References of "Weekers, Laurent"
     in
Bookmark and Share    
Full Text
Peer Reviewed
See detailL'observance thérapeutique en transplantation d'organe - L'exemple de la greffe de rein
Milicevic, Martina ULg; Grosch, Stéphanie ULg; Weekers, Laurent ULg et al

in Revue Médicale de Liège (2010), 65(5-6), 386-390

A successful transplantation implies that immunosuppressive drugs will have to be taken during the whole patient’s life. Poor drug compliance is a multifactorial problem, that is particularly dangerous in ... [more ▼]

A successful transplantation implies that immunosuppressive drugs will have to be taken during the whole patient’s life. Poor drug compliance is a multifactorial problem, that is particularly dangerous in organ transplantation as it can lead to loss of graft function and return to dialysis treatment. The medical doctor must stimulate the patient’s adherence to the strict therapeutic drug protocol. The patient must also be reminded at each medical consultation of the importance of such rigorous drug intake. This bad (or non) compliance is particularly well demonstrated a long time after transplantation. The medical staff, all the health participants, but also the family members must continuously fight against non compliance, which is inherent to any chronic disease. [less ▲]

Detailed reference viewed: 144 (4 ULg)
Peer Reviewed
See detailLa transplantation pancréatique isolée : le retour à l'activité physqiue
Malaise, Jacques; Dabe, Alain; Hermant, Christophe et al

Conference (2009, October 10)

Detailed reference viewed: 79 (3 ULg)
Full Text
Peer Reviewed
See detailA Retrospective Monocenter Review of Simultaneous Pancreas-Kidney Transplantation.
Decker, Emmanuel ULg; Coimbra, C.; Weekers, Laurent ULg et al

in Transplantation Proceedings (2009), 41(8), 3389-3392

OBJECTIVE: Herein we have reviewed a consecutive series of simultaneous pancreas-kidney (SPK) transplantations performed at our institution over a 6-year period. PATIENTS AND METHODS: The study population ... [more ▼]

OBJECTIVE: Herein we have reviewed a consecutive series of simultaneous pancreas-kidney (SPK) transplantations performed at our institution over a 6-year period. PATIENTS AND METHODS: The study population included 22 patients (15 males and 7 females) who underwent SPK transplantation between 2001 and 2007. The mean recipient age was 47 years (range, 26-63 years). Eighteen patients suffered type 1 and 4 type 2 diabetes mellitus. The mean donor age was 33 years (range, 14-56 years). The mean HLA match was 2.1 (range, 1-5). Immunosuppressive treatment consisted of basiliximab induction followed by tacrolimus, mycophenolate mofetil, and prednisone. RESULTS: The mean hospital stay was 20 days (range, 11-52 days). After a mean follow-up of 44 months (range, 17-88 months), patient, kidney, and pancreas graft survivals were 86%, 82%, and 73%, respectively. Two patients died in the immediate postoperative period due to, respectively, disseminated intravascular coagulation and pulmonary embolism. A kidney graft was lost due to early hyperacute rejection. Other early complications associated with the pancreas graft included 2 cases of immediate reperfusion defects that led to early vascular thrombosis in 1 patient and a duodenal graft fistula in the other patient; a third patient developed type 2 diabetes mellitus. Beyond the postoperative period, graft loss was limited to 1 case of noncompliance to the immunosuppressive medications and 1 death secondary to pulmonary infection with a functional allograft after 4 years. CONCLUSIONS: SPK transplantation is a valid therapeutic option for patients with insulin-dependent diabetes mellitus and renal failure due to diabetic nephropathy. The main complications of SPK transplantation occur in the immediate postoperative period consequent to vascular or rejection processes. [less ▲]

Detailed reference viewed: 46 (14 ULg)
Full Text
Peer Reviewed
See detailLes anticorps monoclonaux en transplantation rénale
Bonvoisin, Catherine ULg; Weekers, Laurent ULg; Grosch, Stéphanie ULg et al

in Revue Médicale de Liège (2009), 64(5-6), 287-292

Renal transplantation is the best treatment for end-stage renal disease, but requires efficient immunosuppressive therapy. The latter has evolved over recent years with the development of more powerful ... [more ▼]

