Pedram Ahmadpoor

Centre Hospitalier Régional Universitaire de Nîmes · Department of Nephrology

Bullous pemphigoid is the most common autoimmune blistering disease induced by autoantibodies against basement membrane anchoring proteins (anti‐BP‐180 and anti‐BP‐230). The disease generally appears after the age of 70 and is associated with a 23.5% 1‐year mortality, especially in diabetics, or in the presence of ischemic heart disease and high an...

We present the case of a 58-year-old male diabetic patient admitted to our department for a slight decrease in kidney function, with nephrotic range proteinuria, hematuria (16,000/ml) and positive anti-glomerular basement membrane antibodies. Kidney biopsy revealed diabetic nephropathy with no evidence of crescent formation or linear immunoglobulin...

Background and Aims Therapeutic plasmapheresis (TP) is an established therapy in different pathology according to international guidelines. There is different method of TP such as single plasma exchange (SPE) and Double plasmafiltration (DFPP) defined as non selective or semi selective method. Centrifugal (cSPE) and Filtration-membrane based (mSPE)...

Background: Cytomegalovirus (CMV) infections caused by the cytomegalovirus are one of the most common problems in patients after kidney transplant. We examined the association of the relationship between the number and activity of natural killer cells with increased cytomegalovirus and its related disease after kidney transplantation. Material an...

Background and Aims Chronic kidney disease (CKD) is a common disease with a heterogeneous course. The Kidney Failure Risk Equation (KFRE) is designed to predict 5-year End stage renal disease (ESRD). This score has shown poor performance in predicting 5-years ESRD in elderly patients, probably because of a competitive risk with death. Indeed, patie...

Introduction Des patients peuvent nécessiter dans le même temps d’un traitement chronique par hémodialyse intermittente(HDI) et lDLapherese. L’objectif de notre étude est d’évaluer la performance, la sécurité et le coût de la pratique du tandem permettant la realisation dans un même temps d’une séance d’HDI et d’une plasmaphérèses double filtration...

Background: Impaired renal function is considered as a significant risk factor for cardiovascular events in chronic kidney disease patients. Several immunosuppressive drugs are used in these patients, which necessitates to minimize the drug-related side effects by employing alternative strategies. Objective: This study aimed to evaluate prospect...

Introduction: Certain patients require simultaneous lipoprotein apheresis (LA) and intermittent hemodialysis (HD). Instead of undergoing 2 consecutive treatment sessions, a double filtration plasmapheresis (DFPP) and HD tandem procedure could be offered to reduce treatment times and costs. Our study evaluated the performance, safety and cost of th...

Kidney biopsy is the gold standard for diagnosing glomerular kidney disease. Some authors debate the necessity of systematically performing kidney biopsies in ANCA-associated vasculitis (AAV) to confirm the diagnosis and assess the severity of renal damage. Nevertheless, kidney involvement is considered an organ-threatening disease requiring an agg...

IntroductionChronic kidney disease (CKD) affects > 10% of the population but not all CKD patients require referral to a nephrologist. Various recommendations for referral to nephrologists are proposed worldwide. We examined the profile of French patients consulting a nephrologist for the first time and compared these characteristics with the recomm...

Introduction: Cardiovascular disease is considered as the main cause of mortality and morbidity in HD-patients and AS is a fundamental cause. This study was conducted to investigate whether intradialytic BP changes can use as a surrogate clinical marker. Methods: Fifty-one patients on maintenance hemodialysis, for at least 12 hours per week, wer...

Background: Cytomegalovirus (CMV) infection is the most common complications following kidney transplantation. Natural killer (NK) cells demonstrated critical anti-viral role in controlling and elimination of CMV after transplantation. Interleukin-15 (IL-15) is a pleiotropic cytokine that promotes the activity of NK cells and strengthens the acqui...

Background and Aims Todays increasing effort are made to detect non-invasive and reliable methods for prediction of organ rejection. In the current study, we evaluated the degree of CD3, CD20, Th17 and Tregs infiltration in kidney biopsy of the patients with acute cellular rejection and the possible relation with graft outcome. Method From 70 biop...

Aim To evaluate the degree of CD3, CD20, Th17, and Tregs infiltration in kidney biopsy of the patients with acute cellular rejection and the possible relation with graft outcome. Materials and methods In this retrospective study, fifty patients with Acute T Cell-Mediated Rejection (ATCMR) were enrolled. Previous and one year clinical follow-up dat...

