References of "Delanaye, Pierre"
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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 (in press)

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 detailL'éveil de la matrix-gla-protéine sonnera le glas des calcifications vasculaires
DELANAYE, Pierre ULg; Liabeuf, Sophie; BOUQUEGNEAU, Antoine ULg et al

in Néphrologie & Thérapeutique (in press)

La matrix-gla-protéine (MGP) est principalement sécrétée par les chondrocytes et les cellules musculaires lisses des parois vasculaires. Son rôle est d’inhiber localement le développement des ... [more ▼]

La matrix-gla-protéine (MGP) est principalement sécrétée par les chondrocytes et les cellules musculaires lisses des parois vasculaires. Son rôle est d’inhiber localement le développement des calcifications vasculaires. MGP doit bénéficier de deux processus post-transcriptionnels avant d’être pleinement active : une phosphorylation de résidus sérine et une carboxylation de résidus glutamate. Cette carboxylation ne peut se faire qu’en présence de quantité suffisante de vitamine K. Plusieurs formes de MGP circulent donc dans le plasma, certaines étant totalement inactives (la MGP déphosphorylée et décarboxylée), d’autres possédant une activité biologique variable en fonction du nombre de sites carboxylés ou phosphorylés. Il existe un lien théorique étroit entre MGP, vitamine K, calcifications vasculaires et maladies cardiovasculaires et ce, particulièrement chez les patients souffrant d’insuffisance rénale chronique, a fortiori s’ils sont dialysés. Si l’existence de ce lien a été démontrée via de nombreuses et solides données fondamentales, les données cliniques restent, à ce jour, observationnelles et doivent donc être interprétées avec prudence. Mesurer une fraction de MGP dans le plasma pour estimer le degré de calcification d’un patient donné n’est pas encore d’actualité . La forme inactive pourrait être utile pour juger des réserves en vitamine K au niveau vasculaire. Dans cet article de revue, nous reviendrons sur les bases théoriques du rôle de MGP dans le processus de calcification vasculaire, sur le défi analytique que représente sa détermination dans le plasma, ainsi que sur les liens entre MGP, vitamine K et calcifications vasculaires en population géne´ rale et chez les patients insuffisants rénaux. [less ▲]

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See detailKDIGO Guidelines and Kidney Transplantation: Is the cystatin-C Based Recommendation relevant?
Masson, I; Maillard, N; CAVALIER, Etienne ULg et al

in American Journal of Transplantation (in press)

The KDIGO guidelines propose a new approach to diagnose chronic kidney disease (CKD) based on estimated glomerular ®ltration rate (GFR). In patients with a GFR value comprised between 45 and 59 mL/ min/1 ... [more ▼]

The KDIGO guidelines propose a new approach to diagnose chronic kidney disease (CKD) based on estimated glomerular ®ltration rate (GFR). In patients with a GFR value comprised between 45 and 59 mL/ min/1.73m2 as estimated by the CKD-EPI creatinine equation (eGFRcreat), it is suggested to con®rm the diagnosis with a second estimation using the CKD-EPI cystatin C-based equations (eGFRcys/eGFRcreat-cys). We sought to determine whether this new diagnostic strategy might extend to kidney transplant recipients (KTR) and help to identify those with decreased GFR. In 670 KTR for whom a measured GFR was available, we simulated the detection of CKD using the two-steps approach recommended by the guidelines in comparison to the conventional approach relying on creatinine equation. One hundred forty-®ve patients with no albuminuria had eGFRcreat between 45 and 59 mL/ min/1.73m2. Among them, 23% had inulin clearance over 60 mL/min/1.73m2 and were thus incorrectly classi®ed as CKD patients. When applying the Kidney Disease: Improving Global Outcomes (KDIGO) strategy, 138 patients were con®rmed as having a GFR below 60 mL/min with eGFRcreat-cys. However, 21% of them were misclassi®ed in reference to measured GFR. Our data do no not support the use of cystatin C as a con®rmatory test of stage 3A CKD in KTR. [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 detailVascular calcification: from pathophysiology to biomarkers
EVRARD, Séverine ULg; DELANAYE, Pierre ULg; Kamel, S et al

in Clinica Chimica Acta (2015), 438

The link between vascular calcification (VC) and increased mortality is now well established. Over time, as clinical importance of this phenomenon has begun to be fully considered, scientists have ... [more ▼]

