Publications by authors named "Audard V"

Cancer treatments have been dramatically modified by the introduction and the development of immunological checkpoint inhibitors (ICI). These treatments have many side effects, including acute kidney injury (AKI). Their combination with other treatments makes the diagnosis complex.

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  • A retrospective study of 183 adult patients treated with rituximab for podocytopathies showed that 82% achieved complete or partial remission within 6 months.
  • *Long-term follow-up revealed that 55% of initial responders maintained relapse-free survival over three years, with improved outcomes linked to maintenance therapy.
  • *Patients on maintenance therapy experienced significantly fewer relapses per year and maintained stable kidney function compared to non-responders.
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  • The study focuses on transthyretin cardiac amyloidosis (ATTR-CM) as a significant cause of heart failure in older patients, analyzing how age and amyloidosis subtype affect patient outcomes.
  • It included 943 patients, revealing that geriatric patients (≥75 years) had worse health outcomes and lower 3-year survival rates (55%) compared to non-geriatric patients (<75 years) who had a survival rate of 76%.
  • Key mortality predictors differed by age group, with geriatric patients relying on alkaline phosphatase and troponin T levels, while non-geriatric patients linked outcomes to NT-proBNP and glomerular filtration rates; a new 3-stage prognostic
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Background And Hypothesis: Recurrence of focal segmental glomerulosclerosis (FSGS) is common after kidney transplantation and is classically associated with a significant decrease in graft survival. A major risk factor is a prior history of FSGS recurrence on a previous graft. This analysis reports the impact of a prophylactic treatment of FSGS recurrence in very high-risk patients who experienced a recurrence on a previous graft.

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Key Points: We evidenced terminal pathway activation (C5b-9 deposits) in most of the glomeruli on kidney biopsy of C3 glomerulopathy. The amount of C5b-9 deposits correlated with disease prognosis in C3 glomerulopathy. Increased terminal pathway activation was found predominantly in a subgroup exhibiting an immuno-fibroblastic signature.

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Introduction: Toxic gain-of-function () variants contribute to the development of proteinuric nephropathies collectively referred to as APOL1-mediated kidney disease (AMKD). Despite standard-of-care treatments, patients with AMKD experience accelerated progression to end-stage kidney disease. The identification of two variants as the genetic cause of AMKD inspired development of inaxaplin, an inhibitor of APOL1 channel activity that reduces proteinuria in patients with AMKD.

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Aims: Predicting mortality in severe AL cardiac amyloidosis is challenging due to elevated biomarker levels and limited thresholds for stratifying severe cardiac damage.

Methods And Results: This prospective, observational, cohort study included de novo, confirmed cardiac AL amyloidosis patients at the Henri Mondor National Reference Centre. The goal was to identify predictors of mortality to enhance prognostic stratification and improve informed decision-making regarding therapy.

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  • Atypical anti-glomerular basement membrane (GBM) nephritis is a rare kidney condition that presents differently than typical cases, showing bright linear immunoglobulin staining without the usual serum anti-GBM antibodies.
  • In a study involving patients diagnosed from 2003 to 2022, 25 out of 38 potential cases were confirmed, with a majority exhibiting symptoms like hematuria and varying forms of glomerulonephritis.
  • The findings suggest that atypical anti-GBM nephritis often progresses slower than typical cases, but further research is necessary to understand its complete nature and implications.
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A high prevalence of chronic kidney disease (CKD) occurs in patients with myeloproliferative neoplasms (MPN). However, MPN-related glomerulopathy (MPN-RG) may not account for the entirety of CKD risk in this population. The systemic vasculopathy encountered in these patients raises the hypothesis that vascular nephrosclerosis may be a common pattern of injury in patients with MPN and with CKD.

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Introduction: Patients with immune-mediated glomerular diseases are considered at high risk for severe COVID-19 outcomes. However, conclusive evidence for this patient population is scarce.

Methods: We created a global registry and retrospectively collected clinical data of patients with COVID-19 and a previously diagnosed immune-mediated glomerular disease to characterize specific risk factors for severe COVID-19 outcomes.

