References of "Saint-Remy, Annie"
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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 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 detailMasked hypertension is associated with a high cardiovascular risk in hypertensive kidney transplant recipients
XHIGNESSE, Patricia ULg; Saint-Remy, Annie ULg; BONVOISIN, Catherine ULg et al

Poster (2013, June 16)

Objective: High blood pressure (BP) is a major risk factor for graft function in kidney transplant recipients (KTs) Our aim was to evaluate BP control in the office, but also in the ambulatory and home ... [more ▼]

Objective: High blood pressure (BP) is a major risk factor for graft function in kidney transplant recipients (KTs) Our aim was to evaluate BP control in the office, but also in the ambulatory and home settings, in stable KTs, ali treated for hypertension, and to characterize patients with masked hypertension (MHT). Design and Method: Three BP measurement techniques were used in 70 late KT patients, (mean age 56.5 years; 43 males): ambulatory BP monitoring (ABPM-Spacelab 90207) office (OBP) and home BP monitoring (HBPM)- (OMRON M6). Carotid­ femoral pulse wave velocity was measured (Sphygmocor) as weil as a calcification score (arteries) and the systolic ankle brachial index (ABI) as recommended. The period since transplantation was 6.9±6.6 years, the mean GFR was 65.6±24±ml/min, Body Mass Index was 25.8±4.7 kg/m2 and the number of antihypertensive drug was 2.1±1 pills/d. Results: Uncontrolled hypertension (HTN) remained frequent in our treated population, 46 % were still hypertensive in the office, 39% using ABPM and 43% with HBPM. The proportion of MHT was 22% whatever the out-of-clinic method used, with more males, more overweight (BMI between, 25-30). lnterestingly when compared with controlled KTs (i.e both OBP and Daytime ABP controlled or both OBP and HBP controlled), using either ABPM or Home BP, patients with MHT had significantly higher PWV, a higher aortic augmentation pressure (AP), a higher calcification score and a higher ABI. However we did not find any significant impact of graft survival, immunosuppressive drugs, smoking habits, diabetes, or alcohol use. Conclusion: A high percentage of uncontrolled HTN was noted by OBP, but also by ABPM and HBPM despite antihypertensive treatment. MHT was frequently observed in KTs. This particular HT subtype, either defined by OBP vs ABPM or by OBP vs HBP, was significantly associated with major markers of arterial stiffness. So, MHT is associated with a high cardiovascular (cv) risk and therefore has to be manage to reduce incidence of cv events and graft loss. [less ▲]

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See detailPeritoneal equilibration test with conventional ‘low pH/high glucose degradation product’ or with biocompatible ‘normal pH/low glucose degradation product’ dialysates: does it matter?
VAN OVERMEIRE, Lionel ULg; Goffin, Eric; Krzesinski, Jean-Marie ULg et al

in Nephrology Dialysis Transplantation (2013)

Abstract Background. The evaluation of the peritoneal transport characteristics is mandatory in peritoneal dialysis (PD) patients. This is usually performed in routine clinical practice with a peritoneal ... [more ▼]

Abstract Background. The evaluation of the peritoneal transport characteristics is mandatory in peritoneal dialysis (PD) patients. This is usually performed in routine clinical practice with a peritoneal equilibration test (PET) using conventional dialysates, with low pH and high glucose degradation product (GDP) concentrations. An increasing proportion of patients are now treated with biocompatible dialysates, i.e. with physiological pH and lower GDP concentrations. This questions the appropriateness to perform a PET with conventional solutions in those patients. The aim of our study is to compare the results of the PET using biocompatible and conventional dialysates, respectively. Methods. Nineteen stable PD patients (13 males, 6 females; mean age: 67.95 ± 2.36 years, mean body surface area: 1.83 ± 0.04 m2, dialysis vintage: 2.95 ± 0.19 years) were included, among which 10 were usually treated with biocompatible and 9 with conventional solutions. Two PETs were performed, within a 2-week interval, in each patient. PET sequence (conventional solution first or biocompatible solution first) was randomized in order to avoid ‘time bias’. Small (urea, creatinine and glucose), middle (beta-2-microglobulin) and large molecules’ (albumin and alpha-2-macroglobulin) dialysate/plasma (D/P) concentration ratios and clearances were measured during each PET. Ultrafiltration (UF) and sodium filtration were also recorded. Results of both tests were compared by the Wilcoxon paired test. Results. No statistical difference was found between both dialysates for small molecule transport rates or for sodium filtration and UF. However, a few patients were not similarly classified for small-solute transport characteristics within the PET categories. Beta-2-microglobulin and albumin D/P ratios at different time points of the PET were significantly higher with the biocompatible, when compared with the conventional, solutions: 0.10 ± 0.03 versus 0.08 ± 0.02 (P < 0.01) and 0.008 ± 0.003 versus 0.007 ± 0.003 (P = 0.01), respectively. A similar difference was also observed for beta-2-microglobulin that was higher with biocompatible dialysates (1.04 ± 0.32 versus 0.93 ± 0.32 mL/min, respectively). Conclusion. Peritoneal transport of water and small solutes is independent of the type of dialysate which is used. This is not the case for the transport of beta-2-microglobulin and albumin that is higher under biocompatible dialysates. Vascular tonus modification could potentially explain such differences. The PET should therefore always be carried out with the same dialysate to make longitudinal comparisons possible. [less ▲]

