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2. COVID-19 et transplantation d’organes, les leçons du recensement national de la Société francophone de transplantation

Author

Caillard, S., Moulin, B., Fafi-Kremer, S., Hazzan, M., Anglicheau, D., Hertig, A., Tourret, J., Barrou, B., Morelon, E., Thaunat, O., Couzi, L., Merville, P., Moal, V., Legris, T., Westeel, P.-F., Jaureguy, M., Frimat, L., Ducloux, D., Bamoulid, J., Bertrand, D., Tsimaratos, M., Garaix-Gilardo, F., Dumortier, J., Mussot, S., Roux, A., Sebbag, L., Le Meur, Y., Blancho, G., Masset, C., Kamar, N., Francois, H., Rondeau, E., Bouvier, N., Mousson, C., Buchler, M., Gatault, P., Augusto, J.-F., Duveau, A., Vigneau, C., Morin, M.-C., Chemouny, J., Golbin, L., Grimbert, P., Matignon, M., Durrbach, A., Greze, C., Snanoudj, R., Colosio, C., Schvartz, B., Malvezzi, P., Mariat, C., Thierry, A., Le Quintrec, M., Sicard, A., Rerolle, J.P., Heng, A.-É., Garrouste, C., Coponat, H.V., Epailly, É., Brugiere, O., Dharancy, S., Salame, É., Saliba, F., and Caillard, Sophie

Published
2022
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8. Factors associated with changes in echocardiographic parameters following kidney transplantation.

Author

d'Hervé, Q., Girerd, N., Bozec, E., Lamiral, Z., Panisset, V., Frimat, L., Huttin, O., and Girerd, S.

Abstract

Background: Chronic kidney disease leads to cardiac remodelling of multifactorial origin known as "uraemic cardiomyopathy", the reversibility of which after kidney transplantation (KT) remains controversial. Our objectives were to assess, in the modern era, changes in echocardiographic parameters following KT and identify predictive clinical and biological factors associated with echocardiographic changes. Methods: One hundred six patients (mean age 48 ± 16, 73% male) who underwent KT at the University Hospital of Nancy between 2007 and 2018 were retrospectively investigated. Pre- and post-KT echocardiography findings (8.6 months before and 22 months after KT on average, respectively) were centralised, blind-reviewed and compared. Results: A majority of patients (60%) had either a left ventricular (LV) ejection fraction < 50%, at least moderately abnormal LV mass index or left atrial (LA) dilatation at pretransplanted echocardiography. After KT, LV remodelling and diastolic doppler indices did not significantly change whereas LA volume index (LAVI) increased (35.9 mL/m2 post-KT vs. 30.9 mL/m2 pre-KT, p = 0.006). Advancing age, cardiac valvular disease, delayed graft function, lower post-KT haemoglobin, and more severe post-KT hypertension were associated with higher LAVI after KT. Higher post-KT serum creatinine, more severe post-KT hypertension and lower pre-KT blood calcium levels were associated with a deterioration in LAVI after KT. Discussion/Conclusion: Adverse remodelling of the left atrial volume occurred after KT, predominantly in patients with lower pre-KT blood calcium, poorer graft function and post-KT hypertension. These results suggest that a better management of modifiable factors such as pre-KT hyperparathyroidism or post-KT hypertension could limit post-KT cardiac remodelling. [ABSTRACT FROM AUTHOR]

Published
2024
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17. Evolution du profil cognitive des patients ayant une maladie rénale chronique : étude longitudinale de la cohorte CKD REIN

Author

Levassort, H., primary, Pépin, M., additional, Boucquemont, J., additional, Lambert, O., additional, Alencar De Pinho, N., additional, Turinici, M., additional, Helmer, C., additional, Metzger, M., additional, Teillet, L., additional, Frimat, L., additional, Combe, C., additional, Fouque, D., additional, Laville, M., additional, Ayav, C., additional, and Jacquelinet, C., additional

Published
2022
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46. Evaluation of the adequacy of drug prescriptions in patients with chronic kidney disease: results from the CKD-REIN cohort

Author

Laville, S. M., Metzger, M., Stengel, B., Jacquelinet, C., Combe, C., Fouque, Denis, Laville, M., Frimat, L., Ayav, C., Speyer, E., Robinson, B. M., Massy, Z. A., Liabeuf, S., Chronic Kidney Dis Renal, Epidemiol, Information Network, C. K. D. Rein Stud, Université de Picardie Jules Verne (UPJV), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse, Agence de la biomédecine [Saint-Denis la Plaine], Service de Néphrologie-Transplantation-Dialyse, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] (Pôle S2R), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Réseau Lorrain de prise en charge de l’insuffisance rénale chronique : Réseau NEPHROLOR (Nephrolor), Service Néphrologie/Dialyse [AP-HP Ambroise-Paré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Centre de Recherche Clinique, CHU Amiens-Picardie, CKD REIN, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Néphrologie [Ambroise Paré], Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Ambroise Paré, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Service de Néphrologie Transplantation, Dialyse et Aphérèse [CHU Bordeaux], CHU Bordeaux [Bordeaux], INSERM U1026 (INSERM, U1026), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Service de Néphrologie [CHRU Nancy], Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Arbor Research Collaborative for Health, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), DIPI (DIPI), ENISE, Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux, and Université de Picardie Jules Verne (UPJV)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
pharmacoepidemiology, adjustment, [SDV]Life Sciences [q-bio], cockcroft-gault, prescribing, urologic and male genital diseases, female genital diseases and pregnancy complications, information, medications, equations, residents, community, epidemiology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, guidelines, Pharmacology & Pharmacy, drug utilization, ComputingMilieux_MISCELLANEOUS, chronic kidney disease
Abstract

