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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 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 detailIn-depth phenotyping of a Donnai-Barrow patient helps clarify proximal tubule dysfunction.
Dachy, Angelique; Paquot, Francois ULg; Debray, François-Guillaume ULg et al

in Pediatric nephrology (Berlin, Germany) (2015), 30(6), 1027-31

BACKGROUND: The megalin/cubilin/amnionless complex is essential for albumin and low molecular weight (LMW) protein reabsorption by renal proximal tubules (PT). Mutations of the LRP2 gene encoding megalin ... [more ▼]

BACKGROUND: The megalin/cubilin/amnionless complex is essential for albumin and low molecular weight (LMW) protein reabsorption by renal proximal tubules (PT). Mutations of the LRP2 gene encoding megalin cause autosomal recessive Donnai-Barrow/facio-oculo-acoustico-renal syndrome (DB/FOAR), which is characterized by LMW proteinuria. The pathophysiology of DB/FOAR-associated PT dysfunction remains unclear. CLINICAL CASE: A 3-year-old girl presented with growth retardation and proteinuria. Clinical examination was unremarkable, except for a still-opened anterior fontanel and myopia. Psychomotor development was delayed. At 6, she developed sensorineural hearing loss. Hypertelorism was noted when she turned 12. Blood analyses, including renal function parameters, were normal. Urine sediment was bland. Proteinuria was significant and included albumin and LMW proteins. Immunoblotting analyses detected cubilin and type 3 carbonic anhydrase (CA3) in the urine. Renal ultrasound was unremarkable. Optical examination of a renal biopsy did not disclose any tubular or glomerular abnormality. Electron microscopy revealed that PT apical endocytic apparatus was significantly less developed. Immunostaining for megalin showed a faint signal in PT cytosol contrasting with the distribution of cubilin at the apical membrane. The diagnostic procedure led to identifying two mutations of the LRP2 gene. CONCLUSIONS: The functional loss of megalin in DB/FOAR causes PT dysfunction characterized by increased urinary shedding of CA3 and cubilin. [less ▲]

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See detailOverlap syndrome consisting of PSC-AIH with concomitant presence of a membranous glomerulonephritis and ulcerative colitis
Warling, O; BOVY, Christophe ULg; COIMBRA MARQUES, Carla ULg et al

in World Journal of Gastroenterology (2014), 20(16), 4811-4816

Abstract The association of primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH) is known as an overlap syndrome (OS). OS can also be described in the setting of concomitant presence of AIH ... [more ▼]

Abstract The association of primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH) is known as an overlap syndrome (OS). OS can also be described in the setting of concomitant presence of AIH and PSC. These diseases can in some cases be associated with ulcerative colitis. In this case report we describe, to our knowledge, the first case in the literature of a young Caucasian male suffering from ulcerative colitis and an overlap syndrome consisting of an association between PSC-AIH, with the concomitant presence of a membranous glomerulonephritis. [less ▲]

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See detailUn cas particulier d'amyloïdose AA
MILICEVIC, Martina ULg; GROSCH, Stéphanie ULg; Krzesinski, Jean-Marie ULg et al

Conference (2014, January 22)

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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 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 detailLa glomérulonéphrite fibrillaire non amyloïde : une cause rare de syndrome néphrotique
GROSCH, Stéphanie ULg; VAN OVERMEIRE, Lionel ULg; Krzesinski, Jean-Marie ULg et al

in Néphrologie & Thérapeutique (2011), 7

La glomérulonéphrite fibrillaire non amyloïde est une pathologie glomérulaire à dépôts fibrillaires, non amyloïdes, composés principalement d'immunoglobulines G polyclonales. Il s'agit d'une ... [more ▼]

La glomérulonéphrite fibrillaire non amyloïde est une pathologie glomérulaire à dépôts fibrillaires, non amyloïdes, composés principalement d'immunoglobulines G polyclonales. Il s'agit d'une glomérulopathie idiopathique responsable de protéinurie sévère, souvent néphrotique et d'insuffisance rénale arrivant à un stade terminal dans 40% des cas à cinq ans. Elle peut prendre différents aspects anatomopathologiques déterminants en terme de pronostic rénal. La négativité des dépôts en coloration rouge Congo et l'épaisseur des fibrilles en microscopie électronique permettent le diagnostic différentiel avec les dépôts amyloïdes. Il n'y a pas de traitement efficace. Après transplantation rénale, la récidive est fréquente avec un pronostic rénal cependant moins péjoratif. [less ▲]

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See detailLe syndrome néphrotique
Bovy, Christophe ULg; Krzesinski, Jean-Marie ULg

Conference (2010, April 27)

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See detailComparaison des taux de BNP et de NT-proBNP chez des patients insuffisants rénaux pour prévenir l'insuffisance cardiaque
Le Goff, Caroline ULg; Kaux, Jean-François ULg; Bovy, Christophe ULg et al

in Biotribune Magazine (2010), 34

Background: The aim of the study is to compare the performances of BNP and NT-proBNP for diagnosing heart failure (HF) in a population of patients with high incidence of chronic renal insufficiency (CRI ... [more ▼]

Background: The aim of the study is to compare the performances of BNP and NT-proBNP for diagnosing heart failure (HF) in a population of patients with high incidence of chronic renal insufficiency (CRI, plasma creatinine > 1.5 mg/dl). Patients and methods: Ninety-eight patients were included in this study. BNP and NT-proBNP determinations were performed by an immunofluorescent assay (Biosite®) and by an electrochemiluminescence sandwich immuno assay (Roche Diagnostic®), respectively. Results and discussion: BNP and NTproBNP level are correlated in CRI and non CRI . Both assays are useful to rule out CRI pts suspected of HF. However, in renal failure pts, higher decision limits should be used for improving the positive predictive value of the assays. [less ▲]

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See detailLa néphropathie tubulo-interstitielle aiguë: une cause rare d’insuffisance rénale aiguë
Bouquegneau, A.; Longton, J.; Bovy, Christophe ULg et al

in Revue Médicale de Liège (2010), 65(7-8), 459-463

We report the case of an acute renal failure due to an acute interstitial nephropathy (ATIN) induced by non steroidal anti-inflammatory drugs (NSAID). Even though this pathology is a rare cause of acute ... [more ▼]

We report the case of an acute renal failure due to an acute interstitial nephropathy (ATIN) induced by non steroidal anti-inflammatory drugs (NSAID). Even though this pathology is a rare cause of acute renal failure, it still requires special attention in view of the fact that it induces a high risk of acute morbidity but it also can evolve into chronic renal failure. Its differential diagnosis with other causes of acute renal failure becomes essential because of the different therapeutic care. In this article, we are going to briefly sum up the reasoning to adopt in order to diagnose an acute renal failure. [less ▲]

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See detailL'image du mois. La polykystose rénale autosomique dominante
Couvreur, Thierry ULg; Szepetiuk, G.; Meunier, Paul ULg et al

in Revue Médicale de Liège (2008), 63(11), 637-639

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See detailClinico-pathological prognostic factors of IgA vasculitis
Bovy, Christophe ULg; Parotte, Marie-Christine ULg; Krzesinski, Jean-Marie ULg

in Acta Clinica Belgica (2007, October), 62(5), 369

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