Publications by authors named "Denis Fouque"

Background: Hyperuricemia is a hallmark of gout and a suspected risk factor for the progression of chronic kidney disease (CKD). However, the impact of urate-lowering therapy on CKD progression is subject to debate. The objective of the present study was to describe the prevalence of inappropriate urate-lowering therapy prescriptions and evaluate the association between urate-lowering therapy prescription and the progression of kidney disease in patients with CKD.

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Chronic kidney disease (CKD) is a progressive condition that affects more than 10% of the population worldwide, accounting for more than 843 million (M) individuals. The prevalence of CKD (844 M patients) is higher than that of diabetes mellitus (422 M patients), cancer (42 M patients), and HIV (37 M patients), but people are often less aware of it. Global expert groups predict reductions in the nephrology workforce in the next decade, with a declining interest in nephrology careers.

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  • Blood pressure (BP) control is crucial for preventing complications in chronic kidney disease (CKD), yet many patients struggle to reach target levels; this study evaluates how antihypertensive prescriptions change over time in CKD patients.
  • Conducted with 2,755 hypertensive CKD patients in France, the study tracked factors influencing prescription changes, such as patient demographics and healthcare provider interactions.
  • Results showed that over five years, there was a high rate of changes in medication; poor adherence to medications increased the likelihood of needing additional drugs, while having a lower education level led to more frequent withdrawals of antihypertensive medications.
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  • Elexacaftor/tezacaftor/ivacaftor (ETI) is a new treatment for cystic fibrosis that significantly improves lung health, but its effects on kidneys remain uncertain.
  • A study involving 19 adults with cystic fibrosis showed no significant change in kidney function after 7 months of ETI treatment, though there was a decrease in aldosterone levels and magnesuria.
  • The results indicate that ETI does not negatively affect renal function in the short term and may help address related issues like hyperaldosteronism; however, further research is needed to understand the implications for kidney stone risk.
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  • - Chronic kidney disease affects around 13% of the global population and is expected to be a major cause of life years lost by 2040, with end-stage kidney disease leading to complications like renal cachexia, which is not well understood and has limited treatment options.
  • - The study aims to understand the experiences of individuals with renal cachexia and their carers through in-depth interviews, adhering to ethical research practices in a UK healthcare setting.
  • - Seven participants (four patients and three carers) were recruited, with the data analyzed to identify six key themes related to their lived experiences, including issues like appetite loss, weight decline, social withdrawal, and emotional struggles.
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Nuclear factor-erythroid 2-related factor 2 (Nrf2) is an important transcription factor that activates antioxidant genes and increases detoxifying enzymes. Studies have shown that dietary compounds can activate the Nrf2 expression and improve the antioxidant response in patients with exacerbated oxidative stress, such as chronic kidney disease (CKD). We aimed to evaluate the efficacy of nutritional interventions on Nrf2 expression and phase II antioxidant enzymes in clinical trials in CKD.

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Background: Influenza vaccines are effective in decreasing hospitalizations and mortality related to influenza and its complications. However, the Vaccine Coverage Rate of influenza remains low and multifaceted efforts are required to improve it. The aim of this study was to assess the impact on influenza vaccine perception using a digital tool among outpatients and health care workers (HCWs).

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  • * In a cohort of 2505 CKD patients, researchers found that while urea levels did not significantly predict new antidepressant prescriptions, higher urea was linked to worsening depressive symptoms over a 5-year follow-up.
  • * The findings suggest a connection between serum urea levels and depression symptoms, highlighting the need for further research to clarify the mechanisms involved.
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Adjusting drug dose levels based on equations that standardize the estimated glomerular filtration rate (eGFR) to a body surface area (BSA) of 1.73 m can pose challenges, especially for patients with extremely high or low body mass index (BMI). The objective of the present study of patients with CKD and diabetes was to assess the impact of deindexing creatinine-based equations on estimates of kidney function and on the frequency of inappropriate prescriptions of oral antidiabetic drugs (OADs).

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Background: Chronic kidney disease (CKD) is associated with increased mortality. Individual mortality prediction could be of interest to improve individual clinical outcomes. Using an independent regional dataset, the aim of the present study was to externally validate the recently published 2-year all-cause mortality prediction tool developed using machine learning.

