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Article ; Online: Renal Doppler in the management of the acute kidney injury in intensive care unit.

Dewitte, Antoine

2013 Volume 28, Issue 3, Page(s) 314

MeSH term(s)	Acute Kidney Injury/diagnostic imaging ; Humans ; Intensive Care Units ; Prognosis ; Ultrasonography, Doppler ; Urea/urine
Chemical Substances	Urea (8W8T17847W)
Language	English
Publishing date	2013-06
Publishing country	United States
Document type	Letter
ZDB-ID	632818-0
ISSN	1557-8615 ; 0883-9441
ISSN (online)	1557-8615
ISSN	0883-9441
DOI	10.1016/j.jcrc.2013.01.003
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Zs.A 2152: Show issues

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Article ; Online: Insuffisance rénale aiguë en soins intensifs-réanimation et ses conséquences : mise au point.

Orieux, Arthur / Boyer, Alexandre / Dewitte, Antoine / Combe, Christian / Rubin, Sébastien

Nephrologie & therapeutique

2021 Volume 18, Issue 1, Page(s) 7–20

Abstract: Acute kidney injury is a common complication in intensive care unit. Its incidence is variable according to the studies. It is considered to occur in more than 50 % of patients. Acute kidney injury is responsible for an increase in morbidity (length of ... ...

Title translation	Acute kidney injury in intensive care unit: A review.
Abstract	Acute kidney injury is a common complication in intensive care unit. Its incidence is variable according to the studies. It is considered to occur in more than 50 % of patients. Acute kidney injury is responsible for an increase in morbidity (length of hospitalization, renal replacement therapy) but also for excess mortality. The commonly accepted definition of acute kidney injury comes from the collaborative workgroup named Kidney Disease: Improving Global Outcomes (KDIGO). It made it possible to standardize practices and raise awareness among practitioners about monitoring plasma creatinine and also diuresis. Acute kidney injury in intensive care unit is a systemic disease including circulatory, endothelial, epithelial and cellular function involvement and an acute kidney injury is not accompanied by ad integrum repair. After prolonged injury, inadequate repair begins with a fibrotic process. Several mechanisms are involved (cell cycle arrest, epithelial-mesenchymal transition, mitochondrial dysfunction) and result in improper repair. A continuum exists between acute kidney disease and chronic kidney disease, characterized by different renal recovery phenotypes. Thus, preventive measures to prevent the occurrence of kidney damage play a major role in management. The nephrologist must be involved at every stage, from the prevention of the first acute kidney injury (upon arrival in intensive care unit) to long-term follow-up and the care of a chronic kidney disease.
MeSH term(s)	Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Humans ; Incidence ; Intensive Care Units ; Kidney Function Tests ; Renal Replacement Therapy ; Retrospective Studies
Language	French
Publishing date	2021-12-03
Publishing country	France
Document type	Journal Article ; Review
ZDB-ID	2229575-6
ISSN	1872-9177 ; 1769-7255
ISSN (online)	1872-9177
ISSN	1769-7255
DOI	10.1016/j.nephro.2021.07.324
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Zs.A 6298: Show issues

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Article: Impact of dexamethasone in severe COVID-19-induced acute kidney injury: a multicenter cohort study.

Rubin, Sébastien / Orieux, Arthur / Prezelin-Reydit, Mathilde / Garric, Antoine / Picard, Yoann / Mellati, Nouchan / Le Gall, Lisa / Dewitte, Antoine / Prevel, Renaud / Gruson, Didier / Louis, Guillaume / Boyer, Alexandre

Annals of intensive care

2024 Volume 14, Issue 1, Page(s) 26

Abstract: Background: Acute kidney injury (AKI) in intensive care unit (ICU) patients with severe COVID-19 is common (> 50%). A specific inflammatory process has been suggested in the pathogenesis of AKI, which could be improved by dexamethasone (DXM). In a small ...

