References of "Nephrology Dialysis Transplantation"
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See detailErrors induced by indexing glomerular filtration rate for body surface area: reductio ad absurdum.
Delanaye, Pierre ULg; Mariat, Christophe; Cavalier, Etienne ULg et al

in Nephrology Dialysis Transplantation (2009), 24(12), 3593-6

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See detailPrevalence of chronic kidney disease in Kinshasa: results of a pilot study from the Democratic Republic of Congo
Sumaili, Ernest K.; Krzesinski, Jean-Marie ULg; Zinga, Chantal V. et al

in Nephrology Dialysis Transplantation (2009), 24(1), 117-122

Abstract Background. The burden of chronic kidney disease (CKD) in sub-Saharan Africa is unknown. The aim of this study was to investigate the prevalence and the risk factors associated with CKD in ... [more ▼]

Abstract Background. The burden of chronic kidney disease (CKD) in sub-Saharan Africa is unknown. The aim of this study was to investigate the prevalence and the risk factors associated with CKD in Kinshasa, the capital of the Democratic Republic of Congo (DRC). Methods. In a cross-sectional study, 503 adult residents in 10 of the 35 health zones of Kinshasa were studied in a randomly selected sample. Glomerular filtration rate was estimated using the simplified Modification of Diet in Renal Disease Study equation (eGFR) and compared with the Cockcroft–Gault equation for creatinine clearance. The associations between health characteristics, indicators of kidney damage (proteinuria) and kidney function (<60 ml/min/1.73 m2) were examined. Results. The prevalence of all stages of CKD according to K/DOQI guidelines was 12.4% [95% confidence interval (CI), 11.0–15.1%]. By stage, 2% had stage 1 (proteinuria with normal eGFR), 2.4% had stage 2 (proteinuria with an eGFR of 60–89 ml/min/1.73 m2), 7.8% had stage 3 (eGFR, 30–59 ml/min/1.73 m2) and 0.2% had stage 5 (eGFR < 15 ml/min/1.73 m2). Hypertension and age were independently associated with CKD stage 3. The prevalences of major non-communicable diseases considered in this study were 27.6% (95% CI, 25.7–31.3%) for hypertension, 11.7% (95% CI, 10.3–14.4%) for diabetes mellitus and 14.9% (95% CI, 13.3–17.9%) for obesity. Hypertension was also independently associated with proteinuria. Conclusion. More than 10% of the Kinshasa population exhibits signs of CKD, which is affecting adults in their productive years. Risk factors for CKD, including hypertension, diabetes and obesity, are increasing. These alarming data must guide current and future healthcare policies to meet the challenge raised by CKD in this city and hopefully in the whole country. [less ▲]

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See detailIntermittent versus continuous renal replacement therapy for acute kidney injury patients admitted to the intensive care unit: results of a randomized clinical trial.
Lins, Robert L; Elseviers, Monique M; Van der Niepen, Patricia et al

in Nephrology Dialysis Transplantation (2009), 24(2), 512-8

BACKGROUND: There is uncertainty on the effect of different dialysis modalities for the treatment of patients with acute kidney injury (AKI), admitted to the intensive care unit (ICU). This controlled ... [more ▼]

BACKGROUND: There is uncertainty on the effect of different dialysis modalities for the treatment of patients with acute kidney injury (AKI), admitted to the intensive care unit (ICU). This controlled clinical trial performed in the framework of the multicentre SHARF 4 study (Stuivenberg Hospital Acute Renal Failure) aimed to investigate the outcome in patients with AKI, stratified according to severity of disease and randomized to different treatment options. METHODS: This was a multicentre prospective randomized controlled trial with stratification according to severity of disease expressed by the SHARF score. ICU patients were eligible for inclusion when serum creatinine was >2 mg/dL, and RRT was initiated. The selected patients were randomized to intermittent (IRRT) or continuous renal replacement therapy (CRRT). RESULTS: A total of 316 AKI patients were randomly assigned to IRRT (n = 144) or CRRT (n = 172). The mean age was 66 (range 18-96); 59% were male. Intention-to-treat analysis revealed a mortality of 62.5% in IRRT compared to 58.1% in CRRT (P = 0.430). No difference between IRRT and CRRT could be observed in the duration of ICU stay or hospital stay. In survivors, renal recovery at hospital discharge was comparable between both groups. Multivariate analysis, including the SHARF score, APACHE II and SOFA scores for correction of disease severity, showed no difference in mortality between both treatment modalities. This result was confirmed in pre-specified subgroup analysis (elderly, patients with sepsis, heart failure, ventilation) and after exclusion of possible confounders (early mortality, delayed ICU admission). CONCLUSIONS: Modality of RRT, either CRRT or IRRT, had no impact on the outcome in ICU patients with AKI. Both modalities need to be considered as complementary in the treatment of AKI (Clinical Trial: SHARF 4, NCT00322933, http://ClinicalTrials.gov). [less ▲]