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  • The study investigates how chronic kidney disease (CKD) affects sex differences in cardiovascular disease (CVD) risk, specifically distinguishing between atheromatous CVD (ACVD) and nonatheromatous CVD (NACVD).
  • Utilizing data from a cohort of nearly 3,000 patients with moderate to severe CKD across France, the results indicate that women have a significantly lower rate of ACVD compared to men, but no significant difference in NACVD rates was found between the sexes.
  • The findings highlight that as kidney function declines (measured by eGFR), the sex differences in ACVD risk diminish, whereas NACVD risk remains consistent across both sexes, suggesting gender impacts risk differently based on CVD
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  • Diabetic nephropathy (DKD) is a leading cause of kidney failure globally, and current clinical practices show gaps in the effective screening and management of the condition, particularly in primary care settings.
  • There are barriers to starting important treatments like SGLT2 inhibitors for patients with DKD, especially among the elderly, with difficulties in achieving blood pressure goals also noted.
  • Real-world data suggest that SGLT2 inhibitors not only slow kidney decline and lower acute kidney injury risk better than GLP-1 receptor agonists but also highlight the need for a comprehensive strategy to improve care for diabetic patients with kidney issues.
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The enteric nervous system (ENS) regulates numerous functional and immunological attributes of the gastrointestinal tract. Alterations in ENS cell function have been linked to intestinal outcomes in various metabolic, intestinal, and neurological disorders. Chronic kidney disease (CKD) is associated with a challenging intestinal environment due to gut dysbiosis, which further affects patient quality of life.

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Aim: The risk of cardiorenal events remains high among patients with diabetes and chronic kidney disease (CKD), despite the prescription of recommended treatments. We aimed to determine whether the attainment of a combination of nephroprotection targets at baseline (glycated haemoglobin <7.0%, urinary albumin-creatinine ratio <300 mg/g, blood pressure <130/80 mmHg, renin-angiotensin system inhibition) was associated with better cardiorenal outcomes and lower mortality.

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Vitamin E is a lipid-soluble nutrient found mainly in vegetable oils and oilseeds. It is divided into eight homologous compounds; however, only α-tocopherol exhibits vitamin activity. Many advantages are related to these compounds, including cellular protection through antioxidant and anti-inflammatory activity, and improving lipid metabolism.

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  • Kynurenine, a toxin that increases in patients with chronic kidney disease (CKD), has been linked to poor cardiovascular health outcomes and mortality.
  • In a study of over 2400 CKD patients, higher levels of serum-free kynurenine were found to increase the risk of cardiovascular events and mortality, independent of other factors.
  • The results suggest that serum-free kynurenine may play a significant role in cardiovascular risks among CKD patients, although it was not linked to overall mortality after adjusting for other compounds.
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The most common kidney replacement therapy (KRT) worldwide is hemodialysis (HD), and only 5%-10% of patients are prescribed peritoneal dialysis (PD) as KRT. Despite PD being a different method, these patients also present particular complications, such as oxidative stress, gut dysbiosis, premature aging, and mitochondrial dysfunction, leading to an inflammation process and high cardiovascular mortality risk. Although recent studies have reported nutritional strategies in patients undergoing HD with attempts to mitigate these complications, more information must be needed for PD patients.

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Rationale & Objective: Adverse drug reactions (ADRs) are common in patients with chronic kidney disease (CKD). The impact of kidney function decline on serious ADR risk has been poorly investigated. We comprehensively describe ADRs and assess the relationship between estimated glomerular filtration rate (eGFR) and serious ADR risk.

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Background: Chronic kidney disease (CKD) is associated with an elevated risk of neurocognitive disorders (NCDs). It remains unclear whether CKD-related NCDs have a specific cognitive pattern or are earlier-onset phenotypes of the main NCDs (vascular NCDs and Alzheimer's disease).

Methods: We used the Mini Mental State Examination score (MMSE) to assess cognitive patterns in 3003 CKD patients (stage 3-4) followed up over 5 years in the Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort.

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Background: The trajectories of haemoglobin in patients with chronic kidney disease (CKD) have been poorly described. In such patients, we aimed to identify typical haemoglobin trajectory profiles and estimate their risks of major adverse cardiovascular events (MACE).

Methods: We used 5-year longitudinal data from the CKD-REIN cohort patients with moderate to severe CKD enrolled from 40 nationally representative nephrology clinics in France.

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Background: Patients with chronic kidney disease (CKD) have reduced expression of erythroid nuclear factor-related factor 2 (NRF2) and increased nuclear factor κB (NF-κB). "Food as medicine" has been proposed as an adjuvant therapeutic alternative in modulating these factors. No studies have investigated the effects of sulforaphane (SFN) in cruciferous vegetables on the expression of these genes in patients with CKD.

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Launched in 2013 supported by the Program “Cohorts – Investments for the Future”, the CKD-REIN (Chronic Kidney Disease – Renal Epidemiology and Information Network) study is a prospective cohort that included and followed for 5 years more than 3000 patients with moderate or advanced chronic kidney disease (CKD), from 40 nationally representative nephrology clinics. A large amount of data was collected on CKD and its treatments, patient social characteristics and reported outcomes, and nephrology practices and services. A total of 170,000 blood and urine samples were collected and stored in a central biobank.

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Diet therapy for hyperkalemia in people with chronic kidney disease (CKD) has shifted considerably in recent years with the observations that reported potassium intake is weakly, or not at all, associated with plasma potassium levels in this population. One of the lingering debates is whether dietary potassium presents a risk of hyperkalemia in the postprandial state. Although there is general agreement about the need for additional research, the commentary by Varshney et al contends that the available research sufficiently demonstrates that high-potassium plant foods do not pose a risk of postprandial hyperkalemia.

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