Acquired Immune thrombotic thrombocytopenic purpura (iTTP) is considered among clinical situations that needs not only urgent treatment in acute setting but also long term management to prevent relapses. Important progresses have been made in management of these patients that are definitely associated with reduced mortality and relapse rate. Howeve...

Coronavirus family has caused several human illnesses, the latest caused by SARS-CoV-2, has led to COVID-19 pandemic posing serious threat to global health. A SARS-CoV-2 variant encoding a D614G mutation in the viral spike (S) protein has now become the most prevalent form of the virus worldwide, suggesting a fitness advantage for the mutant. The G...

Objectives The present study was designed to evaluate the factors involved in long-term graft survival in recipients of kidney transplantation. Materials and Methods We reviewed 755 Iranian adult recipients who underwent kidney transplantation at Shahid Labbafinejad Medical Center in Tehran, Iran. Patients were followed for 5 years after transplan...

Nowadays, therapeutic plasmapheresis (TP) is accepted as part of the treatment for specific groups of diseases. The availability of different methods, including double filtration and adsorption, increases selectivity for the removal of substances. However, the use of these techniques requires a thorough understanding of the characteristics and comp...

Background: Oxidative stress as a major mediator of adverse outcomes in kidney transplant recipients who are prone to oxidative stress-mediated injury by pre-transplant and post-transplant conditions. Objectives: The purpose of this study was to assess the effects of Pioglitazone on oxidative stress biomarkers and blood glucose control in diabetic...

Background and Aims Renal transplantation is considered as the best replacement therapy for advanced ESRD patients. An allograft rejection happens as a result of post transplant immune reactions, which change the outcome of the organ transplantation. Today a major challenge in the field of transplantation is the identification of easy, reliable and...

Coronaviruses primarily cause zoonotic infections, however in the past few decades several interspecies transmissions have occurred, the last one by SARS-CoV-2, causing COVID-19 pandemic, posing serious threat to global health. The SARS-CoV-2 spike (S) protein plays an important role in viral attachment, fusion and entry. However, other structural...

in the reports presented about COVID-19, patients receiving kidney transplantation have not been specifically studied and based on national flowchart, this population is classified as highrisk group, thus it is necessary to be aware of the step-by-step treatment approach of these patients. Suspicious cases included patients with a history of dry co...

The Covid‐19 pandemic has already affected many thousands of people and has become the greatest health challenge worldwide [1]. The range of clinical presentations varies from asymptomatic and mild clinical symptoms to acute respiratory‐distress syndrome (ARDS) and death. Due to the unknown number of asymptomatic viral‐shedding and pauci‐symptomati...

Acute tubular necrosis (ATN), a frequent histopathological feature in the early post‐renal transplant biopsy, affects long‐term graft function. Appropriate markers to identify patients at risk of no or incomplete recovery after delayed graft function are lacking. In this study, we first included 41 renal transplant patients whose biopsy for cause d...

Introduction: Double filtration plasmapheresis (DFPP) could be an alternative method to simple plasma exchange plasmapheresis in the treatment of acquired Thrombotic Thrombocytopenic Purpura (aTTP). Method: In a retrospectively single center case series, we studied clinical presentation, management care and prognosis of aTTP patients from our ac...

A 76-year-old renal transplant patient due to autosomal dominant polycystic kidney disease who resumed chronic haemodialysis was admitted to our hospital for confusion and lassitude. He was afebrile and physical examination revealed diffuse bilateral rales with decreased respiratory sounds in lower right lung. Laboratory data showed hypercalcaemia...

Background: With the introduction of new immunosuppressive agents like Sirolimus (SRL), we could increase long term allograft survival and decrease the use of other agents like calcineurin inhibitors. SRL in combination with other immunosuppressive medications like calcineurin inhibitors can lead to increase graft function and produce better long-t...

Dendritic cells (DCs) have a major role in the initiation of an immune response and Immunoglobulin-like transcript 3&4 (ILT3&ILT4) are inhibitory receptors that induce tolerance in DCs. Recent studies show that immunosuppressive agents affect frequency of DCs. Herein, we compared the effect of mycophenolate mofetil (MMF) and sirolimus (SRL) in tacr...

Delayed graft function (DGF) is a form of acute renal failure which results in increased post-transplantation allograft immunogenicity and risk of acute rejection episodes in addition to decreased long-term survival. Its incidence and risk factors have been extensively studied, especially after deceased donation. Until now, only few data has been p...