Renal transplantation is the best treatment for end-stage renal disease, but requires efficient immunosuppressive therapy. The latter has evolved over recent years with the development of more powerful drugs and of monoclonal antibodies with very specific target. The first monoclonal antibodies, acting against the interleukin 2 receptor, named basiliximab and daclizumab, have showed an excellent tolerance profile and efficacy to reduce acute graft rejection. However, in spite of these properties, the development of delayed graft function or the graft and patient survivals at 1 year were not modified by the use of such specific treatment. One potential advantage could yet be a decreasing need for corticosteroids and sometimes calcineurin inhibitors which could provide some long term benefits for the renal graft, but also the patient. Alemtuzumab, another monoclonal antibody, aimed at the membrane glycoprotein CD52, can also decrease the incidence of acute rejection and the depth of the required immunosuppressive therapy. Other antibodies are still in development with some interesting preliminary results which however demand confirmation in larger studies. [less ▲]

Detailed reference viewed: 48 (1 ULg)
Full Text
Peer Reviewed
See detailPolyomavirus in Renal Transplantation: A Hot Problem
Bonvoisin, Catherine ULg; Weekers, Laurent ULg; Xhignesse, Patricia ULg et al

in Transplantation (2008), 85(7S), 42-48

Polyomavirus BK has emerged as an important complication after kidney transplantation. Although, BK nephropathy develops in only1%to5%of renal transplant recipients, its prognosis when present is very ... [more ▼]

Polyomavirus BK has emerged as an important complication after kidney transplantation. Although, BK nephropathy develops in only1%to5%of renal transplant recipients, its prognosis when present is very poor. The most accepted risk factor is the level of immunosuppressive treatment, but the serostatus of donor and recipient and the absence of human leukocyte antigen C7 in donor and/or recipient influence the BK virus (BKV) reactivation. The gold standard in diagnosing BKV nephropathy (BKVN) continues to be biopsy with use of immunohistochemistry for large T antigens. Urinary decoy cells and blood BKV DNA polymerase chain reaction are used in the screening, but their positive predictive values are poor. However, their use as predictors of the evolution of BKVN is more valuable. The reduction of immunosuppressive therapy currently represents the first-line treatment for BKVN. Cidofovir and leflunomide can be used when BKVN continues to progress. In the event of graft loss, retransplantation is possible with a low risk of recurrence when the infection is no longer active. [less ▲]

Detailed reference viewed: 55 (6 ULg)
Full Text
Peer Reviewed
See detailACE I/D polymorphism predicts end stage renal disease and or mortality in type I diabetic patients except for those with already advanced nephropathy: the follow up of the Genesis/Genediab Studies
Fysekidis, M.; Hadjadj, S.; Roussel, R. et al

in Diabetologia (2007, September), 50(Suppl. 1), 157-158

Detailed reference viewed: 15 (0 ULg)
Full Text
Peer Reviewed
See detailDiarrhea induced by high doses of nicotinamide in dialysis patients
Delanaye, Pierre ULg; Weekers, Laurent ULg; Krzesinski, Jean-Marie ULg

in Kidney International (2006), 69(10), 1914-1914

Detailed reference viewed: 38 (2 ULg)
Full Text
Peer Reviewed
See detailEffets de la duree du diabete de type 1 sur la pression arterielle pulse: etude transversale controlee.
Philips, Jean-Christophe ULg; Marchand, Monique ULg; Weekers, Laurent ULg et al

in Archives des Maladies du Coeur et des Vaisseaux (2006), 99(7-8), 683-6

Diabetes mellitus and arterial pulse pressure (PP) are two independent cardiovascular risk factors. This cross-sectional study investigated the influence of diabetes duration on PP in type 1 diabetic ... [more ▼]