The link between vascular calcification (VC) and increased mortality is now well established. Over time, as clinical importance of this phenomenon has begun to be fully considered, scientists have highlightedmore and more physiopathological mechanisms and signaling pathways that underlie VC. Several conditions such as diabetes, dyslipidemia and renal diseases are undoubtedly identified as predisposing factors. But even if the process is better understood,many questions still remain unanswered. This reviewbriefly develops the various theories that attempt to explain mineralization genesis. Nonetheless, the main purpose of the article is to provide a profile of the various existing biomarkers of VC. Indeed, in the past years, a lot of inhibitors and promoters, which form a dense and interconnected network, were identified. Given importance to assess and control mineralization process, a focusing on accumulated knowledge of each marker seemed to be necessary. Therefore, we tried to define their respective role in the physiopathology and how they can contribute to calcification risk assessment. Among these, Klotho/fibroblast growth factor-23, fetuin-A, Matrix Gla protein, Bone morphogenetic protein-2, osteoprotegerin, osteopontin, osteonectin, osteocalcin, pyrophosphate and sclerostin are specifically discussed. [less ▲]

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See detailAbnormal glomerular filtration rate in children, adolescents and young adults starts below 75 mL/min/1.73 m2
Pottel, Hans; Hoste, Liesbeth; DELANAYE, Pierre ULg

in Pediatric Nephrology : Journal of the International Pediatric Nephrology Association (2015), 30(5), 821-828

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See detailSystematic Analysis of two cystatin C assays using samples of 2057 older adults - The Berlin initiative study
Ebert, natalie; DELANAYE, Pierre ULg; Martus, Peter et al

Poster (2014, November)

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See detailImpact of the dialysis membrane on the Vitamin D metabolims markers
CAVALIER, Etienne ULg; DUBOIS, Bernard ULg; Urena, Pablo et al

Poster (2014, November)

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See detailCalibration and precision of serum creatinine and plasma cystatin C measurement: impact on the estimation of glomerular filtration rate
DELANAYE, Pierre ULg; CAVALIER, Etienne ULg; Cristol, Jean-Paul et al

in Journal of Nephrology (2014), 27(5), 467-75

Serum creatinine (SCr) is the main variable for estimating glomerular filtration rate (GFR). Due to interassay differences, the prevalence of chronic kidney disease (CKD) varies according to the assay ... [more ▼]

Serum creatinine (SCr) is the main variable for estimating glomerular filtration rate (GFR). Due to interassay differences, the prevalence of chronic kidney disease (CKD) varies according to the assay used, and calibration standardization is necessary. For SCr, isotope dilution mass spectrometry (IDMS) is the gold standard. Systematic differences are observed between Jaffe and enzymatic methods. Manufacturers subtract 0.30 mg/dl from Jaffe results to match enzymatic results (‘compensated Jaffe method’). The analytical performance of enzymatic methods is superior to that of Jaffe methods. In the original Modification of Diet in Renal Disease (MDRD) equation, SCr was measured by a Jaffe Beckman assay, which was later recalibrated. A limitation of this equation was an underestimation of GFR in the high range. The Chronic Kidney Disease Epidemiology (CKD-EPI) consortium proposed an equation using calibrated and IDMS traceable SCr. The gain in performance was due to improving the bias whereas the precision was comparable. The CKD-EPI equation performs better at high GFR levels (GFR[60 ml/ min/1.73 m2). Analytical limitations have led to the recommendation to give a grade ([60 ml/min/1.73 m2) rather than an absolute value with the MDRD equation. By using both enzymatic and calibrated methods, this cutoff-grade could be increased to 90 ml/min/1.73 m2 (with MDRD) and 120 ml/min/1.73 m2 (with CKD-EPI). The superiority of the CKD-EPI equation over MDRD is analytical, but the precision gain is limited. IDMS traceable enzymatic methods have been used in the development of the Lund– Malmo¨ (in CKD populations) and Berlin Initiative Study equations (in the elderly). The analytical errors for cystatin C are grossly comparable to issues found with SCr. Standardization is available since 2011. A reference method for cystatin C is still lacking. Equations based on standardized cystatin C or cystatin C and creatinine have been proposed. The better performance of these equations (especially the combined CKD-EPI equation) has been demonstrated. [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 detailStandardization of DiaSorin and Roche automated third generation PTH assays with an international standard: impact on clinical populations
CAVALIER, Etienne ULg; DELANAYE, Pierre ULg; LUKAS, Pierre ULg et al

