19 results match your criteria: "Centre de Référence des Maladies Rénales Rares Filières Maladies Rares ORKID[Affiliation]"

Bone impairment in atypical hemolytic and uremic syndrome treated by long-term eculizumab.

Pediatr Nephrol

October 2024

Centre de Référence Des Maladies Rénales Rares, Centre de Référence Des Maladies Rares du Calcium Et du Phosphore, Filières Maladies Rares ORKID Et OSCAR, Hospices Civils de Lyon & Université Claude-Bernard Lyon 1, Lyon, France.

Article Synopsis
  • - Atypical hemolytic uremic syndrome (aHUS) is a condition caused by issues with the complement system, particularly due to Factor H deficiency, and is typically treated with eculizumab for life.
  • - Two young patients with Factor H deficiency on long-term eculizumab therapy exhibited unusual bone issues, including pain and deformities, with diagnostic imaging revealing active bone remodeling and C3c accumulation.
  • - The bone alterations observed may either be a side effect of eculizumab treatment or a result of the deficiency of Factor H, indicating a need for further research into the bone health of aHUS patients.
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Article Synopsis
  • The study investigates mineral bone disorder in patients with chronic kidney disease after kidney transplantation, focusing on bone biomarkers and microarchitecture changes before and 6 months after the surgery.
  • A subgroup of patients aged 10 to 18 who underwent their first kidney transplant was compared to healthy controls, revealing initially higher bone densities but notable declines in trabecular microarchitecture at the radius six months post-transplant.
  • Despite some improvements in bone health, many patients persisted with metabolic issues like acidosis and elevated parathyroid hormone levels after the transplant, indicating ongoing bone metabolism concerns.
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Article Synopsis
  • Evaluating glomerular filtration rate (GFR) in children is tough, prompting the development of new estimation formulas which were tested in a pediatric population at a nephrology center.
  • In a study of 307 patients deemed at "kidney risk," both creatinine-based and cystatin C-based formulas were used to assess GFR against measued values, revealing that creatinine-based formulas often overestimate GFR across various age groups.
  • Ultimately, the study found that cystatin C-based equations and combined formulas performed significantly better in providing accurate GFR estimations, particularly in patients with higher measured GFR values.
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Anti-CFH-associated hemolytic uremic syndrome: do we still need plasma exchange?

Pediatr Nephrol

November 2024

Pediatric Nephrology Department, Centre de référence des Maladies Rénales Rares MARHEA, Filières Maladies Rares ORKID et ERK-Net, Robert Debré Hospital, APHP, 48 bd Sérurier, 75019, Paris, France.

Article Synopsis
  • A significant portion of atypical hemolytic uremic syndrome (aHUS) in children is linked to autoantibodies against complement factor H, prompting treatments like plasma exchange and eculizumab.
  • In a study of 12 children treated with eculizumab, varying immunosuppressive strategies were used, but the decrease in anti-FH antibody levels was consistent regardless of the regimen.
  • The study concluded that eculizumab is a safe and effective long-term treatment for aHUS related to anti-FH antibodies, and combining it with mycophenolate mofetil (MMF) may be sufficient for management.
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Nephrocalcinosis can disappear in infants receiving early lumasiran therapy.

Pediatr Nephrol

July 2024

Service de Néphrologie, Rhumatologie et Dermatologie Pédiatriques, Centre de Référence des Maladies Rénales Rares Néphrogones, Filières Maladies Rares ORKID et ERK-Net, CHU de Lyon, Bron, France.

Background: Lumasiran is the first RNA interference (RNAi) therapy of primary hyperoxaluria type 1 (PH1). Here, we report on the rapid improvement and even disappearance of nephrocalcinosis after early lumasiran therapy.

Case-diagnosis/treatment: In patient 1, PH1 was suspected due to incidental discovery of nephrocalcinosis stage 3 in a 4-month-old boy.

