An Age-Calibrated Classification of Chronic Kidney Disease.
; DELANAYE, Pierre ;
in JAMA : Journal of the American Medical Association (2015), 314(6), 559-560Detailed reference viewed: 16 (2 ULg)
Safety of living kidney donation: another brick in the wall…and a solid (physiologic) one.
DELANAYE, Pierre ; ;
in American Journal of Kidney Diseases (2015), 66(1), 1-3Detailed reference viewed: 5 (1 ULg)
The myth of the future burden of CKD in United States.
DELANAYE, Pierre ; ;
in American Journal of Kidney Diseases (2015), 66(1), 171-172Detailed reference viewed: 7 (1 ULg)
Glomerular Filtration Rate and Aging: Another Longitudinal Study--A Long Time Coming!
DELANAYE, Pierre ;
in Nephron (2015), 131(1), 1-4Detailed reference viewed: 7 (2 ULg)
Abnormal glomerular filtration rate in children, adolescents and young adults starts below 75 mL/min/1.73 m2
; ; DELANAYE, Pierre
in Pediatric Nephrology : Journal of the International Pediatric Nephrology Association (2015), 30(5), 821-828Detailed reference viewed: 17 (1 ULg)
KDIGO Guidelines and Kidney Transplantation: Is the cystatin-C Based Recommendation relevant?
; ; CAVALIER, Etienne et al
in American Journal of Transplantation (2015), 15(8), 2211-4
The KDIGO guidelines propose a new approach to diagnose chronic kidney disease (CKD) based on estimated glomerular ®ltration rate (GFR). In patients with a GFR value comprised between 45 and 59 mL/ min/1 ... [more ▼]
The KDIGO guidelines propose a new approach to diagnose chronic kidney disease (CKD) based on estimated glomerular ®ltration rate (GFR). In patients with a GFR value comprised between 45 and 59 mL/ min/1.73m2 as estimated by the CKD-EPI creatinine equation (eGFRcreat), it is suggested to con®rm the diagnosis with a second estimation using the CKD-EPI cystatin C-based equations (eGFRcys/eGFRcreat-cys). We sought to determine whether this new diagnostic strategy might extend to kidney transplant recipients (KTR) and help to identify those with decreased GFR. In 670 KTR for whom a measured GFR was available, we simulated the detection of CKD using the two-steps approach recommended by the guidelines in comparison to the conventional approach relying on creatinine equation. One hundred forty-®ve patients with no albuminuria had eGFRcreat between 45 and 59 mL/ min/1.73m2. Among them, 23% had inulin clearance over 60 mL/min/1.73m2 and were thus incorrectly classi®ed as CKD patients. When applying the Kidney Disease: Improving Global Outcomes (KDIGO) strategy, 138 patients were con®rmed as having a GFR below 60 mL/min with eGFRcreat-cys. However, 21% of them were misclassi®ed in reference to measured GFR. Our data do no not support the use of cystatin C as a con®rmatory test of stage 3A CKD in KTR. [less ▲]Detailed reference viewed: 32 (4 ULg)
Critical care and vitamin D status assessment: What about immunoassays and calculated free 25OH-D?
