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Delanaye P, Scheen AJ. [EMPA-KIDNEY: empagliflozin in chronic kidney disease]. Rev Med Liege 2023; 78:24-28. [PMID: 36634063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The inhibition of the renin-angiotensin system represents the first preventive treatment of the chronic kidney disease (CKD), especially in presence of albuminuria. Recently, sodium-glucose cotransporter type 2 inhibitors (SGLT2i, gliflozins) demonstrated a nephroprotective effect, first in patients with type 2 diabetes at cardiovascular risk, then in diabetic patients with CKD assessed by a reduction of the glomerular filtration rate (GFR) and albuminuria (CREDENCE with canagliflozin), and finally in patients with CKD and albuminuria, with or without diabetes (DAPA-CKD with dapagliflozin). EMPA-KIDNEY study compared the effects of empagliflozin 10 mg/day versus placebo in patients with CKD, with or without diabetes. In comparison with the two previous renal studies, this clinical trial randomised patients with a lower GFR (78 % of patients with GFR inferior to 45 mL/min/1.73 m²) and a lower level of albuminuria (20 % of patients without pathological albuminuria). EMPA-KIDNEY demonstrated a reduction by 28 % (p inferior to 0.001) of the primary composite outcome (progression of CKD or cardiovascular death) and of several renal endpoints, including the shift to terminal CKD (-33 %), independently of the presence of diabetes, and with a tolerance profile comparable to what is already known. EMPA-KIDNEY results reinforce the use of SGLT2is, in general, and of empagliflozin, in particular, in a broader population with CKD and, thus, the indication of this pharmacological class in nephrology in combination with inhibitors of the renin-angiotensin system.
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Affiliation(s)
- P Delanaye
- Service de Néphrologie, Dialyse, Hypertension et Transplantation, CHU Liège, Belgique.,Service de Néphrologie, Dialyse, Aphérèse, Hôpital Universitaire Carémeau, Nîmes, France
| | - A J Scheen
- Service de Diabétologie, Nutrition et Maladies métaboliques, CHU Liège, Belgique
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Salmon A, Delanaye P, Weekers L. La variation de la créatinine sérique au cours de la première année post-transplantation a-t-elle une influence sur le devenir du greffon rénal ? Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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3
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Delanaye P, Masson I, Maillard N, Pottel H, Mariat C. Performance de la nouvelle équation CKD-EPI (sans la variable ethnique) en transplantation rénale. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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4
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Delanaye P, Dubois B, Cavalier E, Jouret F. [Diagnostic approach to chronic kidney disease]. Rev Med Liege 2022; 77:249-252. [PMID: 35389010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Chronic kidney disease (CKD) affects ~7 % of the general population and is burdened with significant morbidity and mortality, especially cardiovascular disease. At the terminal stage, CKD requires demanding and costly treatments for the patient and the society, such as dialysis or kidney transplantation. The symptomatology of CKD is poor and unspecific, which complicates the identification and early management of patients with CKD. Diagnostic criteria for CKD include (1) renal morphological abnormality; and/or (2) proteinuria superior to150 mg/g creatinine; and/or (3) glomerular filtration rate (GFR) inferior to 60 ml/min/ 1.73 m². The persistence of these abnormalities for more than 3 months indicates the chronicity of the renal damage. Starting from an exemplary clinical case, we detail the diagnostic steps when faced with a suspicion of CKD.
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Affiliation(s)
- P Delanaye
- Service de Néphrologie, Dialyse et Transplantation, CHU Liège, Belgique
- Service de Néphrologie, Dialyse, Aphérèse, Hôpital Universitaire Carémeau, Nîmes, France
| | - B Dubois
- Service de Néphrologie, Dialyse et Transplantation, CHU Liège, Belgique
| | - E Cavalier
- Service de Chimie Médicale, ULiège, Belgique
| | - F Jouret
- Service de Néphrologie, Dialyse et Transplantation, CHU Liège, Belgique
- Laboratoire de Recherche Translationnelle en Néphrologie (LTRN), GIGA Sciences Cardio-vasculaires, ULiège, Belgique
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Valdes-Socin H, Scheen AJ, Jouret F, Grosch S, Delanaye P. [From the discovery of phlorizin (a Belgian story) to SGLT2 inhibitors]. Rev Med Liege 2022; 77:175-180. [PMID: 35258866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Most physicians do not know, or do not remember, the name of phlorizin. Hence this molecule has a major historical importance because it was the precursor of gliflozins, a new class of oral antidiabetic drugs with recent therapeutic perspectives beyond diabetes. This article recalls the history of phlorizin: its discovery in the 19th century by De Koninck and Stas, the demonstration of its ability to induce glucosuria and reduce hyperglycaemia by von Mering, its use to demonstrate the concept of glucose toxicity by the team of DeFronzo and finally the development of selective (phlorizin being not selective) sodium-glucose cotransporter type 2 inhibitors (gliflozins) which block glucose reabsorption in renal tubules. Gliflozins have increasing therapeutic indications, not only in type 2 diabetes, but also in cardiology and nephrology among non-diabetic people with heart failure or renal insufficiency.
