References of "KRZESINSKI, Jean-Marie"
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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 (in press)

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 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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See detailCinacalcet treatment at the time of transplantation is associated with a significant risk of delayed graft function in kidney transplant recipients
Jouret, François ULg; WEEKERS, Laurent ULg; GROSCH, Stéphanie ULg et al

in Transplant International (2014, May), 27(S1), 167

The calcium-sensing receptor (CaSR) has been implicated in the ischemia/ reperfusion (I/R) cascade in heart, liver and brain. Renal I/R occurs at the time of transplantation (Tx), with a deleterious ... [more ▼]

The calcium-sensing receptor (CaSR) has been implicated in the ischemia/ reperfusion (I/R) cascade in heart, liver and brain. Renal I/R occurs at the time of transplantation (Tx), with a deleterious impact on early graft function. Here, we retrospectively investigated if the use of cinacalcet, a CaSR agonist, in kidney transplant recipients (KTR) influences early graft recovery. All KTR from 2007 to 2012 in our Academic Hospital were prospectively included in a database. Patients actively treated with cinacalcet on the day of Tx were retrospectively identified from this database and matched with controls on (i) type of donor (living [LD], deceased after brain or circulatory death [DCD]); (ii) cold ischemic time (CIT) ` 1 h; (iii) residual diuresis (` 500 ml); and (iv) donor age (` 5 years). Delayed graft function (DGF) was defined as dialysis requirement after Tx. Baseline characteristics were compared between groups with student’s t-test or Chi-2 as appropriate. The endpoint was the percentage of DGF in both groups. Among 337 KTR, 36 (10.7%) were treated with cinacalcet at Tx. Control group included 61 patients. Characteristics of patients and donors are summarized in the table. DGF occurred in 42 and 23% of cinacalcet-treated and control groups, respectively (p = 0.05). These retro- spective observations suggest that CaSR activation at the time of Tx impairs early graft recovery. [less ▲]

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See detailComportements à risque et maladies cardio-vasculaires. Comment infléchir le cours des choses?
Etienne, Anne-Marie ULg; Krzesinski, Jean-Marie ULg; André, Jean-François

Scientific conference (2014, April 01)

«Comportements à risques et maladies cardio-vasculaires, comment infléchir le cours des choses ?» Entre recommandations, croyances et attitudes des médecins, croyances, attitudes et vécu des patients ... [more ▼]

«Comportements à risques et maladies cardio-vasculaires, comment infléchir le cours des choses ?» Entre recommandations, croyances et attitudes des médecins, croyances, attitudes et vécu des patients, comment améliorer la prévention dans le domaine cardio-vasculaire ? [less ▲]

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See detailComportements à risques et maladies cardio-vasculaires, comment infléchir le cours des choses?
Krzesinski, Jean-Marie ULg; andre, Jean-François

Conference (2014, April 01)

Entre recommandations, croyances et attitudes des médecins, croyances, attitudes et vécu des patients, comment améliorer la prévention dans le domaine cardio-vasculaire?

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See detailTraitement antihypertenseur : quelles sont les meilleures associations?
Krzesinski, Jean-Marie ULg

Conference (2014, February 22)

Stratégie du traitement de l’HTA en 2014: toujours basée sur le calcul du risque CV. L’HTA, tueur silencieux, est généralement associée à de nombreux autres facteurs de risque CV. Il faut préciser le ... [more ▼]

Stratégie du traitement de l’HTA en 2014: toujours basée sur le calcul du risque CV. L’HTA, tueur silencieux, est généralement associée à de nombreux autres facteurs de risque CV. Il faut préciser le niveau de risque CV en tenant compte de la valeur de PA et des autres F.R. pour décider le moment et le type de traitement ! [less ▲]

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See detailDetection of decreased glomerular filtration rate in intensive care units: serum cystatin C versus serum creatinine
DELANAYE, Pierre ULg; CAVALIER, Etienne ULg; Morel, Jérôme et al

in BMC Nephrology (2014), 15(9), 1471-2369

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See detailScreening, early diagnosis, genetic markers, and predictors of diabetic nephropathy
Cohen, Eric P.; Krzesinski, Jean-Marie ULg

in Lerna, Edgar V.; Batuman, Vecihi (Eds.) Diabetes and kidney disease (2014)

Kidney disease in diabetes greatly diminishes quality and quantity of life, and is very expensive. Focused attention to the early stages of diabetic nephropathy is urgently needed, to define better ... [more ▼]

