Article Dans Une Revue Kidney International Année : 2021

Results of a nation-wide cohort study suggest favorable long-term outcomes of clone-targeted chemotherapy in immunotactoid glomerulopathy

1 CRIBL - Contrôle de la Réponse Immune B et des Lymphoproliférations
2 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
3 CRMR Amylose AL - Centre national de référence Maladie rare : Amyloses AL et autres maladies de dépôts d’immunoglobulines monoclonales
4 CIC 1402 - CIC de Poitiers – Centre d'investigation clinique de Poitiers (CIC 1402)
5 Service de néphrologie - hémodialyse et transplantation rénale [CHU Poitiers]
6 IRM - Immuno-Rhumatologie Moléculaire
7 Laboratoire d'excellence (Labex) Transplantex (Nouveaux loci d’histocompatibilité et biomarqueurs en transplantation humaine, de la découverte à l’application clinique)
8 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
9 FMTS - Fédération de Médecine Translationnelle de Strasbourg
10 Centre Hospitalier Boulogne-sur-mer
11 Centre Hospitalier de Verdun Saint-Mihiel
12 CHELTER - Role of intra-Clonal Heterogeneity and Leukemic environment in ThErapy Resistance of chronic leukemias
13 Service Néphrologie, Hémodialyses [CHU Clermont-Ferrand]
14 Service de Néphrologie Dialyse, Transplantation rénale [CHU Saint Etienne]
15 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
16 IRTOMIT [Poitiers] - Ischémie Reperfusion en Transplantation d’Organes Mécanismes et Innovations Thérapeutiques [U 1082]
17 UFR Santé [Poitiers] - Université de Poitiers – UFR Santé [Faculté de Médecine et de Pharmacie]
18 MSAP - Miniaturisation pour la Synthèse, l’Analyse et la Protéomique - UAR 3290
19 Service de pathologie [CHU Lille]
20 AP-HP - Hopital Saint-Louis [AP-HP]
Pierre Bataille
  • Fonction : Auteur
  • PersonId : 1416061
Jean-Paul Fermand
  • Fonction : Auteur
  • PersonId : 934689

Résumé

Background: Creatinine-based equations are the most used to estimate glomerular filtration rate (eGFR). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), the re-expressed Lund-Malmö Revised (r-LMR) and the European Kidney Function Consortium (EKFC) equations are the most validated. The EKFC and r-LMR equations have been suggested to have better performances in young adults, but this is debated.
Methods: We collected data (GFR) measured by clearance of an exogenous marker (reference method), serum creatinine, age and sex from 2366 young adults (aged between 18 and 25 years) both from Europe and the USA.
Results: In the European cohorts (n = 1892), the bias (in mL/min/1.73 m²) was systematically better for the EKFC and r-LMR equations compared with the CKD-EPI equation [2.28, 95% confidence interval (1.59; 2.91), –2.50 (–3.85; –1.76), 17.41 (16.49; 18.47), respectively]. The percentage of estimated GFR within 30% of measured GFR (P30) was also better for EKFC and r-LMR equations compared with the CKD-EPI equation [84.4% (82.8; 86.0), 87.2% (85.7; 88.7) and 65.4% (63.3; 67.6), respectively]. In the US cohorts (n = 474), the bias for the EKFC and r-LMR equations was better than for the CKD-EPI equation in the non-Black population [0.97 (–1.69; 3.06), –2.62 (–5.14; –1.43) and 7.74 (5.97; 9.63), respectively], whereas the bias was similar in Black US individuals. P30 results were not different between the three equations in US cohorts. Analyses in sub-populations confirmed these results, except in individuals with high GFR levels (GFR ≥120 mL/min/1.73 m²) for whom the CKD-EPI equation might have a lower bias.
Conclusions: We demonstrated that both the EKFC and r-LMR creatinine-based equations have a better performance than the CKD-EPI equation in a young population. The only exception might be in patients with hyperfiltration.

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hal-05095159 , version 1 (09-07-2025)

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Vincent Javaugue, Léa Dufour-Nourigat, Estelle Desport, Audrey Sibille, Bruno Moulin, et al.. Results of a nation-wide cohort study suggest favorable long-term outcomes of clone-targeted chemotherapy in immunotactoid glomerulopathy. Kidney International, 2021, 99 (2), pp.421-430. ⟨10.1016/j.kint.2020.06.039⟩. ⟨hal-05095159⟩
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