References of "CAVALIER, Etienne"
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See detailHow the reference values for serum parathyroid hormone concentration are (or should be) established?
Souberbielle, J.-C.; Brazier, F.; Piketty, M.-L. et al

in Journal of Endocrinological Investigation (2017), 40(3), 241-256

Well-validated reference values are necessary for a correct interpretation of a serum PTH concentration. Establishing PTH reference values needs recruiting a large reference population. Exclusion criteria ... [more ▼]

Well-validated reference values are necessary for a correct interpretation of a serum PTH concentration. Establishing PTH reference values needs recruiting a large reference population. Exclusion criteria for this population can be defined as any situation possibly inducing an increase or a decrease in PTH concentration. As recommended in the recent guidelines on the diagnosis and management of asymptomatic primary hyperparathyroidism, PTH reference values should be established in vitamin D-replete subjects with a normal renal function with possible stratification according to various factors such as age, gender, menopausal status, body mass index, and race. A consensus about analytical/pre-analytical aspects of PTH measurement is also needed with special emphasis on the nature of the sample (plasma or serum), the time and the fasting/non-fasting status of the blood sample. Our opinion is that blood sample for PTH measurement should be obtained in the morning after an overnight fast. Furthermore, despite longer stability of the PTH molecule in EDTA plasma, we prefer serum as it allows to measure calcium, a prerequisite for a correct interpretation of a PTH concentration, on the same sample. Once a consensus is reached, we believe an important international multicentre work should be performed to recruit a very extensive reference population of apparently healthy vitamin D-replete subjects with a normal renal function in order to establish the PTH normative data. Due to the huge inter-method variability in PTH measurement, a sufficient quantity of blood sample should be obtained to allow measurement with as many PTH kits as possible. [less ▲]

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See detailImpact of an ultra-marathon of 330km on plasma levels of cardiac biomarkers
Le Goff, Caroline ULiege; Kaux, Jean-François ULiege; Gergelé, Laurent et al

in British Journal of Sports Medicine (2017, February), 51(4), 347

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See detailThe added value of plasma or urinary NGAL concentrations in clinical practice
Gregoire, Emilien ULiege; Claisse, Guillaume; GUIOT, Julien ULiege et al

Poster (2017, January 13)

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See detailEtude rétrospective du bilan thyroïdien: définition de valeurs de référence pédiatriques
LADANG, Aurélie ULiege; VRANKEN, Laura ULiege; LUYCKX, Françoise ULiege et al

in Revue Médicale de Liège (2017)

Defining reference range is an essential tool for diagnostic. Age and sexe influences on thyroid hormone levels have been already discussed. In this study, we are defining a new pediatric reference range ... [more ▼]

Defining reference range is an essential tool for diagnostic. Age and sexe influences on thyroid hormone levels have been already discussed. In this study, we are defining a new pediatric reference range for TSH, FT3 and FT4 for Cobas C6000 analyzer. To do so, we have taken in account 0 to 18 year old outclinic patients. During the first year of life, thyroid hormone levels change dramatically before getting stabilized around 3 years old. We also compared our results to those obtained in a Canadian large-scale prospective study (the CALIPER initiative). [less ▲]

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See detailAssessment of vitamin D status - a changing landscape.
Herrmann, Markus; Farrell, Christopher-John L.; Pusceddu, Irene et al

in Clinical Chemistry & Laboratory Medicine (2017)

In recent years it has been shown that vitamin D deficiency is associated with an increased incidence as well as the progression of a broad range of diseases including osteoporosis, rickets ... [more ▼]