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See detailAbdominal aortic calcification in dialysis patients: results
Honkanen, Eero; Kauppila, Leena; Wikström, Björn et al

in Nephrology Dialysis Transplantation (2008), 12

Abstract Background. Patients with chronic kidney disease stage 5 have a high prevalence of vascular calcification, but the specific anatomical distribution and severity of abdominal aortic calcification ... [more ▼]

Abstract Background. Patients with chronic kidney disease stage 5 have a high prevalence of vascular calcification, but the specific anatomical distribution and severity of abdominal aortic calcification (AAC), in contrast to coronary calcification, is less well documented. AAC may be recorded using plain radiographs. The present report is an analysis of baseline data on AAC in patients enrolled in the CORD (Calcification Outcome in Renal Disease) study. Methods. A total of 47 centres in six European countries participated in this cross-sectional study. Inclusion criteria were age ≥18 years and duration of dialysis ≥3 months. Lateral lumbar radiography of the abdominal aortawas used to determine the overall AAC score, which is related to the severity of calcific deposits at lumbar vertebral segments L1–L4. The reliability of the method was tested by double reading of 64 radiographs (coefficient of correlation 0.9). Results. A lateral lumbar radiograph was obtained in 933 patients. Calcification (AAC score ≥ 1) was present in 81% of the patients; its severity increased significantly from L1 to L4 (P < 0.0001) and affected all of these segments in 51% of patients. Independent predictors for the presence and severity of calcification were age (odds ratio [OR] 1.103/year; P < 0.0001), duration of dialysis (OR 1.110/year; P = 0.002) and history of cardiovascular disease (OR 3.247; P < 0.0001). Conclusions. AAC detected by lateral lumbar radiograph is associated with several risk factors of uraemic calcification. This semi-quantitative method is more widely available and less expensive than the current procedures for studying calcification and could formpart of a pre-transplantworkup and cardiovascular risk stratification. [less ▲]

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See detailEfficacy and safety of tacrolimus compared with ciclosporin A in renal transplantation: three-year observational results
Krämer, Bernhard K.; Del Castillo, Domingo; Margreiter, Raimund et al

in Nephrology Dialysis Transplantation (2008), 23(7), 2386-2392

BACKGROUND: The European tacrolimus versus ciclosporin A microemulsion (CsA-ME) renal transplantation study showed that tacrolimus was significantly more effective in preventing acute rejection and had a ... [more ▼]

BACKGROUND: The European tacrolimus versus ciclosporin A microemulsion (CsA-ME) renal transplantation study showed that tacrolimus was significantly more effective in preventing acute rejection and had a superior cardiovascular risk profile at 6 months. METHODS: The endpoints of this investigator-initiated, observational, 36-month follow-up were acute rejection incidence rates, rates of patient and graft survival and renal function. An additional analysis was performed using the combined endpoints BPAR, graft loss and patient death. Data available from the original ITT population (557 patients; 286 tacrolimus and 271 CsA-ME) were analysed. RESULTS: A total of 231 tacrolimus and 217 CsA-ME patients participated. At 36 months, Kaplan-Meier-estimated BPAR-free survival rates were 78.8% in the tacrolimus group and 60.6% in the CsA-ME group, graft survival rates were 88.0% and 86.9% and patient survival rates were 96.6% and 96.7%, respectively. The estimated combined endpoint-free survival rate was 71.4% with tacrolimus and 55.4% with CsA-ME (P <or= 0.001, chi-square test). Significantly more CsA-ME patients crossed over to tacrolimus during the 3-year follow-up: 21.2% versus 2.6%, P <or= 0.0001, chi-square test. Most patients in the tacrolimus arm discontinued steroids and received monotherapy and fewer tacrolimus patients remained on a triple regimen. Mean serum creatinine concentration was 145.4 +/- 90.9 micromol/L with tacrolimus and 149.0 +/- 92.1 micromol/L with CsA-ME. Significantly more CsA-ME patients had a classified cholesterol value >6 mmol/L (26.3% versus 12.6%, P <or= 0.0003, chi-square test). CONCLUSIONS: Patients treated with tacrolimus had significantly higher combined endpoint-free survival rates and lower acute rejection rates with less immunosuppressive medication at 36 months. [less ▲]

