  GFR Estimation Using Standardized Cystatin C in Kidney Transplant Recipients; ; et al in American Journal of Kidney Diseases (2013), 61(2), 279-284 Background: The utility of serum cystatin C (SCysC) as a filtration marker in kidney transplantation is uncertain. We took advantage of the recent validation of a reference calibrator for SCysC and of ... [more ▼] Background: The utility of serum cystatin C (SCysC) as a filtration marker in kidney transplantation is uncertain. We took advantage of the recent validation of a reference calibrator for SCysC and of newly developed CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equations (2012) expressed for use with standardized SCysC level to reassess the performance of SCysC as a filtration marker in kidney transplant recipients. Study Design: Study of diagnostic test accuracy. Setting & Participants: 670 kidney transplant recipients from 3 centers undergoing glomerular filtration rate (GFR) measurements from December 2006 to November 2012. Index Test: Estimated GFR (eGFR) using the 2012 SCysC-based and serum creatinine (SCr)/SCysCbased CKD-EPI equations (eGFRcys and eGFRcr-cys, respectively) and the 2009 SCr-based CKD-EPI equation (eGFRcr), with SCysC and SCr measured at a single laboratory between April 2011 and June 2011. Reference Test: Measured GFR (mGFR) using urinary clearance of inulin. Results: Bias (the difference between mGFR and eGFR) was significantly smaller for eGFRcys and eGFRcr-cys versus eGFRcr ( 2.82 and 0.54 vs 4.4 mL/min/1.73 m2, respectively; P 0.001). Precision (standard deviation of the mean bias) also was better for eGFRcys and eGFRcr-cys versus eGFRcr (12 and 11 vs 13 mL/min/1.73 m2 [P 0.001 for both comparisons]). Accuracy (percentage of GFR estimates within 30% of mGFR) was greater for eGFRcys and eGFRcr-cys versus eGFRcr (81% and 86% vs 75%, respectively [P 0.004 and P 0.001]). Net reclassification index with respect to mGFR of 30 mL/min/1.73 m2 for eGFRcr-cys and eGFRcys versus eGFRcr was 18.8% [95% CI, 8.6%-28.9%] and 22.5% [95% CI, 10.2%-34.9%]. Limitations: Patients were exclusively of European descent; association with transplant outcome was not evaluated. Conclusions: Our data validate the use of both the newly developed SCysC-based and SCr/SCysC-based CKD-EPI equations (2012) in kidney transplant recipients. Both equations perform better than the SCr-based CKD-EPI equation (2009). [less ▲] Detailed reference viewed: 13 (6 ULg) Le débit de filtration glomérulaire est-il un déterminant de la concentration plasmatique du NGAL aux soins intensifs ?DELANAYE, Pierre  ; ; et alPoster (2012) Detailed reference viewed: 14 (3 ULg)Detection of decreased glomerular filtration rate in intensive care units: interest of cystatin CDELANAYE, Pierre ; CAVALIER, Etienne ; et alPoster (2012) Detailed reference viewed: 15 (7 ULg) Trimethoprim, creatinine and creatinine-based equationsDELANAYE, Pierre ; CAVALIER, Etienne ; et alin Kidney International (2011), 80(5), 439-40 Co-trimoxazole is a frequently prescribed antibiotic worldwide. It is composed of both trimethoprim and sulfamethoxazol (Sfx) and is used in the treatment and prophylaxis of urinary tract and Pneumocystis ... [more ▼] Co-trimoxazole is a frequently prescribed antibiotic worldwide. It is composed of both trimethoprim and sulfamethoxazol (Sfx) and is used in the treatment and prophylaxis of urinary tract and Pneumocystis jirovecii infections. The Sfx component appears to be nephrotoxic at high doses or doses inappropriately adjusted for glomerular filtration rate (GFR). The trimethoprim component, even at recommended doses, inhibits tubular creatinine secretion, leading to a rapid but ultimately reversible increase in serum creatinine independent of any changes in GFR. This translates into a falsely low estimated GFR when creatinine-based equations are used. This review focuses on evidence of the differential effects of trimethoprim and Sfx on serum creatinine concentrations and GFR and their relevance to clinical practice, with particular attention to kidney transplantation. [less ▲] Detailed reference viewed: 16 (5 ULg)Are the creatinine-based equations accurate to estimate glomerular filtration rate in african american populations ?DELANAYE, Pierre ; ; et alin Clinical Journal of the American Society of Nephrology (2011), 6 Regarding the high prevalence of African American patients with ESRD, it is important to estimate the prevalence of early stages of chronic kidney disease in this specific population. Because serum ... [more ▼] Regarding the high prevalence of African American patients with ESRD, it is important to estimate the prevalence of early stages of chronic kidney disease in this specific population. Because serum creatinine concentration is dependent on muscular mass, an ethnic factor has to be applied to creatinine-based equations. Such ethnic factors have been proposed in the Modification of Diet in Renal Disease (MDRD) study equation and in the more recent Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. This review analyzes how these correction factors have been developed and how they have, or have not, been validated in external populations. It will be demonstrated that the African American factor in the MDRD study equation is accurate in African American chronic kidney disease (CKD) patients. However, it will be shown that this factor is probably too high for subjects with a GFR of >60 ml/min per 1.73 m2, leading to an underestimation