Angiogenic Activity in the Sera of Patients with Post-Kidney Transplant Erythrocytosis

International audiencePost-kidney transplant erythrocytosis (PTE) is one of the hematological complications in the renal transplant patients. While its pathogenesis still remains to be elucidated completely, a number of therapies are available for the management of PTE. The aim of this prospective study was to investigate whether angiogenesis may be involved in the pathogenesis of post-transplant erythrocytosis by comparing its level with those of different classes of erythrocytosis [polycythemia vera (PV), idiopathic erythrocytosis and secondary erythrocytosis]. The angiogenic activity was evaluated by the assessment of the serum vascular endothelial growth factor (VEGF) levels, as one of circulating angiogenic factor, using a standardized enzyme-linked immunosorbent assay commercial kit in 13 PTE (2 F/11 M), in 75 untreated erythrocytosis non-transplant patients and in 21 healthy subjects controls. The results indicated that VEGF was overproduced in advanced and untreated PV patients and to a lesser degree in idiopathic erythrocytosis thus confirming an increased angiogenic activity. However, there is no evidence of increased angiogenesis in PTE and in secondary erythrocytosis. The absence of angiogenesis in PTE and its presence in PV is another argument that the pathogenesis of these two entities is different

Clinical and Epidemiological Profile of Reversible Acute Kidney Injury with Full Recovery: Experience of a Nephrology Department

Purpose: Acute kidney injury (AKI) is a real public health problem due to its severity and gravity. In a 2013 meta-analysis, Susantitaphong, et al. estimated the incidence of AKI worldwide at between 10% and 20%. In the latter study, no African studies were included, given the lack of data in the literature. Our objective was to identify the clinical and paraclinical epidemiological characteristics of patients with AKI.Patients and methods: We conducted a retrospective study including patients who had AKI with recovery of normal renal function hospitalized in a nephrology service between 2002 and 2015.Results: Our population consisted of 107 men and 107 women with a median age of 61 years (IQR 43-73.25) of which 42.1% were multitargeted. Functional AKI represented the predominant mechanism of AKI retained in our study with a rate of 53.2% with dehydration as the main etiology for 108 patients (50.46%). Organic cause was retained in 38.8% of patients, with acute tubular necrosis (ATN) as the most frequent etiology (37.35%). Kidney disease improving global outcomes (KDIGO) stage 3 was the stage retained for 115 patients included in our series, 31 of whom required extra renal purification. During their hospitalization, 78.5% of the patients presented a persistent AKI (duration of the episode > 7 days). A glomerular filtration rate (GFR) lower than 60 ml/min/1.73 m² at discharge was found in 119 patients and 10 patients had a GFR higher than 90 ml/min/1.73 m². After 3 months from discharge, 77.5% of patients had a GFR between 60 and 90 ml/min/1.73 m².Conclusion: Our results give us an idea of the epidemiological and clinical characteristics of patients who have had acute renal failure with recovery of normal renal function and enable us to better recognize patients at risk in order to avoid such complications. AKI remains a major issue and knowing its epidemiological and clinical characteristics will allow its prevention