Long-term renal outcome in methylmalonic acidemia in adolescents and adults.

Chronic kidney disease Estimated glomerular filtration rate Measured glomerular filtration rate Methylmalonic acidemia Tubulopathy

Journal

Orphanet journal of rare diseases
ISSN: 1750-1172
Titre abrégé: Orphanet J Rare Dis
Pays: England
ID NLM: 101266602

Informations de publication

Date de publication:
13 05 2021
Historique:
received: 28 12 2020
accepted: 04 05 2021
entrez: 14 5 2021
pubmed: 15 5 2021
medline: 29 6 2021
Statut: epublish

Résumé

Chronic kidney disease (CKD) is one of the main long-term prognosis factors in methylmalonic acidemia (MMA), a rare disease of propionate catabolism. Our objective was to precisely address the clinical and biological characteristics of long-term CKD in MMA adolescent and adult patients. In this retrospective study, we included MMA patients older than 13 years who had not received kidney and/or liver transplantation. We explored tubular functions, with special attention to proximal tubular function. We measured glomerular filtration rate (mGFR) by iohexol clearance and compared it to estimated glomerular filtration rate (eGFR) by Schwartz formula and CKD-EPI. Thirteen patients were included (M/F = 5/8). Median age was 24 years (13 to 32). Median mGFR was 57 mL/min/1.73 m CKD is a common complication of the MMA. Usual equations overestimate GFR. Therefore, mGFR should be performed to inform therapeutic decisions such as dialysis and/or transplantation. Mild evidence of proximal tubular dysfunction was found in only one patient, suggesting that other mechanisms are involved.

Sections du résumé

BACKGROUND
Chronic kidney disease (CKD) is one of the main long-term prognosis factors in methylmalonic acidemia (MMA), a rare disease of propionate catabolism. Our objective was to precisely address the clinical and biological characteristics of long-term CKD in MMA adolescent and adult patients.
PATIENTS AND METHODS
In this retrospective study, we included MMA patients older than 13 years who had not received kidney and/or liver transplantation. We explored tubular functions, with special attention to proximal tubular function. We measured glomerular filtration rate (mGFR) by iohexol clearance and compared it to estimated glomerular filtration rate (eGFR) by Schwartz formula and CKD-EPI.
RESULTS
Thirteen patients were included (M/F = 5/8). Median age was 24 years (13 to 32). Median mGFR was 57 mL/min/1.73 m
CONCLUSION
CKD is a common complication of the MMA. Usual equations overestimate GFR. Therefore, mGFR should be performed to inform therapeutic decisions such as dialysis and/or transplantation. Mild evidence of proximal tubular dysfunction was found in only one patient, suggesting that other mechanisms are involved.

Identifiants

pubmed: 33985557
doi: 10.1186/s13023-021-01851-z
pii: 10.1186/s13023-021-01851-z
pmc: PMC8120835
doi:

Substances chimiques

Creatinine AYI8EX34EU

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

220

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Auteurs

Myriam Dao (M)

Adult Nephrology and Transplantation Department, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France. myriam.dao@aphp.fr.
Reference Center of Inherited Metabolic Diseases (MAMEA and MetabERN), Hôpital Necker-Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France. myriam.dao@aphp.fr.

Jean-Baptiste Arnoux (JB)

Reference Center of Inherited Metabolic Diseases (MAMEA and MetabERN), Hôpital Necker-Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.

Frank Bienaimé (F)

Department of Physiology, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.

Anaïs Brassier (A)

Reference Center of Inherited Metabolic Diseases (MAMEA and MetabERN), Hôpital Necker-Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.

François Brazier (F)

Department of Physiology, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.

Jean-François Benoist (JF)

Reference Center of Inherited Metabolic Diseases (MAMEA and MetabERN), Hôpital Necker-Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.
Biochemistry Department, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.

Clément Pontoizeau (C)

Reference Center of Inherited Metabolic Diseases (MAMEA and MetabERN), Hôpital Necker-Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.
Biochemistry Department, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.

Chris Ottolenghi (C)

Reference Center of Inherited Metabolic Diseases (MAMEA and MetabERN), Hôpital Necker-Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.
Biochemistry Department, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.

Pauline Krug (P)

Pediatric Nephrology Department, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.

Olivia Boyer (O)

Pediatric Nephrology Department, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.

Pascale de Lonlay (P)

Reference Center of Inherited Metabolic Diseases (MAMEA and MetabERN), Hôpital Necker-Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.

Aude Servais (A)

Adult Nephrology and Transplantation Department, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.
Reference Center of Inherited Metabolic Diseases (MAMEA and MetabERN), Hôpital Necker-Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.

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