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See detailUrinary and dietary sodium and potassium associated with blood pressure control in treated hypertensive kidney transplant recipients: an observational study
Saint-Remy, Annie ULg; SOMJA, Mélanie ULg; Gellner, Karen et al

in BMC Nephrology (2012), 13

Background In kidney transplant (Kt) recipients, hypertension is a major risk for cardiovascular complications but also for graft failure. Blood pressure (BP) control is therefore mandatory. Office BP ... [more ▼]

Background In kidney transplant (Kt) recipients, hypertension is a major risk for cardiovascular complications but also for graft failure. Blood pressure (BP) control is therefore mandatory. Office BP (OBP) remains frequently used for clinical decisions, however home BP (HBP) have brought a significant improvement in the BP control. Sodium is a modifiable risk factor, many studies accounted for a decrease of BP with a sodium restricted diet. Increased potassium intake has been also recommended in hypertension management. Using an agreement between office and home BP, the present study investigated the relations between the BP control in Kt recipients and their urinary excretion and dietary consumption of sodium and potassium. Methods The BP control defined by OBP <140/90 mmHg and HBP <135/85 mmHg was tested in 70 Kt recipients (mean age 56 +/- 11.5 years; mean graft survival 7 +/- 6.6 years) treated with antihypertensive medications. OBP and HBP were measured with a validated oscillometric device (Omron M6(R)). The 24-hour urinary sodium (Na+) and potassium (K+) excretions as well as dietary intakes were compared between controlled and uncontrolled (in office and at home) recipients. Non parametric Wilcoxon Mann--Whitney Test was used for between groups comparisons and Fisher's exact test for frequencies comparisons. Pearson correlation coefficients and paired t-test were used when sample size was >30. Results Using an agreement between OBP and HBP, we identified controlled (21%) and uncontrolled recipients (49%). Major confounding effects susceptible to interfere with the BP regulation did not differ between groups, the amounts of sodium excretion were similar (154 +/- 93 vs 162 +/- 88 mmol/24 h) but uncontrolled patients excreted less potassium (68 +/- 14 vs 54 +/- 20 mmol/24 h; P = 0.029) and had significantly lower potassium intakes (3279 +/- 753 vs 2208 +/- 720 mg/24 h; P = 0.009), associated with a higher urinary Na+/K + ratio. Systolic HBP was inversely and significantly correlated to urinary potassium (r = -0.48; P = 0.002), a positive but non significant relation was observed with urinary sodium (r = 0,30;P = 0.074). Conclusions Half of the treated hypertensive Kt recipients remained uncontrolled in office and at home. Restoring a well-balanced sodium/potassium ratio intakes could be a non pharmacological opportunity to improve blood pressure control. [less ▲]

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See detailComment je mesure la pression artérielle au cabinet
Krzesinski, Jean-Marie ULg; Saint-Remy, Annie ULg

in Revue Médicale de Liège (2012), 67(9), 492-498

Routinely measuring blood pressure is still performed according to the auscultatory method using recognition of Korotkoff sounds. This usual technique is, however, often mishandled and is thus a source of ... [more ▼]

Routinely measuring blood pressure is still performed according to the auscultatory method using recognition of Korotkoff sounds. This usual technique is, however, often mishandled and is thus a source of error in the estimation of the true blood pressure level. Accuracy of such measure is, however, of paramount importance to be useful in daily medical practice. This methodology paper more specifically written for medical students recalls the essential principles of blood pressure measurement at the medical office, but also at home. [less ▲]