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Affiliation(s)
| | - A J Scheen
- Service de Diabétologie, Nutrition et Maladies métaboliques, CHU Liège, Belgique
| | - F Jouret
- Service de Néphrologie, Dialyse, Hypertension et Transplantation, CHU Liège, Belgique
| | - S Grosch
- Service de Néphrologie, Dialyse, Hypertension et Transplantation, CHU Liège, Belgique
| | - P Delanaye
- Service de Néphrologie, Dialyse, Hypertension et Transplantation, CHU Liège, Belgique
- Service de Néphrologie-Dialyse-Aphérèse, Hôpital Universitaire Carémeau, Nîmes, France
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Scheen AJ, Delanaye P. [SGLT2 inhibitors and RAAS blockers : similarities, differences and complementarity]. Rev Med Liege 2022; 77:18-24. [PMID: 35029336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Both renin-angiotensin-aldosterone system inhibitors (RAASi) and sodium-glucose cotransporter type 2 inhibitors (SGLT2i, gliflozins) reduce the risk of heart failure and of progressing towards end-stage renal disease, especially in patients with type 2 diabetes (T2D). Positive results reported in patients with T2D have been confirmed in people without diabetes. These two pharmacological classes now occupy a privileged place in international guidelines, in diabetology, cardiology and nephrology. The present article describes similarities and differences between these two types of medications. It emphasizes the importance of combining both approaches in order to optimize the cardiovascular and renal prognosis, while maintaining a good safety profile.
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Affiliation(s)
- A J Scheen
- Service de Diabétologie, Nutrition et Maladies métaboliques et Unité de Pharmacologie clinique, CHU Liège, Belgique
| | - P Delanaye
- Service de Néphrologie, Dialyse, Hypertension et Transplantation, CHU Liège, Belgique
- Service de Néphrologie-Dialyse-Aphérèse, Hôpital Universitaire Carémeau, Nîmes, France
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Resimont G, Vranken L, Cavalier E, Delanaye P. Estimation d’un ratio Albumine/Créatinine urinaire à partir d’un ratio Protéine/Créatinine urinaire au départ de mesures réalisées sur un même échantillon : validation d’équations. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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8
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Delanaye P. Performance des équations d’estimation du DFG basées sur la créatinine dans le contexte de l’adaptation posologique. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gaillard F, Courbebaisse M, Couzi L, Dubourg L, Garrouste C, Hourmant M, Kamar N, Rostaing L, Mariat C, Delanaye P. Age-adapted percentiles for older candidates to living kidney donation. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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10
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Scheen AJ, Delanaye P. [SGLT2 inhibitors in patients with chronic kidney disease : from clinical trials to guidelines and new prospects for clinical practice]. Rev Med Liege 2021; 76:186-194. [PMID: 33682388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Sodium-glucose cotransporter type 2 inhibitors (iSGLT2 or gliflozins) exert their antidiabetic action through a specific renal mechanism, by inhibiting tubular glucose reabsorption. These agents have proven their efficacy to reduce major cardiovascular events and hospitalisation for heart failure, but also the progression of chronic kidney disease (CKD), in patients with type 2 diabetes (T2DM) at high risk, independently of glucose control. While the glucose-lowering effect of iSGLT2 is decreasing with the decline of estimated glomerular filtration rate (eGFR), both cardiovascular and renal protections remain present until an eGFR as low as 30 ml/min/1,73 m². These effects were demonstrated in several meta-analyses and in two trials specifically dedicated to renal outcomes in patients with CKD and macroalbuminuria : CREDENCE with canagliflozin and Dapa-CKD with dapagliflozin. In addition, Dapa-CKD showed similar positive results whatever the presence or absence of T2DM. Safety profile of SGLT2is among patients with CKD is good and similar to that of patients with normal renal function. These favourable findings led to a privileged place of SGLT2i in recent international guidelines promoted by diabetologists, cardiologists and nephrologists. Current restrictive criteria for the prescription and reimbursement of SGLT2i in Belgium according to eGFR level (initiation only if eGFR superior to 60 and interruption if eGFR inferior to 45 ml/min/1.73 m²) should be enlarged very soon owing to convincing results of published controlled trials.
