Apheresis in Adult With Refractory Idiopathic Nephrotic Syndrome on Native Kidneys
| Autor: | Christophe Mariat, Jean-Michel Halimi, Vincent Audard, Christiane Mousson, Fatouma Touré, Olivier Moranne, Noémie Jourde-Chiche, Lise Marie Pouteau, Lacraz Adeline, Alexandre Cez, Cyril Garrouste, Yahsou Delmas, Léa Moret, Bertrand Knebelman, Alexandre Ganea, Jean François Subra, Olivier Fritz, Myriam Dao, Johan Noble, Charlotte Laurent, Aurélie Hummel |
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| Přispěvatelé: | Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Régional d'Orléans (CHRO), Service Néphrologie et transplantation rénale Adultes [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Centre Hospitalier Universitaire [Grenoble] (CHU), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), CHU Limoges, Service de Néphrologie - Hémodialyses [CHU Clermont-Ferrand], Pôle RHEUNNIRS [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, CHU Rouen, Normandie Université (NU), Centre Hospitalier de la Côte Basque (CHCB), CHU Bordeaux [Bordeaux], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier de La Rochelle (CHR), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier de Laval (CH Laval), Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), CHU Trousseau [Tours], EA4245 - Transplantation, Immunologie, Inflammation [Tours] (T2i), Université de Tours (UT), Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Henri Mondor, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Le CHCB, Centre Hospitalier de la Côte Basque, Service de Département de Néphrologie = Service de Néphrologie et Dialyses [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU) |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment 030232 urology & nephrology Renal function apheresis 030204 cardiovascular system & hematology Gastroenterology [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology 03 medical and health sciences 0302 clinical medicine Focal segmental glomerulosclerosis Refractory Clinical Research Internal medicine minimal change nephrotic syndrome medicine Dialysis focal segmental glomerulosclerosis Proteinuria business.industry nephrotic syndrome medicine.disease Transplantation Apheresis Nephrology medicine.symptom business Nephrotic syndrome |
| Zdroj: | Kidney International Reports Kidney International Reports, 2021, 6 (8), pp.2134-2143. ⟨10.1016/j.ekir.2021.04.029⟩ Kidney International Reports, Elsevier, 2021, 6 (8), pp.2134-2143. ⟨10.1016/j.ekir.2021.04.029⟩ |
| ISSN: | 2468-0249 |
| Popis: | Background Apheresis is the gold standard for idiopathic nephrotic syndrome (INS) relapse after transplantation, but it remains unknown whether such treatment is useful for adults with refractory INS on native kidneys. Methods This retrospective study included patients older than 16 years with biopsy-proven refractory (persistent nephrotic syndrome on corticosteroids plus at least 1 immunosuppressive drug) INS treated by apheresis and followed for at least 3 months. Results Between September 1997 and January 2020, 21 patients (focal segmental glomerulosclerosis: 12, minimal change nephrotic syndrome: 9, men: 67%, median age: 34 years) were identified. At last follow-up (12 months), 7 of 21 patients were in complete or partial remission. Remission was associated with older age (51 vs. 30 years, P = 0.05), lower proteinuria (3.9 vs. 7.3 g/d, P = 0.03), and lower estimated glomerular filtration rate (eGFR) (28.0 vs. 48.5 ml/min per 1.73 m2, P = 0.05) at apheresis. The need for dialysis before apheresis (odds ratio [OR] 22.0 [1.00–524], P = 0.026), age ≥50 years (OR: 22.6 [1.00–524], P = 0.006), a marked (>4.5 g/d) decrease in proteinuria (OR: 9.17 [1.15–73.2], P = 0.041), and a short ( Graphical abstract |
| Databáze: | OpenAIRE |
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