Diabetes mellitus and arterial pulse pressure (PP) are two independent cardiovascular risk factors. This cross-sectional study investigated the influence of diabetes duration on PP in type 1 diabetic patients without any cardiovascular disease. PP was measured continuously during 3 minutes (active orthostatic test: 1 min standing--1 min squatting--1 min standing) using a fingertip plethysmograph (Finapres) in 159 type 1 diabetic patients aged 20-60 yrs. They were divided into 4 groups according to diabetes duration: (1) G1 : <10 yrs (n=39); G2: 11-20 yrs (n=45); G3: 21-30 yrs (n=57); and G4: >30 yrs (n=18). In order to separate the effects of age from the effects of diabetes duration, diabetic patients were compared to age- and sex-matched non diabetic controls. PP (expressed in mmHg; mean +/- SD) was higher in men than in women in both diabetic (58 +/- 15 vs. 50 +/- 14; p = 0.001) and non diabetic subjects (55 +/- 14 vs. 47 +/- 12; p = 0.001). Overall PP was higher in diabetic than in non diabetic individuals (54 +/- 15 vs. 50 +/- 13; p = 0.025). PP progressively increased according to diabetes duration: 47 +/- 16 vs. 51 +/- 13 vs. 59 +/- 14 vs. 62 +/- 12, from G1 to G4 respectively; p < 0.0001. Such an increase was not observed in age-matched non diabetic subjects: 50 +/- 11 vs. 52 +/- 12 vs. 49 +/- 14 vs. 52 +/- 18, from G1 to G4, respectively; NS. PP was higher in squatting than in standing position in non diabetic subjects (52 +/- 16 vs. 47 +/- 13; p < 0.0001) and even more in diabetic patients (59 +/- 17 vs. 50 +/- 14; p < 0.0001). Overall, PP difference between diabetic and non diabetic individuals was not significant in standing position (50 +/- 14 vs. 47 +/- 13; NS) although it became highly significant in squatting position (59 +/- 17 vs. 52 +/- 16; p = 0.0005). The squatting-standing difference in PP markedly increased with diabetes duration: 69 +/- 14 during squatting vs. 50 +/- 18 during standing in G4 compared to respectively 50 +/- 17 vs. 44 +/- 15 in G1 diabetic patients. Finally, PP was similar (NS) in diabetic patients with HbA1c < 8% (54 +/- 14) or > or =8% (55 +/- 16), with (57 +/- 17) or without (54 +/- 14) microalbuminuria, treated (56 +/- 14) or not (54 +/- 15) by inhibitors of the renin-angiotensin system. In conclusion, PP progressively increased with the duration of type 1 diabetes, independently of age. Such increase was more marked in squatting than in standing position. The role of such PP rise in the increased cardiovascular risk of patients with type 1 diabetes, although suspected in the recent EURODIAB Prospective Complications Study, deserves further investigation. [less ▲]

Detailed reference viewed: 39 (2 ULg)
Full Text
Peer Reviewed
See detailModulation of the renal response to ACE inhibition by ACE insertion/deletion polymorphism during hyperglycemia in normotensive, normoalbuminuric type 1 diabetic patients
Weekers, Laurent ULg; Bouhanick, B.; Hadjadj, S. et al

in Diabetes (2005), 54(10), 2961-2967

ACE inhibition protects kidney function, but ACE insertion/ deletion (LID) polymorphism affects renal prognosis in type 1 diabetic patients'. ACE genotype may influence the renal benefits of ACE ... [more ▼]

ACE inhibition protects kidney function, but ACE insertion/ deletion (LID) polymorphism affects renal prognosis in type 1 diabetic patients'. ACE genotype may influence the renal benefits of ACE inhibition. We studied the impact of ACE 1/D polymorphism on the renal hemodynamic changes induced by ACE inhibition in type 1 diabetes. We studied renal hemodynamics (glomerular filtration rate [GFR], effective renal plasma flow [ERPF], filtration fraction [GFR/ERPF], mean arterial pressure [MAP], and total renal resistances [MAP/ ERPF]) repeatedly during normoglycemia, and then hyperglycemia in 12 normotensive, normoalbuminuric type 1 diabetes and the 11 genotype (associated with nephrorotection) versus 22 age- and sex-matched subjects with the ACE D allele after three randomly allocated 2- to 6-week periods on placebo, 1.25 mg/day ramipril, and 5.mg/day ramipril in A double-blind, cross-over study. During normoglycemia, the hemodynamic changes induced by ramipril were similar in both genotypes. During hyperglycemia, the changes induced by ramipril were accentuated in the 11 genotype group and attenuated dose dependently in the D allele group (treatment-genotype interaction P values for ERPF, 0.018; MAP 0.018; and total renal resistances, 0.0.55). These results provide a basis to. different renal responses to ACE inbibition according to ACE genotype in type 1 diabetes. [less ▲]

Detailed reference viewed: 12 (4 ULg)
Full Text
Peer Reviewed
See detailPrévalence des calcifications vasculaires et facteurs associés chez le patient hémodialysé
XHIGNESSE, Patricia ULg; Saint-Remy, Annie ULg; WEEKERS, Laurent ULg et al

Poster (2005, September 27)

Les maladies cardiovasculaires constituent la première cause de décès chez les patients dialysés chroniques. Parmi les facteurs impliqués on trouve les anomalies du métabolisme phosphocalcique. Le but de ... [more ▼]

