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1. Dietary Patterns and Mortality in a Multinational Cohort of Adults Receiving Hemodialysis

Author

Saglimbene, Valeria M., primary, Wong, Germaine, additional, Teixeira-Pinto, Armando, additional, Ruospo, Marinella, additional, Garcia-Larsen, Vanessa, additional, Palmer, Suetonia C., additional, Natale, Patrizia, additional, Campbell, Katrina, additional, Carrero, Juan-Jesus, additional, Stenvinkel, Peter, additional, Gargano, Letizia, additional, Murgo, Angelo M., additional, Johnson, David W., additional, Tonelli, Marcello, additional, Gelfman, Rubén, additional, Celia, Eduardo, additional, Ecder, Tevfik, additional, Bernat, Amparo G., additional, Del Castillo, Domingo, additional, Timofte, Delia, additional, Török, Marietta, additional, Bednarek-Skublewska, Anna, additional, Duława, Jan, additional, Stroumza, Paul, additional, Hansis, Martin, additional, Fabricius, Elisabeth, additional, Felaco, Paolo, additional, Wollheim, Charlotta, additional, Hegbrant, Jörgen, additional, Craig, Jonathan C., additional, Strippoli, Giovanni F.M., additional, Badino, A., additional, Petracci, L., additional, Villareal, C., additional, Soto, M., additional, Arias, M., additional, Vera, F., additional, Quispe, V., additional, Morales, S., additional, Bueno, D., additional, Bargna, R., additional, Peñaloza, G., additional, Alcalde, L., additional, Dayer, J., additional, Milán, A., additional, Centurión, N., additional, Ramos, A., additional, De Orta, E., additional, Menardi, S., additional, Austa Bel, N., additional, Marileo, E., additional, Junqueras, N., additional, Favalli, C., additional, Trioni, R., additional, Valle, G., additional, López, M., additional, Marinaro, C., additional, Fernandez, A., additional, Corral, J., additional, Nattiello, E., additional, Marone, S., additional, García, J., additional, Carrizo, G., additional, González, P., additional, Delicia, O., additional, Maza, M., additional, Chauque, M., additional, Mora, J., additional, Grbavac, D., additional, López, L., additional, Alonso, M., additional, Villalba, C., additional, Simon, M., additional, Cernadas, M., additional, Moscatelli, C., additional, Vilamajó, I., additional, Tursky, C., additional, Martínez, M., additional, Villalba, F., additional, Pereira, D., additional, Araujo, S., additional, López, H., additional, Alonso, V., additional, Vázquez, B., additional, Rapetti, M., additional, Raña, S., additional, Capdevila, M., additional, Ljubich, C., additional, Acosta, M., additional, Coombes, M., additional, Doria, V., additional, Ávila, M., additional, Cáceres, D., additional, Geandet, E., additional, Romero, C., additional, Morales, E., additional, Recalde, C., additional, Casanú, M., additional, Lococo, B., additional, Da Cruz, O., additional, Focsaner, C., additional, Galarce, D., additional, Albarracín, L., additional, Vescovo, E., additional, Gravielle, M., additional, Florio, D., additional, Baumgart, L., additional, Corbalán, M., additional, Aguilera, V., additional, Hermida, O., additional, Galli, C., additional, Ziombra, L., additional, Gutierrez, A., additional, Frydelund, S., additional, Hardaman, A., additional, Maciel, A., additional, Arrigo, M., additional, Mato