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Article Synopsis
  • Shrunken pore syndrome (SPS) in children is determined by specific eGFR ratios and is linked to higher cardiovascular risk, though prior studies haven't shown this connection to increased morbidity and mortality.
  • The study examined 307 pediatric patients at renal risk, using various formulas to assess SPS prevalence and its correlation with cardiovascular health.
  • Findings indicated that SPS prevalence varies significantly based on the methods used; children with SPS had higher levels of C-reactive protein and phosphate, along with smaller body size, signaling potential long-term cardiovascular issues that warrant further investigation.
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[Revolution in the field of primary and secondary hyperoxalurias: Stay tuned!].

Med Sci (Paris)

March 2023

Service de néphrologie, rhumatologie et dermatologie pédiatriques, Centre de référence des maladies rénales rares, Filières maladies rares ORKID et ERK-Net, Service de néphrologie, rhumatologie et dermatologie pédiatriques, Hôpital femme mère enfant, boulevard Pinel, 69500 Bron Cedex, France - Inserm 1033, 69008 Lyon, France.

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Purposes Of Review: With chronic kidney disease (CKD) progression, secondary hyperparathyroidism (sHPT) and mineral and bone metabolism disease (MBD) almost inevitably develop and result in renal osteodystrophy and cardiovascular disease (CVD). Together with active vitamin D, calcimimetics are the main therapy for sHPT in CKD. This review provides an overview of the therapeutic effects of oral cinacalcet and intravenous etelcalcetide on CKD-MBD and vascular disease, with a focus on pediatric dialysis patients.

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X-Linked Hypophosphatemia, Not Only a Skeletal Disease But Also a Chronic Inflammatory State.

J Clin Endocrinol Metab

November 2022

Service de Néphrologie, Rhumatologie et Dermatologie Pédiatriques, Centre de Référence des Maladies Rares du Calcium et du Phosphore, Centre de Référence des Maladies Rénales Rares Filières Maladies Rares ORKID, OSCAR et ERN ERK-Net, CHU de Lyon, 69 500 Bron, France.

Article Synopsis
  • X-linked hypophosphatemia (XLH) is a rare genetic disorder linked to high levels of fibroblast growth factor 23 (FGF23), which may affect inflammation and bone cell activity, but hasn't been thoroughly studied in this context.
  • A multicenter study analyzed the expression of eight inflammatory markers in blood samples from 28 XLH patients and 19 healthy controls, finding significantly increased inflammation in XLH patients along with impaired osteoclast formation.
  • The findings suggest that the unique inflammatory profile in XLH patients may contribute to associated health issues like hypertension and obesity, indicating that inflammation might exacerbate these complications.
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Article Synopsis
  • Hyperoxaluria is when urinary oxalate excretion exceeds 0.5 mmol per day, and it can be classified into two types: primary and secondary.
  • Primary hyperoxaluria arises from genetic factors, while secondary hyperoxaluria, also known as enteric hyperoxaluria, is related to dietary habits and malabsorption issues.
  • Both primary and enteric hyperoxalurias can lead to serious health problems like kidney stones, crystal nephropathy, chronic kidney disease, and systemic oxalosis.
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Fluconazole in hypercalciuric patients with increased 1,25(OH)D levels: the prospective, randomized, placebo-controlled, double-blind FLUCOLITH trial.

Trials

June 2022

Centre de Référence des Maladies Rénales Rares, filières maladies rares ORKID and ERK-Net, Service de Néphrologie, Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Boulevard Pinel, 69677, Bron, Cedex, France.

Background: Hypercalciuria is one of the most frequent metabolic disorders associated with nephrolithiasis and/or nephrocalcinosis possibly leading to chronic kidney disease (CKD) and bone complications in adults. Orphan diseases with different underlying primary pathophysiology share inappropriately increased 1,25(OH)D levels and hypercalciuria, e.g.

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Oxalate crystals in the kidney were first described in 1925. Since then, many major milestones have been reached in the understanding of genetic primary hyperoxaluria(s). Primary hyperoxaluria type 1 (PH1) is an autosomal recessive disease due to a mutation in the gene, which encodes the hepatic peroxisomal enzyme alanine-glyoxylate aminotransferase (AGT), inducing excess oxalate production and further kidney stones, nephrocalcinosis and chronic kidney disease (CKD).