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See detailDietary and urinary excretion of sodium and potassium associated with blood pressure control in treated hypertensive kidney transplant patients
Saint-Remy, Annie ULg; SOMJA, Mélanie ULg; BONVOISIN, Catherine ULg et al

Conference (2012, April 26)

Abstract Background. In kidney transplant (kt) recipients , hypertension is a major risk for cardiovascular complications but also for graft failure. Blood pressure (BP) control is therefore mandatory ... [more ▼]

Abstract Background. In kidney transplant (kt) recipients , hypertension is a major risk for cardiovascular complications but also for graft failure. Blood pressure (BP) control is therefore mandatory. Office BP (OBP) remains the most frequently used for clinical decisions, however home BP (HBP) have brought a significant improvement in the BP control. Sodium is a modifiable risk factor, many studies accounted for a decrease of BP with a sodium restricted diet. Increased potassium intake has been also recommended in hypertension management. Using an agreement between office and home BP, the present study investigated the relations between the BP control in kt recipients and their urinary excretion and dietary consumption of sodium and potassium. Methods. The BP control defined by OBP <140/90 mmHg and HBP <135/85 mmHg was measured in 70 kt recipients (mean age 56 ± 11.5 years; mean graft survival 7 ± 6.6 years) treated with antihypertensive medications. OBP and HBP were measured with a validated oscillometric device (Omron M6â). 24-hour urinary sodium (Na+) and potassium (K+) excretion as well as dietary intakes (food recall) were compared between controlled and uncontrolled (in office and at home) recipients. Non parametric Wilcoxon Mann-Whitney Test was used for between groups comparisons and Fisher’s exact test for frequencies comparisons. Results. Using an agreement between OBP and HBP, we identified controlled (21%) and uncontrolled recipients (49%). Major confounding effects susceptible to interfere with the BP regulation did not differ between groups, the amounts of sodium excretion were similar (154 ± 93 vs 162 ± 88 mmol/24h) but uncontrolled patients excreted less potassium (68 ± 14 vs 54 ± 20 mmol/24h; P=0.029) and had significantly lower intakes (3279 ± 753 vs 2208 ± 720 mg/24h; P=0.009), resulting in a higher Na+/K+ ratio. Systolic HBP was inversely and significantly correlated to urinary potassium when age, BMI and urinary sodium were controlled (r= -0.46; P=0.002). When age, BMI and urinary potassium were controlled, a positive relation was observed with urinary sodium (P=0.042). Conclusions. Half of the treated hypertensive kt recipients remained uncontrolled in office and at home. Restoring a well-balanced sodium/potassium ratio intakes could be a non pharmacological opportunity to improve blood pressure control. [less ▲]

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See detailMesure de la pression artérielle : un geste quotidien à ne pas banaliser
Saint-Remy, Annie ULg

Conference (2012, February 11)

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See detailLes maladies complexes : l'hypertension artérielle
Krzesinski, Jean-Marie ULg; Saint-Remy, Annie ULg

in Revue Médicale de Liège (2012), 67(5-6), 279-285

Essential hypertension, defined as a blood pressure equal to or above 140/90 mmHg, is a common (25% of the population), but complex disease the phenotype of which results from interactions between ... [more ▼]

Essential hypertension, defined as a blood pressure equal to or above 140/90 mmHg, is a common (25% of the population), but complex disease the phenotype of which results from interactions between numerous genes and environmental factors. The role attributable to genetic factors amounts to some 25% among hypertensive families, but can reach 65% when monozygotic twins are compared. In the present state of our knowledge, there is no hope to obtain a genetic test of value for the diagnosis and prognosis of hypertension. An individualized environmental approach, applied early in life, is the only worhtwhile attitude. Nonetheless, in the presence of a subject with still normal blood pressure values, but with a family history of hypertension, the physician should firmly recommend an appropriate hygieno-dietetic lifestyle with a view to lower blood pressure, or retard the development of arterial hypertension [less ▲]

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See detailAssociation entre le contrôle de la pression artérielle et le rapport sodium/potassium urinaire chez les transplantés rénaux hypertendus
Saint-Remy, Annie ULg; SOMJA, Mélanie ULg; WEEKERS, Laurent ULg et al

Poster (2011, December 15)

Design and method : Office blood pressure (OBP) and home BP (HBP) were measured in 70 kidney transplant patients (KT) (43 men/27 women;KT>1 year), all were treated with antihypertensive drugs (mean number ... [more ▼]

