References of "Krzesinski, Jean-Marie"
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See detailThe Case : Acute renal failure and refractory hyponatremia
denis, Chloé; JADOT, Virginie ULg; BOUQUEGNEAU, Antoine ULg et al

in Kidney International (2016), 90

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See detailLa polykystose rénale autosomique dominante : comment et pourquoi identifier les patients "rapidement progresseurs" vers l'insuffisance rénale terminale?
bodson, aurélie; MEUNIER, Paul ULg; Krzesinski, Jean-Marie ULg et al

in Revue Médicale de Liège (2016), 71(4), 184-192

Autosomal dominant polycystic kidney disease (ADPKD) is a common inherited disease characterised by the progressive development of multiple and bilateral cysts in kidneys and other organs. Most patients ... [more ▼]

Autosomal dominant polycystic kidney disease (ADPKD) is a common inherited disease characterised by the progressive development of multiple and bilateral cysts in kidneys and other organs. Most patients with ADPKD will develop, sooner or later, end-stage renal disease (ESRD). The morbidity and mortality associated with ESRD prompt physicians to identify early ADPKD patients considered as «rapid progressors», who have the greatest risk to rapidly develop ESRD. The rate of progression can be assessed by clinical - especially with the «predicting renal outcome in polycystic kidney disease score» (PROPKD-Score) -, biological (a decline of the glomerular filtration rate (GFR) of 4,4 - 5,9 ml/min/year and/or the doubling of serum creatinine within a 36-month period), or radiological criteria (total kidney volume (TKV) adjusted for the size > 600 cc/m and/or TKV annual growth rate > 5 %). Nowadays, there is no curative treatment for ADPKD. However, vasopressin-2 receptor antagonists, such as tolvaptan, appear to slow down the growth of renal cysts and the slope of GFR decline. The current management of ADPKD patients is mostly based on correcting the risk factors for progression, i.e. encouraging (over)-hydration, normalizing blood pressure, stimulating smoking cessation. [less ▲]

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See detailImportance des différentes formes d'hypertension artérielle en pratique clinique
Krzesinski, Jean-Marie ULg

Scientific conference (2016, January 30)

Définition et classification de la PA en consultation. Prévention de l'HTA et des risques CV. Caractéristiques de l'HTA selon l'âge. Traitement et recommandations ESH 2013.

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See detailIntérêt d'une approche personnalisée de l'HTA
Krzesinski, Jean-Marie ULg

Scientific conference (2016, January 30)

Présentation d'un cas clinique : Attitude thérapeutique chez un hypertendu confirmé NON compliqué, de race noire.

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See detailMesure ambulatoire de la PA (MAPA) : pour qui?, pourquoi?, comment?
Krzesinski, Jean-Marie ULg

Scientific conference (2016, January 28)

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See detailThe Uptake of 18F-FDG by Renal Allograft in Kidney Transplant Recipients Is Not Influenced by Renal Function.
Jadoul, Alexandre; Lovinfosse, Pierre; Weekers, Laurent et al

in Clinical Nuclear Medicine (2016), 41(9), 683-7

PURPOSE OF THE REPORT: F-FDG PET/CT has been recently proposed as a noninvasive tool for the diagnosis of renal allograft acute rejection (AR) in kidney transplant recipients (KTRs). Still, the influence ... [more ▼]