In recent years it has been shown that vitamin D deficiency is associated with an increased incidence as well as the progression of a broad range of diseases including osteoporosis, rickets, cardiovascular disease, autoimmune disease, multiple sclerosis and cancer. Consequently, requests for the assessment of vitamin D status have increased dramatically. Despite significant progress in the analysis of vitamin D metabolites and an expansion of our pathophysiological knowledge of vitamin D, the assessment of vitamin D status remains a challenging and partially unresolved issue. Current guidelines from scientific bodies recommend the measurement of 25-hydroxy vitamin D (25-OHD) in blood as the preferred test. However, growing evidence indicates significant limitations of this test, including analytical aspects and interpretation of results. In addition, the relationships between 25-OHD and various clinical indices, such as bone mineral density and fracture risk, are rather weak and not consistent across races. Recent studies have systematically investigated new markers of vitamin D status including the vitamin D metabolite ratio (VMR) (ratio between 25-OHD and 24,25-dihydroxy vitamin D), bioavailable 25-OHD [25-OHD not bound to vitamin D binding protein (DBP)], and free 25-OHD [circulating 25-OHD bound to neither DBP nor albumin (ALB)]. These parameters may potentially change how we will assess vitamin D status in the future. Although these new biomarkers have expanded our knowledge about vitamin D metabolism, a range of unresolved issues regarding their measurement and the interpretation of results prevent their use in daily practice. It can be expected that some of these issues will be overcome in the near future so that they may be considered for routine use (at least in specialized centers). In addition, genetic studies have revealed several polymorphisms in key proteins of vitamin D metabolism that affect the circulating concentrations of vitamin D metabolites. The affected proteins include DBP, 7-dehydrocholesterol synthase and the vitamin D receptor (VDR). Here we aim to review existing knowledge regarding the biochemistry, physiology and measurement of vitamin D. We will also provide an overview of current and emerging biomarkers for the assessment of vitamin D status, with particular attention methodological aspects and their usefulness in clinical practice. [less ▲]

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See detailRelevance of vitamin D in the pathogenesis and therapy of frailty.
Bruyère, Olivier ULiege; Cavalier, Etienne ULiege; Buckinx, Fanny ULiege et al

in Current Opinion in Clinical Nutrition & Metabolic Care (2017), 20(1), 26-29

PURPOSE OF REVIEW: This article reviews recently published evidence regarding the role of vitamin D in the physiopathology of physical frailty in elderly populations and its role in the management of this ... [more ▼]

PURPOSE OF REVIEW: This article reviews recently published evidence regarding the role of vitamin D in the physiopathology of physical frailty in elderly populations and its role in the management of this geriatric condition. RECENT FINDINGS: Some recent studies have found a low level of 25-hydroxyvitamin D, considered the best marker of vitamin D status, in frail individuals. All prospective studies consistently report that low vitamin D status is associated with an increased risk of becoming frail. Recent studies also suggest that the relationship between vitamin D status and frailty is largely mediated by the development of sarcopenia. Very few well designed randomized controlled trials are available that assess the effectiveness of vitamin D supplementation in the prevention or management of frailty. In the absence of specific guidelines, a minimal serum 25-hydroxyvitamin D level of 75 nmol/l is proposed for frail elderly patients by some scientific societies. The doses necessary to reach this target are between 800 and 2000 IU/day. SUMMARY: Several studies suggest a potential effect of vitamin D on physical frailty but large clinical trials are lacking at this time to provide solid evidence of clinical benefit. [less ▲]

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See detailSkeletal health in breast cancer survivors
Bruyère, Olivier ULiege; Bergmann, Pierre; CAVALIER, Etienne ULiege et al

in Maturitas (2017), (105),

Although some risk factors for breast cancer might be protective for osteoporosis, several cross-sectional studies have reported, nevertheless, that patients with breast cancer have a lower bone mass and ... [more ▼]