Abstract	Background: Acute kidney injury (AKI) in intensive care unit (ICU) patients with severe COVID-19 is common (> 50%). A specific inflammatory process has been suggested in the pathogenesis of AKI, which could be improved by dexamethasone (DXM). In a small monocenter study (n = 100 patients), we reported a potential protective effect of DXM on the risk of AKI. This study aimed to investigate the preventive impact of DXM on AKI in a multicenter study of patients with severe COVID-19. Methods: We conducted a multicenter study in three French ICUs from March 2020 to August 2021. All patients admitted to ICU for severe COVID-19 were included. Individuals with preexistent AKI or DXM administration before admission to ICU were excluded. While never used during the first wave, DXM was used subsequently at ICU entry, providing two treatment groups. Multivariate Cause-specific Cox models taking into account changes in ICU practices over time, were utilized to determine the association between DXM and occurrence of AKI. Results: Seven hundred and ninety-eight patients were included. Mean age was 62.6 ± 12.1 years, 402/798 (50%) patients had hypertension, and 46/798 (6%) had previous chronic kidney disease. Median SOFA was 4 [3-6] and 420/798 (53%) required invasive mechanical ventilation. ICU mortality was 208/798 (26%). AKI was present in 598/798 (75%) patients: 266/598 (38%), 163/598 (27%), and 210/598 (35%) had, respectively, AKI KDIGO 1, 2, 3, and 61/598 (10%) patients required renal replacement therapy. Patients receiving DXM had a significantly decreased hazard of AKI occurrence compared to patients without DXM (HR 0.67; 95CI 0.55-0.81). These results were consistent in analyses that (1) excluded patients with DXM administration to AKI onset delay of less than 12 h, (2) incorporating the different 'waves' of the COVID-19 pandemic. Conclusions: DXM was associated with a decrease in the risk of AKI in severe COVID-19 patients admitted to ICU. This supports the hypothesis that the inflammatory injury of AKI may be preventable.
Language	English
Publishing date	2024-02-13
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2617094-2
ISSN	2110-5820
ISSN	2110-5820
DOI	10.1186/s13613-024-01258-6
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Article ; Online: Impaired balance between neutrophil extracellular trap formation and degradation by DNases in COVID-19 disease.

Garcia, Geoffrey / Labrouche-Colomer, Sylvie / Duvignaud, Alexandre / Clequin, Etienne / Dussiau, Charles / Trégouët, David-Alexandre / Malvy, Denis / Prevel, Renaud / Zouine, Atika / Pellegrin, Isabelle / Goret, Julien / Mamani-Matsuda, Maria / Dewitte, Antoine / James, Chloe

Journal of translational medicine

2024 Volume 22, Issue 1, Page(s) 246

Abstract: Background: Thrombo-inflammation and neutrophil extracellular traps (NETs) are exacerbated in severe cases of COVID-19, potentially contributing to disease exacerbation. However, the mechanisms underpinning this dysregulation remain elusive. We ... ...

