.85] for 1.006 ≤ specific gravity ≤1.010, P = 0.01; and OR 11.06 [95% CI 2.76-44.26] for 1.011 ≤ specific gravity ≤ 1.014, P < 0.001). Increased urine pH significantly increased the risk of calcium phosphate crystalluria (OR 1 for pH≤ 6.5; OR 6.09 [95% CI 2.15-17.25] for pH >8.0, P <0.001). CONCLUSION Adverse events were frequent with D-penicillamine and tiopronin. Alkaline hyperdiuresis was well tolerated and reduced cystine crystalluria. Urine specific gravity ≤1.005 and urine pH >7.5, while warning about calcium-phosphate crystallization, should be the goals of medical therapy.
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Affiliation(s)
- Caroline Prot-Bertoye
- Department of Physiology, Functional Renal Explorations Department, AP-HP (Public Assistance Hospitals of Paris), Georges Pompidou European Hospital, Paris Descartes University, Paris, France.,INSERM UMRS 1138, Paris, France
| | - Saïd Lebbah
- Department of Biostatistics, AP-HP, Necker Hospital for Sick Children, Paris Descartes University, Medicine, Paris, France
| | - Michel Daudon
- Department of Physiology, Functional Renal Explorations Department, AP-HP, Tenon Hospital Pierre and Marie Curie University, INSERM UMR S 1155, Paris, France
| | - Isabelle Tostivint
- Department of Nephrology, AP-HP, Pitié-Salpétrière Hospital, Paris, France
| | - Jean-Philippe Jais
- Department of Biostatistics, AP-HP, Necker Hospital for Sick Children, Paris Descartes University, Paris, France.,Inserm UMRS 1138 team 22, Paris, France
| | - Agnés Lillo-Le Louët
- Department of Pharmacovigilance, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Clément Pontoizeau
- Functional Unit of Metabolomics, Functional Explorations Department, APHP, Necker Hospital for Sick Children, Paris Descartes University, Paris, France
| | - Pierre Cochat
- Department of Pediatrics, Hospices Civils de Lyon, Centre de Référence des Maladies Rénales Rares Néphrogones, Lyon, France
| | - Pierre Bataille
- Department of Nephrology, Boulogne-sur-Mer Hospital, Boulogne sur Mer, France
| | - Franck Bridoux
- Department of Neprhology, Poitiers University Hospital, Poitiers University, Poitiers, France
| | - Pierre Brignon
- Department of Nephrology, Pasteur Hospital, Colmar, France
| | | | - Christian Combe
- Department of Nephrology, Bordeaux University Hospital, Bordeaux University, Bordeaux, France
| | - Pierre Conort
- Department of Urology, AP-HP, Pitié-Salpétrière Hospital, Paris, France
| | - Stéphane Decramer
- Department of Nephrology and Internal Medicine, Toulouse University Children Hospital, Toulouse, France.,INSERM U1048, Toulouse, France
| | - Bertrand Doré
- Department of Urology, Poitiers University Hospital, Poitiers University, Poitiers, France
| | - Bertrand Dussol
- Department of Nephrology, AP-HM (Public Assistance Hospitals of Marseille), Conception Hospital, Aix-Marseille University, Marseille, France
| | - Marie Essig
- Department of Nephrology, Dialysis and Transplantation, Limoges University Hospital, Limoges University, Limoges, France.,INSERM UMR-S850, Limoges, France
| | - Marie Frimat
- Department of Nephrology, Claude Huriez University Hospital, Lille, France
| | | | - Dominique Joly
- Department of Nephrology, AP-HP, Necker Hospital for Sick Children, Paris Descartes University, Medicine, Paris, France
| | | | - Arnaud Méjean
- Department of Urology, AP-HP, Georges Pompidou European Hospital, Paris Descartes University, Medicine, Paris, France
| | - Paul Meria
- Department of Urology, AP-HP, Saint-Louis Hospital, Paris, France
| | - Denis Morin
- Department of Pediatrics (Pediatric Nephrology and Diabetology), Montpellier University Hospital, Montpellier, France.,CNRS, UMR 5203-INSERM U661, Montpellier, France
| | - Hung V N'Guyen
- Department of Urology, AP-HP, Saint-Louis Hospital, Paris, France
| | - Michel Normand
- Department of Nephrology, Private Saint-Martin Hospital, Pessac, France
| | - Michel Pietak
- Department of Urology, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Pierre Ronco
- Department of Nephrology and Dialysis, AP-HP, Tenon Hospital, Pierre and Marie Curie University, Paris, France.,INSERM Unit 702, Paris, France
| | - Christian Saussine
- Department of Urology, Strasbourg University Hospital, Strasbourg University, Strasbourg, France
| | - Michel Tsimaratos
- Department of Pediatrics, AP-HM, La Timone Hospital, Aix-Marseille University, Marseille, France
| | - Gérard Friedlander
- Department of Physiology, Functional Renal Explorations Department, AP-HP (Public Assistance Hospitals of Paris), Georges Pompidou European Hospital, Paris Descartes University, Paris, France.,INSERM U1151, Paris, France
| | - Olivier Traxer
- Department of Urology, AP-HP, Tenon Hospital, Pierre and Marie Curie University, Paris, France
| | - Bertrand Knebelmann
- Department of Nephrology, AP-HP, Necker Hospital for Sick Children, Paris Descartes University, Medicine, Paris, France
| | - Marie Courbebaisse
- Department of Physiology, Functional Renal Explorations Department, AP-HP (Public Assistance Hospitals of Paris), Georges Pompidou European Hospital, Paris Descartes University, Paris, France.,INSERM U1151, Paris, France
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Frishberg Y, Deschenes G, Cochat P, Magen D, Groothoff J, Hulton S, Harambat J, Van’t Hoff W, Hoppe B, Lieske J, McGregor T, Tamimi N, Haslett P, Talamudupula S, Erbe D, Milliner D. A safety and efficacy study of lumasiran, an investigational RNA interference (RNAi) therapeutic, in adult and pediatric patients with primary hyperoxaluria type 1. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/s1569-9056(19)30291-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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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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Selistre L, Rabilloud M, De Souza V, Iwaz J, Bertoldo M, De Figueiredo CP, Lemoine S, Cochat P, Dubourg L. Regarding “Combination of pediatric and adult formulas yield valid glomerular filtration rate estimates in young adults with a history of pediatric chronic kidney disease”. Kidney Int 2018; 94:827-828. [DOI: 10.1016/j.kint.2018.05.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 05/31/2018] [Indexed: 10/28/2022]