Mira, C., additional, Leibovich, J., additional, Paparone, R., additional, Muller, E., additional, Malimar, A., additional, Leocadio, I., additional, Cruz, W., additional, Tirado, S., additional, Peñalba, A., additional, Cejas, R., additional, Mansilla, S., additional, Campos, C., additional, Abrego, E., additional, Chávez, P., additional, Corpacci, G., additional, Echavarría, A., additional, Engler, C., additional, Vergara, P., additional, Hubeli, M., additional, Redondo, G., additional, Noroña, B., additional, Boriceanu, C., additional, Lankester, M., additional, Poignet, J.L., additional, Saingra, Y., additional, Indreies, M., additional, Santini, J., additional, Mahi, A., additional, Robert, A., additional, Bouvier, P., additional, Merzouk, T., additional, Villemain, F., additional, Pajot, A., additional, Tollis, F., additional, Brahim-Bounab, M., additional, Benmoussa, A., additional, Albitar, S., additional, Guimont, M.C., additional, Ciobotaru, P., additional, Guerin, A., additional, Diaconita, M., additional, Hoischen, S.H., additional, Saupe, J., additional, Ullmann, I., additional, Grosser, S., additional, Kunow, J., additional, Grueger, S., additional, Bischoff, D., additional, Benders, J., additional, Worch, P., additional, Pfab, T., additional, Kamin, N., additional, Roesch, M., additional, May, M., additional, Albert, K., additional, Csaszar, I., additional, Kiss, E., additional, Kosa, D., additional, Orosz, A., additional, Redl, J., additional, Kovacs, L., additional, Varga, E., additional, Szabo, M., additional, Magyar, K., additional, Zajko, E., additional, Bereczki, A., additional, Csikos, J., additional, Kerekes, E., additional, Mike, A., additional, Steiner, K., additional, Nemeth, E., additional, Tolnai, K., additional, Toth, A., additional, Vinczene, J., additional, Szummer, S.z., additional, Tanyi, E., additional, Szilvia, M., additional, Murgo, A.M., additional, Sanfilippo, N., additional, Dambrosio, N., additional, Saturno, C., additional, Matera, G., additional, Benevento, M., additional, Greco, V., additional, di Leo, G., additional, Papagni, S., additional, Alicino, F., additional, Marangelli, A., additional, Pedone, F., additional, Cagnazzo, A.V., additional, Antinoro, R., additional, Sambati, M.L., additional, Donatelli, C., additional, Ranieri, F., additional, Torsello, F., additional, Steri, P., additional, Riccardi, C., additional, Flammini, A., additional, Moscardelli, L., additional, Boccia, E., additional, Mantuano, M., additional, Di Toro Mammarella, R., additional, Meconizzi, M., additional, Fichera, R., additional, D’Angelo, A., additional, Latassa, G., additional, Molino, A., additional, Fici, M., additional, Lupo, A., additional, Montalto, G., additional, Messina, S., additional, Capostagno, C., additional, Randazzo, G., additional, Pagano, S., additional, Marino, G., additional, Rallo, D., additional, Maniscalco, A., additional, Trovato, O.M., additional, Strano, C., additional, Failla, A., additional, Bua, A., additional, Campo, S., additional, Nasisi, P., additional, Salerno, A., additional, Laudani, S., additional, Grippaldi, F., additional, Bertino, D., additional, Di Benedetto, D.V., additional, Puglisi, A., additional, Chiarenza, S., additional, Lentini Deuscit, M., additional, Incardona, C.M., additional, Scuto, G., additional, Todaro, C., additional, Dino, A., additional, Novello, D., additional, Coco, A., additional, Bocheńska-Nowacka, E., additional, Jaroszyński, A., additional, Drabik, J., additional, Wypych-Birecka, M., additional, Daniewska, D., additional, Drobisz, M., additional, Doskocz, K., additional, Wyrwicz-Zielińska, G., additional, Kosicki, A., additional, Ślizień, W., additional, Rutkowski, P., additional, Arentowicz, S., additional, Dzimira, S., additional, Grabowska, M., additional, Ostrowski, J., additional, Całka, A., additional, Grzegorczyk, T., additional, Dżugan, W., additional, Mazur, M., additional, Myślicki, M., additional, Piechowska, M., additional, Kozicka, D., additional, de