References of "Weekers, Laurent"
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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 ▲]

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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 ▲]

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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 ▲]

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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

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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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See detailLe contrôle de la pression artérielle chez le patient greffé rénal
Ait Oile, Fatima; Saint-Remy, Annie ULg; Weekers, Laurent ULg et al

in Archives des Maladies du Coeur et des Vaisseaux (2003), 96

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See detailEtude clinique du mois. Rôle néphroprotecteur des antagonistes du récepteur de l'angiotensine II (ARA) dans le diabète de type 2: résultats des études IDNT et RENAAL
Weekers, Laurent ULg; Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2001), 56(10), 723-726

Nephropathy associated with type 2 diabetes mellitus is a rising cause of end-stage renal disease and is a major public health problem. If blocking of the renin angiotensin system has a well established ... [more ▼]

Nephropathy associated with type 2 diabetes mellitus is a rising cause of end-stage renal disease and is a major public health problem. If blocking of the renin angiotensin system has a well established nephroprotective effect in type 1 diabetic nephropathy, this remained to be shown for type 2 diabetes. Two large outcome trials using angiotensin II receptor antagonists (ARA's) in proteinuric chronic renal impairment and hypertensive type 2 diabetic patients have now closed this gap: the Irbesartan Diabetic Nephropathy Trial (IDNT) and the Reduction of Endpoints in NIDDM with Angiotensin II Antagonist Losartan (RENAAL) trial. Both trials showed a significant reduction in the primary pre-specified end-point of death, or worsening of renal function (doubling of serum creatinine) or the development of end-stage renal disease. This effect goes beyond the reduction in blood pressure and makes of ARA's one of the important tools in the treatment of type 2 diabetic nephropathy. [less ▲]

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See detailL'etude clinique du mois. L'etude CALM ou interet de combiner un inhibiteur de l'enzyme de conversion et un antagoniste du recepteur de type 1 de l'angiotensine II dans le traitement de la nephropathie diabetique.
Philips, Jean-Christophe ULg; Weekers, Laurent ULg; Scheen, André ULg

in Revue Médicale de Liège (2001), 56(2), 126-8

The main objective of the CALM (Candesartan And Lisinopril Microalbuminuria) study is to assess the effect of a dual blockade of the renin-angiotensin system--using both an angiotensin converting enzyme ... [more ▼]

The main objective of the CALM (Candesartan And Lisinopril Microalbuminuria) study is to assess the effect of a dual blockade of the renin-angiotensin system--using both an angiotensin converting enzyme inhibitor (ACE-I) and an angiotensin II type 1 receptor blocker--in patients with type 2 diabetes, high blood pressure and microalbuminuria. The study included 200 patients randomized to receive candesartan 16 mg or lisinopril 20 mg for 12 weeks, followed by 12 weeks of the same monotherapy or a combination treatment. Main outcomes are the reduction of microalbuminuria and blood pressure. All three of the treatments are effective, but the dual blockade is respectively 18%, 8 mmHg and 5 mmHg more effective in reducing microalbuminuria, systolic and diastolic blood pressure. No comparison is made between this "new" association and the more frequently used biotherapy (i.e. ACE-I plus thiazidic diuretic) and therefore its usefulness in regular practice is still to be determined. [less ▲]

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See detailRenal response to increasing doses of angiotensin converting enzyme inhibitor (ACEI) in type 1 diabetes mellitus according to ACE I/D polymorphism
Weekers, Laurent ULg; Bouhanick, Béatrice; Gallois, Yves et al

in Nephrology Dialysis Transplantation (2001), 16(6), 7

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See detailGénétique de la Néphropathie diabétique
Hadjadj, Samy; Weekers, Laurent ULg; Marre, Michel

in Sang Thrombose Vaisseaux [=STV] (2000), 12(3), 151-156

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See detailRecommandations a propos du traitement de l'hypertension arterielle chez le patient diabetique.
Scheen, André ULg; Rorive, Marcelle ULg; Estrella, F. et al

in Revue Médicale de Liège (2000), 55(5), 376-82

Diabetes mellitus is frequently associated with arterial hypertension and the combination of the two entities markedly increases the cardiovascular risk and accelerates the progression of microangiopathy ... [more ▼]

Diabetes mellitus is frequently associated with arterial hypertension and the combination of the two entities markedly increases the cardiovascular risk and accelerates the progression of microangiopathy (more particularly nephropathy) in both type 1 and type 2 diabetic patients. Numerous international guidelines have been published during the last few years to help the practitioner in targeting ideal arterial blood pressure levels (lower in diabetic than in non-diabetic patients) and in selecting first-choice antihypertensive agents. We will concisely summarize the main messages of these recommendations and insist upon the persistence of uncertainties, or even the existence of inconsistencies, more particularly regarding preferential indications of antihypertensive agents in diabetic patients. [less ▲]

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See detailGenetic polymorphism of transforming growth factor-β1 and microvascular complications in type 1 diabetes
Weekers, Laurent ULg; Hadjadj, Samy; Bouhanick, Béatrice et al

in Diabetologia (2000), 43(1), 137

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See detailRelationship between incipiens nephropathy and cardiac autonomic neuropathy in type 1 diabetes
Estrella, Frederico; Scheen, André ULg; Marchand, Monique et al

in Diabetes (2000), 49(sup. 1), 379-380

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