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Claramunt-Taberner D, Flammier S, Gaillard S, Cochat P, Peyruchaud O, Machuca-Gayet I, Bacchetta J. Bone disease in nephropathic cystinosis is related to cystinosin-induced osteoclastic dysfunction. Nephrol Dial Transplant 2018; 33:1525-1532. [PMID: 29365190 DOI: 10.1093/ndt/gfx362] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 12/05/2017] [Indexed: 01/22/2023] Open
Abstract
Background Bone impairment is a poorly described complication of nephropathic cystinosis (NC). The objectives of this study were to evaluate in vitro effects of cystinosin (CTNS) mutations on bone resorption and of cysteamine treatment on bone cells [namely human osteoclasts (OCs) and murine osteoblasts]. Methods Human OCs were differentiated from peripheral blood mononuclear cells (PBMCs) of patients and healthy donors (HDs). Cells were treated with increasing doses of cysteamine in PBMCs or on mature OCs to evaluate its impact on differentiation and resorption, respectively. Similarly, cysteamine-treated osteoblasts derived from murine mesenchymal stem cells were assessed for differentiation and activity with toxicity and proliferation assays. Results CTNS was expressed in human OCs derived from HDs; its expression was regulated during monocyte colony-stimulating factor- and receptor activator of nuclear factor-κB-dependent osteoclastogenesis and required for efficient bone resorption. Cysteamine had no impact on osteoclastogenesis but inhibited in vitro HD osteoclastic resorption; however, NC OC-mediated bone resorption was impaired only at high doses. Only low concentrations of cysteamine (50 μM) stimulated osteoblastic differentiation and maturation, while this effect was no longer observed at higher concentrations (200 µM). Conclusion CTNS is required for proper osteoclastic activity. In vitro low doses of cysteamine have beneficial antiresorptive effects on healthy human-derived OCs and may partly correct the CTNS-induced osteoclastic dysfunction in patients with NC. Moreover, in vitro low doses of cysteamine also stimulate osteoblastic differentiation and mineralization, with an inhibitory effect at higher doses, likely explaining, at least partly, the bone toxicity observed in patients receiving high doses of cysteamine.
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Affiliation(s)
- Debora Claramunt-Taberner
- Centre de Référence des Maladies Rénales Rares, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Sacha Flammier
- INSERM, UMR 1033, Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France
| | - Ségolène Gaillard
- INSERM CIC 1407, CNRS UMR 5558 and Service de Pharmacotoxicologie Clinique, Hospices Civils de Lyon, Bron, France
| | - Pierre Cochat
- Centre de Référence des Maladies Rénales Rares, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
- Université de Lyon, Lyon, France
| | - Olivier Peyruchaud
- INSERM, UMR 1033, Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France
| | - Irma Machuca-Gayet
- INSERM, UMR 1033, Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France
| | - Justine Bacchetta
- Centre de Référence des Maladies Rénales Rares, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
- INSERM, UMR 1033, Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France
- Université de Lyon, Lyon, France
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40
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Negrier C, Delmas MC, Ranchin B, Cochat P, Dechavanne M. Decreased Factor XII Activity in a Child with Nephrotic Syndrome and Thromboembolic Complications. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1646450] [Citation(s) in RCA: 3] [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] [Indexed: 10/28/2022]
Affiliation(s)
- C Negrier
- Laboratoire d'Hémobiologie, Institut Pasteur, INSERM U331, Faculté A. Carrel, 69003 Lyon, France
| | - M C Delmas
- Service de Pédiatric, Hôpital E. Herriot, 69003 Lyon, France
| | - B Ranchin
- Service de Pédiatric, Hôpital E. Herriot, 69003 Lyon, France
| | - P Cochat
- Service de Pédiatric, Hôpital E. Herriot, 69003 Lyon, France
| | - M Dechavanne
- Laboratoire d'Hémobiologie, Institut Pasteur, INSERM U331, Faculté A. Carrel, 69003 Lyon, France
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41
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Laurent A, Klich A, Roy P, Lina B, Kassai B, Bacchetta J, Cochat P. Pediatric renal transplantation: A retrospective single-center study on epidemiology and morbidity due to EBV. Pediatr Transplant 2018; 22:e13151. [PMID: 29430795 DOI: 10.1111/petr.13151] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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] [Accepted: 12/30/2017] [Indexed: 11/29/2022]
Abstract
Pediatric R-Tx patients are at high risk of developing EBV primary infection. Although high DNA replication is a risk factor for PTLD, some patients develop PTLD with low viral load. In this retrospective single-center study including all pediatric patients having received R-Tx (2003-2012 period), we aimed to identify risk factors for uncontrolled reactions to EBV (defined as the presence of a viral load >10 000 copies/mL or PTLD). A Cox proportional hazard model was performed. A total of 117 patients underwent R-Tx at a mean age of 9.7 ± 5.3 years, 46 of them being seronegative for EBV at the time of R-Tx. During follow-up, 54 patients displayed positive EBV viral load, 22 of whom presenting with primary infection. An uncontrolled reaction to EBV was observed in 24 patients, whilst 4 patients developed PTLD. Univariate and multivariate analyses suggested the following risk factors for an uncontrolled reaction: age below 5 years, graft from a deceased donor, ≥5 HLA mismatches, EBV-seronegative status at the time of R-Tx, and a secondary post-Tx loss of anti-EBNA. Monitoring anti-EBNA after R-Tx may contribute to the early identification of patients at risk for uncontrolled reaction.