Sá Martins, V., additional, Aguiar, L., additional, Mira, A.R., additional, Velez, B., additional, Pinheiro, T., additional, Agapi, E., additional, Ardelean, C.L., additional, Baidog, A., additional, Bako, G., additional, Barb, M., additional, Blaga, A., additional, Bodurian, E., additional, Bumbea, V., additional, Dragan, E., additional, Dumitrache, D., additional, Florescu, L., additional, Havasi, N., additional, Hint, S., additional, Ilies, R., additional, Mandita, A.G.M., additional, Marian, R.I., additional, Medrihan, S.L., additional, Mitea, L., additional, Mitea, S., additional, Mocanu, R., additional, Moro, D.C., additional, Nitu, M., additional, Popa, M.L., additional, Popa, M., additional, Railean, E., additional, Scuturdean, A.R., additional, Szentendrey, K., additional, Teodoru, C.L., additional, Varga, A., additional, García, M., additional, Olaya, M., additional, Abujder, V., additional, Carreras, J., additional, López, A., additional, Ros, F., additional, Cuesta, G., additional, García, A., additional, Orero, E., additional, Ros, E., additional, Bea, S., additional, Pizarro, J.L., additional, Luengo, S., additional, Romero, A., additional, Navarro, M., additional, Cermeño, L., additional, Rodriguez, A., additional, Lopez, D., additional, Barrera, A., additional, Montoya, F., additional, Tajahuerce, J., additional, Carro, M., additional, Cunill, M.Q., additional, Narci, S., additional, Ballester, T., additional, Soler, M.J., additional, Traver, S., additional, Buta, P.P., additional, Cucuiat, L., additional, Rosu, L., additional, Garcia, I., additional, Gavra, C.M., additional, Gonzalez, R., additional, Filimon, S., additional, Peñalver, M., additional, Benages, V., additional, Cardo, M.I., additional, García, E., additional, Soler, P., additional, Fernnandez, E., additional, Popescu, F., additional, Munteanu, R., additional, Tanase, E., additional, Sagau, F., additional, Prades, D., additional, Esteller, S., additional, Gonzalez, E., additional, Martinez, R., additional, Diago, A., additional, Torres, J., additional, Perez, E., additional, Garcia, C., additional, Lluch, I., additional, Forcano, J., additional, Fóns, M., additional, Rodríguez, A., additional, Millán, N.A., additional, Fernández, J., additional, Ferreiro, B., additional, Otero, M., additional, Pesqueira, V., additional, Abal, S., additional, Álvarez, R., additional, Jorge, C., additional, Rico, I., additional, de Dios Ramiro, J., additional, Duzy, L., additional, Soto, A., additional, Lopez, J.L., additional, Diaz, Y., additional, Herrero, I., additional, Farré, M., additional, Blasco, C., additional, Ferrás, S., additional, Agost, M.J., additional, Miracle, C., additional, Farto, J., additional, Goch, J., additional, Katzarski, K.S., additional, Wulcan, A., additional, Akbiber, H., additional, Arslan, H., additional, Bicen, L., additional, Buyukkiraz, A., additional, Celik, R., additional, Dogan, I.S., additional, Erkalkan, S., additional, Ertas, A., additional, Hark, U., additional, Iravul, E., additional, Karakaya, M., additional, Mengu, K., additional, Ongun, S., additional, Ozkan, Z., additional, Ozlu, A., additional, Ozveren, N., additional, Sifil, H.M., additional, Sonmez Turksoz, N., additional, and Yilmaz, Z., additional