Les maladies cardiovasculaires constituent la première cause de décès chez les patients dialysés chroniques. Parmi les facteurs impliqués on trouve les anomalies du métabolisme phosphocalcique. Le but de cette étude est de relier l'incidence de nouvelles calcifications et des décès (22%, n=18) avec les paramètres du métabolisme phosphocalcique au travers d'une étude prospective portant sur les années 2003-2004. L'établissement d'un score de calcification vasculaire précoce (dès la prise en charge en dialyse) permettra un suivi étroit et une adaptation prudente du traitement contrôlant le métaboisme phosphocalcique. [less ▲]

Detailed reference viewed: 20 (0 ULg)
Full Text
Peer Reviewed
See detailPrévalence des calcifications vasculaires et facteurs associés chez le patient hémodialysé
Xhignesse, Patricia ULg; Saint-Remy, Annie ULg; Weekers, Laurent ULg et al

in Néphrologie & Thérapeutique (2005, September), 1(S2), 107

Detailed reference viewed: 67 (9 ULg)
Full Text
Peer Reviewed
See detailLa néphropathie diabétique
Weekers, Laurent ULg; Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2005), 60(5-6, May-Jun), 479-486

Diabetic nephropathy is a constantly increasing pathology in western countries. The trend is more pronounced in type 2 diabetic patients than in type 1 diabetic patients. Among individuals with type 2 ... [more ▼]

Diabetic nephropathy is a constantly increasing pathology in western countries. The trend is more pronounced in type 2 diabetic patients than in type 1 diabetic patients. Among individuals with type 2 diabetes, kidney disease is often multifactorial. This paper reviews recent developments in the pathophysiology, epidemiology and treatment of diabetic nephropathy. [less ▲]

Detailed reference viewed: 266 (3 ULg)
Full Text
Peer Reviewed
See detailHypertension et diabète
Krzesinski, Jean-Marie ULg; Weekers, Laurent ULg

in Revue Médicale de Liège (2005), 60(5-6, May-Jun), 572-577

Hypertension frequently accompanies diabetes mellitus, as it is present in 50% of diabetic patients. Hypertension can sometimes preceed diabetes. In type 2 diabetes, insulin resistance plays a major role ... [more ▼]

Hypertension frequently accompanies diabetes mellitus, as it is present in 50% of diabetic patients. Hypertension can sometimes preceed diabetes. In type 2 diabetes, insulin resistance plays a major role in the hypertensive risk. In type 1 diabetes, nephropathy is often noted as soon as hypertension is present. Both hypertension and diabetes increase the risk for cardiovascular and renal complications. For their prevention, first of all, modification of the diet with increasing exercise must be proposed, associated to antihypertensive agents with a blood pressure target lower than 130/80 mmHg. Renin-angiotensin blockers constitute the main drug therapy in such patients associated with diuretics or betablocker if angina pectoris is present or even calcium channel blocker when large arteries abnormalities exist. A frequent evaluation of the cardiovascular risk is required together with research of renal dysfunction or microproteinuria. [less ▲]

Detailed reference viewed: 431 (8 ULg)
Full Text
Peer Reviewed
See detailDifferent patterns of insulin resistance in relatives of type 1 diabetic patients with retinopathy or nephropathy
Hadjadj, S.; Pean, F.; Pean, F. et al

in Diabetes Care (2004), 27(11), 2661-2668

OBJECTIVE- Insulin resistance may be a risk factor for diabetic microangiopathy, which may have a familial component. We carried out a family-based study to determine which components of the insulin ... [more ▼]

OBJECTIVE- Insulin resistance may be a risk factor for diabetic microangiopathy, which may have a familial component. We carried out a family-based study to determine which components of the insulin resistance syndrome are associated with diabetic retinopathy and nephropathy in type 1 diabetes. RESEARCH DESIGN AND METHODS- The Genesis France-Belgium Study is a multicenter binational study designed to investigate the genetic factors involved in the microvascular complications of type 1 diabetes using a family-based design. Probands were type 1 diabetic patients with diabetic retinopathy (classified as background, preproliferative, or proliferative) and possibly diabetic nephropathy (absent, incipient, established, or advanced). The insulin resistance score of their first-degree relatives was calculated according to their BMI and history of arterial hypertension, lipid disorders, and type 2 diabetes. RESULTS- The insulin resistance score of relatives was positively correlated with the albumin excretion rate (P = 0.0009) and fasting plasma glucose (P = 0.0003) and HbA(1c) (P < 0.0001) concentrations. This score was higher in the relatives of probands with than in those without diabetic nephropathy (P = 0.0370). Similarly, it was higher in relatives of subjects with proliferative diabetic retinopathy than in those of probands without, even after controlling for subjects with versus without diabetic nephropathy (P = 0.0379). However, the components of the insulin resistance score in relatives differed according to the severity of diabetic retinopathy or nephropathy in the probands. Obesity and history of arterial hypertension were most common in relatives of probands with proliferative diabetic retinopathy, whereas obesity and history of lipid disorders were most common in the relatives of probands with diabetic nephropathy. CONCLUSIONS- Familial insulin resistance segregates with diabetic complications: lipid disorders and obesity segregate with diabetic nephropathy, whereas arterial hypertension and obesity segregate with diabetic retinopathy. [less ▲]