PURPOSE OF THE REPORT: F-FDG PET/CT has been recently proposed as a noninvasive tool for the diagnosis of renal allograft acute rejection (AR) in kidney transplant recipients (KTRs). Still, the influence of kidney function on F-FDG uptake by renal grafts remains unknown. PATIENTS AND METHODS: We retrospectively identified all KTRs who underwent at least one F-FDG PET/CT. Kidney transplant recipients with documented pyelonephritis or AR were excluded. Estimated glomerular filtration rate (eGFR) was assessed using chronic kidney disease (CKD)-EPI equation. Mean standardized uptake values (SUVmean) of renal graft cortex and aorta were measured in 4 and 1 volumes of interest, respectively. Spearman rank correlation coefficient (rho) and analysis of variance (ANOVA) were performed. RESULTS: Eighty-two KTRs underwent F-FDG PET/CT for tumor staging (n = 46), suspected infection (n = 11), or fever of unknown origin (n = 25). Mean eGFR was 50 +/- 19 mL/min per 1.73 m, including CKD stage 1 (n = 3), stage 2 (n = 21), stage 3a (n = 20), stage 3b (n = 29), and stage 4 (n = 9). Mean kidney and aorta SUVmean were 1.8 +/- 0.2 and 1.7 +/- 0.3, respectively. No significant correlation was observed between eGFR and kidney SUVmean (rho, 0.119; P, 0.28) or aorta SUVmean (rho, -0.144; P, 0.20). ANOVA showed no difference of kidney (P, 0.62) and aorta (P, 0.85) SUVmean between CKD groups. Mean coefficient of variation (on the basis of kidney SUVmean of >3 consecutive F-FDG PET/CT in 15 patients with no significant change of eGFR) reached 13.1%. CONCLUSIONS: The uptake of F-FDG by renal allografts within an hour postinjection is not significantly impacted by CKD. [less ▲]

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See detailHyperuricémie et risque potentiel de pathologie cardiovasculiare et rénale
Schils, Raphaël ULg; Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2016)

Besides the well accepted need to treat hyperuricemia associated with gout, some large observational studies and small prospective therapeutic trials have suggested that treating asymptomatic ... [more ▼]

Besides the well accepted need to treat hyperuricemia associated with gout, some large observational studies and small prospective therapeutic trials have suggested that treating asymptomatic hyperuricemia, especially by xanthine oxidase inhibition, the enzyme producing uric acid, could be beneficial for cardiovascular and renal risk prevention. This article discusses the literature about this promising approach, which, however, requests prospective validation. [less ▲]

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See detailCreatinine-based equations for the adjustment of drug dosage in an obese population.
BOUQUEGNEAU, Antoine ULg; Vidal-Petiot, E; Moranne, O et al

in British Journal of Clinical Pharmacology (2016), 81(2), 349-361

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See detailEfficiency of delivery observed treatment in hemodialysis patients: the example of the native vitamin D therapy
DELANAYE, Pierre ULg; CAVALIER, Etienne ULg; Fafin, Coraline et al

in Journal of Nephrology (2016), 29(1), 99-103

Introduction Adherence to therapy is a relevant challenge in chronic hemodialysis patients. The directly observed therapy (DOT) could be an effective method to increase adherence for specific therapies ... [more ▼]

Introduction Adherence to therapy is a relevant challenge in chronic hemodialysis patients. The directly observed therapy (DOT) could be an effective method to increase adherence for specific therapies. We aimed to study the performance of DOT versus home medication. We follow the impact of providing native vitamin D directly by the nurse after a dialysis session on the 25-hydroxyvitamin [25(OH)D] concentrations. Methods In this observational study, we included 38 dialysis patients treated by stable dosage of cholecalciferol. DOT was implemented in December 2010. We considered the concentrations of 25-OH vitamin D three times before (T1 = June 2010, T2 = July 2010 and T3 = September 2010) and three times after the modification of prescription (T4 = February 2011, T5 = March 2011 and T6 = April 2011). Results Median age was 72 [62; 79] years and 48 % were diabetics. Mean body mass index was 26 ± 5 kg/m2 and median dialysis vintage was 20 [8; 46] months. The patients were compared to themselves. Before DOT, median concentrations of 25(OH)D were 27 (14–36), 23 (17–31), 31 (22–38) ng/mL at T1, T2 and T3, respectively. When DOT was effective, the concentrations significantly increased to 34 (28–44), 35 (29–41), 39 (32–47) ng/mL at T4, T5 and T6, respectively. Before DOT, 19 patients (50 %) reached the target of 30 ng/mL. After DOT, 29 patients (76 %) reached the target concentration of 30 ng/ mL. Conclusions In hemodialysis patients, DOT is both simple and effective to increase the therapeutic impact to native vitamin D. [less ▲]