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Affiliation(s)
- A J Scheen
- Service de Diabétologie, Nutrition et Maladies métaboliques et Unité de Pharmacologie clinique, CHU Liège, Liège Université, Belgique
| | - P Delanaye
- Service de Néphrologie, Dialyse, Hypertension et Transplantation, CHU Liège, Belgique
- Service de Néphrologie-Dialyse-Aphérèse, Hôpital Universitaire Carémeau, Nîmes, France
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Erpicum P, Grosch S, Bouquegneau A, Huart J, Résimont G, Bovy C, Habran L, Delvenne P, Krzesinski JM, Burtey S, Delanaye P, Jouret F. [Kidney injury in COVID-19]. Rev Med Liege 2020; 75:109-114. [PMID: 33211431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The SARS-CoV-2 virus causes a respiratory distress syndrome, the main symptom of COVID-19 (for "COronaVIrus Disease 2019"). This infectious disease has been causing a major health and socio-economic pandemic since December 2019. The pulmonary alveolus is regarded as the main target of SARS-CoV-2. However, this coronavirus is capable of directly or indirectly affecting other organs, including the kidneys. Here, we summarize the presumed pathophysiology of COVID-19 renal disease. The incidence of acute kidney injury ranges from 0,5 to 22 % of all patients infected with SARS-CoV-2. The need for renal replacement therapy is reported in 5-9 % of patients in intensive care. Histological analysis of renal biopsies mainly shows acute tubular necrosis of varying severity, as well as the congestion of glomerular and peri-tubular capillaries. Endothelitis has been described in few cases. Evidence for a factual inflammation of the glomerulus remains controversial. The medium/long term consequences of COVID-19 nephropathy are unknown and will deserve a tight follow-up.
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Affiliation(s)
- P Erpicum
- Service de Néphrologie, CHU Liège, Belgique
- Unité de Recherche cardio-vasculaire, GIGA, Université de Liège, Belgique
| | - S Grosch
- Service de Néphrologie et Service d'Anatomo-Pathologie, CHU Liège, Belgique
| | | | - J Huart
- Service de Néphrologie, CHU Liège, Belgique
- Unité de Recherche cardio-vasculaire, GIGA, Université de Liège, Belgique
| | - G Résimont
- Service de Néphrologie, CHU Liège, Belgique
| | - C Bovy
- Service de Néphrologie et Service d'Anatomo-Pathologie, CHU Liège, Belgique
| | - L Habran
- Service d'Anatomo-Pathologie, CHU Liège, Belgique
| | - P Delvenne
- Service d'Anatomo-Pathologie, CHU Liège, Belgique
| | - J M Krzesinski
- Service de Néphrologie, CHU Liège, Belgique
- Unité de Recherche cardio-vasculaire, GIGA, Université de Liège, Belgique
| | - S Burtey
- Centre de Néphrologie et Transplantation rénale, Assistance Publique des Hôpitaux de Marseille, Marseille, France
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
| | - P Delanaye
- Service de Néphrologie, CHU Liège, Belgique
- Service de Néphrologie-Dialyse-Aphérèse, Hôpital Universitaire Caremeau, Nîmes, France
| | - F Jouret
- Service de Néphrologie, CHU Liège, Belgique
- Unité de Recherche cardio-vasculaire, GIGA, Université de Liège, Belgique
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Faucon AL, Flamant M, Delanaye P, Geri G, Vidal-Petiot E. Développement d’une équation de prédiction du volume extracellulaire théorique. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Pelaez A, Dinic M, Roche F, Barthélémy J, Alamartine E, Cavalier E, Delanaye P, Maillard N, Mariat C. Cystatine C, inflammation et dysfonction autonomique : un « ménage à trois » caché ? Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Bovy C, Delanaye P, Jouret F, Krzesinski JM. [Therapeutic innovation in nephrology : 10 years of progress]. Rev Med Liege 2020; 75:336-343. [PMID: 32496676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Chronic kidney disease (CKD) impairs the quality of life and increases the risk for cardiovascular morbimortality. Intensive research is conducted in order to slow down CKD development and progression. During the past decade, a better understanding of the pathophysiological mechanisms of glomerular diseases has highlighted the benefits of rituximab. Progresses have also been made in the understanding of the mechanisms of autosomal polycystic kidney disease, the most frequent inherited kidney disease. These observations led to the discovery and validation of tolvaptan, a blocker of the V2 receptor of the antidiuretic hormone as an innovative treatment. Type 2 diabetic disease is the leading cause worldwide of endstage kidney disease and dialysis. The development of new drugs, such as the gliflozins (inhibiting the sodium glucose reabsorption in the proximal tubule), has contributed to an improvement in the management of the cardiovascular and renal risks especially reducing congestive heart failure rate. Another important progress in nephrology since the beginning of the new century concerns a more precise estimation of the kidney function, which allows to better evaluate the slope of CKD progression and test the influence of different therapeutic approaches aiming at correcting anemia, hyperkalemia, metabolic acidosis and disturbances of calcium and phosphate. The present review summarizes all of these major advances in the field of CKD diagnosis and treatment, and envisions the future of nephrology for the next decade.