Kidney disease in diabetes greatly diminishes quality and quantity of life, and is very expensive. Focused attention to the early stages of diabetic nephropathy is urgently needed, to define better thérapies that may slow it down or even stop its progression, thus reducing its heavy burden. This chapter will address screening, early diagnosis, genetic markers, and predictors of diabetic nephropathy. [less ▲]

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See detailTwo novel mutations of the CLDN16 gene cause familial hypomagnesaemia with hypercalciuria and nephrocalcinosis
Hanssen, Oriane ULg; CASTERMANS, Emilie ULg; BOVY, Christophe ULg et al

in Clinical Kidney Journal (2014), 7

Familial hypomagnesaemia with hypercalciuria and nephrocalcinosis is an autosomal-recessive disease caused by mutations in the CLDN16 or CLDN19 genes, which encode tight junction-associated proteins ... [more ▼]

Familial hypomagnesaemia with hypercalciuria and nephrocalcinosis is an autosomal-recessive disease caused by mutations in the CLDN16 or CLDN19 genes, which encode tight junction-associated proteins, claudin-16 and -19. The resultant tubulopathy leads to urinary loss of Mg2+ and Ca2+, with subsequent nephrocalcinosis and end-stage renal disease (ESRD). An 18-year-old boy presented with chronic kidney disease and proteinuria, as well as hypomagnesaemia, hypercalciuria and nephrocalcinosis. A kidney biopsy revealed tubular atrophy, interstitial fibrosis and segmental sclerosis of some glomeruli. Two novel mutations in the CLDN16 gene were identified: c.340C>T (nonsense) and c.427+5G>A (splice site). The patient reached ESRD at 23 and benefited from kidney transplantation. [less ▲]

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See detailMesenchymal stromal cell therapy in conditions of renal ischaemia/reperfusion.
Erpicum, Pauline; Detry, Olivier; Weekers, Laurent et al

in Nephrology Dialysis Transplantation (2014)

Acute kidney injury (AKI) represents a worldwide public health issue of increasing incidence, with a significant morbi-mortality. AKI treatment mostly relies on supportive manoeuvres in the absence of ... [more ▼]

Acute kidney injury (AKI) represents a worldwide public health issue of increasing incidence, with a significant morbi-mortality. AKI treatment mostly relies on supportive manoeuvres in the absence of specific target-oriented therapy. The pathophysiology of AKI commonly involves ischaemia/reperfusion (I/R) events, which cause both immune and metabolic consequences in renal tissue. Similarly, at the time of kidney transplantation (KT), I/R is an unavoidable event which contributes to early graft dysfunction and enhanced graft immunogenicity. Mesenchymal stromal cells (MSCs) represent a heterogeneous population of adult, fibroblast-like multi-potent cells characterized by their ability to differentiate into tissues of mesodermal lineages. Because MSC have demonstrated immunomodulatory, anti-inflammatory and tissue repair properties, MSC administration at the time of I/R and/or at later times has been hypothesized to attenuate AKI severity and to accelerate the regeneration process. Furthermore, MSC in KT could help prevent both I/R injury and acute rejection, thereby increasing graft function and survival. In this review, summarizing the encouraging observations in animal models and in pilot clinical trials, we outline the benefit of MSC therapy in AKI and KT, and envisage their putative role in renal ischaemic conditioning. [less ▲]

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See detailPrise en charge de l'hypertension. Nouvelles recommandations et objectifs à atteindre chez le diabétique (DT).
Krzesinski, Jean-Marie ULg

Scientific conference (2013, November 16)

La prise en charge de l’HTA chez le DT est importante car cette double pathologie expose à un risque majeur cardiovasculaire et rénal. L’approche doit être multifactorielle et globale. Pour l’HTA, la ... [more ▼]

La prise en charge de l’HTA chez le DT est importante car cette double pathologie expose à un risque majeur cardiovasculaire et rénal. L’approche doit être multifactorielle et globale. Pour l’HTA, la cible préconisée est actuellement de 140/85 mmHg mais on peut imaginer qu’un patient sans comorbidité puisse atteindre une cible plus basse. [less ▲]

