References of "Krzesinski, Jean-Marie"
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See detailLa maladie renale diabetique: prise en charge actuelle et perspectives d'avenir.
Krzesinski, Jean-Marie ULg; Scheen, Andre ULg

in Revue medicale suisse (2015), 11(483), 1534-81540-2

The diabetic kidney disease is the most frequent cause of end stage renal disease in Western countries. Its detection is obtained by simultaneously measuring urinary albumin excretion and estimating ... [more ▼]

The diabetic kidney disease is the most frequent cause of end stage renal disease in Western countries. Its detection is obtained by simultaneously measuring urinary albumin excretion and estimating glomerular filtration rate through serum creatinine dosage. Many type 1 and type 2 diabetic patients can present decreased glomerular filtration rate before the occurrence of increased urinary albumin. While waiting for promising new pharmacological approaches currently evaluated in clinical trials, the best approach to stop the epidemic of diabetic nephropathy remains an early and individual multifactorial approach controlling the glucose level (without inducing hypoglycaemia), blood pressure (using a renin-angiotensin blocker), dyslipidaemia and over-weight. [less ▲]

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See detailMesenchymal Stromal Cell Therapy in Ischemia/Reperfusion Injury.
Rowart, Pascal ULg; Erpicum, Pauline; Detry, Olivier et al

in Journal of immunology research (2015), 2015

Ischemia/reperfusion injury (IRI) represents a worldwide public health issue of increasing incidence. IRI may virtually affect all organs and tissues and is associated with significant morbidity and ... [more ▼]

Ischemia/reperfusion injury (IRI) represents a worldwide public health issue of increasing incidence. IRI may virtually affect all organs and tissues and is associated with significant morbidity and mortality. Particularly, the duration of blood supply deprivation has been recognized as a critical factor in stroke, hemorrhagic shock, or myocardial infarction, as well as in solid organ transplantation (SOT). Pathophysiologically, IRI causes multiple cellular and tissular metabolic and architectural changes. Furthermore, the reperfusion of ischemic tissues induces both local and systemic inflammation. In the particular field of SOT, IRI is an unavoidable event, which conditions both short- and long-term outcomes of graft function and survival. Clinically, the treatment of patients with IRI mostly relies on supportive maneuvers since no specific target-oriented therapy has been validated thus far. In the present review, we summarize the current literature on mesenchymal stromal cells (MSC) and their potential use as cell therapy in IRI. MSC have demonstrated immunomodulatory, anti-inflammatory, and tissue repair properties in rodent studies and in preliminary clinical trials, which may open novel avenues in the management of IRI and SOT. [less ▲]

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See detailIncidence and outcomes of acute kidney injury after cardiac surgery using either criteria of the RIFLE classification.
Lagny, Marc-Gilbert; Jouret, François ULg; Koch, Jean-Noel et al

in BMC nephrology (2015), 16(1), 76

BACKGROUND: Adult cardiac surgery is significantly associated with the development of acute kidney injury (AKI). Still, the incidence and outcomes of AKI vary according to its definition. Our ... [more ▼]

BACKGROUND: Adult cardiac surgery is significantly associated with the development of acute kidney injury (AKI). Still, the incidence and outcomes of AKI vary according to its definition. Our retrospective monocentric study comparatively investigates the yield of RIFLE definition, which is based on the elevation of serum creatinine levels (SCr) or the reduction of urine output (UO), taking into account only one or both criteria. Pre- and per-operative risk factors for post-operative AKI were evaluated. METHODS: All adult patients undergoing cardiac surgery, with or without cardiopulmonary bypass, from April 2008 to March 2009 were included. Clinical, biological and surgical features were recorded. Baseline serum creatinine was determined as its value on day 7 before surgery. Post-operative AKI was diagnosed and scored based upon the highest serum creatinine and/or the lowest urine output. RESULTS: 443 patients (Male/Female ratio, 2.3; median age, 69y) were included, with 221 (49.9 %) developing postoperative AKI. Elevated serum creatinine (AKISCr) and oliguria (AKIUO) was observed in 9.7 % and 40.2 %, respectively. AKI patients had a significantly higher BMI and baseline SCr. In comparison to AKIUO, AKISCr mostly occurred in patients with co-morbidities, and was associated with an increased mortality at 1-year post surgery. CONCLUSIONS: The use of standard RIFLE definition of AKI in a cohort of 443 patients undergoing cardiac surgery resulted in an incidence reaching 50 %. Still, significant discrepancies were found between AKISCr and AKIUO regarding the incidence and outcomes. In line with previous reports, our data questions the utility of urine output as a criterion for AKI diagnosis and management after cardiac surgery. [less ▲]

