References of "KRZESINSKI, Jean-Marie"
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See detailLe débit de filtration glomérulaire est-il un déterminant de la concentration plasmatique du NGAL aux soins intensifs ?
DELANAYE, Pierre ULg; Claisse, Guillaume; Mehdi, Manoli et al

Poster (2012)

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See detailY a-t-il encore une place pour la double inhibition du système rénine-angiotensine en 2012?
Krzesinski, Jean-Marie ULg; Scheen, André ULg

in Revue Médicale Suisse (2012), 8(351), 1598-1603

The blockade of the renin-angiotensin system (RAS) improves the prognosis of patients with complications related to diabetes, hypertension or, in general, atherosclerosis. Several observational studies ... [more ▼]

The blockade of the renin-angiotensin system (RAS) improves the prognosis of patients with complications related to diabetes, hypertension or, in general, atherosclerosis. Several observational studies have suggested the use of a dual blockade of the RAS to benefit from a better cardiorenal protection. However, recent randomized controlled studies failed to demonstrate that a dual blockade exert a better protection than single blockade, but showed a higher risk for renal complications and hyperkalemia. To decrease the residual risk, other opportunities may be recommended such as reinforcement of low salt diet, use of supraphysiological dose of a monotherapy inhibiting the RAS (perhaps prescribed at the evening) or addition of an aldosterone antagonist. However, all these approaches, as dual therapy, may also increase the risk of hypotension and renal insufficiency and thus require to be used under strict medical supervision. [less ▲]

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See detailDelayed graft function does not harm the future of donation-after-cardiac death in kidney transplantation.
Le Dinh, Hieu; WEEKERS, Laurent ULg; BONVOISIN, Catherine ULg et al

in Transplantation Proceedings (2012), 44(9), 2795-802

INTRODUCTION: Delayed graft function (DGF) occurs more frequently in kidney transplants from donation after cardiac death (DCD) than from donation after brain death (DBD). We investigated the effect of ... [more ▼]

INTRODUCTION: Delayed graft function (DGF) occurs more frequently in kidney transplants from donation after cardiac death (DCD) than from donation after brain death (DBD). We investigated the effect of DGF on posttransplantation outcomes among grafts from controlled DCD kidneys. PATIENTS AND METHODS: This single-center retrospective study recruited 80 controlled DCD kidneys transplanted from January 2005 to December 2011. Mean patient follow-up was 28.5 months. RESULTS: There were no primary nonfunction grafts; the DGF rate was 35.5%. Overall graft survival rates between groups with versus without DGF were 92.4% and 95.2% at 1 year, 92.4% and 87.1% at 3 years, and 84.7% and 87.1% at 5 years, respectively (P = not significant (NS)). Patients with versus without DGF showed the same survival rates at the corresponding time 92.4% vs 97.2%, 92.4% vs 93.9%, and 84.7% vs 93.9% (P = NS). Estimated glomerular filtration rate was significantly lower in the DGF compared with the non-DGF group at hospital discharge (29 vs 42 mL/min; P = .00) and at 6 months posttransplantation (46 vs 52 mL/min; P = .04), but the difference disappeared thereafter: 47 vs 52 mL/min at 1 year, 50 vs 48 mL/min at 3 years, and 54 vs 53 mL/min at 5 years (P = NS). DGF did not increase the risk of an acute rejection episode (29.6% vs 30.6%; P = NS) or rate of surgical complications (33.3% vs 26.5%; P = NS). However, DGF prolonged significantly the length of hospitalization in the DGF versus the non- DGF group (18.9 vs 13 days; P = .00). Donor body mass index (BMI) >/= 30 kg/m(2), recipient BMI >/=30 kg/m(2), and pretransplantation dialysis duration increased the risk of DGF upon multivariate logistic regression analysis. CONCLUSIONS: Apart from the longer hospital stay, DGF had no deleterious impact on the future of kidney allografts from controlled DCD, which showed comparable graft and patient survivals, renal function, rejection rates, and surgical complications as a group without DGF. Therefore, DGF should no longer be considered to be a medical barrier to the use of kidney grafts from controlled DCD. [less ▲]

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See detailAnorexia Nervosa and the Kidney
BOUQUEGNEAU, Antoine ULg; DUBOIS, Bernard ULg; Krzesinski, Jean-Marie ULg et al

in American Journal of Kidney Diseases (2012), 60(2), 299-307

Anorexia nervosa is a common psychiatric disorder that disproportionately affects adolescents and young adults and is associated with high rates of morbidity and mortality. Anorexia nervosa can affect the ... [more ▼]