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Affiliation(s)
- C Bovy
- Service de Néphrologie-Dialyse-Transplantation, CHU Liège, Belgique
| | - P Delanaye
- Service de Néphrologie-Dialyse-Transplantation, CHU Liège, Belgique
- Service de Néphrologie-Dialyse-Aphérèse, Hôpital Universitaire Caremeau, Nîmes, France
| | - F Jouret
- Service de Néphrologie-Dialyse-Transplantation, CHU Liège, Belgique
| | - J M Krzesinski
- Service de Néphrologie-Dialyse-Transplantation, CHU Liège, Belgique
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Delanaye P, Vranken L, Schoneveld L, Lambermont B, Cavalier E. Prévalence de l’atteinte rénale aiguë chez le patient hospitalisé en fonction du critère de variation de la créatinine utilisé. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Vranken L, Masson G, Pottel H, Cavalier E, Delanaye P. Impact of the creatinine-based EQ. on the chronic kidney disease classification in a large laboratory database. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Vranken L, Schoneveld L, Lambermont B, Cavalier E, Makris K, Delanaye P. The impact of different creatinine criteria on the prevalence of the acute kidney injury in a population of hospitalized patients. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stojkovic V, Delanaye P, Cavalier E. Evaluation of estimated GFR using a point of care (POC) measure of creatinine in patients with iohexol determinate GFR. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Le Goff C, Nyssen L, Ferrante N, Peeters S, Delanaye P, Cavalier E. Validation of the serum iohexol LC-MS/MS method using iohexol deuterated (D5) as internal standard. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Résimont G, Gadisseur R, Lutteri L, Krzesinski JM, Cavalier E, Delanaye P. [How I explore… a proteinuria]. Rev Med Liege 2018; 73:519-525. [PMID: 30335258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The measurement of proteinuria is a very simple tool to screen and manage kidney diseases. Its predictive role is also relevant from a cardiovascular point of view. However, the interpretation of the results is not always easy. Indeed, there are several different methods to detect or measure proteinuria (or albuminuria), varying from the measurement on a 24-hour urine collection to the simplest detection with dipsticks or measurement on a random urine sample. Some methods are measuring total proteins, whereas others are measuring more specifically albuminuria. For all methods, pitfalls exist and will be discussed. A positive result must be confirmed by a quantitative measurement on 24-hour collection or on a first morning sample (this last one can only be interpreted as a ratio to urinary creatinine excretion). Lastly, we will briefly discuss the management of a patient with a new diagnosis of proteinuria (or albuminuria).
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Affiliation(s)
- G Résimont
- Service de Néphrologie, Dialyse, Transplantation rénale, Université de Liège, CHU de Liège, Belgique
| | - R Gadisseur
- Département de Chimie clinique, Université de Liège. Chef de Service, CHU de Liège, Belgique
| | - L Lutteri
- Service de Néphrologie, Dialyse, Transplantation rénale, Université de Liège, CHU de Liège, Belgique
| | - J M Krzesinski
- Département de Chimie clinique, Université de Liège. Chef de Service, CHU de Liège, Belgique
| | - E Cavalier
- Service de Néphrologie, Dialyse, Transplantation rénale, Université de Liège, CHU de Liège, Belgique
| | - P Delanaye
- XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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Gaillard F, Courbebaisse M, Kamar N, Couzi L, Gatault P, Dubourg L, Moulin B, Legendre C, Delanaye P, Mariat C. Impact de l’âge sur le niveau de DFG mesuré acceptable pour le don vivant de rein. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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22
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Yayo E, Bukabau J, Gnionsahé A, Monnet D, Pottel H, Cavalier E, Sumaili E, Delanaye P, Nseka N. Mesure du DFG en population africaine par la clairance plasmatique de l’iohexol : comparaison des méthodes à prélèvement unique et prélèvements multiples. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cavalier E, Yayo E, Attoungbre-Hauhouot M, Konan J, Yao-Yapo C, Monnet D, Souberbielle J, Delanaye P. Établissement des valeurs de référence de parathormone en Côte d’Ivoire : impact sur les guidelines KDIGO évalué sur 100 patients dialysés. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bataille S, Quinonez K, Buckinx F, Warling X, Krzesinski J, Pottel H, Burtey S, Bruyère O, Cavalier E, Delanaye P. La myostatine et l’IGF1 sont de bons biomarqueurs de la force et de la masse musculaire chez les patients hémodialysés chroniques. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bukabau J, Gnionsahé A, Monnet D, Pottel H, Cavalier E, Makulo J, Nseka N, Sumaili E, Delanaye P, Yayo E. Performances des équations basées sur la créatinine ou la cystatine C en Afrique sub-saharienne : intérêt de l’équation « Full Age Spectrum ». Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Gaillard F, Courbebaisse M, Kamar N, Rostaing L, Girerd S, Flamant M, Moulin B, Legendre C, Delanaye P, Mariat C. Impact de la technique d’évaluation du DFG sur l’éligibilité au don des donneurs vivants de rein. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Krzesinski F, Delanaye P, Dubois B, Delcour A, Krzesinski JM, Lancellotti P. P3511Interest and potential risk of increasing concentration potassium in the dialysis bath in patients on chronic hemodialysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- F Krzesinski