in Clinical Chemistry & Laboratory Medicine (2014), 52(8), 1137-41

Background: Standardization of parathyroid hormone (PTH) assays is a major issue, especially in hemodialyzed (HD) patients. Two automated third generation PTH assays (Roche Elecsys and DiaSorin Liaison ... [more ▼]

Background: Standardization of parathyroid hormone (PTH) assays is a major issue, especially in hemodialyzed (HD) patients. Two automated third generation PTH assays (Roche Elecsys and DiaSorin Liaison) are now available. These assays are specific for the (1-84) PTH and do not cross-react with the (7-84) fragment, contrary to second generation (intact) assays. We aimed to calibrate the two methods against the WHO International PTH Standard (IS) 95/646 to see if the two assays could provide comparable results in a population of healthy subjects, HD patients and patients suffering from primary hyperparathyroidism (PHP). Methods: We selected 79 healthy subjects and two populations of patients presenting PTH disorders: 56 HD and 27 PHP patients. We reconstituted the IS in a pool of human serum containing undetectable levels of 1-84 PTH and prepared 13 serum standards ranging from 0 to 2000 pg/mL. The standards were run on the two instruments to calibrate the assays on the IS. The different populations were run before and after restandardization. Results: As these kits were differently calibrated, the results obtained after restandarization were significantly different. Restandardization process improved concordance between assays and, taking the analytical variability of the two kits into account, the results could be considered to be similar. Conclusions: Restandardization of automated third generation PTH assays with the WHO 1-84 PTH Standard significantly reduces inter-method variability. Reference ranges and raw values are totally transposable from one method to the other in healthy subjects, but also in diseased patients, e.g., with HD or those suffering from PHP. [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 detailCan we use circulating biomarkers to monitor bone turnover in CKD haemodialysis patients? Hypotheses and facts
DELANAYE, Pierre ULg; Souberbielle, Jean-Claude; Lafage-Proust, Marie-Hélène et al

in Nephrology Dialysis Transplantation (2014), 29(5), 997-1004

Assessing bone turnover is a key diagnostic tool in the global management of chronic kidney disease-mineral and bone disorder (CKD-MBD). Since bone biopsy is invasive and cannot be repeated in clinical ... [more ▼]

Assessing bone turnover is a key diagnostic tool in the global management of chronic kidney disease-mineral and bone disorder (CKD-MBD). Since bone biopsy is invasive and cannot be repeated in clinical practice and because bone histomorphometry is less available due to the lack of specialized laboratories, we will focus on potential biomarkers used to assess and monitor bone turnover. After briefly reviewing the pathophysiology of bone turnover in CKD and haemodialysis patients, we will focus on the strengths and limitations of the now recommended biomarkers, i.e. parathormone and bone-specific alkaline phosphatase. We will consider the clinical and also the biological aspects of the topic and also insist on the use of these biomarkers for the monitoring, and the follow-up of the turnover in haemodialysis subjects. Finally, we will discuss some of the most promising, but still not recommended, emerging biomarkers. [less ▲]

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