Although some risk factors for breast cancer might be protective for osteoporosis, several cross-sectional studies have reported, nevertheless, that patients with breast cancer have a lower bone mass and potentially a higher incidence of fractures than expected. In any case, it appears that patients with breast cancer are not protected from osteoporosis, which provides further support for the recommendation that bone health is assessed after a diagnosis of breast cancer. Most adjuvant therapies will lead to increased bone loss and a higher fracture rate. Among the adjuvant therapy options for premenopausal patients with breast cancer, endocrine therapy (ovarian suppression) and chemotherapy can result in cancer treatment-induced bone loss (CTIBL) of up to 10% at the lumbar spine after one year. Antiresorptive therapies prevent CTIBL in premenopausal women with breast cancer. Most of the evidence demonstrating the efficacy of bisphosphonates in the prevention of CTIBL is derived from clinical trials with zoledronic acid. The addition of zoledronic acid 4 mg per six months to adjuvant endocrine therapy maintained and even increased bone mass during a 3-year treatment period and significantly improved disease-free survival in a population of young women who underwent menopause due to the adjuvant treatment. The major contributor to bone loss in the adjuvant treatment of breast cancer in postmenopausal women is the use of aromatase inhibitors (AIs). Oncology trials have underestimated the fracture risk in the setting of AI-induced bone loss. In the ABCSG-18 study, the only trial in which fracture incidence was the primary endpoint, the rate of clinical fractures was close to 10% after 3 years in the placebo group on AIs only. Bisphosphonates and denosumab at osteoporosis treatment doses can counteract AI-induced bone loss. In the ABCSG-18 trial, treatment with denosumab 60 mg injection every 6 months reduced the risk of first clinical fracture relative to placebo by 50%. Current guidelines recommend antiresorptive therapy in patients with a baseline T score of<−2.0 or with two or more clinical risk factors for fracture. These recent guidelines will need to be updated, as similar significant protective effects were seen in women with either normal or low bone mass. Moreover, a formal meta-analysis of individual patient data from more than 18,000 women in 26 randomized trials of adjuvant zoledronic acid or clodronate treatment for early breast cancer revealed that bisphosphonates significantly reduced the risk of first distant recurrence in bone and the risk of breast cancer mortality, at least in postmenopausal women. Even though the increased risk of fracture during adjuvant treatment for breast cancer in postmenopausal women is notable, an enhanced risk of fracture in long-term survivors of breast cancer remains under debate. The most recent studies suggest that Caucasian breast cancer survivors do not have a significantly increased risk of osteoporotic fracture over the long term. [less ▲]

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See detailOsteoporosis in Frail Patients: A Consensus Paper of the Belgian Bone Club.
Gielen, Evelien; Bergmann, Pierre; Bruyère, Olivier ULiege et al

in Calcified Tissue International (2017), 101(2), 111-31

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 ... [more ▼]

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. [less ▲]

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See detailDistinction between urine crystals by automated urine analyzer SediMAX conTRUST is specific but lacks of sensitivity.
Castiglione, Vincent ULiege; CAVALIER, Etienne ULiege; Diop, Coumba Souley ULiege et al

in Clinical Chemistry & Laboratory Medicine (2017)

Urine crystals are commonly encountered but few papers have been published about it while it is useful for patient’s follow-up, particularly the stone-formers. For the first time to our knowledge, we have ... [more ▼]

Urine crystals are commonly encountered but few papers have been published about it while it is useful for patient’s follow-up, particularly the stone-formers. For the first time to our knowledge, we have assessed the performance of an automated urine analyzer to identify and distinguish several types of crystals in a very large cohort of samples. We share in this report the results of method comparison of the SediMAX conTRUST with the polarized light microscopy which is the gold standard. We showed that the distinction between crystals and other urine elements was accurate. Negative predictive value was very good, but the positive predictive value was poor for most of crystals. The discrimination of different types of crystals between them by the automated urine analyzer still requires improvement to decrease reviewing rate and help clinician. [less ▲]

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See detailGuidelines for the conduct of pharmacological clinical trials in hand osteoarthritis: Consensus of a Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO).
Reginster, Jean-Yves ULiege; Arden, Nigel K.; Haugen, Ida K. et al

in Seminars in Arthritis & Rheumatism (2017)

OBJECTIVES: To gather expert opinion on the conduct of clinical trials that will facilitate regulatory review and approval of appropriate efficacious pharmacological treatments for hand osteoarthritis (OA ... [more ▼]

OBJECTIVES: To gather expert opinion on the conduct of clinical trials that will facilitate regulatory review and approval of appropriate efficacious pharmacological treatments for hand osteoarthritis (OA), an area of high unmet clinical need. METHODS: The European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal diseases (ESCEO) organized a working group under the auspices of the International Osteoporosis Foundation (IOF) and the World Health Organization (WHO). RESULTS: This consensus guideline is intended to provide a reference tool for practice, and should allow for better standardization of the conduct of clinical trials in hand OA. Hand OA is a heterogeneous disease affecting different, and often multiple, joints of the thumb and fingers. It was recognized that the various phenotypes and limitations of diagnostic criteria may make the results of hand OA trials difficult to interpret. Nonetheless, practical recommendations for the conduct of clinical trials of both symptom and structure modifying drugs are outlined in this consensus statement, including guidance on study design, execution, and analysis. CONCLUSIONS: While the working group acknowledges that the methodology for performing clinical trials in hand OA will evolve as knowledge of the disease increases, it is hoped that this guidance will support the development of new pharmacological treatments targeting hand OA. [less ▲]