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See detailLe traitement de l'hypertension artérielle doit être du "sur mesure"
Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2015)

Hypertension has a high world-wide prevalence, affecting more than 25 % of the population; it remains the silent killer number one in cardiovascular pathology. Although lowering high blood pressure is ... [more ▼]

Hypertension has a high world-wide prevalence, affecting more than 25 % of the population; it remains the silent killer number one in cardiovascular pathology. Although lowering high blood pressure is protective, perfect control of hypertension is far from being optimal in spite of many international guidelines regularly updated according to published scientific studies. A personalized approach of hypertension management is an attractive way to improve this situation. Tools are developing (pharmacogenetics, pharmacometabolomics), but their use in daily clinical practice seems premature. At the present time, it is the physician experience which offers the best opportunity to propose the best treatment to the best patient. The management of hypertension remains a difficult task in some cases. [less ▲]

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See detailNouveaux AntiCoagulants Oraux et risques liés à l’insuffisance rénale et à des interactions médicamenteuses
Krzesinski, Jean-Marie ULg

Scientific conference (2014, December 16)

Les NACO apportent une facilité apparente d’utilisation et une légère avancée en termes de résultats et de prévention de saignement. Cependant, la prudence est de mise lorsque la fonction rénale est ... [more ▼]

Les NACO apportent une facilité apparente d’utilisation et une légère avancée en termes de résultats et de prévention de saignement. Cependant, la prudence est de mise lorsque la fonction rénale est possiblement abaissée et lors d’associations médicamenteuses aux métabolismes similaires.Il est important d’estimer la filtration glomérulaire avant de prescrire les NACO (MDRD). [less ▲]

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See detailInsuffisance rénale aiguë : définition, monitorage et traitement NON dialytique
Krzesinski, Jean-Marie ULg

Scientific conference (2014, October 25)

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See detailLa maladie rénale chronique (MRC)
Krzesinski, Jean-Marie ULg; moonen, martial; WEEKERS, Laurent ULg

Scientific conference (2014, October 17)

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See detailLa prise en charge des facteurs de risque dans le diabète de type 2 est-elle optimale?
Krzesinski, Jean-Marie ULg

Scientific conference (2014, October 10)

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See detailHow to manage HTA in 2014?
Krzesinski, Jean-Marie ULg

Conference (2014, October 07)

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See detailLe médicament du mois Combinaison fixe périndopril-indapamide-amlodipine (Triplixam®) pour le traitement de l’hypertension artérielle
SCHEEN, André ULg; LANCELLOTTI, Patrizio ULg; KRZESINSKI, Jean-Marie ULg

in Revue Médicale de Liège (2014), 69(10), 565-570

Triplixam® is a fixed dose combination of three well known antihypertensive agents, with complementary activities, to control blood pressure in patients with arterial hypertension : perindopril, an ... [more ▼]

Triplixam® is a fixed dose combination of three well known antihypertensive agents, with complementary activities, to control blood pressure in patients with arterial hypertension : perindopril, an angiotensin converting enzyme inhibitor, indapamide, un diuretic whith thiazide-like effects but also specific properties, and amlodipine, a long-acting calcium antagonist of the dihydropyridine family. The potential synergic action allows better control of blood pressure with once daily administration, while limiting the incidence of adverse events. Various presentations with different dosages are available to facilitate individualized therapy. Warnings and precautions for use of every molecule should of course be respected. Such a fixed dose combination should contribute to limit clinical inertia and to improve therapeutic compliance. [less ▲]

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See detailDephosphorylated-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 ULg; KRZESINSKI, Jean-Marie ULg; Warling, X 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 ▲]

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See detailInter-method variability in bone alkaline phosphatase measurement : clinical impact on the management of dialysis patients
CAVALIER, Etienne ULg; Souberbielle, Jean-Claude; GADISSEUR, Romy ULg 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 ▲]