ROUSSEAU, Anne-Françoise ; DAMAS, Pierre ; JANSSENS, Marc et al
in Clinica Chimica Acta (2014), 437Detailed reference viewed: 25 (1 ULg)
Systematic Analysis of two cystatin C assays using samples of 2057 older adults - The Berlin initiative study
; DELANAYE, Pierre ; et al
Poster (2014, November)Detailed reference viewed: 22 (3 ULg)
Impact of the dialysis membrane on the Vitamin D metabolims markers
CAVALIER, Etienne ; DUBOIS, Bernard ; et al
Poster (2014, November)Detailed reference viewed: 17 (3 ULg)
Calibration and precision of serum creatinine and plasma cystatin C measurement: impact on the estimation of glomerular filtration rate
DELANAYE, Pierre ; CAVALIER, Etienne ; et al
in Journal of Nephrology (2014), 27(5), 467-75
Serum creatinine (SCr) is the main variable for estimating glomerular filtration rate (GFR). Due to interassay differences, the prevalence of chronic kidney disease (CKD) varies according to the assay ... [more ▼]
Serum creatinine (SCr) is the main variable for estimating glomerular filtration rate (GFR). Due to interassay differences, the prevalence of chronic kidney disease (CKD) varies according to the assay used, and calibration standardization is necessary. For SCr, isotope dilution mass spectrometry (IDMS) is the gold standard. Systematic differences are observed between Jaffe and enzymatic methods. Manufacturers subtract 0.30 mg/dl from Jaffe results to match enzymatic results (‘compensated Jaffe method’). The analytical performance of enzymatic methods is superior to that of Jaffe methods. In the original Modification of Diet in Renal Disease (MDRD) equation, SCr was measured by a Jaffe Beckman assay, which was later recalibrated. A limitation of this equation was an underestimation of GFR in the high range. The Chronic Kidney Disease Epidemiology (CKD-EPI) consortium proposed an equation using calibrated and IDMS traceable SCr. The gain in performance was due to improving the bias whereas the precision was comparable. The CKD-EPI equation performs better at high GFR levels (GFR[60 ml/ min/1.73 m2). Analytical limitations have led to the recommendation to give a grade ([60 ml/min/1.73 m2) rather than an absolute value with the MDRD equation. By using both enzymatic and calibrated methods, this cutoff-grade could be increased to 90 ml/min/1.73 m2 (with MDRD) and 120 ml/min/1.73 m2 (with CKD-EPI). The superiority of the CKD-EPI equation over MDRD is analytical, but the precision gain is limited. IDMS traceable enzymatic methods have been used in the development of the Lund– Malmo¨ (in CKD populations) and Berlin Initiative Study equations (in the elderly). The analytical errors for cystatin C are grossly comparable to issues found with SCr. Standardization is available since 2011. A reference method for cystatin C is still lacking. Equations based on standardized cystatin C or cystatin C and creatinine have been proposed. The better performance of these equations (especially the combined CKD-EPI equation) has been demonstrated. [less ▲]Detailed reference viewed: 31 (5 ULg)
Les résultats des formules de calcul de la 25(OH)-vitamine D libre varient en fonction des méthodes de dosage de la 25(OH)D
CAVALIER, Etienne ; BEKAERT, Anne-Catherine ; LUKAS, Pierre et al
Poster (2014, October)Detailed reference viewed: 43 (6 ULg)
La membrane de dialyse peut-elle avoir une influence sur le statut en vitamine D du patient?
CAVALIER, Etienne ; DUBOIS, Bernard ; BEKAERT, Anne-Catherine et al
Poster (2014, October)Detailed reference viewed: 34 (11 ULg)
Dephosphorylated-uncarboxylated Matrix Gla protein concentration is predictive of vitamin K status and is correlated with vascular calcification in a cohort of hemodialysis patients.