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See detailFluorodeoxyglucose F Positron Emission Tomography Coupled With Computed Tomography in Suspected Acute Renal Allograft Rejection.
Lovinfosse, P.; Weekers, L.; Bonvoisin, C. et al

in American Journal of Transplantation (2016)

Management of kidney transplant recipients (KTRs) with suspected acute rejection (AR) ultimately relies on kidney biopsy; however, noninvasive tests predicting nonrejection would help avoid unnecessary ... [more ▼]

Management of kidney transplant recipients (KTRs) with suspected acute rejection (AR) ultimately relies on kidney biopsy; however, noninvasive tests predicting nonrejection would help avoid unnecessary biopsy. AR involves recruitment of leukocytes avid for fluorodeoxyglucose F18 (18 F-FDG), thus 18 F-FDG positron emission tomography (PET) coupled with computed tomography (CT) may noninvasively distinguish nonrejection from AR. From January 2013 to February 2015, we prospectively performed 32 18 F-FDG PET/CT scans in 31 adult KTRs with suspected AR who underwent transplant biopsy. Biopsies were categorized into four groups: normal (n = 8), borderline (n = 10), AR (n = 8), or other (n = 6, including 3 with polyoma BK nephropathy). Estimated GFR was comparable in all groups. PET/CT was performed 201 +/- 18 minutes after administration of 3.2 +/- 0.2 MBq/kg of 18 F-FDG, before any immunosuppression change. Mean standard uptake values (SUVs) of both upper and lower renal poles were measured. Mean SUVs reached 1.5 +/- 0.2, 1.6 +/- 0.3, 2.9 +/- 0.8, and 2.2 +/- 1.2 for the normal, borderline, AR, and other groups, respectively. One-way analysis of variance demonstrated a significant difference of mean SUVs among groups. A positive correlation between mean SUV and acute composite Banff score was found, with r2 = 0.49. The area under the receiver operating characteristic curve was 0.93, with 100% sensitivity and 50% specificity using a mean SUV threshold of 1.6. In conclusion, 18 F-FDG PET/CT may help noninvasively prevent avoidable transplant biopsies in KTRs with suspected AR. [less ▲]

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See detailApproche non médicamenteuse de l'hypertension artérielle
Krzesinski, Jean-Marie ULg

Scientific conference (2015, November 09)

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See detailComparable transplant outcomes between DBD and DCD kidney grafts up to 5 years post-transplant: single centre experience
Ledinh, H; DETRY, Olivier ULg; DE ROOVER, Arnaud ULg et al

in Transplant International (2015, November), 28(S4), 193-194188

Introduction: This study aimed to determine the most recent results of kidney transplantation (KT) from donation after brain death (DBD) and circulatory death (DCD). Primary endpoints were graft and ... [more ▼]

Introduction: This study aimed to determine the most recent results of kidney transplantation (KT) from donation after brain death (DBD) and circulatory death (DCD). Primary endpoints were graft and patient survival, and graft function. Acute rejection and post-operative complications were assessed as secondary endpoints. Patient and Methods: This retrospective mono-center review consisted of 226 DBD- and 104 DCD-KT between 2008 and 2014. Results: Graft survival was comparable between two groups (95.1 vs. 91.1% at 1 year, 92.8 vs. 91.1% at 3 years and 89.2 vs. 91.1% at 5 years). 46% and 40% of graft loss were attributed to patient death with a functioning graft and rejection. Patient survival was comparable between 2 groups (97.8 vs. 95.1% at 1 year, 94.1 vs. 91.2% at 3 years, and 89.6 vs. 82.3% at five years). Etiology of patient death included cardiac arrest (16.7%), infection (16.7%), cancer (13.3%), and unknown cause (46.7%). Delayed graft function occurred in 14.6% of DBD- and 30.8% of DCD-KT (p = 0.001). Primary non function was encountered in 2.6% DBD- and 4.8% DCD-KT (p = ns). Graft function was worse in DCD than DBD up to 3 months post-transplant (p = 0.034), however, no difference existed afterwards. Biopsy-proven acute rejection was found in 12.8% and 13.5% of DBD- and DCD-KT during an average 3 months post- transplant (p = ns). This rate was 7.1% vs. 8.9% on surveillance biopsy performed between 3 and 6 months post-transplant (p = ns). Post-operativecomplication rate was comparable between 2 groups, concerning patient death, reoperation, transfusion, perirenal hematoma, macroscopic hematuria, urinary obstruction, wound problem, and infection. Nevertheless, contamination of preservation solution occurred more commonly in DCD than DBD (0.4% vs. 3.8%, p = 0.036). Conclusions: Despite worse early graft function, DCD-KT was not inferior to that originating from DBD up to 5 years post-transplant, therefore deserves to be used. [less ▲]

