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Idiopathic nephrotic syndrome (NIS) is a clinical entity defined by the association of selective albuminuria, hypoalbuminemia, and nonspecific glomerular lesions (lesions minimal glomerular (LGM) or segmental and focal hyalinosis (HSF). The complication of this kidney disease is the progression towards chronic renal failure and in case of kidney transplantation, its immediate recurrence on the graft . The origin of this syndrome is unknown but a number of clinical observations tend to show an involvement of immune system. A link has been highlighted between atopy, diet and nephrotic flare-ups. The speed of recurrence of this initial disease on the graft and the observation of remissions obtained after treatment by plasma exchange or immunoadsorptions support the presence of a pathogenic plasma factor. Anti-CD20 treatments depleting B lymphocytes has made it possible to favorably treat a number of patients. Dysfunction of regulatory T cells has also been shown in SNI patients. This modification seems linked to allergies and could be due to an aberrant microbiota. The hypothesis of causality between dysbiosis, alteration lymphocyte and triggering of an SNI was mentioned recently. Two studies have shown intestinal dysbiosis in pediatric SNI/LGM, with reduction of T circulating regulators
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patient with nephrotic syndrome idiopathic | nephrotic INS patients in primary visit: harvesting of 27.5 ml supplementary blood, 40 mlurine and feces at inclusion visit and at 3 months. No intervention, no treatment administration other than usual/routine INS treatment. |
| |
| Patient with nephrotic syndrome no idiopathic, IgA or GEM type or other glomerulopathy | At least 10 NS no idipathic patients: harvesting of 27.5 ml supplementary blood, 40 ml urine and feces at inclusion visit and at 3 months. No intervention, no treatment administration other than usual/routine care treatment. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Measurement of blood immune populations and microbiota distribution. | Other | Measurement of peripheral cell populations by spectral cytometry and in parallel, sequencing of intestinal and urinary bacterial 16S RNA of each patient. |
| Measure | Description | Time Frame |
|---|---|---|
| Sequencing and analysis of blood peripheral immune populations and intestinal and urinary microbiota | For the analysis of peripheral populations, blood cells will be collected by density gradient (Ficoll) and frozen in 20% DMSO. They will then be marked and identified by flow cytometry. | 3 months |
| Sequencing and analysis of intestinal microbiota | The microbiota will be analyzed using DNA extracted from fecal samples. | 3 months |
| Sequencing and analysis of urinary microbiota | The microbiota will be analyzed using DNA extracted from urine samples. | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Compare blood peripheral immune populations in patients with SNI to that of type SN patients. | We will collect clinical and biological variables from each patient with a syndrome nephrotic type GEM or IgA as well as the results of the analysis of populations peripheral immune systems. | 3 months |
| Compare intestinal microbiota in patients with SNI to that of type SN patients. |
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Inclusion Criteria :
Proteinuria > 3g 24h or A proteinuria/creatinuria ratio > 3 or Defined at the discretion of the clinician
Non inclusion Criteria :
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Patients with idiopathic nephrotic syndrome (LGM or HSF type) will be considered in the main objective, patients with IgA or GEM type nephrotic syndrome or other glomerulopathy will be integrated into the control group for the secondary objectivets
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Christophe Masset | Contact | +33 2 76 64 39 61 | christophe.masset@chu-nantes.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nantes University Hospital | Recruiting | Nantes | Loire-Atlantique | 44093 | France | |
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| ID | Term |
|---|---|
| D009402 | Nephrosis, Lipoid |
| D005923 | Glomerulosclerosis, Focal Segmental |
| ID | Term |
|---|---|
| D009401 | Nephrosis |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
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We will collect clinical and biological variables from each patient with a syndrome nephrotic type GEM or IgA as well as the results of the analysis of the microbiota |
| 3 months |
| Compare urine microbiota in patients with SNI to that of type SN patients. | We will collect clinical and biological variables from each patient with a syndrome nephrotic type GEM or IgA as well as the results of the analysis of the microbiota | 3 months |
| Departemental Hospital Center |
| Recruiting |
| La Roche-sur-Yon |
| 85925 |
| France |
|
| D005261 |
| Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D005921 | Glomerulonephritis |
| D009393 | Nephritis |