References of "Krzesinski, Jean-Marie"
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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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See detail18FDG-PET/CT IMAGING IN SUSPECTED ACUTE RENAL ALLOGRAFT REJECTION
LOVINFOSSE, Pierre ULg; WEEKERS, Laurent ULg; BOVY, Christophe ULg et al

Conference (2015, September 13)

The diagnosis procedure for kidney transplant recipients (KTR) with suspected acute rejection (AR) relies on needle biopsy. Noninvasive tests to predict nonrejection would be preferable. AR is associated ... [more ▼]

The diagnosis procedure for kidney transplant recipients (KTR) with suspected acute rejection (AR) relies on needle biopsy. Noninvasive tests to predict nonrejection would be preferable. AR is associated with a recruitment of activated leukocytes into the transplant, which are characterized by a high metabolic activity and an increased uptake of glucose analog, Fluoro-deoxyglucose ( FDG). Thus, FDG-Positron emission tomography coupled with computed tomography (PET/CT) may help noninvasively distinguish nonrejection from AR. From January 2013 to February 2015, we prospectively performed 32 FDGPET/ CT in 31 adult KTR with suspected renal AR who underwent a biopsy. Biopsies were categorized as “normal”, “borderline”, “AR” or “others” according to Banff classification. PET/CT imaging was performed within 201 ± 18 minutes after i.v. administration of 3.2 ± 0.2 MBq/kg of FDG, before any modification of immunosuppression. The mean standard uptake values (SUV) of both upper and lower renal poles were measured, with no threshold activity. Biopsies were diagnosed as “normal”, “borderline”, “AR” or “others” in 8, 10, 8 and 6 (including 3 polyoma-BK nephropathies) cases. Mean SUV respectively reached 1.5 ± 0.2, 1.6 ± 0.3, 2.9 ± 0.8, 2.2 ± 1.2 in each category. Mean SUV of biopsy-proven AR was significantly higher than “normal” cases (p<0.01). No difference was found between “normal” vs. “borderline”, or between “AR” vs. “others” histopathology. Still, a positive correlation between mean SUV and acute composite (g+i+t+v+ptc) Banff score was found, with a coefficient of 0.70 (p<0.001). Sensitivity and specificity of FDG-PET/CT in detecting pathological biospies were respectively 92.3% and 36.8%, with a mean SUV threshold at 1.4. FDG-PET/CT imaging may help discriminate nonrejection, thereby avoiding unnecessary transplant biopsy in KTR with suspected AR. [less ▲]

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See detailLes complications rénales du diabète
Krzesinski, Jean-Marie ULg

Conference (2015, June 24)

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See detailOnco-Nephrology: Core Curriculum 2015
Cohen, Eric; Krzesinski, Jean-Marie ULg; Launay-Vacher, Vincent et al

in American Journal of Kidney Diseases (2015), 66(5), 869-883

The overlap between oncology and nephrology is an area of growing importance. A major reason for this is that less than half the patients with cancer were long-term survivors years ago, whereas now more ... [more ▼]

The overlap between oncology and nephrology is an area of growing importance. A major reason for this is that less than half the patients with cancer were long-term survivors years ago, whereas now more than two-thirds will live 5 years or longer. Late effects of cancer treatment include nephrotoxicity and are part of current clinical practice. In addition, cancer is now a known feature of chronic kidney disease (CKD), with increased risk in patients receiving dialysis or with a functioning kidney transplant, as well as those with earlier stages of the disease. Therefore, oncologists will refer patients to nephrologists, and nephrologists will need to consult oncologists. This Core Curriculum addresses the key issues at this challenging clinical interface. [less ▲]

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See detailKidney function and cardiac surgery
Krzesinski, Jean-Marie ULg

Conference (2015, April 24)

High prevalence of the problem in part due to ageing with CKD - Consequences for the patient and the economy of health - Danger of CKD development or aggravation, mortality Need for early diagnosis (new ... [more ▼]

High prevalence of the problem in part due to ageing with CKD - Consequences for the patient and the economy of health - Danger of CKD development or aggravation, mortality Need for early diagnosis (new biomarkers?) but not yet proof of efficacy for prevention. Useful for predicting prognosis? Prevention first: interval between contrast agents use and surgery, caution about medical therapy, fluid volume balance, importance of the kind of solution used, quality of the CBP! Treatment: avoid complications when AKI installed, nutrition ! Early RRT (?)(rapid uremic control or fluid balance?) but high mortality even after hospital discharge (max 1/3 survival at 1 y) [less ▲]

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See detailRenal ischemia/reperfusion decreases the expression of DPP-4
Rowart, Pascal ULg; ERPICUM, Pauline ULg; Defraigne, Jean-Olivier ULg et al

Conference (2015, April 24)

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See detailLa dépression est une complication fréquente du lupus érythémateux disséminé : considérations épidémiologiques, pathogéniques et thérapeutiques
Lemaire, Benoît ULg; Geron, Donatienne ULg; MALAISE, Olivier ULg et al

in Revue Médicale de Liège (2015), 70(4), 215-218

Le lupus érythémateux disséminé (LED) est une maladie de système aux conséquences aussi multiples qu’invalidantes. La prévalence des épisodes dépressifs majeurs y est significativement supérieure à celle ... [more ▼]

Le lupus érythémateux disséminé (LED) est une maladie de système aux conséquences aussi multiples qu’invalidantes. La prévalence des épisodes dépressifs majeurs y est significativement supérieure à celle des sujets sains ou atteints d’autres pathologies inflammatoires. S’il est évident que le statut de maladie chronique au dénouement souvent péjoratif et le nombre de traitements qu’elle impose constituent des facteurs favorisants, il est probable que les mécanismes pathogéniques du LED occasionnent une atteinte cérébrale précipitant une symptomatologie dépressive. Cet article approfondit les liens entre LED et dépression à travers des notions épidémiologiques, étiopathogéniques et thérapeutiques. [less ▲]