DELANAYE, Pierre ; KRZESINSKI, Jean-Marie ; et al
in BMC Nephrology (2014), 15
Background: Matrix Gla protein (MGP) is known to act as a potent local inhibitor of vascular calcifications. However, in order to be active, MGP must be phosphorylated and carboxylated, with this last ... [more ▼]
Background: Matrix Gla protein (MGP) is known to act as a potent local inhibitor of vascular calcifications. However, in order to be active, MGP must be phosphorylated and carboxylated, with this last process being dependent on vitamin K. The present study focused on the inactive form of MGP (dephosphorylated and uncarboxylated: dp-ucMGP) in a population of hemodialyzed (HD) patients. Results found in subjects being treated or not with vitamin K antagonist (VKA) were compared and the relationship between dp-ucMGP levels and the vascular calcification score were assessed. Methods: One hundred sixty prevalent HD patients were enrolled into this observational cohort study, including 23 who were receiving VKA treatment. The calcification score was determined (using the Kauppila method) and dp-ucMGP levels were measured using the automated iSYS method. Results: dp-ucMGP levels were much higher in patients being treated with VKA and little overlap was found with those not being treated (5604 [3758; 7836] vs. 1939 [1419; 2841] pmol/L, p <0.0001). In multivariate analysis, treatment with VKA was the most important variable explaining variation in dp-ucMGP levels even when adjusting for all other significant variables. In the 137 untreated patients, dp-ucMGP levels were significantly (p < 0.05) associated both in the uni- and multivariate analysis with age, body mass index, plasma levels of albumin, C-reactive protein, and FGF-23, and the vascular calcification score. Conclusion: We confirmed that the concentration of dp-ucMGP was higher in HD patients being treated with VKA. We observed a significant correlation between dp-ucMGP concentration and the calcification score. Our data support the theoretical role of MGP in the development of vascular calcifications. We confirmed the potential role of the inactive form of MGP in assessing the vitamin K status of the HD patients. [less ▲]Detailed reference viewed: 21 (0 ULg)
Inter-method variability in bone alkaline phosphatase measurement : clinical impact on the management of dialysis patients
CAVALIER, Etienne ; ; GADISSEUR, Romy et al
in Clinical Biochemistry (2014), 47(13-14), 1227-30
BACKGROUND: Bone-specific alkaline phosphatase (BAP) is now recommended to assess bone turnover in hemodialysis (HD) patients. However, little is known about potential variability between methods ... [more ▼]
BACKGROUND: Bone-specific alkaline phosphatase (BAP) is now recommended to assess bone turnover in hemodialysis (HD) patients. However, little is known about potential variability between methods available to measure BAP. METHODS: We measured BAP in 76 HD patients with six different assays (Beckman-Coulter Ostase IRMA, Beckman-Coulter Ostase Access, IDS iSYS Ostase, IDS Ostase enzyme immunoassay, DiaSorin Liaison Ostase and Quidel MicroVue BAP). RESULTS: We observed a high correlation between all the assays ranging from 0.9948 (IDS iSYS vs. IDS EIA) to 0.9215 (DiaSorin Liaison vs. Quidel MicroVue). However, using the regression equations, the equivalent concentration of a Beckman-Coulter Access value of 10μg/L can range from 7.7 to 14.4μg/L and of 20μg/L can range from 16.9 to 27.9μg/L with other assays. According to Beckman-Coulter Access, 13%, 50% and 37% of the patients presented BAP values ≤10, between 10 and 20 and ≥20μg/L, respectively. Discrepancies are observed when other assays are used (concordance from 10 to 100%). CONCLUSIONS: Analytical problems leading to inter-method variation should be overcome to improve the usefulness of this marker in clinical practice. According to correlation results, recalibration of BAP assays is necessary but should not be a major issue. [less ▲]Detailed reference viewed: 51 (20 ULg)
Standardization of DiaSorin and Roche automated third generation PTH assays with an international standard: impact on clinical populations
CAVALIER, Etienne ; DELANAYE, Pierre ; LUKAS, Pierre et al
in Clinical Chemistry & Laboratory Medicine (2014), 52(8), 1137-41
Background: Standardization of parathyroid hormone (PTH) assays is a major issue, especially in hemodialyzed (HD) patients. Two automated third generation PTH assays (Roche Elecsys and DiaSorin Liaison ... [more ▼]
Background: Standardization of parathyroid hormone (PTH) assays is a major issue, especially in hemodialyzed (HD) patients. Two automated third generation PTH assays (Roche Elecsys and DiaSorin Liaison) are now available. These assays are specific for the (1-84) PTH and do not cross-react with the (7-84) fragment, contrary to second generation (intact) assays. We aimed to calibrate the two methods against the WHO International PTH Standard (IS) 95/646 to see if the two assays could provide comparable results in a population of healthy subjects, HD patients and patients suffering from primary hyperparathyroidism (PHP). Methods: We selected 79 healthy subjects and two populations of patients presenting PTH disorders: 56 HD and 27 PHP patients. We reconstituted the IS in a pool of human serum containing undetectable levels of 1-84 PTH and prepared 13 serum standards ranging from 0 to 2000 pg/mL. The standards were run on the two instruments to calibrate the assays on the IS. The different populations were run before and after restandardization. Results: As these kits were differently calibrated, the results obtained after restandarization were significantly different. Restandardization process improved concordance between assays and, taking the analytical variability of the two kits into account, the results could be considered to be similar. Conclusions: Restandardization of automated third generation PTH assays with the WHO 1-84 PTH Standard significantly reduces inter-method variability. Reference ranges and raw values are totally transposable from one method to the other in healthy subjects, but also in diseased patients, e.g., with HD or those suffering from PHP. [less ▲]Detailed reference viewed: 57 (21 ULg)
Altération de la fonction rénale chez le patient âgé, comment gérer?