Abstract	Background: Thrombo-inflammation and neutrophil extracellular traps (NETs) are exacerbated in severe cases of COVID-19, potentially contributing to disease exacerbation. However, the mechanisms underpinning this dysregulation remain elusive. We hypothesised that lower DNase activity may be associated with higher NETosis and clinical worsening in patients with COVID-19. Methods: Biological samples were obtained from hospitalized patients (15 severe, 37 critical at sampling) and 93 non-severe ambulatory cases. Our aims were to compare NET biomarkers, functional DNase levels, and explore mechanisms driving any imbalance concerning disease severity. Results: Functional DNase levels were diminished in the most severe patients, paralleling an imbalance between NET markers and DNase activity. DNase1 antigen levels were higher in ambulatory cases but lower in severe patients. DNase1L3 antigen levels remained consistent across subgroups, not rising alongside NET markers. DNASE1 polymorphisms correlated with reduced DNase1 antigen levels. Moreover, a quantitative deficiency in plasmacytoid dendritic cells (pDCs), which primarily express DNase1L3, was observed in critical patients. Analysis of public single-cell RNAseq data revealed reduced DNase1L3 expression in pDCs from severe COVID-19 patient. Conclusion: Severe and critical COVID-19 cases exhibited an imbalance between NET and DNase functional activity and quantity. Early identification of NETosis imbalance could guide targeted therapies against thrombo-inflammation in COVID-19-related sepsis, such as DNase administration, to avert clinical deterioration. Trial registration: COVERAGE trial (NCT04356495) and COLCOV19-BX study (NCT04332016).
MeSH term(s)	Humans ; Extracellular Traps/metabolism ; Neutrophils/metabolism ; Deoxyribonucleases/metabolism ; COVID-19 ; Deoxyribonuclease I/metabolism ; Inflammation/metabolism ; Nervous System Diseases
Chemical Substances	Deoxyribonucleases (EC 3.1.-) ; Deoxyribonuclease I (EC 3.1.21.1)
Language	English
Publishing date	2024-03-07
Publishing country	England
Document type	Journal Article
ZDB-ID	2118570-0
ISSN	1479-5876 ; 1479-5876
ISSN (online)	1479-5876
ISSN	1479-5876
DOI	10.1186/s12967-024-05044-7
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Article ; Online: CD154 Induces Interleukin-6 Secretion by Kidney Tubular Epithelial Cells under Hypoxic Conditions: Inhibition by Chloroquine.

Dewitte, Antoine / Villeneuve, Julien / Lepreux, Sébastien / Bouchecareilh, Marion / Gauthereau, Xavier / Rigothier, Claire / Combe, Christian / Ouattara, Alexandre / Ripoche, Jean

Mediators of inflammation

2020 Volume 2020, Page(s) 6357046

Abstract: Inflammation is a major contributor to tubular epithelium injury in kidney disorders, and the involvement of blood platelets in driving inflammation is increasingly stressed. CD154, the ligand of CD40, is one of the mediators supporting platelet ... ...

Abstract	Inflammation is a major contributor to tubular epithelium injury in kidney disorders, and the involvement of blood platelets in driving inflammation is increasingly stressed. CD154, the ligand of CD40, is one of the mediators supporting platelet proinflammatory properties. Although hypoxia is an essential constituent of the inflammatory reaction, if and how platelets and CD154 regulate inflammation in hypoxic conditions remain unclear. Here, we studied the control by CD154 of the proinflammatory cytokine interleukin- (IL-) 6 secretion in short-term oxygen (O
MeSH term(s)	Apoptosis ; Blotting, Western ; CD40 Ligand/pharmacology ; Cell Hypoxia/physiology ; Cell Line ; Cell Proliferation ; Cell Survival ; Chloroquine/pharmacology ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells/drug effects ; Epithelial Cells/metabolism ; Flow Cytometry ; Humans ; Interleukin-6/metabolism ; Kidney Tubules/cytology ; Microscopy, Fluorescence ; Real-Time Polymerase Chain Reaction
Chemical Substances	Interleukin-6 ; CD40 Ligand (147205-72-9) ; Chloroquine (886U3H6UFF)
Language	English
Publishing date	2020-01-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	1137605-3
ISSN	1466-1861 ; 0962-9351
ISSN (online)	1466-1861
ISSN	0962-9351
DOI	10.1155/2020/6357046
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Article: Correction to: Blood platelets and sepsis pathophysiology: A new therapeutic prospect in critically ill patients?

Dewitte, Antoine / Lepreux, Sébastien / Villeneuve, Julien / Rigothier, Claire / Combe, Christian / Ouattara, Alexandre / Ripoche, Jean

Annals of intensive care

2018 Volume 8, Issue 1, Page(s) 32

Abstract: Upon publication of the original article [1], it was noticed that the title was incorrect. Instead of 'critical', it should read 'critically', and therefore, the correct title should be. ...