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See detailCystatin C-based equations: don't repeat the same errors with analytical considerations.
Delanaye, Pierre ULg; Cavalier, Etienne ULg; Krzesinski, Jean-Marie ULg et al

in Nephrology Dialysis Transplantation (2008), 23(3), 10651065-6

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See detailReproducibility of GFR measured by chromium-51-EDTA and iohexol.
Delanaye, Pierre ULg; Cavalier, Etienne ULg; Froissart, Marc et al

in Nephrology Dialysis Transplantation (2008), 23(12), 4077-84078

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See detailHow to tackle the avalanche of chronic kidney disease in sub-Saharan Africa: the situation in the Democratic Republic of Congo as an example
Krzesinski, Jean-Marie ULg; Sumaili, Kiswaya Ernest; Cohen, Eric P.

in Nephrology Dialysis Transplantation (2007), 22(2), 332-335

In developing countries chronic kidney disease (CKD) is a growing problem. In most of sub-Saharan Africa, the vast majority of patients with CKD die because of lack of treatment. Renal replacement therapy ... [more ▼]

In developing countries chronic kidney disease (CKD) is a growing problem. In most of sub-Saharan Africa, the vast majority of patients with CKD die because of lack of treatment. Renal replacement therapy is expensive, which makes it unaffordable to the residents of low-income regions. A solution to this problem may lie in preventive interventions. This editorial will focus on the reasons and some ways to reach such objectives. [less ▲]

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See detailMature erythrocyte parameters as new markers of functional iron deficiency in haemodialysis: sensitivity and specificity
Bovy, Christophe ULg; Gothot, André ULg; Krzesinski, Jean-Marie ULg et al

in Nephrology Dialysis Transplantation (2007), 11

Background. The percentage of hypochromic red blood cells (RBCs) (%HYPO) has been demonstrated as the best predictor of response to iron loading in haemodialysis patients treated with recombinant human ... [more ▼]

Background. The percentage of hypochromic red blood cells (RBCs) (%HYPO) has been demonstrated as the best predictor of response to iron loading in haemodialysis patients treated with recombinant human erythropoietin (rHuEPO). However, we have previously shown that this parameter is positively influenced by erythropoietic activity since reticulocytes are considered hypochromic by cell counters. New cell counters are able to determine cell volume and haemoglobin (Hb) concentration separately on reticulocytes and mature erythrocytes. The aim of this study was to assess the sensitivity and specificity of mature erythrocyte parameters in detecting functional iron deficiency (FID). Methods. A total of 32 stable chronic haemodialysis patients in the maintenance phase of rHuEPO therapy were included. Classical parameters of iron monitoring and mature erythrocyte parameters were measured after a 4-week iron-free period. Patients were classified as responders (R) or non-responders (NR) to an iron load of 100 mg iron sucrose at each dialysis session for 4 weeks, according to whether their Hb increased by >1 g/dl at the end of iron loading. Results. Twelve patients were identified as responders. Receiver operating characteristic (ROC) curve analysis demonstrated %HYPO and its corresponding parameter on mature erythrocyte, %HYPOm, as the best predictors of FID. The other parameters were ordered as follows: tranferrin saturation (TSAT), ferritin (FRT), mature RBC Hb content (CHm), mean corpuscular Hb concentration (MCHC), percentage of mature erythrocytes with a low CHm (%lowCHm), mean content in Hb (MCH) and reticulocyte Hb content CHr. Comparing the parameters at different cut-offs, the best sensitivity, specificity and efficiency were demonstrated for HYPOm>6%. Conclusion. The best efficiency to predict FID was found for %HYPOm>6%. The predictive value of %HYPO was quite similar. The clinical impact of %HYPOm in iron monitoring should also be tested in the induction phase of rHuEPO treatment because of its independence from erythropoietic activity. [less ▲]

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See detailRenal extraction of cystatin C
Delanaye, Pierre ULg; Cavalier, Etienne ULg; Chapelle, Jean-Paul ULg et al

in Nephrology Dialysis Transplantation (2006), 21(11), 3333-3333

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See detailCalcification outcome in renal disease (CORD) - A prospective epidemiological multinational study: An analysis of the segmental distribution and severity of calcification of the abdominal aorta in dialysis patients
Honkanen, E.; Kauppila, L.; Wikstrom, B. et al

in Nephrology Dialysis Transplantation (2006, July), 21(Suppl. 4), 408-409

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See detailImportance of the creatinine calibration in the estimation of GFR by MDRD equation
Delanaye, Pierre ULg; Cavalier, Etienne ULg; Chapelle, Jean-Paul ULg et al

in Nephrology Dialysis Transplantation (2006), 21(4), 1130-1130

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See detailIndexing glomerular filtration rate for body surface area is useful in obese subjects - Reply
Delanaye, Pierre ULg; Depas, Gisèle ULg; Radermecker, Régis ULg et al

in Nephrology Dialysis Transplantation (2006), 21(3), 821-822

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See detailPlasma cystatin C for the detection of renal failure in obese patients
Delanaye, Pierre ULg; Cavalier, Etienne ULg; Radermecker, Régis ULg et al