of the prevalence of CKD in the global African American population. It will also be confirmed that this ethnic factor is not accurate in African (non-American) subjects. Lastly, the lack of true external validation of the new CKD-EPI equations will be discussed. Additional trials seem necessary in American African and African populations to better estimate GFR and apprehend the true prevalence of CKD in this population with a high renal risk. [less ▲] Detailed reference viewed: 18 (5 ULg)Le dosage de l'inuline: mise au pointDELANAYE, Pierre ; ; et alin Annales de Biologie Clinique (2011), 69(3), 273-84 L’inuline, polymère de fructose, reste le marqueur de référence du débit de filtration glomérulaire (DFG). Popularisé par les études de Smith et Shannon, son dosage n’en demeure pas moins complexe et ... [more ▼] L’inuline, polymère de fructose, reste le marqueur de référence du débit de filtration glomérulaire (DFG). Popularisé par les études de Smith et Shannon, son dosage n’en demeure pas moins complexe et sujet à des interférences dont celle du glucose est la plus importante. Il existe deux grands types de dosages de l’inuline : les méthodes de dosage « acide » et enzymatiques. Le dosage « acide » consiste en un dosage colorimétrique du fructose obtenu après hydrolyse de l’inuline en milieu très acide. Le dosage du fructose englobe différentes méthodes de dosage dont la plus utilisée est la réaction à l’anthrone. Toutes ces méthodes présentent des interférences au glucose. Différentes méthodes « enzymatiques » ont été décrites au cours du temps. Celles-ci apparaissent plus précises et sans doute moins sujettes aux interférences même si peu d’études comparatives sont disponibles. Plusieurs auteurs ont également développé des dosages de type CLHP. Cette méthode spécifique et précise demeure cependant moins adaptée à la routine. Ainsi, si l’utilisation de l’inuline comme marqueur de référence n’est pas remise en cause, son dosage reste délicat, sujet aux interférences et à une certaine interprétation. Des études supplémentaires restent nécessaires pour valider analytiquement et comparativement les techniques de dosage de l’inuline. [less ▲] Detailed reference viewed: 56 (4 ULg) Exploration de la fonction glomérulaire rénale (I). Méthodes de référence et créatinine sérique.DELANAYE, Pierre ; ; et alBook published by EMC, Elsevier Masson SAS (2011) Detailed reference viewed: 17 (6 ULg)La creatinine : d'hier a aujourd'hui.Delanaye, Pierre ; Cavalier, Etienne ; et alin Annales de Biologie Clinique (2010), 68(5), 531-43 Serum creatinine is certainly one of the most prescribed biological parameters. In this review article, we remind some historical data regarding creatinine. Different methodologies to measure creatinine ... [more ▼] Serum creatinine is certainly one of the most prescribed biological parameters. In this review article, we remind some historical data regarding creatinine. Different methodologies to measure creatinine in blood and urine are deeply described. We also discuss the physiological reason for its use as a glomerular filtration rate marker. However, analytical and physiological limitations are described and discussed. Creatinine clearance usefulness is finally largely discussed. [less ▲] Detailed reference viewed: 52 (4 ULg)Prevalence of Chronic Kidney Disease in an Elderly Population: Impact of the Choice of the Equation Used for Estimating GFR; Cavalier, Etienne ; et alPoster (2009, October) Detailed reference viewed: 17 (6 ULg)Détection et estimation du niveau de la maladie rénale chroniqueDelanaye, Pierre ; Cavalier, Etienne ; et alin Revue Médicale de Liège (2009), 64(2), 73-78 L’insuffisance rénale voit son incidence augmenter. Un diagnostic précoce et précis est requis. Le diagnostic de l’insuffisance rénale repose sur la mesure du débit de filtration glomérulaire. Les ... [more ▼] L’insuffisance rénale voit son incidence augmenter. Un diagnostic précoce et précis est requis. Le diagnostic de l’insuffisance rénale repose sur la mesure du débit de filtration glomérulaire. Les formules basées sur la créatinine pour déterminer ce débit ont, par rapport à la créatinine sérique seule, apporté un plus mais, dans certaines situations, elles fournissent des résultats erronés. Le recours à la mesure de la clairance de créatinine sur une récolte d’urines de 24 heures peut être, dans ces situations où les caractéristiques anthropométriques sont hors normes, utile, mais avec toujours la difficulté d’une récolte minutée correcte. Si une mesure précise du débit de filtration glomérulaire est absolument nécessaire, une méthode de référence doit être choisie telle celle au chrome EDTA ou à l’iohexol. Enfin, tout bilan néphrologique doit, outre le dosage de créatinine, comprendre au moins une analyse d’urine à la tigette. Toute positivité pour la protéinurie lors de ce test mérite de réaliser un dosage quantitatif de la protéinurie soit sur 24 heures, soit plus aisément sur un échantillon [less ▲] Detailed reference viewed: 105 (19 ULg)On the demanding necessity of properly evaluating renal graft function in clinical trials.; ; et al in Transplant International (2009), 22(2), 247-8 Detailed reference viewed: 41 (8 ULg)Creatinine calibration in NHANES: is a revised MDRD study formula needed?Delanaye, Pierre ; Cavalier, Etienne ; et alin American Journal of Kidney Diseases (2008), 51(4), 709709-10 Detailed reference viewed: 28 (2 ULg) |
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