Abstract	Upon publication of the original article [1], it was noticed that the title was incorrect. Instead of 'critical', it should read 'critically', and therefore, the correct title should be.
Language	English
Publishing date	2018-02-28
Publishing country	Germany
Document type	Journal Article ; Published Erratum
ZDB-ID	2617094-2
ISSN	2110-5820
ISSN	2110-5820
DOI	10.1186/s13613-018-0378-6
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Article ; Online: Plasma Markers of Neutrophil Extracellular Trap Are Linked to Survival but Not to Pulmonary Embolism in COVID-19-Related ARDS Patients.

Prével, Renaud / Dupont, Annabelle / Labrouche-Colomer, Sylvie / Garcia, Geoffrey / Dewitte, Antoine / Rauch, Antoine / Goutay, Julien / Caplan, Morgan / Jozefowicz, Elsa / Lanoix, Jean-Philippe / Poissy, Julien / Rivière, Etienne / Orieux, Arthur / Malvy, Denis / Gruson, Didier / Garçon, Loic / Susen, Sophie / James, Chloé

Frontiers in immunology

2022 Volume 13, Page(s) 851497

Abstract: Introduction: Coronavirus disease 2019 (COVID-19) can cause life-threatening acute respiratory distress syndrome (ARDS). Recent data suggest a role for neutrophil extracellular traps (NETs) in COVID-19-related lung damage partly due to microthrombus ... ...

Abstract	Introduction: Coronavirus disease 2019 (COVID-19) can cause life-threatening acute respiratory distress syndrome (ARDS). Recent data suggest a role for neutrophil extracellular traps (NETs) in COVID-19-related lung damage partly due to microthrombus formation. Besides, pulmonary embolism (PE) is frequent in severe COVID-19 patients, suggesting that immunothrombosis could also be responsible for increased PE occurrence in these patients. Here, we evaluate whether plasma levels of NET markers measured shorty after admission of hospitalized COVID-19 patients are associated with clinical outcomes in terms of clinical worsening, survival, and PE occurrence. Patients and methods: Ninety-six hospitalized COVID-19 patients were included, 50 with ARDS (severe disease) and 46 with moderate disease. We collected plasma early after admission and measured 3 NET markers: total DNA, myeloperoxidase (MPO)-DNA complexes, and citrullinated histone H3. Comparisons between survivors and non-survivors and patients developing PE and those not developing PE were assessed by Mann-Whitney test. Results: Analysis in the whole population of hospitalized COVID-19 patients revealed increased circulating biomarkers of NETs in patients who will die from COVID-19 and in patients who will subsequently develop PE. Restriction of our analysis in the most severe patients, i.e., the ones who enter the hospital for COVID-19-related ARDS, confirmed the link between NET biomarker levels and survival but not PE occurrence. Conclusion: Our results strongly reinforce the hypothesis that NETosis is an attractive therapeutic target to prevent COVID-19 progression but that it does not seem to be linked to PE occurrence in patients hospitalized with COVID-19.
MeSH term(s)	Biomarkers ; COVID-19/complications ; Extracellular Traps ; Humans ; Pulmonary Embolism/etiology ; Respiratory Distress Syndrome/etiology
Chemical Substances	Biomarkers
Language	English
Publishing date	2022-03-17
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2022.851497
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Article ; Online: Serum lactate and acute mesenteric ischaemia: An observational, controlled multicentre study.

Collange, Olivier / Lopez, Marc / Lejay, Anne / Pessaux, Patrick / Ouattara, Alexandre / Dewitte, Antoine / Rimmele, Thomas / Girardot, Thibaut / Arnaudovski, Darko / Augustin, Pascal / Chakfe, Nabil / Tacquard, Charles / Oulehri, Walid / Zieleskiewicz, Laurent / Severac, François / Leone, Marc / Mertes, Paul Michel

Anaesthesia, critical care & pain medicine

2022 Volume 41, Issue 6, Page(s) 101141

Abstract: Background: Early diagnosis and prompt management of acute mesenteric ischaemia (AMI) are key to survival but remain extremely difficult, due to vague and non-specific symptoms. Serum lactate (SL) is commonly presented as a useful biomarker for the ... ...

