References of "Krzesinski, Jean-Marie"
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See detailParathormone and bone-specific alkaline phosphatase for the follow-up of bone turnover in hemodialysis patients : Is it so simple?
DELANAYE, Pierre ULiege; DUBOIS, Bernard ULiege; JOURET, François ULiege et al

in Clinica Chimica Acta (2013), 417

Background: Chronic Kidney Disease (CKD) is associated with mineral and bone disorders (MBD). International guidelines suggest that levels of serum parathormone (PTH) or bone-specific alkaline phosphatase ... [more ▼]

Background: Chronic Kidney Disease (CKD) is associated with mineral and bone disorders (MBD). International guidelines suggest that levels of serum parathormone (PTH) or bone-specific alkaline phosphatase (b-ALP) can be used to evaluate MBD in dialysis patients. The evidence remains moderate and based on transversal studies. <br />Methods: We retrospectively investigated the variations of PTH (ΔPTH) and b-ALP (Δb-ALP) serum concentrations over a short (6-weeks) and a long (one-year) period in a monocentric hemodialysis population. The proportion of patients reaching the critical difference (CD) (50% for PTH and 25% for b-ALP) was calculated. <br />Results: Seventy-seven patientswere included. A significant correlation between PTHand b-ALP levelswas found at baseline (r=0.51). By contrast, no correlation was observed between ΔPTH and Δb-ALP over a 6-week interval (r=0.07). The CD for PTH and b-ALP was reached by 19 and 11 patients, respectively, with 2 patients showing consistent variations of both biomarkers. One year later, measurements were repeated in 48 survivors. <br />No correlation was found between ΔPTH and Δb-ALP (r=0.27). The CD for PTH or b-ALP was reached by 24 patients and 28 patients, respectively, with 6 patients (12.5%) showing opposite results for both biomarkers. <br />Conclusion: This study shows the lack of correlation between ΔPTH and Δb-ALP over time in patients under chronic hemodialysis. [less ▲]

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See detailAnnual meeting of the SBN/BVN
BOUQUEGNEAU, Antoine ULiege; DELANAYE, Pierre ULiege; CAVALIER, Etienne ULiege et al

Conference (2013)

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See detailDeterminants of sclerostin concentration in hemodialysis patients.
DELANAYE, Pierre ULiege; KRZESINSKI, Jean-Marie ULiege; Warling, X et al

Poster (2013)

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See detailDéterminant physiologique du NGAL sanguin et discordance entre NGAL sanguin et urinaire.
DELANAYE, Pierre ULiege; Claisse, G; Mehdi, M et al

Poster (2013)

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See detailDéterminant physiologique du NGAL sanguin et discordance entre NGAL sanguin et urinaire.
DELANAYE, Pierre ULiege; Claisse, G; Mehdi, M et al

Poster (2013)

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See detailPeritoneal equilibration test with conventional ‘low pH/high glucose degradation product’ or with biocompatible ‘normal pH/low glucose degradation product’ dialysates: does it matter?
VAN OVERMEIRE, Lionel ULiege; Goffin, Eric; Krzesinski, Jean-Marie ULiege et al

in Nephrology Dialysis Transplantation (2013)

Abstract Background. The evaluation of the peritoneal transport characteristics is mandatory in peritoneal dialysis (PD) patients. This is usually performed in routine clinical practice with a peritoneal ... [more ▼]