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Affiliation(s)
- A Laurent
- Hospices Civils de Lyon, Service de Néphrologie, Rhumatologie et Dermatologie pédiatriques, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Lyon, France
| | - A Klich
- Hospices Civils de Lyon, Service de Biostatistique et de Bioinformatique, Lyon, France.,Université de Lyon, Lyon, France.,CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France
| | - P Roy
- Hospices Civils de Lyon, Service de Biostatistique et de Bioinformatique, Lyon, France.,Université de Lyon, Lyon, France.,CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France
| | - B Lina
- Laboratoire de Virologie, Institut des Agents Infectieux IAI, Hospices Civils de Lyon, Hopital de la Croix Rousse, Lyon, France.,CIRI, Centre International de Recherche en Infectiologie, Virpath, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, École Normale Supérieure de Lyon, Université de Lyon, Lyon, France
| | - B Kassai
- Université de Lyon, Lyon, France.,Centre d'Investigation Clinique de Lyon, 1407 Inserm-Hospices Civils de Lyon, Groupement Hospitalier Est, Hôpital Femme-Mère-Enfant, EPICIME, Bron, France
| | - J Bacchetta
- Hospices Civils de Lyon, Service de Néphrologie, Rhumatologie et Dermatologie pédiatriques, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Lyon, France.,CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France.,Laboratoire de Virologie, Institut des Agents Infectieux IAI, Hospices Civils de Lyon, Hopital de la Croix Rousse, Lyon, France
| | - P Cochat
- Hospices Civils de Lyon, Service de Néphrologie, Rhumatologie et Dermatologie pédiatriques, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Lyon, France.,Université de Lyon, Lyon, France
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Hamo S, Bacchetta J, Bertholet-Thomas A, Ranchin B, Cochat P, Michel-Calemard L. [PKHD1 mutations in autosomal recessive polycystic kidney disease (ARPKD): Genotype-phenotype correlations from a series of 308 cases to improve prenatal counselling]. Nephrol Ther 2018; 14:474-477. [PMID: 29703621 DOI: 10.1016/j.nephro.2018.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 03/17/2018] [Accepted: 03/18/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES ARPKD is a recessive rare disease due to PKHD1 mutation. The main objective of the study was to characterize the phenotypic variability according to the different types of PKHD1 mutations. METHODS This study was performed in 308 ARPKD patients with a genetic diagnosis from our genetic center. Related physicians provided minimal clinical and biological data. RESULTS Patients were divided into three genotypic groups: the first group (G1; n=65) consisted of patients with two truncating mutations, the second group (G2; n=117) of patients with one truncating and one non-truncating mutation, and the third group (G3; n=126) of patients with two non-truncating mutations. In the entire cohort, the outcomes consisted of 31% of pregnancy termination, 18% of neonatal deaths and 51% of patient survival after the neonatal period. The proportion of severe ARPKD (pregnancy termination or neonatal death) was significantly greater in G1: 94% versus 47% in G2 and 27% in G3 (P<0.001). CONCLUSION The presence of two truncating mutations in PKHD1 is associated with the most severe perinatal phenotype. However, the phenotypic variability observed in the other genotypic groups requires caution for prenatal counseling.
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Affiliation(s)
- Suzy Hamo
- Centre de référence des maladies rénales rares néphrogones, filière ORKID, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69677 Bron cedex, France.
| | - Justine Bacchetta
- Centre de référence des maladies rénales rares néphrogones, filière ORKID, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69677 Bron cedex, France; Faculté de médecine Lyon Est, université Claude-Bernard Lyon 1, 69008 Lyon, France
| | - Aurélia Bertholet-Thomas
- Centre de référence des maladies rénales rares néphrogones, filière ORKID, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69677 Bron cedex, France
| | - Bruno Ranchin
- Centre de référence des maladies rénales rares néphrogones, filière ORKID, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69677 Bron cedex, France
| | - Pierre Cochat
- Centre de référence des maladies rénales rares néphrogones, filière ORKID, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69677 Bron cedex, France; Faculté de médecine Lyon Est, université Claude-Bernard Lyon 1, 69008 Lyon, France
| | - Laurence Michel-Calemard
- UM pathologies endocriniennes, rénales, musculaires et mucoviscidose, CBPE, groupement hospitalier Est, 59, boulevard Pinel, 69677 Bron cedex, France