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See detailLe cas clinique du mois : prise en charge d'une hypophosphatémie
HUART, Justine ULg; DUBOIS, Bernard ULg; Krzesinski, Jean-Marie ULg et al

in Revue Médicale de Liège (2015), 70(4), 163-168

Hypophosphatemia is defined by a serum phosphate level lower than 0.8 mmol/l. If hypophosphatemia is chronically maintained, it is associated with muscular, osteous, neurological or cardio-respiratory ... [more ▼]

Hypophosphatemia is defined by a serum phosphate level lower than 0.8 mmol/l. If hypophosphatemia is chronically maintained, it is associated with muscular, osteous, neurological or cardio-respiratory disorders. We describe a patient with isolated hypophosphatemia, detail the mechanisms of phosphate homeostasis, and envisage the differential diagnosis of hypophosphatemia. Furthermore, we propose a sequential decisional algorithm based on basic biological tests and few complementary investigations. Treatment options are reviewed. [less ▲]

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See detailBiomarkers and physiolpathology in the cardiorenal syndrome
BOUQUEGNEAU, Antoine ULg; KRZESINSKI, Jean-Marie ULg; DELANAYE, Pierre ULg et al

in Clinica Chimica Acta (2015), 443

Acute cardiorenal syndrome (CRS) corresponds to an association of acute heart failure and a worsening of renal function. The detection of acute kidney injury (AKI) unfortunately occurs at a late stage of ... [more ▼]

Acute cardiorenal syndrome (CRS) corresponds to an association of acute heart failure and a worsening of renal function. The detection of acute kidney injury (AKI) unfortunately occurs at a late stage of CRS, leading to an increased mortality of the patients. In this review, we described the pathophysiology of CRS and discussed the potential interest of biochemical biomarkers (namely creatinine, cystatin C, NGAL, KIM-1, fatty acid binding protein, Nacetyl-β-D-glucosaminidase and IL-18) that could potentially help to detect AKI earlier and thus reduce the morbi-mortality of the patients suffering from CRS. [less ▲]

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See detailPlace de la vitamine D native en dialyse
DELANAYE, Pierre ULg; BOUQUEGNEAU, Antoine ULg; KRZESINSKI, Jean-Marie ULg et al

in Néphrologie & Thérapeutique (2015), 11(1), 5-15

Chronic kidney disease is frequent and usually responsible of mineral and bone disorder. These abnormalities lead to increased morbidity and mortality. To become active, native vitamin D needs a first ... [more ▼]

Chronic kidney disease is frequent and usually responsible of mineral and bone disorder. These abnormalities lead to increased morbidity and mortality. To become active, native vitamin D needs a first hydroxylation in the liver, and a second one in the kidney. Next to its action on bone metabolism, vitamin D also possesses pleiotropic actions on cardiovascular, immune and neurological systems as well as antineoplastic activities. End-stage renal disease (ESRD) is also associated with a decrease in vitamin D activity by mechanisms including the increase of plasma phosphate concentration, secretion of FGF- 23 and decrease in 1a-hydroxylase activity. The prevalence of 25 hydroxy-vitamin D deficiency depends on the chosen cut-off value to define this lack. Currently it is well established that a patient has to be substituted when 25 hydroxy-vitamin D level is under 30 ng/mL. The use and monitoring of 1.25 hydroxy-vitamin D is still not recommended in routine practice. The goals of vitamin D treatment in case of ESRD are to substitute the deficiency and to prevent or treat hyperparathyroidism. Interest of native vitamin D in first intention is now well demonstrated. This review article describes the vitamin D metabolism and physiology and also the treatment for vitamin D deficiency in ESRD population. [less ▲]

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See detailActivation of the calcium-sensing receptor before renal ischemia/reperfusion exacerbates kidney injury
WEEKERS, Laurent ULg; De Tullio, Pascal ULg; BOVY, Christophe ULg et al

in American Journal of Translational Research (2015), 7(1), 128-138

Activation of the calcium-sensing receptor (CaSR) by ischemia/reperfusion (I/R) favours apoptosis in cardiomyocytes, hepatocytes and neurons. Its role in renal I/R is unknown. We investigated the impact ... [more ▼]

Activation of the calcium-sensing receptor (CaSR) by ischemia/reperfusion (I/R) favours apoptosis in cardiomyocytes, hepatocytes and neurons. Its role in renal I/R is unknown. We investigated the impact of pharmacological preactivation of the CaSR on kidney structure and function in a murine model of bilateral renal 30-min ischemia and 48-hour reperfusion, and in a 6-year cohort of kidney transplant recipients (KTR). C57BL/6J mice were administered daily with CaSR agonist, R-568, or with vehicle for 48 hours. Evaluation of serum urea and creatinine levels, renal histology and urine metabolome by nuclear magnetic resonance showed that R-568 was not nephrotoxic per se. Following I/R, serum urea and creatinine levels increased higher in R-568-treated animals than in controls. Jablonski’s score was significantly greater in R-568-treated kidneys, which showed a higher rate of cell proliferation and apoptosis in comparison to controls. Next, we retrospectively identified 36 patients (10.7% of our cohort) who were treated by CaSR agonist, cinacalcet, at the time of kidney transplantation (KTx). After matching these to 61 KTR upon type of donor, cold ischemic time, residual diuresis, and donor age, we observed that delayed graft function, i.e. need for dialysis in the first week after KTx, occurred in 42 and 23% of cinacalcet-treated and control groups, respectively (p≤0.05). These data suggest that pharmacological preactivation of the CaSR before renal I/R exacerbates kidney injury. [less ▲]

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