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

Conference (2015, June 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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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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