Design and method : Office blood pressure (OBP) and home BP (HBP) were measured in 70 kidney transplant patients (KT) (43 men/27 women;KT>1 year), all were treated with antihypertensive drugs (mean number: 2±1). Mean age: 56±11 years, mean graft survival: 7±6.6 years, mean GFR: 65.6±24 ml/min, diabetes:27% and current smoking:11.5%. HBP (Omron M6) was measured during 7 days following the OBP measurement, mean HBP was calculated from day 2 to day 7. Uncontrolled BP was defined by OBP>=140-90 (>=130-80 when diabetes) and HBP>=135-85 (>=130-80 when diabetes). The day of the OBP measurement and the last day of HBP, patients collected 24h- urine and recorded at the same time their food and beverage consumption. Sodium and potassium were measured in urines and their intakes were quantified through food records. Urinary and diet Na+, K+ did not differ between the two urine collections 7 days apart. Results: 16 patients(23%) had controlled BP (OBP and HBP) while 34 (49%) remained with sustained hypertension (SHT) despite treatment, 14 (20%) had masked uncontrolled hypertension (MHT, OBP<140-90 and HBP>=135-85,130-80 if diabetes for both).When comparing the controlled and SHT, no differences were found with age, graft survival, BMI, GFR, calcineurin inhibitors or number and type of antihypertensive drugs. The groups did not differ by their sodium excretion (154±93 vs 162±88 mmol/24h) but well by their K excretion significantly higher in controlled patients (68±17 vs 53±20 mmol/24h,p=0.018) giving a Na/K ratio higher in SHT (3.2±1.3 vs2.2±1.2,p=0.03). Diet analysis showed significantly higher intakes of K (fruits, vegetables) in controlled patients (3279±753 vs 2208±720 mg/24h,p=0.010) whereas both groups consumed on average 9 g/24h of salt. When controlled for age, BMI and Na excretion, Home systolic BP was inversely and significantly correlated with urinary potassium (- 0.46;P=0.002) while no correlation was found with urinary Na.Conclusions: KT patients remaining hypertensive and well controlled patients had both high salt consumption. However, well controlled patients differed by significant higher potassium intakes and excretion. Urinary Na/K ratio could be a useful tool contributing to an optimal BP control in KT patients. However, impact of increasing potassium intakes on uncontrolled BP in KT has to be validated by prospective randomized studies [less ▲]

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See detailAssociation entre le contrôle de la pression artérielle et le rapport sodium/potassium urinaire chez les transplantés rénaux hypertendus
Saint-Remy, Annie ULg; SOMJA, Mélanie ULg; WEEKERS, Laurent ULg et al

in Archives des Maladies du Coeur et des Vaisseaux (2011, December), Hors série 3

Etude de la relation entre le contrôle de la pression artérielle (PA) mesurée en clinique et/ou à domicile chez des transplantés rénaux (Tr) hypertendus et l'excrétion urinaire du sodium (Na), potassium ... [more ▼]

Etude de la relation entre le contrôle de la pression artérielle (PA) mesurée en clinique et/ou à domicile chez des transplantés rénaux (Tr) hypertendus et l'excrétion urinaire du sodium (Na), potassium (K) et de leur rapport (Na/K urinaire et alimentaire) qui pourrait être un indice utile à prendre en compte dans la recherche d'un contrôle efficace de la PA chez les transplantés rénaux. [less ▲]

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See detailContrôle de la pression artérielle (PA) et mesure de la rigidité artérielle (RA) chez des transplantés rénaux (TR) (étude EPARA)
Gellner, Karen; Saint-Remy, Annie ULg; BONVOISIN, Catherine ULg et al

in Archives des Maladies du Coeur et des Vaisseaux (2011, December), Hors série 3

EPARA a étudié le contrôle de la PA au cabinet de consultation et en dehors, et l'état de rigidité artérielle chez des transplantés rénaux stables, greffés depuis plus d'un an. Le contrôle de la PA est ... [more ▼]

EPARA a étudié le contrôle de la PA au cabinet de consultation et en dehors, et l'état de rigidité artérielle chez des transplantés rénaux stables, greffés depuis plus d'un an. Le contrôle de la PA est loin d‘être satisfaisant dans cette population de TR hypertendus, traîtés pour la plupart, particulièrement à domicile. L‘HTA masquée est fréquente, associée à un risque cardio-vasculaire élevé et une rigidité accrue des grosses artères. La PAS centrale est d‘autant plus élevée que la fonction rénale est mauvaise. Proposer de recourir systématiquement à des mesures ambulatoires de PA est hautement conseillé chez ce type de patients! [less ▲]