Published
2020
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4. Nutrition and dietary intake and their association with mortality and hospitalisation in adults with chronic kidney disease treated with haemodialysis: protocol for DIET-HD, a prospective multinational cohort study

Author

Palmer, Sc, Ruospo, M, Campbell, Kl, Garcia Larsen, V, Saglimbene, V, Natale, P, Gargano, L, Craig, Jc, Johnson, Dw, Tonelli, M, Knight, J, Bednarek Skublewska, A, Celia, E, Del Castillo, D, Dulawa, J, Ecder, T, Fabricius, E, Frazão, Jm, Gelfman, R, Hoischen, Sh, Schön, S, Stroumza, P, Timofte, D, Török, M, Hegbrant, J, Wollheim, C, Frantzen, L, Strippoli, Gf, Raña, S, Serrano, M, Claros, S, Arias, M, Petracci, L, Arana, M, De Rosa, P, Gutierrez, A, Simon, M, Vergara, V, Tosi, M, Cernadas, M, Vilamajó, I, Gravac, D, Paulón, M, Penayo, L, Carrizo, G, Ghiani, M, Perez, G, Da Cruz, O, Galarce, D, Gravielle, M, Vescovo, E, Paparone, R, Mato Mira, C, Mojico, E, Hermida, O, Florio, D, Yucoswky, M, Labonia, W, Rubio, D, Di Napoli, G, Fernandez, A, Altman, H, Rodriguez, J, Serrano, S, Valle, G, Lobos, M, Acosta, V, Corpacci, G, Jofre, M, Gianoni, L, Chiesura, G, Capdevila, M, Montenegro, J, Bequi, J, Dayer, J, Gómez, A, Calderón, C, Abrego, E, Cechín, C, García, J, Corral, J, Natiello, M, Coronel, A, Muñiz, M, Muñiz, V, Bonelli, A, Sanchez, F, Maestre, S, Olivera, S, Camargo, M, Avalos, V, Geandet, E, Canteli, M, Escobar, A, Sena, E, Tirado, S, Peñalba, A, Neme, G, Cisneros, M, Oliszewski, R, Nascar, V, Daud, M, Mansilla, S, Paredes Álvarez, A, Gamín, L, Arijón, M, Coombes, M, Zapata, M, Boriceanu, C, Lankester, M, Poignet, Jl, Saingra, Y, Indreies, M, Santini, J, Amar, M, Robert, A, Bouvier, P, Merzouk, T, Villemain, F, Pajot, A, Tollis, F, Brahim Bounab, M, Benmoussa, A, Albitar, S, Guimont, Mc, Ciobotaru, P, Guerin, A, Diaconita, M, Shh, Saupe, J, Ullmann, I, Grosser, S, Kunow, J, Grueger, S, Bischoff, D, Benders, J, Worch, P, Pfab, T, Kamin, N, Roesch, M, Albert, K, Csaszar, I, Kiss, E, Kosa, D, Orosz, A, Redl, J, Kovacs, L, Varga, E, Szabo, M, Magyar, K, Zajko, E, Bereczki, A, Csikos, J, Kerekes, E, Mike, A, Steiner, K, Nemeth, E, Tolnai, K, Toth, A, Vinczene, J, Szummer, S, Tanyi, E, Szilvia, M, Murgo, Am, Sanfilippo, N, Dambrosio, N, Saturno, C, Matera, G, Benevento, M, Greco, V, di Leo, G, Papagni, S, Alicino, F, Marangelli, A, Pedone, F, Cagnazzo, Av, Antinoro, R, Sambati, Ml, Donatelli, C, Ranieri, F, Torsello, F, Steri, P, Riccardi, C, Flammini, A, Moscardelli, L, Boccia, E, Mantuano, M, Di Toro Mammarella, R, Meconizzi, M, Fichera, R, D'Angelo, A, Latassa, G, Molino, A, Fici, M, Lupo, Antonio, Montalto, G, Messina, S, Capostagno, C, Randazzo, G, Pagano, S, Marino, G, Rallo, D, Maniscalco, A, Trovato, Om, Strano, C, Failla, A, Bua, A, Campo, S, Nasisi, P, Salerno, A, Laudani, S, Grippaldi, F, Bertino, D, Di Benedetto, Dv, Puglisi, A, Chiarenza, S, Lentini Deuscit, M, Incardona, Cm, Scuto, G, Todaro, C, Dino, A, Novello, D, Coco, A, Bocheńska Nowacka, E, Jaroszyński, A, Drabik, J, Wypych Birecka, M, Daniewska, D, Drobisz, M, Doskocz, K, Wyrwicz Zielińska, G, Kosicki, A, Ślizień, Ws, Rutkowski, P, Arentowicz, S, Dzimira, S, Grabowska, M, Ostrowski, J, Całka, A, Grzegorczyk, T, Dżugan, W, Mazur, M, Myślicki, M, Piechowska, M, Kozicka, D, Mira, Ar, Martins, V, Velez, B, Pinheiro, T, Agapi, E, Ardelean, Cl, Baidog, A, Bako, G, Barb, M, Blaga, A, Bodurian, E, Bumbea, V, Dragan, E, Dumitrache, D, Florescu, L, Havasi, N, Hint, S, Ilies, R, Mandita, Ag, Marian, Ri, Medrihan, Sl, Mitea, L, Mitea, S, Mocanu, R, Moro, Dc, Nitu, M, Popa, Ml, Popa, M, Railean, E, Scuturdean, Ar, Szentendrey, K, Teodoru, Cl, Varga, A, Bernat, A, De la Torre, B, Lopez, A, Martin, J, Cuesta, G, Rodriguez, Rm, Ros, F, Garcia, M, Orero, E, Ros, E, Goch, J, Katzarski, Ks, Wulcan, A, Akbiber, H, Arslan, H, Bicen, L, Buyukkiraz, A, Celik, R, Dogan, Is, Erkalkan, S, Ertas, A, Hark, U, Iravul, E, Karakaya, M, Mengu, K, Ongun, S, Ozkan, Z, Ozlu, A, Ozveren, N, Sifil, Hm, Sonmez Turksoz, N, and Yilmaz, Z.