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Dorval G, Gribouval O, Martinez-Barquero V, Machuca E, Tête MJ, Baudouin V, Benoit S, Chabchoub I, Champion G, Chauveau D, Chehade H, Chouchane C, Cloarec S, Cochat P, Dahan K, Dantal J, Delmas Y, Deschênes G, Dolhem P, Durand D, Ekinci Z, El Karoui K, Fischbach M, Grunfeld JP, Guigonis V, Hachicha M, Hogan J, Hourmant M, Hummel A, Kamar N, Krummel T, Lacombe D, Llanas B, Mesnard L, Mohsin N, Niaudet P, Nivet H, Parvex P, Pietrement C, de Pontual L, Noble CP, Ribes D, Ronco P, Rondeau E, Sallee M, Tsimaratos M, Ulinski T, Salomon R, Antignac C, Boyer O. Clinical and genetic heterogeneity in familial steroid-sensitive nephrotic syndrome. Pediatr Nephrol 2018; 33:473-483. [PMID: 29058154 DOI: 10.1007/s00467-017-3819-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 06/25/2017] [Revised: 09/05/2017] [Accepted: 09/07/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Familial steroid-sensitive nephrotic syndrome (SSNS) is a rare condition. The disease pathophysiology remains elusive. However, bi-allelic mutations in the EMP2 gene were identified, and specific variations in HLA-DQA1 were linked to a high risk of developing the disease. METHODS Clinical data were analyzed in 59 SSNS families. EMP2 gene was sequenced in families with a potential autosomal recessive (AR) inheritance. Exome sequencing was performed in a subset of 13 families with potential AR inheritance. Two variations in HLA-DQA1 were genotyped in the whole cohort. RESULTS Transmission was compatible with an AR (n = 33) or autosomal dominant (AD, n = 26) inheritance, assuming that familial SSNS is a monogenic trait. Clinical features did not differ between AR and AD groups. All patients, including primary (n = 7) and secondary steroid resistant nephrotic syndrone (SRNS), (n = 13) were sensitive to additional immunosuppressive therapy. Both HLA-DQA1 variations were found to be highly linked to the disease (OR = 4.34 and OR = 4.89; p < 0.001). Exome sequencing did not reveal any pathogenic mutation, neither did EMP2 sequencing. CONCLUSIONS Taken together, these results highlight the clinical and genetic heterogeneity in familial SSNS. Clinical findings sustain an immune origin in all patients, whatever the initial steroid-sensitivity. The absence of a variant shared by two families and the HLA-DQA1 variation enrichments suggest a complex mode of inheritance.
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Affiliation(s)
- Guillaume Dorval
- INSERM UMR1163, Laboratory of Hereditary Kidney Diseases, Imagine Institute, 24 Boulevard du Montparnasse, 75015, Paris, France. .,Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France.
| | - Olivier Gribouval
- INSERM UMR1163, Laboratory of Hereditary Kidney Diseases, Imagine Institute, 24 Boulevard du Montparnasse, 75015, Paris, France.,Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France
| | - Vanesa Martinez-Barquero
- INSERM UMR1163, Laboratory of Hereditary Kidney Diseases, Imagine Institute, 24 Boulevard du Montparnasse, 75015, Paris, France.,Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France
| | - Eduardo Machuca
- INSERM UMR1163, Laboratory of Hereditary Kidney Diseases, Imagine Institute, 24 Boulevard du Montparnasse, 75015, Paris, France
| | - Marie-Josèphe Tête
- INSERM UMR1163, Laboratory of Hereditary Kidney Diseases, Imagine Institute, 24 Boulevard du Montparnasse, 75015, Paris, France.,Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France
| | - Véronique Baudouin
- Department of Pediatric Nephrology, Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Paris, France
| | - Stéphane Benoit
- Department of Nephrology, University Hospital of Tours, Tours, France
| | - Imen Chabchoub
- Department of Pediatrics, Sfax University, Sfax, Tunisia
| | - Gérard Champion
- Department of Pediatrics, University Hospital of Angers, Angers, France
| | - Dominique Chauveau
- Department of Nephrology and Organ Transplantation, University Hospital Rangueil, Toulouse, France
| | - Hassib Chehade
- Department of Pediatrics, Division of Pediatric Nephrology, Lausanne University Hospital, Lausanne, Switzerland
| | - Chokri Chouchane
- Department of Pediatrics, Monastir University, Monastir, Tunisia
| | - Sylvie Cloarec
- Department of Nephrology, University Hospital of Tours, Tours, France
| | - Pierre Cochat
- Department of Pediatric Nephrology, Claude-Bernard Lyon 1 University, Bron, France
| | - Karin Dahan
- Department of Human Genetics, Institute of Pathology and Genetics, Gosselies, Belgium
| | - Jacques Dantal
- Nephrology and Immunology Department, University Hospital of Nantes, Nantes, France
| | - Yahsou Delmas
- Department of Nephrology, University Hospital of Bordeaux, Bordeaux, France
| | - Georges Deschênes
- Department of Pediatric Nephrology, Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Paris, France
| | - Phillippe Dolhem
- Department of Pediatrics, Saint-Quentin Hospital, Saint-Quentin, France
| | - Dominique Durand
- Department of Nephrology and Organ Transplantation, University Hospital Rangueil, Toulouse, France
| | | | - Khalil El Karoui
- Department of Nephrology, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Paris, France
| | - Michel Fischbach
- Nephrology Dialysis Transplantation Children's Unit, University Hospital Hautepierre, Strasbourg, France
| | - Jean-Pierre Grunfeld
- Department of Nephrology, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Paris, France
| | - Vincent Guigonis
- Department of Pediatrics, University Hospital of Limoges, Limoges, France
| | | | - Julien Hogan
- Department of Pediatric Nephrology, Assistance Publique-Hôpitaux de Paris, Armand Trousseau Hospital, Paris, France
| | - Maryvonne Hourmant
- Nephrology and Immunology Department, University Hospital of Nantes, Nantes, France
| | - Aurélie Hummel
- Department of Nephrology, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Paris, France
| | - Nassim Kamar
- Department of Nephrology and Organ Transplantation, University Hospital Rangueil, Toulouse, France
| | - Thierry Krummel
- Department of Nephrology, University Hospital Hautepierre, Strasbourg, France
| | - Didier Lacombe