Anorexia nervosa is a common psychiatric disorder that disproportionately affects adolescents and young adults and is associated with high rates of morbidity and mortality. Anorexia nervosa can affect the kidney in numerous ways, including increased rates of acute kidney injury and chronic kidney disease, electrolyte abnormalities, and nephrolithiasis. Additionally, the diagnosis and treatment of anorexia nervosa–associated kidney diseases are challenging, reflecting complications such as refeeding syndrome, as well as the limitations of serum creatinine level in this population to estimate kidney function and the psychosocial challenges inherent with treating systemic manifestations of psychiatric conditions. In this review, we discuss kidney diseases and kidney-associated conditions that occur in individuals with anorexia nervosa, summarizing many of the challenges in treating patients with this disease [less ▲]

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See detailHypertension et diabete: a propos d'une association commune mais complexe.
SCHEEN, André ULg; Philips, J.-C.; Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2012), 67(3), 133-8

Both diabetes mellitus and arterial hypertension are commonly observed in a single patient. However, the relationship between these two entities is rather complex and there is a great heterogeneity ... [more ▼]

Both diabetes mellitus and arterial hypertension are commonly observed in a single patient. However, the relationship between these two entities is rather complex and there is a great heterogeneity regarding the underlying pathophysiological mechanisms and the clinical presentations. These particularities may have important consequences from a therapeutic point of view, as far as blood pressure targets or even pharmacological strategies are concerned. The present article will discuss the various causes of hypertension in the different types of diabetes, the different forms of hypertension in the diabetic patient, the modalities of treating hypertension in presence of various specific complications (metabolic syndrome, coronary heart disease or renal impairment), and the specificities when hypertension is associated with diabetic cardiovascular autonomic neuropathy. [less ▲]

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See detailEstimating Glomerular Filtration Rate in 2012 - Does the New Chronic Kidney Disease Epidemiology Equation Fare Better than Older Equations?
DELANAYE, Pierre ULg; Krzesinski, Jean-Marie ULg

in European Nephrology (2012), 6(1), 15-20

Measuring or estimating glomerular filtration rate (GFR) is still considered the best way to apprehend global renal function. In 2009, the Chronic Kidney Disease Epidemiology (CKD-EPI) equation was ... [more ▼]

Measuring or estimating glomerular filtration rate (GFR) is still considered the best way to apprehend global renal function. In 2009, the Chronic Kidney Disease Epidemiology (CKD-EPI) equation was proposed as a better estimator of GFR than the Modification of Diet in Renal Disease (MDRD) study equation. It is supposed to underestimate GFR to a lesser degree in higher GFR levels. In this article, we present and discuss the performances of this new equation. Based on articles published between 2009 and 2012, we underline its advantages, notably better knowledge of chronic kidney disease prevalence, but also its limitations, especially in some specific populations. Our conclusion is that all equations are estimations and that nephrologists should always remain cautions in their interpretation. [less ▲]

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See detailRégulation du phosphore
Krzesinski, Jean-Marie ULg

Conference (2011, December 20)

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See detailAssociation entre le contrôle de la pression artérielle et le rapport sodium/potassium urinaire chez les transplantés rénaux hypertendus
Saint-Remy, Annie ULg; SOMJA, Mélanie ULg; WEEKERS, Laurent ULg et al

Poster (2011, December 15)

Design and method : Office blood pressure (OBP) and home BP (HBP) were measured in 70 kidney transplant patients (KT) (43 men/27 women;KT>1 year), all were treated with antihypertensive drugs (mean number ... [more ▼]

Design and method : Office blood pressure (OBP) and home BP (HBP) were measured in 70 kidney transplant patients (KT) (43 men/27 women;KT>1 year), all were treated with antihypertensive drugs (mean number: 2±1). Mean age: 56±11 years, mean graft survival: 7±6.6 years, mean GFR: 65.6±24 ml/min, diabetes:27% and current smoking:11.5%. HBP (Omron M6) was measured during 7 days following the OBP measurement, mean HBP was calculated from day 2 to day 7. Uncontrolled BP was defined by OBP>=140-90 (>=130-80 when diabetes) and HBP>=135-85 (>=130-80 when diabetes). The day of the OBP measurement and the last day of HBP, patients collected 24h- urine and recorded at the same time their food and beverage consumption. Sodium and potassium were measured in urines and their intakes were quantified through food records. Urinary and diet Na+, K+ did not differ between the two urine collections 7 days apart. Results: 16 patients(23%) had controlled BP (OBP and HBP) while 34 (49%) remained with sustained hypertension (SHT) despite treatment, 14 (20%) had masked uncontrolled hypertension (MHT, OBP<140-90 and HBP>=135-85,130-80 if diabetes for both).When comparing the controlled and SHT, no differences were found with age, graft survival, BMI, GFR, calcineurin inhibitors or number and type of antihypertensive drugs. The groups did not differ by their sodium excretion (154±93 vs 162±88 mmol/24h) but well by their K excretion significantly higher in controlled patients (68±17 vs 53±20 mmol/24h,p=0.018) giving a Na/K ratio higher in SHT (3.2±1.3 vs2.2±1.2,p=0.03). Diet analysis showed significantly higher intakes of K (fruits, vegetables) in controlled patients (3279±753 vs 2208±720 mg/24h,p=0.010) whereas both groups consumed on average 9 g/24h of salt. When controlled for age, BMI and Na excretion, Home systolic BP was inversely and significantly correlated with urinary potassium (- 0.46;P=0.002) while no correlation was found with urinary Na.Conclusions: KT patients remaining hypertensive and well controlled patients had both high salt consumption. However, well controlled patients differed by significant higher potassium intakes and excretion. Urinary Na/K ratio could be a useful tool contributing to an optimal BP control in KT patients. However, impact of increasing potassium intakes on uncontrolled BP in KT has to be validated by prospective randomized studies [less ▲]