- University Hospital of Liege (CHU), Cardiology, Liege, Belgium
| | - P Delanaye
- University Hospital of Liege (CHU), Nephrology, Liege, Belgium
| | - B Dubois
- University Hospital of Liege (CHU), Nephrology, Liege, Belgium
| | - A Delcour
- University Hospital of Liege (CHU), Cardiology, Liege, Belgium
| | - J M Krzesinski
- University Hospital of Liege (CHU), Nephrology, Liege, Belgium
| | - P Lancellotti
- University Hospital of Liege (CHU), Cardiology, Liege, Belgium
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Delanaye P, Lambermont B, Dogné JM, Dubois B, Ghuysen A, Janssen N, Desaive T, Kolh P, D'Orio V, Krzesinski JM. Confirmation of High Cytokine Clearance by Hemofiltration with a Cellulose Triacetate Membrane with Large Pores: An in vivo Study. Int J Artif Organs 2018; 29:944-8. [PMID: 17211815 DOI: 10.1177/039139880602901004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To confirm in vivo the hypothesis that hemofiltration with a large pore membrane can achieve significant cytokine clearance. Method We used a well-known animal model of endotoxinic shock (0.5 mg/kg of lipopolysaccharide from Escherichia Coli over a period of 30 mins). Six pigs were hemofiltrated for 3 hours with a large pore membrane (78 Å pore, 80 kDa cut off) (Sureflux FH 70, Nipro, Osaka, Japan). The ultrafiltration rate was 45 ml/kg/min. Samples were taken from arterial, venous line and in the ultrafiltrate at T120 and T240. We measured concentrations of interleukin 6, interleukin 10 and albumin. Results At T120 and T240, the IL-6 clearances were 22 ± 7 and 15 ± 3 ml/min, respectively. The IL-6 sieving coefficients were 0.97 and 0.7 at T120 and T240, respectively. At T120 and T240, the IL-10 clearances were 14 ± 4 and 10 ± 7 ml/min, respectively. The sieving coefficients were 0.63 and 0.45 at T120 and T240, respectively. The concentrations of IL-6 and IL-10 were the same at T0 and T240. At T60 and T240, the plasmatic albumin concentrations were 24 ± 4 g/L and 23 ± 4 g/L, respectively (p = 0.13). Conclusions In this animal model of endotoxinic shock, we confirm the high cytokine clearance observed when hemofiltration is applied to a large pore membrane. The loss of albumin seems negligible. The impact of such clearances on hemodynamic stability and survival remains to be proved.
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Affiliation(s)
- P Delanaye
- Department of Nephrology, University of Liege, Liege - Belgium.
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Neuville M, Delanaye P, Jouret F. Les patients polykystiques en hémodialyse chronique ont une altération de la perception de soif. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Maillard N, Warling X, Moonen M, Smelten N, Jouret F, Krzesinski J, Pottel H, Cavalier E, Delanaye P. Les pentes d’évolution des CTX, de la phosphatase alcaline osseuse et du PINP sont associées à celles de la PTH en hémodialyse chronique. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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Delanaye P, Quinonez K, Buckinx F, Bruyère O, Cavalier E. Intérêt de nouveaux marqueurs biologiques dans l’évaluation de la sarcopénie en hémodialyse. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yayo E, Yao-Papo E, Gnionsahé A, Monnet D, Pottel H, Cavalier E, Delanaye P. DFG en population saine ouest-africaine : comparaison des performances de 11 équations d’estimation à marqueur unique ou combinés, avec et sans facteur ethnique. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Delanaye P, Quinonez K, Buckinx F, Krzesinski J, Bruyère O. Mesure de la force de préhension chez le patient hémodialysé : quand l’effectuer ? Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dinic M, Maillard N, Delanaye P, Krzesinski J, Saint Remy A, Cavalier E, Mariat C. Association entre les taux circulants de matrix-gla protein et rigidité artérielle en transplantation rénale. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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35
