4 areas of research of chronic kidney disease at CESP in Paris

Today, on my first day in Paris, I’ll be visiting the Groupe Hospitalier Pitié Salpétrière and the Centre for Research in Epidemiology and Population Health.

The team has a long history of research into the epidemiology of diabetes and obesity with a major contribution in the field of descriptive epidemiology (evolutionary trend of these diseases in France) and the connection between these diseases and cardiovascular disease.

Given the rapid increase and the occurrence of increasingly early obesity and type 2 diabetes – and the recognition of the role particularly deleterious recent changes in our lifestyle – the research team has focused on:

• describing the natural history of these diseases with a whole life approach
• studying environmental determinants (nutrition, physical activity) of these diseases and their biomarkers.

The central hypothesis of their research is that type 2 diabetes, hypertension, and chronic renal failure are common determinants in relation to early growth of the fetus and newborn. After birth, a number of factors very common in modern societies (excess calories and nutritional imbalances, physical inactivity) will promote the development of excessive adiposity, which is a second factor common to these diseases.

Finally, there is likely relationship between early growth and development of adiposity. Research based on studies conducted at different stages of life will all connect the assumptions of each other. It is hoped that the synthesis of all the work should allow researchers to approach the natural history of these diseases during life.

I’ll be most interested in the study of chronic kidney disease in relation to the metabolic syndrome and cardiovascular risk.

The work on this topic is developing in four areas:

1. Study of trends and geographical variations of the different stages of chronic kidney disease from analysis of data from French registers (REIN) European and kidney failure. 
2. Studying the relationship between chronic kidney disease and metabolic syndrome, and associated morbidity and mortality. within the cohort of 3 Cities (with LC. Helmer, C. Tzourio, JF Dartigues, A. Alpérovitch, INSERM units 360 and 593) in a subsample of 1500 subjects aged over 65. It should identify the elderly at greatest risk of renal impairment who may benefit from measures referred to as “nephro-protection.”
3. Study of the early factors: our team plans to study the size of the kidneys (as an indicator of nephron mass) to 5 years in children born EDEN cohort with a delay of intrauterine growth compared to a control group.
4. Risk factors for progression of glomerular nephropathy to renal failure from the GN-PROGRESS study (in with J. Rossert (U356)), whose aim is to jointly study the role of environmental factors and polymorphisms of genes encoding proteins or peptides involved in the progression of renal failure in three histological types many phenotypes of primary glomerular nephropathy