- Department of Genetics, University Hospital of Bordeaux, Bordeaux, France
| | - Brigitte Llanas
- Department of Pediatrics, University Hospital of Bordeaux, Bordeaux, France
| | - Laurent Mesnard
- Department of Nephrology and Dialysis, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Paris, France.,Sorbonne University, UPMC University Paris 06, Paris, France.,INSERM, UMR_S 1155, 75020, Paris, France
| | - Nabil Mohsin
- College of Medicine, Sultan Qaboos University, Muscat, Oman
| | - Patrick Niaudet
- Department of Pediatric Nephrology, Centre de référence du syndrome néphrotique idiopathique de l'enfant et l'adulte, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Paris, France.,Centre de Référence Syndrome Néphrotique Idiopathique de l'enfant et de l'adulte, Paris, France
| | - Hubert Nivet
- Department of Nephrology, University Hospital of Tours, Tours, France
| | - Paloma Parvex
- Department of Pediatrics, Division of Pediatric Nephrology, Geneva University Hospital, Geneva, Switzerland
| | - Christine Pietrement
- Departement of Pediatrics, Nephrology Unit, University Hospital of Reims, Reims, France.,Faculty of Medicine, Laboratory of Biochemistry and Molecular Biology, UMR, CNRS/URCA n°7369, University of Champagne-Ardenne, Reims, France
| | - Loic de Pontual
- Department of Pediatrics, Assistance Publique-Hôpitaux de Paris, Jean Verdier Hospital, Bondy, France
| | - Claire Pouteil Noble
- Department of Nephrology and Transplantation, University Hospital of Lyon, Lyon, France
| | - David Ribes
- Department of Nephrology and Organ Transplantation, University Hospital Rangueil, Toulouse, France
| | - Pierre Ronco
- Department of Nephrology and Dialysis, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Paris, France.,Sorbonne University, UPMC University Paris 06, Paris, France.,INSERM, UMR_S 1155, 75020, Paris, France
| | - Eric Rondeau
- Department of Nephrology and Dialysis, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Paris, France
| | - Marion Sallee
- Department of Nephrology and Kidney Transplantation, The Conception Hospital, Marseille, France
| | - Michel Tsimaratos
- Department of Multidisciplinary Pediatrics Timone, Assistance Publique Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Tim Ulinski
- Department of Pediatric Nephrology, Assistance Publique-Hôpitaux de Paris, Armand Trousseau Hospital, Paris, France
| | - Rémi Salomon
- INSERM UMR1163, Laboratory of Hereditary Kidney Diseases, Imagine Institute, 24 Boulevard du Montparnasse, 75015, Paris, France.,Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France.,Department of Pediatric Nephrology, Centre de référence du syndrome néphrotique idiopathique de l'enfant et l'adulte, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Paris, France.,Centre de Référence Syndrome Néphrotique Idiopathique de l'enfant et de l'adulte, Paris, France
| | - Corinne Antignac
- INSERM UMR1163, Laboratory of Hereditary Kidney Diseases, Imagine Institute, 24 Boulevard du Montparnasse, 75015, Paris, France.,Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France.,Centre de Référence Syndrome Néphrotique Idiopathique de l'enfant et de l'adulte, Paris, France.,Department of Genetics, Assistance Publique-Hôpitaux de Paris, Necker-Enfants malades Hospital, Paris, France
| | - Olivia Boyer
- INSERM UMR1163, Laboratory of Hereditary Kidney Diseases, Imagine Institute, 24 Boulevard du Montparnasse, 75015, Paris, France.,Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France.,Department of Pediatric Nephrology, Centre de référence du syndrome néphrotique idiopathique de l'enfant et l'adulte, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Paris, France.,Centre de Référence Syndrome Néphrotique Idiopathique de l'enfant et de l'adulte, Paris, France
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Loiseau Y, Bacchetta J, Klich A, Ranchin B, Demede D, Laurent A, Baudin F, Garaix F, Roy P, Cochat P. Renal transplantation in children under 3 years of age: Experience from a single-center study. Pediatr Transplant 2018; 22. [PMID: 29341372 DOI: 10.1111/petr.13116] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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] [Accepted: 12/12/2017] [Indexed: 11/28/2022]
Abstract
RTx remains challenging in children under 3 years of age. This single-center study reviewed the medical records of children <3 years transplanted since 1987 (N = 32, Group 1). They were matched for donor type and RTx period with children aged 3-13 years (N = 32, Group 2) and 13-18 years (N = 32, Group 3). There were no between-group significant differences regarding distributions of gender, primary renal disease, proportion of dialysis before RTx, and growth (SDS). Compared to Groups 2 and 3, Group 1 had more peritoneal dialyses (P < .001), more EBV mismatches (P = .04), and longer warm ischemia times (P < .001). The risk of graft loss was not significantly different among age groups (hazard ratio, 2.4 in Group 2 and 2.0 in Group 3 vs Group 1; P = .2). Death occurred in four patients (3 in Group 1 and 1 in Group 2) and graft loss occurred in 28 patients, mainly due to chronic allograft nephropathy. In recipients <3 years of age, the outcomes of RTx are close to those obtained in older pediatric age groups. Thus, young patients may be transplanted in experienced multidisciplinary teams without additional risks provided that particular attention is paid to donor selection and prevention/early diagnosis of comorbidities and complications.