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Bukabau J, Sumaili E, Cavalier E, Kayembe P, Makulo J, Mokoli V, Kifakiou B, Nkodila A, Engole Y, Lepira F, Nseka N, Delanaye P. Performance des équations d’estimation du débit de filtration glomérulaire chez l’adulte sain en Afrique centrale (Congo Kinshasa). Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Pottel H, Bataille Y, Moranne O, Bertrand O, Cotesrousse O, Delanaye P. Impact pronostique d’une maladie rénale chronique lors d’un infarctus aigu du myocarde : valeur prédictive de différentes équations basées sur la créatinine. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Flamant M, Vidal-Petiot E, Dubourg L, Ebert N, Lemoine S, Schaeffner E, Pottel H, Cavalier E, Delanaye P. Mesure du débit de filtration glomérulaire par clairance plasmatique : comparaison d’une procédure à prélèvements multiples et à un prélèvement unique. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Gielen E, Bergmann P, Bruyère O, Cavalier E, Delanaye P, Goemaere S, Kaufman JM, Locquet M, Reginster JY, Rozenberg S, Vandenbroucke AM, Body JJ. Osteoporosis in Frail Patients: A Consensus Paper of the Belgian Bone Club. Calcif Tissue Int 2017; 101:111-131. [PMID: 28324124 PMCID: PMC5498589 DOI: 10.1007/s00223-017-0266-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/02/2017] [Indexed: 12/11/2022]
Abstract
In this consensus paper, the Belgian Bone Club aims to provide a state of the art on the epidemiology, diagnosis, and management of osteoporosis in frail individuals, including patients with anorexia nervosa, patients on dialysis, cancer patients, persons with sarcopenia, and the oldest old. All these conditions may indeed induce bone loss that is superimposed on physiological bone loss and often remains under-recognized and under-treated. This is of particular concern because of the major burden of osteoporotic fractures in terms of morbidity, mortality, and economic cost. Therefore, there is an urgent need to appreciate bone loss associated with these conditions, as this may improve diagnosis and management of bone loss and fracture risk in clinical practice.
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Affiliation(s)
- E Gielen
- Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven & Center for Metabolic Bone Diseases, UZ Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - P Bergmann
- Department of Radioisotopes, CHU Brugmann, Université Libre de Bruxelles, Bruxelles, Belgium
| | - O Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU de Liège, Liège, Belgium
| | - E Cavalier
- Department of Clinical Chemistry, UnilabLg, CIRM, University of Liège, CHU de Liège, Liège, Belgium
| | - P Delanaye
- Department of Nephrology, Dialysis, Transplantation, University of Liège, CHU de Liège, Liège, Belgium
| | - S Goemaere
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium
| | - J-M Kaufman
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - M Locquet
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU de Liège, Liège, Belgium
| | - J-Y Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU de Liège, Liège, Belgium
| | - S Rozenberg
- Department of Gynaecology-Obstetrics, Université Libre de Bruxelles, Bruxelles, Belgium
| | - A-M Vandenbroucke
- Clinical Department of Internal Medicine, UZ Leuven, Leuven, Belgium
| | - J-J Body
- Department of Medicine, CHU Brugmann, Université Libre de Bruxelles, Bruxelles, Belgium
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Scheen AJ, Delanaye P. Effects of reducing blood pressure on renal outcomes in patients with type 2 diabetes: Focus on SGLT2 inhibitors and EMPA-REG OUTCOME. Diabetes Metab 2017; 43:99-109. [PMID: 28153377 DOI: 10.1016/j.diabet.2016.12.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 12/16/2016] [Accepted: 12/19/2016] [Indexed: 12/13/2022]
Abstract
Empagliflozin, a sodium-glucose cotransporter type 2 (SGLT2) inhibitor, has enabled remarkable reductions in cardiovascular and all-cause mortality as well as in renal outcomes in patients with type 2 diabetes (T2D) and a history of cardiovascular disease in the EMPA-REG OUTCOME. These results have been attributed to haemodynamic rather than metabolic effects, in part due to the osmotic/diuretic action of empagliflozin and the reduction in arterial blood pressure (BP). The present narrative review includes the results of meta-analyses of trials evaluating the effects on renal outcomes of lowering BP in patients with T2D, with a special focus on the influence of baseline and achieved systolic BP, and compares the renal outcome results of the EMPA-REG OUTCOME with those of other major trials with inhibitors of the renin-angiotensin system in patients with T2D and the preliminary findings with other SGLT2 inhibitors, and also evaluates post hoc analyses from the EMPA-REG OUTCOME of special interest as regards the BP-lowering hypothesis and renal function. While systemic BP reduction associated to empagliflozin therapy may have contributed to the renal benefits reported in EMPA-REG OUTCOME, other local mechanisms related to kidney homoeostasis most probably also played a role in the overall protection observed in the trial.