Abstract Background. The evaluation of the peritoneal transport characteristics is mandatory in peritoneal dialysis (PD) patients. This is usually performed in routine clinical practice with a peritoneal equilibration test (PET) using conventional dialysates, with low pH and high glucose degradation product (GDP) concentrations. An increasing proportion of patients are now treated with biocompatible dialysates, i.e. with physiological pH and lower GDP concentrations. This questions the appropriateness to perform a PET with conventional solutions in those patients. The aim of our study is to compare the results of the PET using biocompatible and conventional dialysates, respectively. Methods. Nineteen stable PD patients (13 males, 6 females; mean age: 67.95 ± 2.36 years, mean body surface area: 1.83 ± 0.04 m2, dialysis vintage: 2.95 ± 0.19 years) were included, among which 10 were usually treated with biocompatible and 9 with conventional solutions. Two PETs were performed, within a 2-week interval, in each patient. PET sequence (conventional solution first or biocompatible solution first) was randomized in order to avoid ‘time bias’. Small (urea, creatinine and glucose), middle (beta-2-microglobulin) and large molecules’ (albumin and alpha-2-macroglobulin) dialysate/plasma (D/P) concentration ratios and clearances were measured during each PET. Ultrafiltration (UF) and sodium filtration were also recorded. Results of both tests were compared by the Wilcoxon paired test. Results. No statistical difference was found between both dialysates for small molecule transport rates or for sodium filtration and UF. However, a few patients were not similarly classified for small-solute transport characteristics within the PET categories. Beta-2-microglobulin and albumin D/P ratios at different time points of the PET were significantly higher with the biocompatible, when compared with the conventional, solutions: 0.10 ± 0.03 versus 0.08 ± 0.02 (P < 0.01) and 0.008 ± 0.003 versus 0.007 ± 0.003 (P = 0.01), respectively. A similar difference was also observed for beta-2-microglobulin that was higher with biocompatible dialysates (1.04 ± 0.32 versus 0.93 ± 0.32 mL/min, respectively). Conclusion. Peritoneal transport of water and small solutes is independent of the type of dialysate which is used. This is not the case for the transport of beta-2-microglobulin and albumin that is higher under biocompatible dialysates. Vascular tonus modification could potentially explain such differences. The PET should therefore always be carried out with the same dialysate to make longitudinal comparisons possible. [less ▲]

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See detailL'hypotension orthostatique: 2eme partie. Epidemiologie, complications et traitements.
Tyberghein, M.; Philips, J.-C.; Krzesinski, Jean-Marie ULiege et al

in Revue Médicale de Liège (2013), 68(4), 163-70

Orthostatic hypotension (OH) is a rather common phenomenon in clinical practice. It may occur in 5-10 % of normal individuals, but its prevalence increases with age and various pathologies, so that it may ... [more ▼]

Orthostatic hypotension (OH) is a rather common phenomenon in clinical practice. It may occur in 5-10 % of normal individuals, but its prevalence increases with age and various pathologies, so that it may rise above 35 % in certain subgroups of patients. OH is associated with various comorbidities, in particular cardio-cerebro-vascular accidents and falls (especially in the elderly), and may even increase mortality. It is, however, difficult to determine whether OH is simply a marker of frailty or whether it is really a risk factor. OH treatment involves physical manoeuvres or medications, which aim at inducing a peripheral vasoconstriction (midodrine, etilefrine) or an increase of circulating blood volume (9-alpha-fluohydrocortisone). However, their use should be cautious, because of a risk of arterial hypertension in supine position. [less ▲]

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See detailL'Hypotension orthostatique: 1ere partie: definition, symptomatologie, evaluation et physiopathologie.
Tyberghein, Maelle; PHILIPS, Jean-Christophe ULiege; Krzesinski, Jean-Marie ULiege et al

in Revue Médicale de Liège (2013), 68(2), 65-73

Orthostatic hypotension (OH) is defined by a drop in arterial blood pressure (BP) of at least 20 mmHg for systolic BP and 10 mmHg for diastolic BP after standing. Symptoms are generally quite typical, but ... [more ▼]