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Affiliation(s)
- Yann Loiseau
- Pédiatrie, Hôpital Nord-Franche-Comté, Trevenans, France.,Service de néphrologie rhumatologie dermatologie pédiatriques, Hôpital Femme Mère Enfant, Bron, France
| | - Justine Bacchetta
- Service de néphrologie rhumatologie dermatologie pédiatriques, Hôpital Femme Mère Enfant, Bron, France.,Université Claude-Bernard Lyon 1, Lyon, France
| | - Amna Klich
- Université Claude-Bernard Lyon 1, Lyon, France.,Service de Biostatistique-Bioinformatique, Lyon, France.,CNRS, Laboratoire de Biométrie et Biologie Evolutive UMR 5558, Villeurbanne, France
| | - Bruno Ranchin
- Service de néphrologie rhumatologie dermatologie pédiatriques, Hôpital Femme Mère Enfant, Bron, France
| | - Delphine Demede
- Service de chirurgie uro-viscérale pédiatrique, Hôpital Femme Mère Enfant, Bron, France
| | - Audrey Laurent
- Service de néphrologie rhumatologie dermatologie pédiatriques, Hôpital Femme Mère Enfant, Bron, France.,Université Claude-Bernard Lyon 1, Lyon, France
| | - Florent Baudin
- Service de réanimation pédiatrique, Hôpital Femme Mère Enfant, Bron, France
| | - Florentine Garaix
- Pédiatrie Multidisciplinaire Timone, CHU Timone-Enfants, Marseille, France
| | - Pascal Roy
- Université Claude-Bernard Lyon 1, Lyon, France.,Service de Biostatistique-Bioinformatique, Lyon, France.,CNRS, Laboratoire de Biométrie et Biologie Evolutive UMR 5558, Villeurbanne, France
| | - Pierre Cochat
- Service de néphrologie rhumatologie dermatologie pédiatriques, Hôpital Femme Mère Enfant, Bron, France.,Université Claude-Bernard Lyon 1, Lyon, France
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45
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Selistre LDS, Cochat P, Rech DL, Parant F, de Souza VC, Dubourg L. Association between glomerular filtration rate (measured by high-performance liquid chromatography with iohexol) and plasma oxalate. J Bras Nefrol 2018; 40:73-76. [PMID: 29738022 PMCID: PMC6533971 DOI: 10.1590/1678-4685-jbn-3743] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 08/31/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Secondary hyperoxalemia is a multifactorial disease that affects several organs and tissues in patients with native or transplanted kidneys. Plasma oxalate may increase during renal failure because it is cleared from the body by the kidneys. However, there is scarce evidence about the association between glomerular filtration rate and plasma oxalate, especially in the early stages of chronic kidney disease (CKD). METHODS A case series focuses on the description of variations in clinical presentation. A pilot study was conducted using a cross-sectional analysis with 72 subjects. The glomerular filtration rate (GFR) and plasma oxalate levels were measured for all patients. Results: Median (IQR) GFR was 70.50 [39.0; 91.0] mL/min/1.73 m2. Plasma oxalate was < 5.0 µmol/L in all patients with a GFR > 30 mL/min/1.73m2. Among the 14 patients with severe CKD (GFR < 30 mL/min/1.73 m2) only 4 patients showed a slightly increased plasma oxalate level (between 6 and 12 µmol/L). CONCLUSION In non-primary hyperoxaluria, plasma oxalate concentration increases when GFR < 30mL/min/1.73 m2 and, in our opinion, values greater than 5 µmol/L with a GFR > 30 mL/min/1.73 m2 are suggestive of primary hyperoxaluria. Further studies are necessary to confirm plasma oxalate increase in patients with low GFR levels (< 30mL/min/1.73 m2).
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Affiliation(s)
| | - Pierre Cochat
- Université Claude-Bernard Lyon, Centre de Référence des Maladies
Rénales Rares Nephrogones, Service de Néphrologie et Rhumatologie Pédiatriques,
Lyon, France
| | | | - François Parant
- Hospices Civils de Lyon, GHS - Centre de Biologie Sud, UM
Pharmacologie - Toxicologie, F-69495, Pierre Bénite, France
| | | | - Laurence Dubourg
- Université Claude-Bernard, Groupement Hospitalier Edouard Herriot,
Hospices Civils de Lyon, UMR 5305, Rhone-Alpes, Lyon, France
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Vivier PH, Augdal TA, Avni FE, Bacchetta J, Beetz R, Bjerre AK, Blickman J, Cochat P, Coppo R, Damasio B, Darge K, El-Ghoneimi A, Hoebeke P, Läckgren G, Leclair MD, Lobo ML, Manzoni G, Marks SD, Mattioli G, Mentzel HJ, Mouriquand P, Nevéus T, Ntoulia A, Ording-Muller LS, Oswald J, Papadopoulou F, Porcellini G, Ring E, Rösch W, Teixeira AF, Riccabona M. Standardization of pediatric uroradiological terms: a multidisciplinary European glossary. Pediatr Radiol 2018; 48:291-303. [PMID: 29138893 PMCID: PMC5790858 DOI: 10.1007/s00247-017-4006-7] [Citation(s) in RCA: 6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 09/27/2017] [Indexed: 01/23/2023]
Abstract
To promote the standardization of nephro-uroradiological terms used in children, the European Society of Paediatric Radiology uroradiology taskforce wrote a detailed glossary. This work has been subsequently submitted to European experts in pediatric urology and nephrology for discussion and acceptance to improve the quality of radiological reports and communication between different clinicians involved in pediatric urology and nephrology.