Subjects
Adult, Male, medicine.medical_specialty, Pediatrics, Adolescent, Turkey, medicine.medical_treatment, Argentina, NUTRITION & DIETETICS, Nutritional Status, Infections, Young Adult, Informed consent, Renal Dialysis, Cause of Death, Fatty Acids, Omega-6, Epidemiology, Fatty Acids, Omega-3, medicine, Protocol, Humans, EPIDEMIOLOGY, Social determinants of health, hemodialysis, Prospective Studies, Prospective cohort study, Dialysis, Renal Medicine, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], General Medicine, medicine.disease, Europe, Hospitalization, Cardiovascular Diseases, Food, Research Design, Emergency medicine, Kidney Failure, Chronic, Female, Hemodialysis, business, Energy Intake, Kidney disease, Cohort study
Abstract

Contains fulltext : 153534.pdf (Publisher’s version ) (Open Access) INTRODUCTION: Adults with end-stage kidney disease (ESKD) treated with haemodialysis experience mortality of between 15% and 20% each year. Effective interventions that improve health outcomes for long-term dialysis patients remain unproven. Novel and testable determinants of health in dialysis are needed. Nutrition and dietary patterns are potential factors influencing health in other health settings that warrant exploration in multinational studies in men and women treated with dialysis. We report the protocol of the "DIETary intake, death and hospitalisation in adults with end-stage kidney disease treated with HaemoDialysis (DIET-HD) study," a multinational prospective cohort study. DIET-HD will describe associations of nutrition and dietary patterns with major health outcomes for adults treated with dialysis in several countries. METHODS AND ANALYSIS: DIET-HD will recruit approximately 10,000 adults who have ESKD treated by clinics administered by a single dialysis provider in Argentina, France, Germany, Hungary, Italy, Poland, Portugal, Romania, Spain, Sweden and Turkey. Recruitment will take place between March 2014 and June 2015. The study has currently recruited 8000 participants who have completed baseline data. Nutritional intake and dietary patterns will be measured using the Global Allergy and Asthma European Network (GA(2)LEN) food frequency questionnaire. The primary dietary exposures will be n-3 and n-6 polyunsaturated fatty acid consumption. The primary outcome will be cardiovascular mortality and secondary outcomes will be all-cause mortality, infection-related mortality and hospitalisation. ETHICS AND DISSEMINATION: The study is approved by the relevant Ethics Committees in participating countries. All participants will provide written informed consent and be free to withdraw their data at any time. The findings of the study will be disseminated through peer-reviewed journals, conference presentations and to participants via regular newsletters. We expect that the DIET-HD study will inform large pragmatic trials of nutrition or dietary interventions in the setting of advanced kidney disease.