Orthostatic hypotension (OH) is defined by a drop in arterial blood pressure (BP) of at least 20 mmHg for systolic BP and 10 mmHg for diastolic BP after standing. Symptoms are generally quite typical, but may also be rather vague. Diagnosis may be easily made by the physician in his/ her office, and confirmed, if necessary, by more sophisticated measurements. Pathophysiology is generally rather complex, but mostly involves a defect in the autonomic nervous system, in its sympathetic component. Failure of peripheral vasoconstriction seems to play a more important role than the defect in reflex tachycardia. Causes of OH are multiples. OH may occur in healthy subjects, when exposed to exceptional circumstances, but is more generally associated with various diseases, either neurological disorders or pathologies characterized by hypovolemia. Medications can also aggravate the risk of OH, among which some antihypertensive or psychotropic agents. Elderly people, especially frailty subjects, are exposed to a high risk of OH, whose origin is often multifactorial, and this complication may have serious medical consequences. [less ▲]

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See detailTolvaptan in autosomal dominant polycystic kidney disease.
JOURET, François ULiege; Krzesinski, Jean-Marie ULiege

in New England Journal of Medicine [=NEJM] (2013), 368(13), 1258-9

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See detailLes syndromes cardio-rénaux
Krzesinski, Jean-Marie ULiege

Learning material (2013)

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See detailHyperuricémie et risque cardiovasculaire dans la maladie rénale chronique
Krzesinski, Jean-Marie ULiege

Scientific conference (2012, December 20)

Plusieurs études de populations ont noté qu’une hyperuricémie peut favoriser l’apparition d’une insuffisance rénale. Par ce biais, l’hyperuricémie participerait au risque CV de l’IRC! Acide urique accru ... [more ▼]

Plusieurs études de populations ont noté qu’une hyperuricémie peut favoriser l’apparition d’une insuffisance rénale. Par ce biais, l’hyperuricémie participerait au risque CV de l’IRC! Acide urique accru: bon, mauvais ou indifférent? Rôle antioxydant à concentration normale A concentration élevée, épidémiologie en faveur d’un rôle délétère sur le plan CV et rénal (marqueur ou acteur?). Participe à la dysfonction endothéliale, à la stimulation du SRA, au stress oxydant et à l’inflammation, tous facteurs de risque CV. Rôle dans l’initiation et la progression de l’IRénale Cependant, EBM non prouvé de l’intérêt du traitement IXO Manque cruel d’études multicentriques, randomisées, contrôlées sur l’intérêt d’une baisse de l’acide urique par un IXO pour la protection CV et rénale ! [less ▲]

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See detailCoronary heart disease: the MONICA-BELLUX Register
JeanJean, Michel; Krzesinski, Jean-Marie ULiege; Wunsch, Guillaume

Conference (2012, December 05)

Background : Cardiovascular diseases contribute to 42% of overall mortality in the European Union. Over a third of deaths from CVD are from coronary heart disease and just over a quarter are from ... [more ▼]

Background : Cardiovascular diseases contribute to 42% of overall mortality in the European Union. Over a third of deaths from CVD are from coronary heart disease and just over a quarter are from cerebrovascular disease (stroke). Standardized death rates for heart disease have fallen dramatically in the last 25 years in Western Europe, both for men and for women. Multinational MONItoring of trends and determinants in CArdiovascular disease The MONICA Project : A major source of information on cardiovascular diseases established in the early 1980s under the auspices of WHO, to monitor trends in cardiovascular diseases and to relate these to risk factor changes over a ten year period. There were a total of 37 MONICA Collaborating Centres in 21 countries (including 29 populations in 16 European countries). The ten year data collection was completed in the late 1990s, though several Centres are still active today. Conclusions : CVD registers remain nevertheless an invaluable source for monitoring levels and trends in incidence and case fatality. Trends in incidence rates and in case fatality rates can significantly differ from one another. This situation requires better detection of individuals at risk. The intervention component of the BELLUX register is well-suited for this task. [less ▲]

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See detailL'insuffisance rénale aiguë dans le décours d'une chirurgie cardiaque adulte: incidence au Centre Hospitalier Universitaire de Liège
LAGNY, Marc-Gilbert ULiege; BLAFFART, Francine ULiege; Defraigne, Jean-Olivier ULiege et al