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Affiliation(s)
- Pierre-Hugues Vivier
- Radiology, Ramsay - Générale de Santé, service de Radiologie, Hôpital Privé de l'Estuaire, 505 rue Irène Joliot Curie, 76620, Le Havre, France. .,Pediatric Radiology, University Hospital Charles Nicolle, Rouen, France.
| | - Thomas A. Augdal
- Pediatric Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Fred E. Avni
- Pediatric Radiology, Jeanne de Flandre Hospital, Lille University hospitals, Lille, France
| | | | - Rolf Beetz
- Pediatric Nephrology, Center for Paediatric and Adolescent Medicine, University Medical Clinic, Mainz, Germany
| | - Anna K. Bjerre
- Pediatric Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Johan Blickman
- Pediatric Radiology, Golisano Childrens Hospital, Rochester, NY USA
| | - Pierre Cochat
- Pediatric nephrology, Hôpital Femme Mère Enfant, Bron, France
| | - Rosana Coppo
- Pediatric nephrology, Regina Margherita Hospital, Turin, Italy
| | | | - Kassa Darge
- Pediatric Radiology, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Alaa El-Ghoneimi
- Pediatric Surgery and Urology, University Hospital Robert Debré, APHP, University of Paris-Diderot, Sorbonne, Paris, France
| | - Piet Hoebeke
- Urology, Ghent University Hospital, Ghent, Belgium
| | - Göran Läckgren
- Pediatric Urology, University Children’s Hospital, Uppsala, Sweden
| | - Marc-David Leclair
- Pediatric Surgery and Urology, Children University Hospital, Nantes, France
| | - Maria-Luisa Lobo
- Radiology, Hospital de Santa Maria, University Hospital, Lisbon, Portugal
| | - Gianantonio Manzoni
- Pediatric Urology, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Stephen D. Marks
- Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Girolamo Mattioli
- Dinogmi University of Genova, Pediatric Surgery and Urology, Gaslini Institute, Genoa, Italy
| | - Hans-Joachim Mentzel
- Pediatric Radiology, Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany
| | - Pierre Mouriquand
- Pediatric Urology, Hôpital Mère-Enfant, Hospices Civils de Lyon and Claude Bernard University, Lyon 1, France
| | - Tryggve Nevéus
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Aikaterini Ntoulia
- Pediatric Radiology, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA ,Paediatric Radiology, King’s College Hospital, London, UK
| | | | - Josef Oswald
- Pediatric Urology, Hospital of the Sisters of Charity, Linz, Austria
| | | | | | - Ekkehard Ring
- Department of Pediatrics, University Hospital LKH Graz, Graz, Austria
| | - Wolfgang Rösch
- Pediatric Urology, University Medical Center Regensburg, Regensburg, Germany
| | - Ana F. Teixeira
- Pediatric Nephrology, Centro Hospitalar São João, Porto, Portugal
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47
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Lemoine S, Cochat P, Bertholet-Thomas A, Levi C, Bonnefoy C, Sellier-Leclerc AL, Bacchetta J. Néphrologie pédiatrique : que doit savoir un néphrologue d’adulte sur ces pathologies ? Nephrol Ther 2017; 13:495-504. [DOI: 10.1016/j.nephro.2017.01.025] [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] [Received: 06/27/2016] [Revised: 01/31/2017] [Accepted: 01/31/2017] [Indexed: 11/25/2022]
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48
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Vivier PH, Augdal TA, Avni FE, Bacchetta J, Beetz R, Bjerre AK, Blickman J, Cochat P, Coppo R, Damasio B, Darge K, El-Ghoneimi A, Hoebeke P, Läckgren G, Leclair MD, Lobo ML, Manzoni G, Marks SD, Mattioli G, Mentzel HJ, Mouriquand P, Nevéus T, Ntoulia A, Ording-Muller LS, Oswald J, Papadopoulou F, Porcellini G, Ring E, Rösch W, Teixeira AF, Riccabona M. Standardization of pediatric uroradiological terms: A multidisciplinary European glossary. J Pediatr Urol 2017; 13:641-650. [PMID: 29174378 DOI: 10.1016/j.jpurol.2017.05.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 05/29/2017] [Indexed: 10/19/2022]
Abstract
To promote the standardization of nephro-uroradiological terms used in children, the European Society of Pediatric Radiology uroradiology taskforce wrote a detailed glossary. This work has been subsequently submitted to European experts in pediatric urology and nephrology for discussion and acceptance to improve the quality of radiological reports and communication among different clinicians involved in pediatric urology and nephrology.
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Affiliation(s)
- Pierre-Hugues Vivier
- Radiology, Ramsay - Générale de Santé, Hôpital Privé de l'Estuaire, Le Havre, France; Pediatric Radiology, University Hospital Charles Nicolle, Rouen, France.