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See detailImpact of timing administration of mesenchymal stromal cells on serum creatinine following renal ischemia/ reperfusion in rats
ERPICUM, Pauline ULg; Rowart, Pascal ULg; POMA, Laurence ULg et al

in Transplant International (2015, November), 28(S4), 1129

Experimental models of renal ischemia/reperfusion (I/R) have suggested protective effects of mesenchymal stromal cells (MSC) therapy. Still, param- eters of MSC injection, including volume, route and ... [more ▼]

Experimental models of renal ischemia/reperfusion (I/R) have suggested protective effects of mesenchymal stromal cells (MSC) therapy. Still, param- eters of MSC injection, including volume, route and timing of cell administration, remain largely debated. Particularly, MSC infusion in mouse has been shown to be beneficial “a priori” but deleterious “a posteriori” of renal I/R injury. In order to further investigate the influence of the timing of MSC administration, we used 10-week-old Lewis rats categorized in 4 groups. Groups 1 (MSC D-7, n = 10) and 2 (MSC D + 1, n = 7) received caudal i.v. injection of MSC (1.5 9 106 in 1 ml of saline) 7 days before or 1 day after renal I/R, respectively. Control groups 3 (saline D-7, n = 6) and 4 (saline D + 1, n = 6) received equal volume of saline at similar time points. Left renal ischemia (by clamping of the renal pedicle) lasted 45 min. Right nephrectomy was simultaneously performed. Blood sample was collected from inferior vena cava at 48 h post reperfusion. MSC phenotype was confirmed by FACS analysis. In groups 1 and 3, serum creatinine (SCr) reached 1.4 ` 0.7 versus 2.4 ` 0.8 mg/dl, respectively (p < 0.05). In groups 2 and 4, SCr was 4.9 ` 0.7 versus 3.3 ` 0.9 mg/dl, respectively (p < 0.001). Furthermore, SCr levels were statistically worse when MSC were administered after renal I/R in comparison to a priori infusion (p < 0.0001). In conclusion, MSC administration 7 days prior to renal I/R attenuates kidney injury in comparison to (i) saline infusion or (ii) MSC infusion 1 day after renal I/R. Conversely, on the basis of SCr levels, MSC therapy performed after renal I/R worsens kidney injury in rats. [less ▲]

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See detailHome Blood Pressure in Kidney Transplant Recipients (ktr)- Validity of different schedules of self-monitoring
Saint-Remy, Annie ULg; WEEKERS, Laurent ULg; BONVOISIN, Catherine ULg et al

Conference (2015, October 24)

HOME BLOOD PRESSURE IN KIDNEY TRANSPLANT RECIPIENTS (KTR)-Validity of different schedules of self-monitoring A. Saint-Remy, L. Weekers, C. Bonvoisin, P. Xhignesse, B.Dubois, JM. Krzesinski NEPHROLOGY ... [more ▼]