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Primary hyperoxaluria type 1: novel therapies at a glance.

Clin Kidney J

May 2022

Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.

Article Synopsis
  • Primary hyperoxaluria type 1 (PH1) is a serious genetic disorder affecting oxalate metabolism due to a mutation in the AGT enzyme, leading to kidney failure and requiring treatments like hydration, medications, and transplants.
  • Recent advancements in treatment include RNA interference (RNAi) therapies, such as lumasiran and nedosiran, which aim to reduce oxalate production by targeting specific liver enzymes.
  • Lumasiran has been approved for PH1, showing promise in reducing urinary oxalate levels, while ongoing trials for nedosiran seek further evidence of its long-term effectiveness and safety.
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Background: Lumasiran, a sub-cutaneous RNA-interference therapy, has been recently approved for primary hyperoxaluria type 1 (PH1), with doses and intervals according to body weight. Little is known as to its use in infants; the aim of this study was to describe treatment outcome in 3 infants who received lumasiran therapy before 2 years of age.

Case-diagnosis/treatment: Patient 1 was diagnosed antenatally and received lumasiran from day 9.

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Background: The assessment of phosphate homeostasis in clinical practice relies not only on circulating phosphate levels but also on phosphate tubular reabsorption, ideally assessed using the tubular maximum phosphate reabsorption per glomerular filtration rate (TmP/GFR). TmP/GFR reference values were established before the onset of isotope-dilution mass spectrometry-standardized (IDMS) creatinine assays and thus need to be updated. Our objective is to provide reference values for TmP/GFR from childhood to adulthood, using the gold-standard of GFR assessment and IDMS-standardized creatinine values.

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Purpose Of Review: To describe the methods that can be used to obtain functional and mature osteoclasts from peripheral blood mononuclear cells (PBMCs) and report the data obtained with this model in two peculiar diseases, namely pediatric chronic kidney disease-associated mineral and bone disorders (CKD-MBD) and nephropathic cystinosis. To discuss future research possibilities in the field.

Recent Findings: Bone tissue undergoes continuous remodeling throughout life to maintain bone architecture; it involves two processes: bone formation and bone resorption with the coordinated activity of osteoblasts, osteoclasts, and osteocytes.

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Hypertension in Children and Adolescents: A Position Statement From a Panel of Multidisciplinary Experts Coordinated by the French Society of Hypertension.

Front Pediatr

July 2021

Centre de Référence des Maladies Rénales Rares, Service de Néphrologie Rhumatologie et Dermatologie Pédiatriques, Filières Maladies Rares ORKID et ERK-Net, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Bron, France.

Hypertension is much less common in children than in adults. The group of experts decided to perform a review of the literature to draw up a position statement that could be used in everyday practice. The group rated recommendations using the GRADE approach.

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Tyrosinemia type 1 in pediatric nephrology: Not always straightforward.

Arch Pediatr

May 2021

Centre de Référence des Maladies Rénales Rares, Filières de santé maladies rares ORKID et ERK-Net, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France; Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France; INSERM, UMR 1033, Faculté de Medecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France. Electronic address:

Article Synopsis
  • * Early detection is essential for proper management and to prevent serious complications associated with the disease.
  • * This report highlights two cases misdiagnosed as "neonatal tubulopathy" and "X-linked hypophosphatemia," stressing the importance of considering tyrosinemia as a potential diagnosis in similar situations.
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Article Synopsis
  • - Sensenbrenner syndrome, a complex genetic disorder, manifests with features like abnormal head shape, kidney disease, liver issues, vision problems, and brain abnormalities, sharing some similarities with other similar disorders.
  • - A review of four children treated for Sensenbrenner syndrome revealed genetic variants in WDR35 or WDR19, with all patients eventually developing end-stage kidney disease.
  • - Early diagnosis of craniosynostosis (like scaphocephaly) can lead to quicker identification of Sensenbrenner syndrome; thus, coordinated care from specialized teams is crucial for managing the disease and its complications.
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