International audience; Aims Drug prescription is difficult to manage in patients with chronic kidney disease (CKD). We assessed the prevalence and determinants of inappropriate drug prescriptions (whether contraindications or inappropriately high doses) with regard to kidney function in patients with CKD under nephrology care. We also assessed the impact of the equation used to estimate GFR on the prevalence estimates. Methods Results The CKD-REIN cohort includes 3033 outpatients with CKD (eGFR between 15 and 60 ml min(-1) 1.73 m(-2)). We examined the daily doses of pharmacological agents prescribed at study entry. Inappropriate prescription was defined as the reported prescription of either a contraindicated drug or an indicated drug at an inappropriately high dose level with regard to the patient's GFR, as estimated with the CKD-EPI equation, the de-indexed CKD-EPI equation, or the Cockcroft-Gault (CG) equation. Multivariate logistic regression was used to assess the determinants of inappropriate prescription risk. At baseline, patients' median [interquartile range] number of drugs prescribed per patient was 8 [5-10]. Half of the patients had been prescribed at least one inappropriate drug. Anti-gout, cardiovascular agents and antidiabetic agents accounted for most of the inappropriate prescriptions. The percentage of inappropriate prescriptions varied from one GFR equation to another: 52% when using the CKD-EPI equation, 47% when using the de-indexed CKD-EPI equation and 41% with the CG equation. A multiple logistic regression analysis showed significantly higher odds ratios [95% confidence interval] for inappropriate prescriptions in male patients (1.28 [1.07; 1.53]), patients with diabetes (1.34 [1.06; 1.70]), those with a high BMI (1.58 [1.25; 1.99]), and those with a low GFR (10.2 [6.02; 17.3]). The risk of having at least one inappropriate prescription increased with the number of drugs per patient (P for trend \textless 0.0001) and therefore the odds ratio was 5.88 [4.17; 8.28] for those who received at least 11 prescribed medications compared to those who received fewer than 5. Conclusion Appendix Our results emphasize the complexity of drug management for CKD patients, for whom inappropriate prescription appears to be common.

Published
2018

49. Short leukocyte telomere length precedes clinical expression of atherosclerosis the blood-And-muscle model

Author

Benetos, A. Toupance, S. Gautier, S. Labat, C. Kimura, M. Rossi, P.M. Settembre, N. Hubert, J. Frimat, L. Bertrand, B. Boufi, M. Flecher, X. Sadoul, N. Eschwege, P. Kessler, M. Tzanetakou, I.P. Doulamis, I.P. Konstantopoulos, P. Tzani, A. Korou, M. Gkogkos, A. Perreas, K. Menenakos, E. Samanidis, G. Vasiloglou-Gkanis, M. Kark, J.D. Malikov, S. Verhulst, S. Aviv, A.

Abstract

Rationale: Short telomere length (TL) in leukocytes is associated with atherosclerotic cardiovascular disease (ASCVD). It is unknown whether this relationship stems from having inherently short leukocyte TL (LTL) at birth or a faster LTL attrition thereafter. LTL represents TL in the highly proliferative hematopoietic system, whereas TL in skeletal muscle represents a minimally replicative tissue. Objective: We measured LTL and muscle TL (MTL) in the same individuals with a view to obtain comparative metrics for lifelong LTL attrition and learn about the temporal association of LTL with ASCVD. Methods and Results: Our Discovery Cohort comprised 259 individuals aged 63±14 years (mean±SD), undergoing surgery with (n=131) or without (n=128) clinical manifestation of ASCVD. In all subjects, MTL adjusted for muscle biopsy site (MTLA) was longer than LTL and the LTL-MTLA gap similarly widened with age in ASCVD patients and controls. Age-and sex-Adjusted LTL (P=0.005), but not MTLA (P=0.90), was shorter in patients with ASCVD than controls. The TL gap between leukocytes and muscle (LTL-MTLA) was wider (P=0.0003), and the TL ratio between leukocytes and muscle (LTL/MTLA) was smaller (P=0.0001) in ASCVD than in controls. Findings were replicated in a cohort comprising 143 individuals. Conclusions: This first study to apply the blood-And-muscle TL model shows more pronounced LTL attrition in ASCVD patients than controls. The difference in LTL attrition was not associated with age during adulthood suggesting that increased attrition in early life is more likely to be a major explanation of the shorter LTL in ASCVD patients. © 2017 The Authors.

Published
2018

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