Renal Involvement in Cystic Fibrosis

Yahiaoui, Yasmina; Jablonski, Mathieu; Hubert, D.; Mosnier-Pudar, Helen; Nôël, Laure-Hélène; Stern, M.; Grenet, Dominique; Grünfeld, Jean‐Pierre; Chauveau, Dominique; Fakhouri, Fádi

doi:10.2215/cjn.00750209

Cited by 48 publications

(41 citation statements)

References 24 publications

(14 reference statements)

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“…We did not observe persistent glomerular or tubular dysfunction associated with multiple aminoglycoside courses. Renal histopathology studies reveal previously undiagnosed and variable renal pathologies associated with CF [5, 6]. Significant renal pathology other than nephrolithiasis or tubulointerstitial disease occurred in 2.5% of a large cohort of 510 adult patients with CF [6].…”

Section: Discussionmentioning

confidence: 99%

“…The CF transmembrane regulator (CFTR) protein is expressed in the proximal and distal kidney tubules [4], but its impact on renal function remains to be elucidated. Results from autopsies on patients with CF [5] and renal biopsies [6] have revealed different renal pathologies, including proliferation of lysosomal bodies which has been attributed to aminoglycoside nephrotoxicity [5]. Repeated courses of aminoglycoside antibiotics may cause chronic renal insufficiency [7], but data are controversial [8].…”

Section: Introductionmentioning

confidence: 99%

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Glomerular and Tubular Renal Function after Repeated Once-Daily Tobramycin Courses in Cystic Fibrosis Patients

et al. 2017

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Introduction. Antibiotic treatment regimens against Pseudomonas aeruginosa lung infection in cystic fibrosis (CF) patients often include aminoglycoside antibiotics that may cause chronic renal failure after repeated courses. Aminoaciduria is an early marker of acute aminoglycoside-induced renal tubular dysfunction. We hypothesized that urinary amino acid reabsorption is decreased after repeated once-daily tobramycin therapies. Methods. In this prospective cross-sectional study creatinine clearance was estimated by the Schwartz and the Cockcroft-Gault formula. Tubular amino acid reabsorption was determined by ion exchange chromatography in 46 patients with CF who received multiple tobramycin courses (6.3 ± 10.1 (1–57)) in a once-daily dosing regimen and 10 who did not. Results. Estimated creatinine clearance employing the Cockcroft-Gault was mildly reduced in 17/46 (37%) of the patients who received tobramycin and 5/10 (50%) of the patients who did not but in none using the Schwartz formula. No association with lifetime tobramycin courses was found. Tubular amino acid reabsorption was not influenced by the amount of once-daily tobramycin courses. Conclusion. Clinically not significant reduction of eCCL occurred in a minority of CF patients. However, chronic tubular dysfunction was not present in patients with CF repeatedly treated with tobramycin in the once-daily dosing scheme.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Glomerular and Tubular Renal Function after Repeated Once-Daily Tobramycin Courses in Cystic Fibrosis Patients

et al. 2017

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“…However, some case reports have described the occurrence of IgAN in patients with mucoviscidosis, although a number of other glomerular diseases also occur in patients with mucoviscidosis 83,84 .…”

Section: Other Mucosal Diseasesmentioning

confidence: 99%

The mucosa–kidney axis in IgA nephropathy

2015

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Links between IgA nephropathy (IgAN) and the mucosa have been recognized since the 1970s. In particular, the observation of visible haematuria induced by respiratory infections in patients with IgAN and the association of IgAN with diseases in which the mucosa plays a part, especially coeliac disease, have been taken as evidence of a mucosa-kidney axis. Here, we review current evidence that links the mucosa, in particular the gastrointestinal mucosa, and IgA produced by the bone marrow with IgAN. Genome-wide association studies in patients with IgAN have identified risk loci in genes involved in the intestinal mucosal integrity and immune network. Furthermore, the systemic immune response to mucosal antigens in IgAN is increased. Moreover, patients with IgAN have an increased reactivity to dietary proteins associated with subclinical intestinal mucosal inflammation. Associations between IgAN and gastrointestinal diseases have also been reported in a small number of patients, but whether these diseases share a common pathogenesis or whether gastrointestinal inflammation exacerbates IgAN is uncertain. Indeed, mucosal alterations such as infections could activate the innate immune system, aggravate a pre-existing IgAN and promote disease manifestations such as macrohaematuria. Various clinical interventions and trials targeting the mucosa or presumed mucosa-associated mechanisms have so far not yielded consistent findings and the results of ongoing trials are eagerly awaited.

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“…Microalbuminuria has been observed in children and adults with CF. As in the general population, proteinuria appears to be associated with progressive renal impairment in patients with CF …”

Section: Discussionmentioning

confidence: 86%

High-dose ibuprofen is not associated with increased biomarkers of kidney injury in patients with cystic fibrosis

et al. 2013

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High-dose ibuprofen (IBU) may slow the decline of lung function in patients with cystic fibrosis (CF), but its use has been limited due to concerns over renal and gastrointestinal toxicity. In this pilot study, we examined the association of IBU with markers of acute kidney injury (AKI) in patients with CF. The effect of aminoglycoside (AG) exposure on AKI biomarkers was also examined. The AKI markers, kidney injury molecule-1 (KIM), N-acetyl-β-glucosaminidase (NAG) and urine protein, normalized for creatinine, were chosen as they are more sensitive indicators of kidney injury than changes in serum creatinine. Urine samples from 52 patients, 26 from patients who were treated with IBU, were analyzed. There was no significant association between IBU treatment and KIM-1, NAG or protein levels, compared to patients never treated with IBU. While there was an association between AG courses and KIM-1 levels, there were no differences in biomarker levels between IBU and non-IBU groups with respect to AG courses. These preliminary results suggest that IBU treatment in patients with CF may be safe with respect to renal toxicity.

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Renal Involvement in Cystic Fibrosis

Cited by 48 publications

References 24 publications

Glomerular and Tubular Renal Function after Repeated Once-Daily Tobramycin Courses in Cystic Fibrosis Patients

Glomerular and Tubular Renal Function after Repeated Once-Daily Tobramycin Courses in Cystic Fibrosis Patients

The mucosa–kidney axis in IgA nephropathy

High-dose ibuprofen is not associated with increased biomarkers of kidney injury in patients with cystic fibrosis

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