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See detailHTA résistante et cible tensionnelle chez le diabétique
Krzesinski, Jean-Marie ULg

Conference (2011, December 13)

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See detailAssociation entre le contrôle de la pression artérielle et le rapport sodium/potassium urinaire chez les transplantés rénaux hypertendus
Saint-Remy, Annie ULg; SOMJA, Mélanie ULg; WEEKERS, Laurent ULg et al

in Archives des Maladies du Coeur et des Vaisseaux (2011, December), Hors série 3

Etude de la relation entre le contrôle de la pression artérielle (PA) mesurée en clinique et/ou à domicile chez des transplantés rénaux (Tr) hypertendus et l'excrétion urinaire du sodium (Na), potassium ... [more ▼]

Etude de la relation entre le contrôle de la pression artérielle (PA) mesurée en clinique et/ou à domicile chez des transplantés rénaux (Tr) hypertendus et l'excrétion urinaire du sodium (Na), potassium (K) et de leur rapport (Na/K urinaire et alimentaire) qui pourrait être un indice utile à prendre en compte dans la recherche d'un contrôle efficace de la PA chez les transplantés rénaux. [less ▲]

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See detailContrôle de la pression artérielle (PA) et mesure de la rigidité artérielle (RA) chez des transplantés rénaux (TR) (étude EPARA)
Gellner, Karen; Saint-Remy, Annie ULg; BONVOISIN, Catherine ULg et al

in Archives des Maladies du Coeur et des Vaisseaux (2011, December), Hors série 3

EPARA a étudié le contrôle de la PA au cabinet de consultation et en dehors, et l'état de rigidité artérielle chez des transplantés rénaux stables, greffés depuis plus d'un an. Le contrôle de la PA est ... [more ▼]

EPARA a étudié le contrôle de la PA au cabinet de consultation et en dehors, et l'état de rigidité artérielle chez des transplantés rénaux stables, greffés depuis plus d'un an. Le contrôle de la PA est loin d‘être satisfaisant dans cette population de TR hypertendus, traîtés pour la plupart, particulièrement à domicile. L‘HTA masquée est fréquente, associée à un risque cardio-vasculaire élevé et une rigidité accrue des grosses artères. La PAS centrale est d‘autant plus élevée que la fonction rénale est mauvaise. Proposer de recourir systématiquement à des mesures ambulatoires de PA est hautement conseillé chez ce type de patients! [less ▲]

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See detailLe médicament du mois, SEVIKAR/HCT° : association d'un antagoniste calcique (bésylate d'amlodipine), d'un inhibiteur des récepteurs de l'angiotensine II (olmésartan médoxomil) et d'un diurétique thiazide (hydrochlorothiazide)
Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2011), 66(12), 636-642

Hypertension is a common treatable risk factor for cardiovascular disease. Even when identified and treated, most patients with hypertension do not reach the blood pressure goal and they often need in ... [more ▼]

Hypertension is a common treatable risk factor for cardiovascular disease. Even when identified and treated, most patients with hypertension do not reach the blood pressure goal and they often need in fact three antihypertensive agents to achieve blood pressure control. Although various combinations of two therapies are currently available for the treatment of hypertension, development of more powerful therapies with 3 molecules is necessary to control more hypertensive patients. Amlodipine/Olmesartan/hydrochlorothiazide (Sevikar/HCT°) is a new triple combination of antihypertensive agents that lower blood pressure via calcium channel blockade, angiotensin receptor blockade and diuretic action. Its potent triple mechanism of action is also likely to attenuate compound-specific adverse events, such as amlodipine-related peripheral oedema or sartan-induced hyperkalemia. Moreover, by reducing the number of pills to be taken every day, the compliance should be better. Currently available data show that such a combination is very powerful and well-tolerated allowing more patients with all grades of hypertension (especially those with the most severe forms) to reach the blood pressure target. The contraindications are those of each compound. [less ▲]

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