Background Acute renal dysfunction still constitutes a highly significant obstacle to renal transplantation outcome. Kidney injury molecule-1 is highly upregulated in proximal tubular cells and shed into the urine and blood circulation following kidney injury. The aim of current cohort study was to evaluate the urine KIM-1 (uKIM-1) mRNA expression...

Objectives: A growing body of evidence has revealed the role of innate immune cells in transplantation; however, the nature of natural killer cell involvement in rejection is still elusive. Here, we aimed to determine the impact of natural killer cell activities in acute and chronic renal transplant rejection. Materials and methods: This prelimi...

Long-term use of calcineurin inhibitors (CNI) is associated with nephrotoxicity, which is an important cause of renal dysfunction. Therefore, CNI-minimization strategies which decrease the CNI nephrotoxicity under the protection of additional immunosuppressant drugs have been developed. The aim of current cohort study was to compare the effect of t...

Background: Accumulating evidence suggests that regulatory T cells (Tregs) have a crucial role in immune tolerance and long-term graft survival. However, the influence of immunosuppressive drugs on the level of Tregs has not been fully understood. Therefore we prospectively compare the effect of two different calcineurin inhibitor (CNI)-based immu...

Background: T cell immunoglobulin and mucin domain 3 (TIM-3), as a co-inhibitory receptor expressed on Th1, Th17, CD8T, FoxP3 + Treg and innate immune cells, plays an important role in suppression of T cell-mediated immune responses, tolerance induction and T cell exhaustion. In this study, we evaluated sequential alterations of TIM-3 mRNA express...

Complement C3 glomerulopathy refers to a disease process in which abnormal control of complement activation or degradation results in predominant C3 fragment deposition within the glomerulus and causes glomerular damage. Abnormal control of the complement alternative pathway is a well-established risk factor for the occurrence of C3 glomerulonephri...

Objective Despite advances in prevention of inflammatory milieu with different anti-inflammatory modalities in hemodialysis patients the rate of inflammatory markers in this population are still high. Inflammation is considered as a major player in uremia associated with morbidity and mortality in hemodialysis patients. The aim of this study was to...

The purpose of this study was to evaluate T-cell immunity markers using serial post-transplantation monitoring of cytokine-producing cells during the first post-transplant months for the prediction of acute rejection and potentially chronic rejection of kidney allograft. We followed 57 kidney allograft recipients for meanly 3 years post-transplanta...

Background: The incidence of ischemic reperfusion injury (IRI) in early phase post-transplantation and activation of toll-like receptor (TLR-2) and TLR-4 remarkably impact the outcome of a renal allograft. Objective: To investigate whether the expression of TLRs in peripheral blood mononuclear cells (PBMCs) can predict the clinical outcome of ki...

Background: While acute rejection and early graft loss rates have decreased substantially over the past four decades, progressive chronic allograft dysfunction (CAD) still remains a common cause of late graft loss in kidney transplant recipients. Objective: This study was conducted to investigate the percentage of natural killer (NK) cell subset...

With an increased incidence of living-donor kidney transplants, in response to increasing unmet needs for renal transplant, a clear understanding of determinants of posttransplant outcomes is essential. The importance of delayed graft function in deceased-donor kidney transplant is now part of conventional medical wisdom, due to the large amount of...

Chronic allograft dysfunction (CAD) remains the major cause of renal transplant loss and characterized by interstitial fibrosis and tubular atrophy (IFTA). MicroRNAs (miRNAs) are implicated in many biological processes as well as innate and adaptive immune responses. We aimed to investigate whether CAD with IFTA is associated with differential expr...

MicroRNAs (miRNAs) regulate most of encoding genes and protein. In this study, we aimed to investigate the expression levels of miR-142-5p, miR-142-3p, miR-155 and miR-223 in paired biopsy and peripheral blood mononuclear cells (PBMCs) samples of renal allograft recipients with acute T-cell mediated rejection (ATCMR), compared with normal allograft...

Soluble major histocompatibility complex class I chain-related antigen A (soluble MICA) has recently been considered as an inhibitory molecule which is shed from tumors and protects them against natural killers and some subgroups of T cells' cytolysis. In transplantation, soluble MICA is also a foreign antigenic molecule that can induce allospecifi...

The genetic variations of co-stimulatory molecules can affect the extent of T cell activity during T-cell mediated immunity, especially in transplant patients. This study aimed to investigate the association of programmed cell death 1 (PDCD1) and programmed cell death 1 ligand 1 (PDCD1LG1) gene polymorphisms with clinical outcome of kidney transpla...