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Affiliation(s)
- A J Scheen
- Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, CHU Liège, Liège, Belgium; Clinical Pharmacology Unit, CHU Liège, Center for Interdisciplinary Research on Medicines (CIRM), University of Liège, Liège, Belgium.
| | - P Delanaye
- Division of Nephrology, Dialysis, Transplantation and Hypertension, Department of Medicine, CHU Liège (ULg-CHU), Liège, Belgium
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Pottel H, Hoste L, Yayo E, Delanaye P. Le débit de filtration glomérulaire normal : une méta-analyse. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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41
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Paquot F, Bouquegneau A, Cavalier E, Delanaye P. Sclérostine et insuffisance rénale : que nous apprennent les différentes méthodes de dosage ? Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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42
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Cavalier E, Bergmann P, Bruyère O, Delanaye P, Durnez A, Devogelaer JP, Ferrari SL, Gielen E, Goemaere S, Kaufman JM, Toukap AN, Reginster JY, Rousseau AF, Rozenberg S, Scheen AJ, Body JJ. The role of biochemical of bone turnover markers in osteoporosis and metabolic bone disease: a consensus paper of the Belgian Bone Club. Osteoporos Int 2016; 27:2181-2195. [PMID: 27026330 DOI: 10.1007/s00198-016-3561-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 03/03/2016] [Indexed: 01/22/2023]
Abstract
The exact role of biochemical markers of bone turnover in the management of metabolic bone diseases remains a topic of controversy. In this consensus paper, the Belgian Bone Club aimed to provide a state of the art on the use of these biomarkers in different clinical or physiological situations like in postmenopausal women, osteoporosis in men, in elderly patients, in patients suffering from bone metastasis, in patients with chronic renal failure, in pregnant or lactating women, in intensive care patients, and in diabetics. We also gave our considerations on the analytical issues linked to the use of these biomarkers, on potential new emerging biomarkers, and on the use of bone turnover biomarkers in the follow-up of patients treated with new drugs for osteoporosis.
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Affiliation(s)
- E Cavalier
- Department of Clinical Chemistry, UnilabLg, CIRM, University of Liège, CHU de Liège, Domaine du Sart-Tilman, 4000, Liège, Belgium.
| | - P Bergmann
- Department of Radioisotopes, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - O Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - P Delanaye
- Department of Nephrology Dialysis Transplantation, University of Liège, CHU de Liège, Liège, Belgium
| | - A Durnez
- Pôle de Pathologie Rhumatismale, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - J-P Devogelaer
- Pôle de Pathologie Rhumatismale, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - S L Ferrari
- Department of Bone Diseases, Hôpitaux Universitaires Genève, Geneva, Switzerland
| | - E Gielen
- Gerontology and Geriatrics Section, Department of Clinical and Experimental Medicine, K.U. Leuven, Leuven, Belgium
| | - S Goemaere
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium
| | - J-M Kaufman
- Department of Endocrinology and Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium
- Centre Académique de Recherche et d'Expérimentation en Santé SPRL (CARES SPRL), Liège, Belgium
| | - A Nzeusseu Toukap
- Pôle de Pathologie Rhumatismale, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - J-Y Reginster
- Centre Académique de Recherche et d'Expérimentation en Santé SPRL (CARES SPRL), Liège, Belgium
| | - A-F Rousseau
- Burn Centre and General Intensive Care Department, University of Liège, CHU de Liège, Liège, Belgium
| | - S Rozenberg
- Department of Gynaecology-Obstetrics, Université Libre de Bruxelles, Brussels, Belgium
| | - A J Scheen
- Division of Diabetes, Nutrition and Metabolic Disorders, University of Liège CHU de Liège, Liège, Belgium
| | - J-J Body
- Department of Medicine, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
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Delanaye P, Warling X, Moonen M, Smelten N, Krzesinski J, Moranne O, Pottel H, Cavalier E. Variation de la parathormone et de différents biomarqueurs osseux chez le patient hémodialysé. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Delanaye P, Pottel H, Mariat C. Quelle formule pour l’adaptation posologique des médicaments ? Une simulation mathématique illustrative. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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45
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Yayo E, Konan J, Aye M, Emième A, Gnionsahé A, Gbago V, Monnet D, Cavalier E, Delanaye P. Évaluation du débit de filtration glomérulaire de la population générale : résultats en Côte d’Ivoire. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Claisse G, Hougardy J, Alamartine E, Delanaye P, Maillard N, Morel J, Mariat C. Évaluation d’un nouvel estimateur du débit de filtration glomérulaire cinétique (KeGFR) pour prédire la survenue d’une insuffisance rénale aiguë après chirurgie cardiaque : étude AKInetic. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Masson I, Maillard N, Cavalier E, Alamartine E, Mariat C, Delanaye P. KDIGO Guidelines and Kidney Transplantation: Is the Cystatin-C Based Recommendation Relevant? Am J Transplant 2015; 15:2211-4. [PMID: 25808194 DOI: 10.1111/ajt.13258] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 01/11/2015] [Accepted: 01/29/2015] [Indexed: 01/25/2023]
