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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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See detailLa variation de l’équilibre glycémique (mais pas du poids) est corrélée positivement à la modification du risque cardiovasculaire absolu chez le patient diabétique
Hadjadj, Samy; Guilloteau, Gérard; Weekers, Laurent ULg et al

in Archives des Maladies du Coeur et des Vaisseaux (2000), 93(8), 1033-1036

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See detailIron monitoring under vitamin C therapy in hemodialysed patients treated with erythropoietin
Bovy, Christophe ULg; Dubois, Bernard ULg; Weekers, Laurent ULg et al

in Nephrology Dialysis Transplantation (2000), 15(9), 156

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

Conference (2000)

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See detailWhat do the needles, syringes, lancets and reagent strips of diabetic patients become in the absence of a common attitude? About 1070 questionnaires in diabetic clinics.
Bouhanick, B.; Hadjadj, S.; Weekers, Laurent ULg

in Diabètes & Métabolism (2000), 26(4), 288-93

The aim was to investigate the fate of injection and monitoring material after its use by diabetic patients in different countries (France, Belgium, Luxemburg, Switzeland and Tunisia). Some suitable ... [more ▼]

The aim was to investigate the fate of injection and monitoring material after its use by diabetic patients in different countries (France, Belgium, Luxemburg, Switzeland and Tunisia). Some suitable containers are available for disposal but little is known about the attitudes of patients and physicians to them. 1 070 questionnaires were completed by patients (age: 50 +/- 18 years; diabetes duration: 15 +/- 11 years; 2.8 +/- 1.1 injections per day) visiting 109 doctors. Injections were done at home (72.6%), or both at home and at work (26.6%). At home: needles, syringes, lancets and reagent strips were thrown directly into the bin in 46.9%, 49.9%, 52.2% and 67.6% of cases, respectively; and in a closed plastic bottle in 29. 6%, 28.5%, 28.9% and 19.9% of cases, respectively. Specific containers were used in 8.6% and 6.3% of cases for needles and syringes, respectively. 62% of the bottles and containers were thrown directly into the bin, whereas 15.5% were returned to a pharmacy (4.5% taken to hospitals, 2.9% were burned). At work: 63% of the patients brought their needles and syringes home for disposal, 6.9% kept suitable containers at work and 30% threw their materials directly into local bins. We conclude that awareness should be increased and the organization of the collection of used material improved. [less ▲]

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See detailHypertension arterielle et diabete de type 2.
Scheen, André ULg; Estrella, F.; Weekers, Laurent ULg

in Revue Médicale de Liège (1999), 54(10), 789-95

Diabetes mellitus is frequently associated with arterial hypertension and the combination of both entities markedly increases the vascular risk. In type 2 diabetes, hypertension appears very early ... [more ▼]

Diabetes mellitus is frequently associated with arterial hypertension and the combination of both entities markedly increases the vascular risk. In type 2 diabetes, hypertension appears very early, especially in the presence of obesity, is part of the insulin resistance syndrome, and contributes to high cardiovascular morbidity and mortality rates in this population. Appropriate regulation of blood pressure is crucial in order to reduce not only microangiopathy (nephropathy and retinopathy) but also macroangiopathy (coronary heart disease and stroke) in hypertensive type 2 diabetic patients. Target blood pressure values have been decreased in recent years and should be < 130/85 mmHg, and may be even lower according to recent data. The optimal modalities of pharmacological treatment remain controversial, but obviously several medications are required to reach such objectives in most hypertensive patients with type 2 diabetes. [less ▲]

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See detailLa variation de l’équilibre glycémique (mais pas du poids) est correlée positivement à la modification du risque cardio-vasculaire absolu chez le sujet diabétique
Hadjadj, Samy; Guilloteau, Gérard; Weekers, Laurent ULg et al

in Archives des Maladies du Coeur et des Vaisseaux (1999), 92

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See detailContribution de l'hypertension arterielle au risque vasculaire du diabetique.
Marre, M.; Bouhanick, B.; Hadjadj, S. et al

in Diabètes & Métabolism (1999), 25 Suppl 3

Hypertension is a major cardiovascular risk factor in diabetic subjects. Recent trials have suggested that blood pressure objectives should be < or = 140/80 mmHg. However, there is currently no evidence ... [more ▼]

Hypertension is a major cardiovascular risk factor in diabetic subjects. Recent trials have suggested that blood pressure objectives should be < or = 140/80 mmHg. However, there is currently no evidence supporting any particular preferential drug strategy for this treatment objective. [less ▲]

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See detailLack of contribution of two endotelial nitric oxide synthase (eNOS) gene polymorphisms to diabetic nephropathy in type 1 diabetes
Weekers, Laurent ULg; Hadjadj, S.; Belloum, R. et al

in Diabetologia (1999), 42(Sup. 1), 226

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