KRZESINSKI, Jean-Marie ; DELANAYE, Pierre
in Revue Médicale de Liège (2014), 69(5-6), 287-293
From age 30 onwards, kidney function physiologically decreases although this deterioration cannot yet be called chronic kidney disease. The latter appears in those exposed to cardiovascular risk factors ... [more ▼]
From age 30 onwards, kidney function physiologically decreases although this deterioration cannot yet be called chronic kidney disease. The latter appears in those exposed to cardiovascular risk factors associated with inflammation and oxidative stress. A diffuse atherosclerosis then develops Patients with a decreased glomerular filtration rate, especially below the threshold of 45 ml/min, are characterised by a poor physical heath and by cognitive disorders, leading to frailty. In these conditions, a management strategy to reduce the increased risk of acute kidney injury should be outlined and the need for renal replacement therapy be considered. One must try to maintain the best possible quality of life, promoting in some situations a conservative approach. [less ▲]Detailed reference viewed: 25 (4 ULg)
Can we use circulating biomarkers to monitor bone turnover in CKD haemodialysis patients? Hypotheses and facts
DELANAYE, Pierre ; ; et al
in Nephrology Dialysis Transplantation (2014), 29(5), 997-1004
Assessing bone turnover is a key diagnostic tool in the global management of chronic kidney disease-mineral and bone disorder (CKD-MBD). Since bone biopsy is invasive and cannot be repeated in clinical ... [more ▼]
Assessing bone turnover is a key diagnostic tool in the global management of chronic kidney disease-mineral and bone disorder (CKD-MBD). Since bone biopsy is invasive and cannot be repeated in clinical practice and because bone histomorphometry is less available due to the lack of specialized laboratories, we will focus on potential biomarkers used to assess and monitor bone turnover. After briefly reviewing the pathophysiology of bone turnover in CKD and haemodialysis patients, we will focus on the strengths and limitations of the now recommended biomarkers, i.e. parathormone and bone-specific alkaline phosphatase. We will consider the clinical and also the biological aspects of the topic and also insist on the use of these biomarkers for the monitoring, and the follow-up of the turnover in haemodialysis subjects. Finally, we will discuss some of the most promising, but still not recommended, emerging biomarkers. [less ▲]Detailed reference viewed: 148 (12 ULg)
Evaluation of automated immunoassays for 25 (OH)-vitamin D determination in different critical populations before and after standardization of the assays
CAVALIER, Etienne ; LUKAS, Pierre ; CRINE, Yannick et al
in Clinica Chimica Acta (2014), 431Detailed reference viewed: 84 (28 ULg)
Standardization of 25-hydroxyvitamin D assays: impact of vitamin-D binding protein concentrations and uremic media on the re-standardization of six different 25(OH) vitamin D immunoassays
CAVALIER, Etienne ; LUKAS, Pierre ; CRINE, Yannick et al
Poster (2014, April)Detailed reference viewed: 15 (3 ULg)