Abstract
The KDIGO guidelines propose a new approach to diagnose chronic kidney disease (CKD) based on estimated glomerular filtration rate (GFR). In patients with a GFR value comprised between 45 and 59 mL/min/1.73 m(2) as estimated by the CKD-EPI creatinine equation (eGFRcreat ), it is suggested to confirm the diagnosis with a second estimation using the CKD-EPI cystatin C-based equations (eGFRcys /eGFRcreat-cys) . We sought to determine whether this new diagnostic strategy might extend to kidney transplant recipients (KTR) and help to identify those with decreased GFR. In 670 KTR for whom a measured GFR was available, we simulated the detection of CKD using the two-steps approach recommended by the guidelines in comparison to the conventional approach relying on creatinine equation. One hundred forty-five patients with no albuminuria had eGFRcreat between 45 and 59 mL/min/1.73 m(2) . Among them, 23% had inulin clearance over 60 mL/min/1.73 m(2) and were thus incorrectly classified as CKD patients. When applying the Kidney Disease: Improving Global Outcomes (KDIGO) strategy, 138 patients were confirmed as having a GFR below 60 mL/min with eGFRcreat-cys . However, 21% of them were misclassified in reference to measured GFR. Our data do no not support the use of cystatin C as a confirmatory test of stage 3 A CKD in KTR.
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Affiliation(s)
- I Masson
- Renal Laboratory and Department of Nephrology-Dialysis-Transplantation, University Jean Monnet, CHU Hôpital Nord, Saint-Etienne, France
| | - N Maillard
- Renal Laboratory and Department of Nephrology-Dialysis-Transplantation, University Jean Monnet, CHU Hôpital Nord, Saint-Etienne, France
| | - E Cavalier
- Department of Clinical Chemistry, University of Li, e, ge, CHU Sart Tilman, Liège, Belgium
| | - E Alamartine
- Renal Laboratory and Department of Nephrology-Dialysis-Transplantation, University Jean Monnet, CHU Hôpital Nord, Saint-Etienne, France
| | - C Mariat
- Renal Laboratory and Department of Nephrology-Dialysis-Transplantation, University Jean Monnet, CHU Hôpital Nord, Saint-Etienne, France
| | - P Delanaye
- Department of Nephrology-Dialysis-Transplantation, University of Liège, CHU Sart Tilman, Liège, Belgium
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von Frenckell C, Delanaye P. [Rituximab (MabThera): a new therapy for ANCA vasculitis]. Rev Med Liege 2015; 70:92-100. [PMID: 26011994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Three recently published randomized studies have demonstrated the efficacy of rituximab in the induction and maintenance therapy of ANCA vasculitis. This is a major advance since these types of vasculitis entail a high morbity and mortality.
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Hougardy JM, Delanaye P, Le Moine A, Nortier J. [Estimation of the glomerular filtration rate in 2014 by tests and equations: strengths and weaknesses]. Rev Med Brux 2014; 35:250-257. [PMID: 25675627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The accurate estimation of the glomerular filtration rate (GFR) is a goal of multiple interests regarding clinical, research and public health aspects. The strong relationship between progressive loss of renal function and mortality underlines the need for early diagnosis and close follow-up of renal diseases. Creatinine is the commonest biomarker of GFR in use. By reason of non-renal determinants of GFR, it is required to integrate creatinine values within equations that take in account its most important determinants (i.e., age, sex). The CKD-EPI 2009 equation is now recommended as the first line equation to estimate GFR within the general population. In this indication, it should replace MDRD that tends to overestimate the prevalence of stage 3 chronic kidney disease with GFR around 60 ml/min. However, many questions remain about the accuracy of GFR equations in specific situations such as extremes of age or body weight. The identification of new biomarkers, less determined by non-renal determinants, is of importance. Among these biomarkers, cystatin-C is more accurate to estimate GFR when it is combined to creatinine (i.e., equation CKD-EPI 2012). However the indica. tions for using cystatin-C instead of creatinine alone are still unclear and its use remains limited in routine practice. In conclusion, neither biomarker nor equation gives an accurate estimation for the whole range of GFR and for all patient populations. Limits of prediction are relying on both biomarker's properties and the range of GFR that is concerned, but also rely on the measurement methods. Therefore, it is crucial to interpret the estimated GFR according to the strengths and weaknesses of the equation in use.
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Mariat C, Guerber F, Pottel H, Delanaye P. Estimation du DFG et adaptation posologique : la formule de Cockcroft-Gault et l’équation CKD-EPI désindexée sont-elles interchangeables ? Nephrol Ther 2014. [DOI: 10.1016/j.nephro.2014.07.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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