References of "KRZESINSKI, Jean-Marie"
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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 (2016), 29(1), 99-103

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 detailComparable transplant outcomes between DBD and DCD kidney grafts up to 5 years post-transplant: single centre experience
Ledinh, H; DETRY, Olivier ULg; DE ROOVER, Arnaud ULg et al

in Transplant International (2015, November), 28(S4), 193-194188

Introduction: This study aimed to determine the most recent results of kidney transplantation (KT) from donation after brain death (DBD) and circulatory death (DCD). Primary endpoints were graft and ... [more ▼]

Introduction: This study aimed to determine the most recent results of kidney transplantation (KT) from donation after brain death (DBD) and circulatory death (DCD). Primary endpoints were graft and patient survival, and graft function. Acute rejection and post-operative complications were assessed as secondary endpoints. Patient and Methods: This retrospective mono-center review consisted of 226 DBD- and 104 DCD-KT between 2008 and 2014. Results: Graft survival was comparable between two groups (95.1 vs. 91.1% at 1 year, 92.8 vs. 91.1% at 3 years and 89.2 vs. 91.1% at 5 years). 46% and 40% of graft loss were attributed to patient death with a functioning graft and rejection. Patient survival was comparable between 2 groups (97.8 vs. 95.1% at 1 year, 94.1 vs. 91.2% at 3 years, and 89.6 vs. 82.3% at five years). Etiology of patient death included cardiac arrest (16.7%), infection (16.7%), cancer (13.3%), and unknown cause (46.7%). Delayed graft function occurred in 14.6% of DBD- and 30.8% of DCD-KT (p = 0.001). Primary non function was encountered in 2.6% DBD- and 4.8% DCD-KT (p = ns). Graft function was worse in DCD than DBD up to 3 months post-transplant (p = 0.034), however, no difference existed afterwards. Biopsy-proven acute rejection was found in 12.8% and 13.5% of DBD- and DCD-KT during an average 3 months post- transplant (p = ns). This rate was 7.1% vs. 8.9% on surveillance biopsy performed between 3 and 6 months post-transplant (p = ns). Post-operativecomplication rate was comparable between 2 groups, concerning patient death, reoperation, transfusion, perirenal hematoma, macroscopic hematuria, urinary obstruction, wound problem, and infection. Nevertheless, contamination of preservation solution occurred more commonly in DCD than DBD (0.4% vs. 3.8%, p = 0.036). Conclusions: Despite worse early graft function, DCD-KT was not inferior to that originating from DBD up to 5 years post-transplant, therefore deserves to be used. [less ▲]

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See detailImpact of timing administration of mesenchymal stromal cells on serum creatinine following renal ischemia/ reperfusion in rats
ERPICUM, Pauline ULg; Rowart, Pascal ULg; POMA, Laurence ULg et al

in Transplant International (2015, November), 28(S4), 1129

Experimental models of renal ischemia/reperfusion (I/R) have suggested protective effects of mesenchymal stromal cells (MSC) therapy. Still, param- eters of MSC injection, including volume, route and ... [more ▼]

Experimental models of renal ischemia/reperfusion (I/R) have suggested protective effects of mesenchymal stromal cells (MSC) therapy. Still, param- eters of MSC injection, including volume, route and timing of cell administration, remain largely debated. Particularly, MSC infusion in mouse has been shown to be beneficial “a priori” but deleterious “a posteriori” of renal I/R injury. In order to further investigate the influence of the timing of MSC administration, we used 10-week-old Lewis rats categorized in 4 groups. Groups 1 (MSC D-7, n = 10) and 2 (MSC D + 1, n = 7) received caudal i.v. injection of MSC (1.5 9 106 in 1 ml of saline) 7 days before or 1 day after renal I/R, respectively. Control groups 3 (saline D-7, n = 6) and 4 (saline D + 1, n = 6) received equal volume of saline at similar time points. Left renal ischemia (by clamping of the renal pedicle) lasted 45 min. Right nephrectomy was simultaneously performed. Blood sample was collected from inferior vena cava at 48 h post reperfusion. MSC phenotype was confirmed by FACS analysis. In groups 1 and 3, serum creatinine (SCr) reached 1.4 ` 0.7 versus 2.4 ` 0.8 mg/dl, respectively (p < 0.05). In groups 2 and 4, SCr was 4.9 ` 0.7 versus 3.3 ` 0.9 mg/dl, respectively (p < 0.001). Furthermore, SCr levels were statistically worse when MSC were administered after renal I/R in comparison to a priori infusion (p < 0.0001). In conclusion, MSC administration 7 days prior to renal I/R attenuates kidney injury in comparison to (i) saline infusion or (ii) MSC infusion 1 day after renal I/R. Conversely, on the basis of SCr levels, MSC therapy performed after renal I/R worsens kidney injury in rats. [less ▲]

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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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