| | - Thomas A Augdal
- Pediatric Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Fred E Avni
- Pediatric Radiology, Jeanne de Flandre Hospital, Lille University Hospitals, Lille, France
| | | | - Rolf Beetz
- Pediatric Nephrology, Center for Paediatric and Adolescent Medicine, University Medical Clinic, Mainz, Germany
| | - Anna K Bjerre
- Pediatric Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Johan Blickman
- Pediatric Radiology, Golisano Children's Hospital, Rochester, NY, USA
| | - Pierre Cochat
- Pediatric Nephrology, Hôpital Femme Mère Enfant, Bron, France
| | - Rosana Coppo
- Pediatric Nephrology, Regina Margherita Hospital, Turin, Italy
| | | | - Kassa Darge
- Pediatric Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alaa El-Ghoneimi
- Pediatric Surgery and Urology, University Hospital Robert Debré, APHP, University of Paris-Diderot, Sorbonne, Paris, France
| | | | - Göran Läckgren
- Pediatric Urology, University Children's Hospital, Uppsala, Sweden
| | - Marc-David Leclair
- Pediatric Surgery and Urology, Children University Hospital, Nantes, France
| | - Maria-Luisa Lobo
- Radiology, Hospital de Santa Maria, University Hospital, Lisbon, Portugal
| | - Gianantonio Manzoni
- Pediatric Urology, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Stephen D Marks
- Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Girolamo Mattioli
- Dinogmi University of Genova, Pediatric Surgery and Urology, Gaslini Institute, Genova, Italy
| | - Hans-Joachim Mentzel
- Pediatric Radiology, Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany
| | - Pierre Mouriquand
- Pediatric Urology, Hôpital Mère-Enfant, Hospices Civils de Lyon and Claude Bernard University, Lyon 1, France
| | - Tryggve Nevéus
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Aikaterini Ntoulia
- Pediatric Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Paediatric Radiology, King's College Hospital, London, UK
| | | | - Josef Oswald
- Pediatric Urology, Hospital of the Sisters of Charity, Linz, Austria
| | | | | | - Ekkehard Ring
- Department of Pediatrics, University Hospital LKH Graz, Austria
| | - Wolfgang Rösch
- Pediatric Urology, University Medical Center Regensburg, Regensburg, Germany
| | - Ana F Teixeira
- Pediatric Nephrology, Centro Hospitalar São João, Porto, Portugal
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De Rechter S, Bacchetta J, Godefroid N, Dubourg L, Cochat P, Maquet J, Raes A, De Schepper J, Vermeersch P, Van Dyck M, Levtchenko E, D'Haese P, Evenepoel P, Mekahli D. Evidence for Bone and Mineral Metabolism Alterations in Children With Autosomal Dominant Polycystic Kidney Disease. J Clin Endocrinol Metab 2017; 102:4210-4217. [PMID: 29092060 DOI: 10.1210/jc.2017-01157] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 05/19/2017] [Accepted: 09/13/2017] [Indexed: 01/08/2023]
Abstract
CONTEXT Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease. Hypophosphatemia was demonstrated in adult patients with preserved renal function, together with high fibroblast growth factor 23 (FGF23) and low soluble Klotho levels. The latter explained the relative FGF23 hyporesponsiveness in this cohort. OBJECTIVE Evaluating phosphate and bone mineral metabolism in children with ADPKD compared with what is known in adult ADPKD patients. DESIGN Observational cross-sectional study. SETTING Multicenter study via ambulatory care in tertiary centers. PARTICIPANTS Ninety-two children with ADPKD (52 males; mean ± standard deviation age, 10.2 ± 5.0 years) and 22 healthy controls (HCs, 10 males; mean ± standard deviation age, 10.3 ± 4.1 years). MAIN OUTCOME MEASURES The predictor was early ADPKD stage. Bone mineral metabolism and renal phosphate handling were the main outcome measures. Performed measurements were serum phosphate, tubular maximum phosphorus reabsorption per glomerular filtration rate, FGF23, soluble Klotho, sclerostin, and bone alkaline phosphatase. RESULTS ADPKD children had significantly lower serum phosphate levels compared with HC. Low tubular maximum phosphorus reabsorption per glomerular filtration rate was observed in 24% of patients, although not significantly different from HC. Serum FGF23 and soluble Klotho levels were comparable between patients and HC. In addition, we showed decreased bone alkaline phosphatase levels in ADPKD children, suggesting suppressed bone formation. CONCLUSIONS This report demonstrates hypophosphatemia and suppressed bone formation in a pediatric ADPKD cohort, with preserved renal function, compared with HC. Although FGF23 levels were not different from controls, they should be considered inappropriate, given the concomitant hypophosphatemia. Further studies are required to elucidate underlying pathophysiology and potential clinical consequences.
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Affiliation(s)
- Stéphanie De Rechter
- Department of Pediatric Nephrology, University Hospitals Leuven, Leuven 3000, Belgium
- Laboratory of Pediatric Nephrology, KU Leuven, Leuven, Leuven 3000, Belgium
| | - Justine Bacchetta
- Centre de Référence des Maladies Rénales Rares, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500 Bron, France
| | - Nathalie Godefroid
- Department of Pediatric Nephrology, Cliniques Universitaires Saint-Luc, Brussels 1200, Belgium
| | - Laurence Dubourg
- Centre de Référence des Maladies Rénales Rares, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500 Bron, France
| | - Pierre Cochat
- Centre de Référence des Maladies Rénales Rares, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500 Bron, France
| | - Julie Maquet
- Department of Pediatric Nephrology, CHC, Liège 4420, Belgium
| | - Ann Raes
- Department of Pediatric Nephrology, University Hospitals Ghent, Ghent 9000, Belgium
| | - Jean De Schepper
- Department of Pediatric Endocrinology, Department of Pediatrics, Brussels University Hospital, Brussels 1090, Belgium
| | - Pieter Vermeersch
- Laboratory Medicine, University Hospitals Leuven 3000, Leuven, Belgium
| | - Maria Van Dyck
- Department of Pediatric Nephrology, University Hospitals Leuven, Leuven 3000, Belgium
- Laboratory of Pediatric Nephrology, KU Leuven, Leuven, Leuven 3000, Belgium
| | - Elena Levtchenko
- Department of Pediatric Nephrology, University Hospitals Leuven, Leuven 3000, Belgium
- Laboratory of Pediatric Nephrology, KU Leuven, Leuven, Leuven 3000, Belgium
| | - Patrick D'Haese
- Laboratory of Pathophysiology, University of Antwerp, Antwerp 2000, Belgium
| | - Pieter Evenepoel
- Department of Internal Medicine, Division of Nephrology, University Hospitals Leuven, Leuven 3000, Belgium
| | - Djalila Mekahli
- Department of Pediatric Nephrology, University Hospitals Leuven, Leuven 3000, Belgium
- Laboratory of Pediatric Nephrology, KU Leuven, Leuven, Leuven 3000, Belgium
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50
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Niamien-Attai C, Bacchetta J, Ranchin B, Sanlaville D, Cochat P. Atteintes rénales de la trisomies 21. Arch Pediatr 2017; 24:1013-1018. [DOI: 10.1016/j.arcped.2017.07.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 03/21/2017] [Accepted: 07/04/2017] [Indexed: 11/28/2022]
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