Scientific conference (2012, November 20)

Cadre théorique En chirurgie cardiaque, l’insuffisance rénale aiguë (IRA) est une complication postopératoire sévère et est associée à une augmentation du taux de mortalité, de morbidité et des durées de ... [more ▼]

Cadre théorique En chirurgie cardiaque, l’insuffisance rénale aiguë (IRA) est une complication postopératoire sévère et est associée à une augmentation du taux de mortalité, de morbidité et des durées de séjour aux soins intensifs (SI). Elle survient dans 5 à 30 % des cas selon le type de définition utilisée (1,2). Objectifs L’objectif de cette étude est de présenter un état des lieux de l’IRA survenant dans le décours d’une chirurgie cardiaque, dans notre Centre. Matériel et Méthodes Cette étude rétrospective inclut des patients pris en charge pour une chirurgie cardiaque entre le 1er avril 2008 et le 31 mars 2009. Les patients sélectionnés sont des opérés de : pontages aorto-coronaires avec CEC (PAC CEC), pontages aorto-coronaires à cœur battant (PAC battant), remplacement valvulaire aortique (RVA), remplacement ou réparation valvulaire mitral (RVM), ou remplacement valvulaire aortique associé à des pontages aorto-coronaires (RVA+PAC). Les insuffisants rénaux chroniques dialysés, en période préopératoire, sont exclus. La classification RIFLE (Risk, Injury, Failure, Loss and End stage kidney disease) permet de stratifier les patients en trois grades de sévérité d’IRA. Cette stratification est basée sur l’élément le plus péjoratif observé durant les 7 premiers jours postopératoires : augmentation du niveau de créatinine sérique ou diminution de la diurèse, ou diminution de la filtration glomérulaire selon les critères définis par Bellomo (3). La fréquence d’IRA est étudiée par type de chirurgie ainsi que son impact sur les durées de séjour aux SI et hospitalier. Les proportions sont comparées par un test du Chi2 et les valeurs médianes par un test U de Mann Whitney. Les résultats sont considérés comme étant significatifs au niveau d’incertitude de 5% (p<0.05). Résultats Quatre cent trente-quatre patients sont inclus : âge médian (interquartiles) 69.0 (60.0-76.0) ans, 30.2% de femmes, 2.76 de cas urgents. Cinquante-huit patients (13.4%) sont opérés par la technique PAC battant, 182 (41.9%) PAC CEC, 104 (24.0%) RVA, 44 (10.1%) RVM et 46 (10.6%) RVA+PAC. Une IRA est diagnostiquée chez 213 (49.1%) patients : 79 (37.1%) « Risk », 108 (50.7%) « Injury » et 26 (12.2%) « Failure ». La distribution d’IRA par type de chirurgie est respectivement égale à 36.2% pour le groupe PAC battant, 44.0% PAC CEC, 49.0% RVA, 52.3 RVM et 82.6% RVA+PAC. La fréquence d’IRA diffère significativement selon le type d’intervention chirurgicale (p<0.0001). Les durées de séjour aux SI sont statistiquement plus longues (p<0.0001) pour le groupe de patients ayant développé une IRA, respectivement : 3(2-4) jours versus 2(2-3) jours. Cependant, il n’y a pas de différence (p=0.65) observée entre les deux groupes (IRA et non IRA) en termes de durées de séjour hospitalier : 13 (10-18) jours versus 12 (10-16) jours. Discussion L’incidence d’IRA est très élevée dans cette population de patients, comparée aux données disponibles dans la littérature. Cela est probablement dû au fait que les trois éléments de la classification RIFLE ont été utilisés sur toute la population de l’étude. Conclusions L’IRA après chirurgie cardiaque associée à la CEC devrait être étudiée, à l’avenir pour développer des mesures préventives pour réduire les IRA. [less ▲]

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