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  • The study examines kidney transplantation outcomes for patients with renal AA amyloidosis, revealing previously unclear results regarding survival and disease recurrence, mostly based on older data.
  • Conducted as a retrospective multicenter cohort study, it analyzed patients who underwent transplantation in France from 2008 to 2018, focusing on factors like age and treatment methods.
  • Results indicated high survival rates (94% at 1 year, 85.5% at 5 years) but also significant complications, including infection (55.8%) and acute rejection episodes (27.9%), with a low recurrence rate of amyloidosis (5.8%).
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  • Early diagnosis of cardiac amyloidosis (CA) is crucial for effective treatment, but it is often overlooked, misdiagnosed, and poorly managed.
  • A retrospective study over 11 years analyzed 3,022 patients referred for suspected CA, showing a significant increase in referrals and a shift towards wild-type transthyretin amyloidosis (ATTRwt) being the most common diagnosis.
  • The findings indicate that while awareness among cardiologists has grown, leading to more diagnoses of ATTRwt and less severe cases, patients with amyloid light chain (AL) amyloidosis still frequently present with severe cardiac symptoms.
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Background: C3 glomerulopathy and idiopathic immunoglobulin-mediated membranoproliferative GN (Ig-MPGN) are rare complement-mediated kidney diseases. Inherited forms of C3 glomerulopathy/Ig-MPGN are rarely described.

Methods: Three hundred ninety-eight patients with C3 glomerulopathy ( n =296) or Ig-MPGN ( n =102) from a national registry were screened for three complement genes: factor H ( CFH ), factor I ( CFI ), and C3 .

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  • The study investigates how hemodialysis (HD) affects the retinal and choroidal blood vessels in patients with end-stage kidney disease (ESKD) using advanced imaging techniques.
  • Results showed a significant decrease in subfoveal choroidal thickness (SCT) and an increase in non-perfusion of the choriocapillaris after HD, while retinal vascular density remained unchanged.
  • A higher level of B-Nitric Peptide (BNP) before HD was correlated with a greater decrease in SCT, suggesting a link between this biomarker and choroidal health in ESKD patients undergoing dialysis.
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  • * Among 7218 patients who began dialysis, 17.5% had unknown kidney disease, with a higher prevalence (31.4%) in the most deprived socioeconomic group.
  • * The research found a significant association (odds ratio 1.40) between social deprivation and unknown nephropathy but failed to identify any mediating factors that could explain this relationship.
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Focal and segmental glomerulosclerosis (FSGS) is a severe form of idiopathic nephrotic syndrome (INS), a glomerulopathy of presumably immune origin that is attributed to extrarenal pathogenic circulating factors. The recurrence of FSGS (rFSGS) after transplant occurs in 30% to 50% of cases. The direct analysis of patient plasma proteome has scarcely been addressed to date, mainly due to the methodological difficulties associated with plasma complexity and dynamic range.

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Background: Inter-individual variations of non-glomerular filtration rate (GFR) determinants of serum creatinine, such as muscle mass, account for the imperfect performance of estimated GFR (eGFR) equations. We aimed to develop an equation based on creatinine and total lumbar muscle cross-sectional area measured by unenhanced computed tomography scan at the third lumbar vertebra.

Methods: The muscle mass-based eGFR (MMB-eGFR) equation was developed in 118 kidney donor candidates (iohexol clearance) using linear regression.

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Background And Objectives: Activation of the complement system is involved in the pathogenesis of anti-glomerular basement membrane (anti-GBM) disease. Glomerular deposits of complement 3 (C3) are often detected on kidney biopsies. The primary objective of this study was to analyze the prognostic value of the serum C3 level and the presence of C3 glomerular deposits in patients with anti-GBM disease.

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Background: Hereditary transthyretin (ATTRv) p.Val142Ile (V122I) mutation is the most common inherited cause of cardiac amyloidosis and little is known about the phenotype and outcome of the rare homozygotic genotype. This study aimed to compare phenotypic characteristics and outcomes between heterozygous and homozygous patients with ATTRv V122I amyloidosis.

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Background: IgG4-related kidney disease is a major manifestation of IgG4-related disease, a systemic fibroinflammatory disorder. However, the clinical and prognostic kidney-related factors in patients with IgG4-related kidney disease are insufficiently defined.

Methods: We conducted an observational cohort study using data from 35 sites in two European countries.

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Rationale & Objective: C3 glomerulopathy (C3GN) and atypical hemolytic uremic syndrome (aHUS) are 2 distinct rare kidney diseases caused by dysregulation of the alternative complement pathway. Patients with C3GN and concurrent kidney lesions of thrombotic microangiopathy (TMA) have been rarely reported. We characterized the clinical features and underlying immunological abnormalities in these patients.

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  • The study aimed to validate the Amylo-AFFECT-QOL questionnaire to measure health-related quality of life (HR-QoL) in patients with cardiac amyloidosis (CA), as no specific questionnaire existed for this condition.
  • It involved 515 patients, primarily those diagnosed with CA, and showed that the Amylo-AFFECT-QOL scores significantly correlated with established HR-QoL assessments, indicating its reliability.
  • Findings revealed that those with cardiac amyloidosis had worse HR-QoL scores compared to other conditions, and higher scores were associated with increased mortality or heart transplant risk after one year.
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