Introduction: The aim of this study was to assess the effects of pioglitazone on blood glucose control and inflammatory biomarkers in diabetic patients receiving insulin after kidney transplantation. Materials and methods: In a randomized placebo-controlled trial, 62 diabetic kidney transplant patients were followed for 4 months after randomly a...

Background: Regulatory T cells have been suggested to have a protective role against acute rejection in allograft recipients. However, there is little information available about their contribution to chronic rejection process. The role of transforming growth factor-beta 1 (TGF-β1) as a profibrogenic and/or immunoregulatory cytokine in renal allog...

Systemic lupus erythematosus is a group of diseases that seem to become separate entities by etiology in the near future. Its pathogenesis remains elusive; however, multifactorial interactions among genetic and environmental factors may be involved. Systemic lupus erythematosus is the perfect prototype of autoimmune disorder with multiple derangeme...

Introduction: Recurrence of cytomegalovirus (CMV) infection following solid organ transplantation causes mortality and morbidity in allograft recipients. The aim of this study was to evaluate prevalence and risk factors of recurrent CMV infection in kidney transplant patients. Materials and methods: Four hundred and twenty-seven consecutive kidn...

Introduction: We aimed to identify immune status of the stable kidney allografts from the point of some cellular changes that may occur after transplantation. Materials and methods: This study considered 57 patients with no rejection during the 6 months after transplantation. Flow cytometric frequencies of circulatory CD4+CD25+FoxP3+ and CD8+CD2...

There are limited clinical investigations identifying the percentage of T helper 1 (Th1) and T regulatory (Treg) cells in stable as well as rejected kidney allografts, a concept which needs to be more studied. The aim of our study was to compare the percentage of CD4+ IFN-γ+ cells, the number of IFN-γ secreting cells and the amount of FoxP3 express...

Introduction. We aimed to identify immune status of the stable kidney allografts from the point of some cellular changes that may occur after transplantation. Materials and Methods. This study considered 57 patients with no rejection during the 6 months after transplantation. Flow cytometric frequencies of circulatory CD4+CD25+FoxP3+ and CD8+CD28-r...

Sirolimus is the one of new immunosuppressants that may be a substitute to traditional drugs such as cyclosporine. We present our investigation on sirolimus-based immunosuppression in kidney transplant recipients as compared with cyclosporine-based immunosuppression. We enrolled 100 patients in an open-labeled randomized clinical trial at Shahid La...

Malignancy is a common complication after renal transplantation. However, limited data are available on post-transplant malignancy in living kidney transplantation. Therefore, we made a plan to evaluate the incidence and types of malignancies, association with the main risk factors and patient survival in a large population of living kidney transpl...

Objective: In spite of dramatic improvements in the allograft maintenance and survival, there are lots of problematic issues that affect the long-term survival of a graft. The molecular mechanisms of rejection and major player cells are still unidentified. In the immune system, the Th1 subset supplies the first line of defense against intracellular...

Erythropoietin is administered for treatment of anemia in chronic kidney disease and kidney transplantation. Erythropoietin improves oxygenation of organs and prevents them against apoptosis. The aim of this study was evaluation of erythropoietin's effect on graft survival in the early phase after transplantation. Forty kidney transplant candidates...

Invasive mucormycosis is a very rare infection after kidney transplantation. Here, we report 25 renal transplant recipients with mucormycosis; to our knowledge, this is the largest reported population of mucormycosis in these patients. In a retrospective study, we collected all kidney transplants with mucormycosis from 9 Transplant Centers of Iran...

Aldosterone, a mineralocorticoid hormone, has a well-known function on water balance and blood pressure homeostasis. Recently, its role in metabolic syndrome, insulin resistance, and obesity has come into a spotlight. Aldosterone induces inflammation and oxidative stress that are attenuated by mineralocorticoid receptor blockers such as spironolact...

Incidence and risk factors for skin tumors following renal transplantation can vary geographically; therefore, a retrospective study was performed to determine the incidence of and potential risk factors for skin cancer at 14 Transplant Centers in Iran between 1984 and 2008. We enrolled 11,255 kidney transplant recipients who were examined for all...

Single nucleotide polymorphisms within promoter or other regulatory sequences of cytokine genes mainly influence the level of production and secretion of proteins. A large amount of evidence has shown that cytokine gene variations alter graft survival length after kidney transplantation. We studied the association of gene polymorphisms in the inter...