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See detailReproducibility of blood pressure (BP) measurement techniques in late kidney transplantation (KT): the EPARA study
Gellner, Karen; Saint-Remy, Annie ULg; WEEKERS, Laurent ULg et al

Conference (2011, October 08)

There has been a long debate about appropriate BP measurement techniques for evaluating the quality of BP control, especially in kidney transplantation (KT). Thus, one aim of the present study was to ... [more ▼]

There has been a long debate about appropriate BP measurement techniques for evaluating the quality of BP control, especially in kidney transplantation (KT). Thus, one aim of the present study was to examine 3 methods of BP measurement and their reproducibility over a short period of 8 weeks. Conclusion: Home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM) should be applied more often also in KT, among others for reasons of better reproducibility over time than office blood pressure monitoring (OBPM). [less ▲]

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See detailWhich factors might explain the divergence between clinic and out-of-clinic blood pressure (BP) in kidney transplantation (KT): the EPARA study?
Gellner, Karen; Saint-Remy, Annie ULg; BONVOISIN, Catherine ULg et al

Conference (2011, October 08)

Differences between clinic and out-of-clinic BP, defined as white coat effect (WCE), white coat hypertension (WCH) or masked hypertension (MH), can leat to misdiagnosis and -handling when decisions are ... [more ▼]

Differences between clinic and out-of-clinic BP, defined as white coat effect (WCE), white coat hypertension (WCH) or masked hypertension (MH), can leat to misdiagnosis and -handling when decisions are solely based on clinic BP measurement. One aim of the study was to examine the risk factors of WCE and MH in late KT. Conclusion:Out-of-clinic BP monitoring should be encouraged to be applied more often in high risk-populations such as KT, especially when risk factors for WCE or MH are present. [less ▲]

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See detailControl of hypertension in renal transplantation : the EPARA study
Gellner, Karen; SAINT-REMY, Annie ULg; WEEKERS, Laurent ULg et al

Conference (2011, June 26)

Blood pressure (BP) is a cardiovascular but also kidney disease risk factor, especially in high risk populations such as kidney transplantated one (KT). Therefore it must be accurately measured. The aim ... [more ▼]

Blood pressure (BP) is a cardiovascular but also kidney disease risk factor, especially in high risk populations such as kidney transplantated one (KT). Therefore it must be accurately measured. The aim of the current study was to evaluate the quality of BP control in such a population followed at the CHU Liège. [less ▲]

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See detailLe contrôle de la pression artérielle en Belgique
Saint-Remy, Annie ULg

Conference (2011, May 17)

La prévalence de l'hypertension artérielle dans la population générale atteint aujourd'hui 28,4% conre 35% dans les années 80-90. A peine 21,5% des patients sont effectivement contrôlés, un chiffre qui ... [more ▼]

La prévalence de l'hypertension artérielle dans la population générale atteint aujourd'hui 28,4% conre 35% dans les années 80-90. A peine 21,5% des patients sont effectivement contrôlés, un chiffre qui monte chez les plus de 65 ans (48,5%) sauf chez les diabétiques (24%). Communication orale présentée lors du symposium du CBH le 26/02/2011, [less ▲]

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See detailPrévalence et contrôle de l'hypertension artérielle en Belgique
Saint-Remy, Annie ULg

Conference (2011, February 26)

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See detailControl of hypertension in a kidney transplanted population : the EPARA study
Gellner, Karen; Saint-Remy, Annie ULg; Weekers, Laurent ULg et al

in Acta Clinica Belgica (2010, November 27), 66(1), 79

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See detailControl of hypertension in a kidney transplanted population : the EPARA study”.
Gellner, Karen ULg; Saint-Remy, Annie ULg; Weekers, Laurent ULg et al

Scientific conference (2010, November 27)

The prevalence of hypertension in this specific KT population remains high in spite of different antiHTA drugs use and the well known deleterious effect of HTA on kidney function and cardiovascular risk ... [more ▼]

The prevalence of hypertension in this specific KT population remains high in spite of different antiHTA drugs use and the well known deleterious effect of HTA on kidney function and cardiovascular risk. Home BP (and/or ABPM) should thus be recommended to identify this situation and secondary to adapt the treatment. [less ▲]

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See detailEvolution nutritionnelle des patients hémodialysés du CHBAH
Meurice, C.; Smelten, Nicole; Furnemont, L. et al

Poster (2010, September 30)

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