HOME BLOOD PRESSURE IN KIDNEY TRANSPLANT RECIPIENTS (KTR)-Validity of different schedules of self-monitoring A. Saint-Remy, L. Weekers, C. Bonvoisin, P. Xhignesse, B.Dubois, JM. Krzesinski NEPHROLOGY - CHU LIEGE AIM: Office blood pressure (OBP), 24-h ambulatory monitoring (ABPM) and home self- monitoring (HBP) allow assessing BP control in treated HT patients. For HBP, ESH guidelines recommend 7 days of measurements but that duration is questioned. The present study analyzed the agreement between daytime ABP and different schedules for HBP in 70 treated hypertensive KTR. METHOD: BP control defined by OBP <140/90 and daytime ABP or HBP <135/85 mmHg was tested in 70 KTR (mean age 56 ± 11 y; mean graft survival 7 ± 6.6 y). OBP and HBP were measured with an Omron M6 and 24-h ABPM with a Spacelabs 90207. HBP was measured on consecutive days (2 times in morning and 2 times at evening/day), the first day was discarded for the mean calculation. Agreement between daytime and HBP was studied when HBP was measured during 7, 5 or 3 days. RESULTS: BP was uncontrolled in 50% of the KTR based on OBP, in 61 % according to daytime ABP and even in 64 % with HBP. Sensitivity (Se) testing agreement between daytime ABP and HBP decreased progressively when number of days was shortened: the highest Se was observed for a 7 days duration with 1st day discarded (86 %). Specificity (Sp) fluctuated around 70 % and was the highest for a 5 (73 %) and 3 days schedule. However the 5 days schedule had higher Se (83 %) than the 3 days. Proportions of KTR correctly classified according to daytime ABP were 79 %, 79 % and 78 % with the 7, 5 or 3 days schedule, respectively. CONCLUSIONS: HBP, easier and less restricting method than 24h ABPM, is a good alternative to daytime ABPM as nearly 80 % of treated KTR were similarly classified. HBP recording period can be shortened to 5 days according to Se and Sp. A 3 days schedule seems more risky reducing the chance to identify masked HT due to a decreased drug adherence. [less ▲]

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See detailLeucocytes and lipid particles filtration in suction blood during cardiopulmonary bypass: impact on kidney function evaluated with a monocentric prospective randomized study.
LAGNY, Marc-Gilbert ULg; KOCH, Jean-Noël ULg; BLAFFART, Francine ULg et al

Conference (2015, October 03)

OBJECTIVE: Cardiac surgery may be complicated by acute kidney injury (AKI). Cardiotomy suction during cardiopulmonary bypass (CPB) is deleterious. A few studies have demonstrated that shed mediastinal ... [more ▼]

OBJECTIVE: Cardiac surgery may be complicated by acute kidney injury (AKI). Cardiotomy suction during cardiopulmonary bypass (CPB) is deleterious. A few studies have demonstrated that shed mediastinal blood (SMB) suction during cardiopulmonary bypass (CPB) can increase inflammatory response and lipids emboli. These 2 factors contribute to the development of postoperative AKI. The RemoweLL (RemoweLeucoLipids, Eurosets™, Italy) filter is a recent designed cardiotomy with a multilayer filter for activated leucocytes filtration and a syphon for lipid particles sequestration. The SMB can be collected and filtered in this supplementary cardiotomy added to CPB circuit. The aim of this monocentric prospective study was to compare the specific RemoweLL cardiotomy filtration for suction blood during CPB and a conventional 40 µm filter (Admiral, Eurosets™, Italy). The primary goal was to evaluate the AKI within 48 hours after surgery using the Acute Kidney Injury Network classification (AKIN classification) but also measuring early specific biomarkers of AKI: serum Cystatine C and urinary neutrophil gelatinase-associated lipocalin (NGAL). METHODS: Sixty patients scheduled for elective cardiac surgery (aortic or mitral valvular combined or not with coronary bypass grafting) with a glomerular filtration rate (GFR) > 45mL/min. were randomly into 2 groups for SMB filtration: - Groupe 1 (n=30) with RemoweLL cardiotomy (Leucocytes and lipids filter); - Groupe 2 (n=30) with Admiral cardiotomy (conventional 40 µm filter). All components: venous reservoir, oxygenator and surface treatment were similar in both groups. [less ▲]

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