in Nephrology Dialysis Transplantation (2006), 21(S4), 214

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See detailTopiramate induces type 3 renal tubular acidosis by inhibiting renal carbonic anhydrase.
Sacre, Anne; JOURET, François ULg; Manicourt, Daniel et al

in Nephrology Dialysis Transplantation (2006), 21(10), 2995-6

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See detailIndexing glomerular filtration rate for body surface area in obese patients is misleading: concept and example
Delanaye, Pierre ULg; Radermecker, Régis ULg; Rorive, Marcelle ULg et al

in Nephrology Dialysis Transplantation (2005), 20(10), 2024-2028

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See detailMassive renal and adrenal calcifications in a young dialysis patient with familial Mediterranean fever
Delanaye, Pierre ULg; Krzesinski, Jean-Marie ULg

in Nephrology Dialysis Transplantation (2005), 20(1), 238-238

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See detailEfficacy and safety of tacrolimus compared with ciclosporin A microemulsion in renal transplantation: 2 year follow-up results
Krämer, Bernhard K.; Montagnino, Giuseppe; del Castillo, Domingo et al

in Nephrology Dialysis Transplantation (2005), 20

BACKGROUND: Comparison studies of calcineurin inhibitors as cornerstone immunosuppressants in renal transplantation have demonstrated that tacrolimus consistently reduces acute rejection rates and, in ... [more ▼]

BACKGROUND: Comparison studies of calcineurin inhibitors as cornerstone immunosuppressants in renal transplantation have demonstrated that tacrolimus consistently reduces acute rejection rates and, in some studies, also improves long-term renal outcome in comparison to cyclosporin A (CsA). The aim of the present 2 year follow-up of the European Tacrolimus vs Cyclosporin A Microemulsion Renal Transplantation Study was to investigate long-term clinical outcome in terms of rate of acute rejection, graft and patient survival and graft function. METHODS: The European Tacrolimus vs Cyclosporin A Microemulsion Renal Transplantation Study was a randomized, comparative 6 month trial of the calcineurin inhibitors tacrolimus and CsA in combination with both azathioprine and steroids. The intent-to-treat population (ITT) consisted of 286 patients in the tacrolimus arm and 271 in the CsA microemulsion (CsA-ME) arm. Whereas whole blood level targets were 10-20 and 5-15 ng/ml for tacrolimus and 100-400 and 100-200 ng/ml for CsA during months 0-3 and 4-6, respectively, during the investigator-driven follow-up after termination of the main study (months 7-24) no specific calcineurin inhibitor target levels were required. Follow-up data were collected at 2 years post-transplantation from 237 (82.9% of the ITT population) patients who received tacrolimus and 222 (81.9% of the ITT population) patients who received CsA-ME. RESULTS: Calculated on ITT populations, mortality (2.0% vs 3.3%; P<0.05 in Kaplan-Meier analysis) was lower, but rate of graft loss (9.3% vs 11.2%; P = 0.12 in Kaplan-Meier analysis) was not significantly different after 2 years with tacrolimus- vs CsA-ME-based immunosuppression. Biopsy-proven acute rejection was significantly lower (19.6%) with tacrolimus than with CsA-ME (37.3%) during months 0-6 (P<0.0001), but was not significantly different during months 7-12 and 13-24 of follow-up (1.7% and 0.8% with tacrolimus and 4.7% and 0.9% with CsA-ME, respectively). A composite endpoint consisting of graft loss, patient death and biopsy-proven acute rejection occurred significantly more frequently in CsA-ME patients than in tacrolimus patients (42.8% vs 25.9%; P<0.001) during 24 months follow-up. Renal function 2 years post-transplant, measured by serum creatinine concentrations, was significantly better in tacrolimus-based compared with CsA-ME-based immunosuppression (136.9 vs 161.6 micromol/l; P<0.01). Cornerstone immunosuppression remained unchanged in 82.5% and 66.2% of patients treated with tacrolimus and CsA-ME, respectively. At 2 years, more patients in the tacrolimus arm were off steroids and received calcineurin inhibitor monotherapy, and fewer tacrolimus patients remained on a triple immunosuppressive regimen. The cardiovascular risk profile was affected favourably in the tacrolimus arm, with lower cholesterol and triglyceride concentrations (despite less use of cholesterol-lowering drugs); no significant difference in requirement for antidiabetic medication was noted. CONCLUSIONS: The 2 year study results confirm that tacrolimus is a highly efficacious cornerstone immunosuppressant in kidney transplantation. Tacrolimus-based immunosuppression may induce long-term benefits with regard to graft function and graft survival. The overall side-effect profile is considered to be favourable. [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 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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