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See detailIntérêt des cellules stromales mésenchymateuses en transplantation d’organes solides
Delens, Loic ULg; Jouret, François ULg; DETRY, Olivier ULg et al

in Revue Médicale Suisse (2014), 10

Solid organ transplantation (SOT) currently represents the best therapeutic option in end-stage diseases caused by the irrevocable functional loss of an organ. Still, SOT is associated with immunological ... [more ▼]

Solid organ transplantation (SOT) currently represents the best therapeutic option in end-stage diseases caused by the irrevocable functional loss of an organ. Still, SOT is associated with immunological and non-immunological injuries, whose severity impacts on early functional recovery and long-term survival of the transplant. Current research focuses on the identification of innovative approaches to 1) attenuate ischemia/reperfusion-induced damage, 2) accelerate processes of tissue repair, and 3) induce in fine graft tolerance. Encouraging observations from both preclinical studies and clinical trials suggest that the administration of mesenchymal stromal cells at the time of SOT might be beneficial, as a result of theirs immunomodulatory, anti-inflammatory and regenerative properties. [less ▲]

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See detailAltération de la fonction rénale chez le patient âgé, comment gérer?
KRZESINSKI, Jean-Marie ULg; DELANAYE, Pierre ULg

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 ▲]

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See detailPrise en charge de l'hypertension artérielle du patient âgé
XHIGNESSE, Patricia ULg; Saint-Remy, Annie ULg; Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2014), 69(5-6), 294-300

High blood pressure is very frequent in the elderly; it represents a real threat for the patient’s health and a source of huge costs for the economic system. Systolic hypertension is the most frequent ... [more ▼]

High blood pressure is very frequent in the elderly; it represents a real threat for the patient’s health and a source of huge costs for the economic system. Systolic hypertension is the most frequent form observed in the old, due to large arteries stiffness. Antihypertensive therapy has proven effective to decrease significantly the cardiovascular morbi-mortality and total mortality in this population. A non pharmacological approach is also very useful, but should not be too restrictive. Blood pressure target in patients older than 65 (and, particularly, in octogenarians) is 150/80 mmHg. Blood pressure should be checked in the upright position before changing the drug dosage. The first line therapy in the old should generally be a calcium channel antagonist or a low dose diuretic. [less ▲]

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See detailY-a-t-il une place pour le placebo dans le traitement de l'hypertension artérielle?
Krzesinski, Jean-Marie ULg

Conference (2014, May 18)

La pression artérielle est très influencée par des stimuli émotionnels ou physiques. Il est donc nécessaire de bien valider le niveau réel de pression artérielle avant de se lancer dans un traitement ... [more ▼]

La pression artérielle est très influencée par des stimuli émotionnels ou physiques. Il est donc nécessaire de bien valider le niveau réel de pression artérielle avant de se lancer dans un traitement actif. Le placebo s’inscrit dans cette mise au point pour garantir l’intérêt réel d’un traitement, en connaître les avantages et les limites. Dans l’hypertension confirmée, l’approche placebo n’a plus réellement sa place au long cours. [less ▲]

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See detailLes nouvelles directives du contrôle de l'HTA
Krzesinski, Jean-Marie ULg

Conference (2014, May 17)

Successivement au mois de juin 2013 et fin de l’année 2013 sont apparues trois recommandations sur la prise en charge de l’hypertension artérielle. La première relevait de la Société Européenne ... [more ▼]

Successivement au mois de juin 2013 et fin de l’année 2013 sont apparues trois recommandations sur la prise en charge de l’hypertension artérielle. La première relevait de la Société Européenne d’Hypertension et les deux autres de sociétés américaines et internationales. Ces directives accordaient toutes une importante place aux mesures de pression artérielle (PA) en dehors du cabinet de consultation (automesure et mesure ambulatoire de pression sur 24 heures). Elles ont voulu aussi simplifier les cibles de PA à viser qui apparaissent beaucoup moins exigeantes qu’auparavant. Chez les patients âgés, les cibles sont différentes de celles des patients plus jeunes et l’initiation du traitement est d’ailleurs moins rapide. Les bêtabloquants ont été réhabilités dans la stratégie de traitement possible lorsqu’on initie un médicament en présence d’une hypertension artérielle considérée comme nécessitant un médicament antihypertenseur et enfin une stratégie un peu plus claire a été proposée pour l’hypertension artérielle résistante. [less ▲]

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See detailL'hypertension artérielle
Krzesinski, Jean-Marie ULg

Conference (2014, May 08)

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