Detailed reference viewed: 9 (0 ULg)
Full Text
Peer Reviewed
See detailAntihypertensive therapy and blood pressure control in renal transplant recipients.
Saint-Remy, Annie ULg; Ait Oile, Fatima; Weekers, Laurent ULg et al

in American Journal of Hypertension : Journal of the American Society of Hypertension (2004), 17(5), 122-123

Renal transplant recipients are at high risk of cardiovascular diseases which represent,with infections, their major cause of excessive deaths. Immunosuppressive treatments are partly responsible leading ... [more ▼]

Renal transplant recipients are at high risk of cardiovascular diseases which represent,with infections, their major cause of excessive deaths. Immunosuppressive treatments are partly responsible leading to hypertension (HT), diabetes and hyperlipidemia. Aim: This study analyses the blood pressure (BP) control in renal transplant recipients with functioning graft according to their current antihypertensive and immunosuppressive therapies. Data were collected for 211 patients (M:58%; F:42%) transplanted on average since 7.7 years (2-360 months). Mean age was 50 years (16–72), 84% had hypercholesterolemia (>1.9 g/l), 18% were diabetics and 24% were smokers. Seventy-eight % were under antihypertensive treatment. Results: HT (mean OBP of 3 visits: >140 and/or >90 mmHg or treated) was observed in half of the untreated patients and uncontrolled in 80% of the treated ones. Ninety % of the treated hypertensive diabetic patients didn't reach target BP <130/80 mmHg. HT was significantly more frequent in patients whose glomerular filtration(GFR) was lower than the median value of GFR (55 ml/min/1.73 m2) of the population. Among treated patients, 48% had 1 drug, 29% had 2 drugs and 23% had 3 drugs or more. Beta-Blockers were the most prescribed even in association, while diuretics were less used since, even in 3 drugs therapy, only 60% received such class. Calcium inhibitors were not prescribed readily in first line but accounted for 47% in 2 drugs combinations. These observations were not related to the GFR level. Only 26% received an ACE inhibitor, their prescription decreases roughly in patients with impaired GFR. AII-RB concerned only 10% of therapies. Body weight, creatinine, graft survival and recipient's age were significantly related to SBP and DBP. In patients treated with cyclosporin, a highly significant relation (p=0.02) was found between BP and blood level of CsA, this was not observed in patients treated with tacrolimus . Conclusion: HT was highly prevalent in renal transplant recipients( 88% of patients) even when treated. This study leads to reconsider habits of prescrition in view to improve the BP control by increasing the use of diuretics and to improve cardioprotection by using more often ACE inhibitors (when not contra-indicated) in that high cardiovascular risk population. As mentioned in literature, the effect of tacrolimus on BP appears lesser than the cyclosporine one. [less ▲]

Detailed reference viewed: 20 (1 ULg)
Full Text
Peer Reviewed
See detailPrevention de la nephropathie diabetique: de la microalbuminurie a l'insuffisance renale terminale.
Weekers, Laurent ULg; Scheen, André ULg; Rorive, Georges ULg

in Revue Médicale de Liège (2003), 58(5), 297-306

Diabetic nephropathy is one of the leading causes of end-stage renal failure in western countries. This disease develops over several years. Early stages, if they are detected in time, can lead to ... [more ▼]

Diabetic nephropathy is one of the leading causes of end-stage renal failure in western countries. This disease develops over several years. Early stages, if they are detected in time, can lead to preventive treatment at a moment when the disease is still reversible. This paper reviews the main primary and secondary preventive measures that have been proven efficacious. Those are essentially the optimal treatment of hyperglycaemia and hypertension, and probably the use of agents that specifically block the renin-angiotensin axis. We briefly discuss the results of the main studies that have led to those conclusions. [less ▲]

Detailed reference viewed: 306 (3 ULg)