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See detailModification of diet in renal disease versus chronic kidney disease epidemiology collaboration equation to estimate glomerular filtration rate in obese patients
BOUQUEGNEAU, Antoine ULg; Vidal-Petiot, Emanuelle; Vrtovsnik, François et al

in Nephrology Dialysis Transplantation (2013), 28(4), 122-130

Background Obesity is a recognized risk factor for both the development and progression of chronic kidney disease (CKD). Accurate estimation of glomerular filtration rate (GFR) is thus important in these ... [more ▼]

Background Obesity is a recognized risk factor for both the development and progression of chronic kidney disease (CKD). Accurate estimation of glomerular filtration rate (GFR) is thus important in these patients. We tested the performances of two creatinine-based GFR estimates, the Modification of Diet in Renal Disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, in an obese population. Methods Patients with body mass index (BMI) > 30 kg/m2 were included. The reference method for measured GFR (mGFR) was 51Cr-EDTA (single-injection method, two blood samples at 120 and 240 min). Both indexed and non-indexed results were considered. Serum creatinine was measured using the IDMS-traceable compensated Jaffe method. Mean bias (eGFR–mGFR), precision (SD around the bias) and accuracy within 30% (percentage of estimations within 30% of mGFR) were calculated for both equations. Results The population included 366 patients (185 women) from two different areas. Mean age was 55 ± 14 years, and mean BMI was 36 ± 7 kg/m2. Mean mGFR was 56 ± 26 mL/min/1.73 m2 (71 ± 35 mL/min without indexation). In the total population, mean bias was +1.9 ± 14.3 and +4.6 ± 14.7 mL/min/1.73 m2 (P < 0.05), and accuracy 30% was 80 and 76% for the MDRD and CKD-EPI equations (P < 0.05), respectively. In patients with mGFR > 60 mL/min/1.73 m2, mean bias was +4.6 ± 18.4 and +9.3 ± 17.2 mL/min/1.73 m2 (P < 0.05), and accuracy 30% was 81 and 79% (NS) for the MDRD and CKD-EPI equations, respectively. Conclusions The CKD-EPI equation did not outperform the MDRD study equation in this population of obese patients [less ▲]

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See detailBlood pressure dipping and arterial stiffness in kidney transplant recipients
XHIGNESSE, Patricia ULg; Saint-Remy, Annie ULg; BONVOISIN, Catherine ULg et al

Conference (2013, October 05)

In 70 kidney transplant recipients, nocturnal blood pressure(BP) nondipping (nondipping or reversed rhythm) was highly frequent (48% were nondippers and 29% had a reversed rhythm). When compared dippers ... [more ▼]

In 70 kidney transplant recipients, nocturnal blood pressure(BP) nondipping (nondipping or reversed rhythm) was highly frequent (48% were nondippers and 29% had a reversed rhythm). When compared dippers, nondippers and reversed, neither BMI, time on hemodialysis, graft survival, eGFR or antihypertensive drugs allowed to distinct the three groups. Pulse Wave Velocity (PWV) did not differ between groups but calcification score and ambulatory arterial stiffness index (AASI) were significantly the highest in récipients with reversed rhythm. That was also the case in nondippers recipients. [less ▲]

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See detailComment concilier médecine factuelle et médecine personnalisée en pratique clinique
Krzesinski, Jean-Marie ULg

Conference (2013, October 01)

Médecine factuelle (EBM) et médecine personnalisée : définition, avantages et limites. Cas cliniques exemplatifs dans l'HTA

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See detail« Quoi de neuf pour la prise en charge de l’hypertension artérielle en 2013 ? » Nouvelles directives des Sociétés Européennes d’Hypertension et de Cardiologie.
XHIGNESSE, Patricia ULg; Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2013), 68(10), 511-520

The 2013 guidelines for arterial hypertension have just been released by the European Societies of Cardiology and Hypertension. As already discussed in earlier versions, the decision to treat must be ... [more ▼]

The 2013 guidelines for arterial hypertension have just been released by the European Societies of Cardiology and Hypertension. As already discussed in earlier versions, the decision to treat must be based on the assessment of the cardiovascular risk. The value of out-of-the office blood pressure measurements to confirm the diagnosis of hypertension is underlined and the authors stress the need for a close follow up of non pharmacological therapeutic measures. A novelty, however, consists in the simplification of the blood pressure target under treatment, which must be < 140/90 mmHg in the vast majority of patients, except for octogenerians whose systolic blood pressure target should be < 150 mmHg. For resistant hypertension, renal denervation and carotid baroreceptor stimulation are proposed as new invasive modes of therapy; their clinical values, however, remain to be confirmed. [less ▲]

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