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See detailMeasured (and estimated) glomerular filtration rate: reference values in West Africa.
Yayo, Eric; Aye, Mireille; Yao, Carine et al

in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (2017)

Background: Establishment of normal reference values for glomerular filtration rate (GFR) is mandatory in nephrology. However, no data are available for measured GFR (mGFR) in Africa. Methods: GFR was ... [more ▼]

Background: Establishment of normal reference values for glomerular filtration rate (GFR) is mandatory in nephrology. However, no data are available for measured GFR (mGFR) in Africa. Methods: GFR was measured in 237 healthy adult subjects (103 women and 134 men, mean age 34 +/- 10 years) by iohexol plasma clearance. Results: The mean mGFR was 103 +/- 17 mL/min/1.73 m 2 and the median value was 103 mL/min/1.73 m 2 (2.5th and 97.5th percentiles are 76 and 137 mL/min/1.73 m 2 , respectively). No significant difference in mGFR results was observed in patients < 40 years of age, whereas a significant decline in mGFR was observed after 40 years of age. There was no significant difference between mGFR in men and women. Conclusions: Normal GFR values and descriptions of percentiles are now available for West Africa. As in Caucasians, no significant difference was observed between men and women. Moreover, the same age-associated decline in mGFR is also observed after 40 years of age, as in Caucasians. [less ▲]

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See detailGeneral Steps to Standardize the Laboratory Measurement of Serum Total 25-Hydroxyvitamin D.
Sempos, Christopher T.; Betz, Joseph M.; Camara, Johanna E. et al

in Journal of AOAC International (2017), 100(5), 1230-1233

The Vitamin D Standardization Program (VDSP) has collaborated with numerous groups and agencies to assemble a set of tools, i.e., a reference measurement system, that can be used to establish the ... [more ▼]

The Vitamin D Standardization Program (VDSP) has collaborated with numerous groups and agencies to assemble a set of tools, i.e., a reference measurement system, that can be used to establish the traceability of 25-hydroxyvitamin D [25(OH)D] assays to relevant reference measurement procedures and reference materials. This is done with the goal of verifying end-user laboratory performance using precise statistical criteria to determine whether a specific assay is standardized. The purpose of this paper was to outline a set of steps that routine clinical and research laboratories can use to standardize their 25(OH)D assays using these tools. These steps apply to laboratories using commercially developed immunoassay measurement systems as well as in-house assays, usually based on high HPLC or LC tandem MS measurement systems. The steps are (1) initial calibration, (2) initial assessment of accuracy and bias, (3) assessment of total percent CV and mean bias, (4) use of trueness controls, and (5) participation in accuracy-based performance testing and/or external quality assessment schemes. The goal of each laboratory assay is to have a total CV of </=10% and mean bias of </=5%. Rigorous and less rigorous but low-cost options for meeting these statistical criteria are provided. Research laboratories who infrequently measure 25(OH)D are advised to repeat steps 1-4 for every measurement cycle. For users of commercial immunoassays who have relatively little control over standardization, we present an option for using trueness controls to develop a master equation that can be used to standardize results to the reference methods. [less ▲]

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See detailBaseline Assessment of 25-Hydroxyvitamin D Reference Material and Proficiency Testing/External Quality Assurance Material Commutability: A Vitamin D Standardization Program Study.
Phinney, Karen W.; Sempos, Christopher T.; Tai, Susan S.-C. et al

in Journal of AOAC International (2017), 100(5), 1288-1293

The Vitamin D Standardization Program (VDSP) coordinated a study in 2012 to assess the commutability of reference materials and proficiency testing/external quality assurance materials for total 25 ... [more ▼]

The Vitamin D Standardization Program (VDSP) coordinated a study in 2012 to assess the commutability of reference materials and proficiency testing/external quality assurance materials for total 25-hydroxyvitamin D [25(OH)D] in human serum, the primary indicator of vitamin D status. A set of 50 single-donor serum samples as well as 17 reference and proficiency testing/external quality assessment materials were analyzed by participating laboratories that used either immunoassay or LC-MS methods for total 25(OH)D. The commutability test materials included National Institute of Standards and Technology Standard Reference Material 972a Vitamin D Metabolites in Human Serum as well as materials from the College of American Pathologists and the Vitamin D External Quality Assessment Scheme. Study protocols and data analysis procedures were in accordance with Clinical and Laboratory Standards Institute guidelines. The majority of the test materials were found to be commutable with the methods used in this commutability study. These results provide guidance for laboratories needing to choose appropriate reference materials and select proficiency or external quality assessment programs and will serve as a foundation for additional VDSP studies. [less ▲]