Published
2015

12. HIBISCUS: Hydroxychloroquine for the secondary prevention of thrombotic and obstetrical events in primary antiphospholipid syndrome.

Author

Belizna C, Pregnolato F, Abad S, Alijotas-Reig J, Amital H, Amoura Z, Andreoli L, Andres E, Aouba A, Apras Bilgen S, Arnaud L, Bienvenu B, Bitsadze V, Blanco P, Blank M, Borghi MO, Caligaro A, Candrea E, Canti V, Chiche L, Chretien JM, Cohen Tervaert JW, Damian L, Delross T, Dernis E, Devreese K, Djokovic A, Esteve-Valverde E, Favaro M, Fassot C, Ferrer-Oliveras R, Godon A, Hamidou M, Hasan M, Henrion D, Imbert B, Jeandel PY, Jeannin P, Jego P, Jourde-Chiche N, Khizroeva J, Lambotte O, Landron C, Latino JO, Lazaro E, de Leeuw K, Le Gallou T, Kiliç L, Limper M, Loufrani L, Lubin R, Magy-Bertrand N, Mahe G, Makatsariya A, Martin T, Muchardt C, Nagy G, Omarjee L, Van Paasen P, Pernod G, Perrinet F, Pïres Rosa G, Pistorius MA, Ruffatti A, Said F, Saulnier P, Sene D, Sentilhes L, Shovman O, Sibilia J, Sinescu C, Stanisavljevic N, Stojanovich L, Tam LS, Tincani A, Tollis F, Udry S, Ungeheuer MN, Versini M, Cervera R, and Meroni PL

Subjects
Female, Humans, Pregnancy, Pregnancy Outcome, Secondary Prevention, Thrombosis etiology, Antiphospholipid Syndrome complications, Delivery, Obstetric, Hydroxychloroquine therapeutic use, Thrombosis prevention & control
Abstract

The relapse rate in antiphospholipid syndrome (APS) remains high, i.e. around 20%-21% at 5 years in thrombotic APS and 20-28% in obstetrical APS [2, 3]. Hydroxychloroquine (HCQ) appears as an additional therapy, as it possesses immunomodulatory and anti-thrombotic various effects [4-16]. Our group recently obtained the orphan designation of HCQ in antiphospholipid syndrome by the European Medicine Agency. Furthermore, the leaders of the project made the proposal of an international project, HIBISCUS, about the use of Hydroxychloroquine in secondary prevention of obstetrical and thrombotic events in primary APS. This study has been launched in several countries and at now, 53 centers from 16 countries participate to this international trial. This trial consists in two parts: a retrospective and a prospective study. The French part of the trial in thrombosis has been granted by the French Minister of Health in December 2015 (the academic trial independent of the pharmaceutical industry PHRC N PAPIRUS) and is coordinated by one of the members of the leading consortium of HIBISCUS., (Copyright © 2018. Published by Elsevier B.V.)

Published
2018
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13. Low Serum Complement C3 Levels at Diagnosis of Renal ANCA-Associated Vasculitis Is Associated with Poor Prognosis.

Author

Augusto JF, Langs V, Demiselle J, Lavigne C, Brilland B, Duveau A, Poli C, Chevailler A, Croue A, Tollis F, Sayegh J, and Subra JF

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Disease-Free Survival, Female, Humans, Male, Middle Aged, Retrospective Studies, Survival Rate, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis blood, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis diagnosis, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis mortality, Complement C3 metabolism, Kidney Diseases blood, Kidney Diseases diagnosis, Kidney Diseases mortality
Abstract