Abstract	Background: Early diagnosis and prompt management of acute mesenteric ischaemia (AMI) are key to survival but remain extremely difficult, due to vague and non-specific symptoms. Serum lactate (SL) is commonly presented as a useful biomarker for the diagnosis or prognosis of AMI. The aim of our study was test SL (1) as a diagnostic marker and (2) as a prognostic marker for AMI. Study design: This was an ancillary multicentre case-control study. Patients with AMI at intensive care unit (ICU) admission were included (AMI group) and matched to ICU patients without AMI (control group). SL was measured and compared on day 0 (D0) and day 1 (D1). Diagnosis and prognosis accuracy were assessed by receiver operating characteristic (ROC) and their area under the curve (AUC). Results: Each group consisted of 137 matched ICU patients. There was no significant difference of SL between the two groups at D0 or at D1 (p = 0.26 and p = 0.29 respectively). SL was a poor marker of AMI: at D0 and D1, AUC were respectively 0.57 [0.51; 0.63] and 0.60 [0.53; 0.67]. SL at D0 and D1 correctly predicted ICU mortality, independently of AMI (AUC D0: 0.69 [0.59; 0.79] vs. 0.74 [0.65; 0.82]; p = 0.51 and D1: 0.74 [0.64; 0.84] vs. 0.76 [0.66; 0.87]; p = 0.77, respectively, for control and AMI groups]. Conclusions: SL has no specific link with AMI, both for diagnosis and prognosis. SL should not be used for the diagnosis of AMI but, despite its lack of specificity, it may help to assess severity.
MeSH term(s)	Humans ; Mesenteric Ischemia/diagnosis ; Case-Control Studies ; Retrospective Studies ; Intensive Care Units ; ROC Curve ; Prognosis ; Biomarkers ; Lactates
Chemical Substances	Biomarkers ; Lactates
Language	English
Publishing date	2022-08-12
Publishing country	France
Document type	Observational Study ; Multicenter Study ; Journal Article
ISSN	2352-5568
ISSN (online)	2352-5568
DOI	10.1016/j.accpm.2022.101141
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Article ; Online: Amino acids and vitamins status during continuous renal replacement therapy: An ancillary prospective observational study of a randomised control trial.

Schneider, Antoine G / Picard, Walter / Honoré, Patrick M / Dewitte, Antoine / Mesli, Samir / Redonnet-Vernhet, Isabelle / Fleureau, Catherine / Ouattara, Alexandre / Berger, Mette M / Joannes-Boyau, Olivier

Anaesthesia, critical care & pain medicine

2021 Volume 40, Issue 2, Page(s) 100813

Abstract: Background: Continuous renal replacement therapy (CRRT) is associated with micronutrients loss. Current recommendations are to administer 1-1.5g/kg/day of proteins during CRRT. We aim to evaluate the net effect of CRRT on amino acids (AA), vitamins A ... ...

Abstract	Background: Continuous renal replacement therapy (CRRT) is associated with micronutrients loss. Current recommendations are to administer 1-1.5g/kg/day of proteins during CRRT. We aim to evaluate the net effect of CRRT on amino acids (AA), vitamins A and C (Vit A, Vit C) levels. Methods: This is a prospective observational study embedded within a randomised controlled trial comparing two CRRT doses in patients with septic shock. CRRT was provided in continuous veno-venous haemofiltration mode at a dose of either 35ml/kg/h or 70ml/kg/h. All patients received parenteral nutrition with standard trace elements and vitamins (protein intake 1g/kg/d). We measured serum levels of glutamine, valine and alanine as well as Vit A and Vit C upon randomisation, study day four and eight. In addition, we measured a larger panel of AA in a subset of 11 patients. Results: We included 30 patients (17 allocated to 70ml/kg/h and 13 to 35ml/kg/h CRRT). Before CRRT initiation, mean plasma levels of glutamine and valine, Vit A and Vit C were low. CRRT was not associated with any significant change in AA levels except for a decrease in cystein. It was associated with an increase in Vit A and a decrease in Vit C levels. CRRT dose had no impact on those nutrients blood levels. Conclusions: Irrespective of dose, CRRT was associated with a decrease in cysteine and Vit C and an increase in Vit A with no significant change in other AA. Further studies should focus on lean mass wasting during CRRT.
MeSH term(s)	Acute Kidney Injury ; Amino Acids ; Continuous Renal Replacement Therapy ; Critical Illness ; Humans ; Prospective Studies ; Renal Replacement Therapy ; Vitamins
Chemical Substances	Amino Acids ; Vitamins
Language	English
Publishing date	2021-02-12
Publishing country	France
Document type	Journal Article ; Observational Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ISSN	2352-5568
ISSN (online)	2352-5568
DOI	10.1016/j.accpm.2021.100813
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Article: High mean arterial pressure target to improve sepsis-associated acute kidney injury in patients with prior hypertension: a feasibility study.

Dewitte, Antoine / Labat, Aurore / Duvignaud, Pierre-Antoine / Bouche, Gauthier / Joannes-Boyau, Olivier / Ripoche, Jean / Hilbert, Gilles / Gruson, Didier / Rubin, Sébastien / Ouattara, Alexandre / Boyer, Alexandre / Combe, Christian

Annals of intensive care

2021 Volume 11, Issue 1, Page(s) 139

Abstract: Background: The optimal mean arterial pressure (MAP) in cases of septic shock is still a matter of debate in patients with prior hypertension. An MAP between 75 and 85 mmHg can improve glomerular filtration rate (GFR) but its effect on tubular function ... ...

Abstract	Background: The optimal mean arterial pressure (MAP) in cases of septic shock is still a matter of debate in patients with prior hypertension. An MAP between 75 and 85 mmHg can improve glomerular filtration rate (GFR) but its effect on tubular function is unknown. We assessed the effects of high MAP level on glomerular and tubular renal function in two intensive care units of a teaching hospital. Inclusion criteria were patients with a history of chronic hypertension and developing AKI in the first 24 h of septic shock. Data were collected during two 6 h periods of MAP regimen administered consecutively after haemodynamic stabilisation in an order depending on the patient's admission unit: a high-target period (80-85 mmHg) and a low-target period (65-70 mmHg). The primary endpoint was the creatinine clearance (CrCl) calculated from urine and serum samples at the end of each MAP period by the UV/P formula. Results: 26 patients were included. Higher urine output (+0.2 (95%:0, 0.4) mL/kg/h; P = 0.04), urine sodium (+6 (95% CI 0.2, 13) mmol/L; P = 0.04) and lower serum creatinine (- 10 (95% CI - 17, - 3) µmol/L; P = 0.03) were observed during the high-MAP period as compared to the low-MAP period, resulting in a higher CrCl (+25 (95% CI 11, 39) mL/mn; P = 0.002). The urine creatinine, urine-plasma creatinine ratio, urine osmolality, fractional excretion of sodium and urea showed no significant variation. The KDIGO stage at inclusion only interacted with serum creatinine variation and low level of sodium excretion at inclusion did not interact with these results. Conclusions: In the early stage of sepsis-associated AKI, a high-MAP target in patients with a history of hypertension was associated with a higher CrCl, but did not affect the kidneys' ability to concentrate urine, which may reflect no effect on tubular function.
Language	English
Publishing date	2021-09-22
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2617094-2
ISSN	2110-5820
ISSN	2110-5820
DOI	10.1186/s13613-021-00925-2
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