Background: Recent studies have demonstrated the key role of the complement alternative pathway (cAP) in the pathophysiology of experimental ANCA-associated vasculitis (AAV). However, in human AAV the role of cAP has not been extensively explored. In the present work, we analysed circulating serum C3 levels measured at AAV onset and their relation to outcomes., Methods: We conducted a retrospective observational cohort study including 45 consecutive patients with AAV diagnosed between 2000 and 2014 with serum C3 measurement at diagnosis, before immunosuppressive treatment initiation. Two groups were defined according to the median serum C3 level value: the low C3 group (C3<120 mg/dL) and the high C3 level group (C3≥120 mg/dL). Patient and renal survivals, association between C3 level and renal pathology were analysed., Results: Serum complement C3 concentration remained in the normal range [78-184 mg/dL]. Compared with the high C3 level, the patients in the low C3 level group had lower complement C4 concentrations (P = 0.008) and lower eGFR (P = 0.002) at diagnosis. The low C3 level group had poorer patient and death-censored renal survivals, compared with the high C3 level group (P = 0.047 and P = 0.001, respectively). We observed a significant negative correlation between C3 levels and the percentage of glomeruli affected by cellular crescent (P = 0.017, r = -0.407). According to the Berden et al renal histologic classification, patients in the crescentic/mixed category had low C3 levels more frequently (P<0.01). Interestingly, we observed that when patients with the crescentic/mixed histologic form were analysed according to C3 level, long term renal survival was significantly greater in the high C3 level group than in the low C3 level group (100% vs 40.7% at 6 years, p = 0.046). No relationship between serum C4 and renal outcome was observed., Conclusion: A Low C3 serum level in AAV patients at diagnosis is associated with worse long-term patient and renal survival.

Published
2016
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14. Addition of plasma exchange to glucocorticosteroids for the treatment of severe Henoch-Schönlein purpura in adults: a case series.

Author

Augusto JF, Sayegh J, Delapierre L, Croue A, Tollis F, Cousin M, and Subra JF

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Combined Modality Therapy, Female, Follow-Up Studies, Glomerular Filtration Rate physiology, Humans, IgA Vasculitis physiopathology, Male, Middle Aged, Proteinuria physiopathology, Retrospective Studies, Treatment Outcome, Young Adult, Glucocorticoids therapeutic use, IgA Vasculitis therapy, Plasma Exchange
Abstract

Background: Adult Henoch-Schönlein purpura (HSP) has been associated with poor outcome and end-stage renal disease in >20% of cases. Although the benefit of adding another immunosuppressant to steroids in severe adult HSP has not been shown, the benefit of plasma exchange (PE) therapy has been poorly evaluated., Study Design: Case series., Setting & Participants: 11 consecutive patients with severe and newly diagnosed HSP since 1988 who were treated with steroids and PE., Outcome & Measurement: Patients' characteristics and outcome were analyzed. Birmingham Vasculitis Activity Score (BVAS), estimated glomerular filtration rate (eGFR), and proteinuria were measured at baseline, at the end of PE treatment, at months 6 and 12, and at the last visit. Side effects of corticoid treatment and PE were recorded., Results: 11 patients were identified in 1988-2010. Patients received intravenous corticoid pulses in 64% of cases, followed by oral prednisone for a median of 6.6 months. They received a median of 12 PE sessions. BVAS, eGFR, and proteinuria improved significantly between baseline and the last PE at a median of 2 months. PE sessions were well tolerated, except in one patient who developed central catheter-associated septicemia. One patient required dialysis therapy 15 days after HSP diagnosis and did not recover kidney function. At the last medical evaluation at a mean follow-up of 6 years, median eGFR and proteinuria were 83 ± 22 mL/min/1.73 m(2) and protein excretion of 140 ± 10 mg/d, respectively. 3 women had pregnancy without complications., Limitations: This case series did not have a control group., Conclusions: The combination of PE and corticoid therapy in severe forms of HSP was associated with fast improvement and good long-term outcome., (Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)

Published
2012
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15. [Recommendations for prevention of contrast-media induced nepropathy].

Author

Arkouche W, Brillet G, Cao-Huu T, Issad B, Siohan P, Souid M, Stroumza P, Tollis F, Urena P, and Pengloan J

Subjects
Creatinine blood, Dehydration etiology, Dehydration prevention & control, Female, Humans, Kidney Diseases chemically induced, Male, Risk Assessment, Risk Factors, Contrast Media adverse effects, Kidney Diseases prevention & control
Published
2004

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