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See detailL'hypophosphatasie.
Winckert, A.; Vranken, L.; BOEMER, François ULiege et al

in Revue Médicale de Liège (2017), 72(12), 547-551

Hypophosphatasia (HPP) is a rare genetic disorder characterized by the diminution of the enzymatic activity of the alkaline phosphatase (ALP). The disease mainly involves multiple defects of the ... [more ▼]

Hypophosphatasia (HPP) is a rare genetic disorder characterized by the diminution of the enzymatic activity of the alkaline phosphatase (ALP). The disease mainly involves multiple defects of the mineralization of the skeleton including bone fragilities. It will be expressed to varying degrees of severity and will allow to characterize different forms of HPP. Unfortunately, the prevalence of this pathology remains probably underestimated and its diagnosis must be multidisciplinary by taking into account the biochemical assays, the clinical history as well as the radiological imaging. So, in the approach of this diagnosis, a retrospective screening was carried out by the clinical chemistry department of the CHU of Liege. The aim of this study is to potentially identify the affected patients on the basis of their biochemical assays and their anamnesis in order to propose a genetic screening. Unfortunately, no case could be formally identified, which testifies the difficulty to establish a diagnosis of the slight forms encountered mainly in the adults. [less ▲]

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See detailSclerostin and chronic kidney disease: the assay impacts what we (thought to) know.
DELANAYE, Pierre ULiege; PAQUOT, Francois ULiege; BOUQUEGNEAU, Antoine ULiege et al

in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (2017)

Background: Sclerostin, a 22-kDa protein secreted by osteocytes, acts as a potent inhibitor of osteoblast activity. In chronic kidney disease (CKD), sclerostin is a putative driver of the bone-vascular ... [more ▼]

Background: Sclerostin, a 22-kDa protein secreted by osteocytes, acts as a potent inhibitor of osteoblast activity. In chronic kidney disease (CKD), sclerostin is a putative driver of the bone-vascular axis. However, large discrepancies between sclerostin assays have been described. Methods: We compared four different assays [Biomedica (BM), TecoMedical (TE), R&D (RD) and MesoScaleDiscovery (MSD)] in an analytical study and addressed the question whether bioassay choice affects the correlation between circulating sclerostin and clinical and biochemical determinants. Circulating sclerostin levels were determined in 39 prevalent dialysis patients and 82 non-dialysis patients referred for glomerular filtration rate measurement. Results: In the 82 non-dialysis patients, we observed large differences in median (interquartile range) sclerostin concentrations (in pg/mL): BM, 984 [interquartile range (IQR) 648]; TE, 629 (IQR 237); RD, 154 (IQR 84) and MSD, 36 (IQR 19). The concordance correlation coefficient between assays was poor (0.1-0.44). The same discrepancies were observed in dialysis patients. A significant negative rank correlation was found between glomerular filtration rate and sclerostin measured by BM and TE but not by MSD and RD. Associations between sclerostin and age, gender, weight or parathormone were also different according to the assay considered. Conclusions: Clinical inference relating sclerostin levels found in the general, CKD and dialysis populations is largely influenced by the assay used to measure this biomarker. [less ▲]

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See detailBaseline Assessment of 25-Hydroxyvitamin D Assay Performance: A Vitamin D Standardization Program (VDSP) Interlaboratory Comparison Study.
Wise, Stephen A.; Phinney, Karen W.; Tai, Susan S.-C. et al

in Journal of AOAC International (2017), 100(5), 1244-1252

The Vitamin D Standardization Program (VDSP) coordinated an interlaboratory study to assess the comparability of measurements of total 25-hydroxyvitamin D [25(OH)D] in human serum, which is the primary ... [more ▼]

The Vitamin D Standardization Program (VDSP) coordinated an interlaboratory study to assess the comparability of measurements of total 25-hydroxyvitamin D [25(OH)D] in human serum, which is the primary marker of vitamin D status. A set of 50 individual donor samples were analyzed by 15 different laboratories representing national nutrition surveys, assay manufacturers, and clinical and/or research laboratories to provide results for total 25(OH)D using both immunoassays (IAs) and LC tandem MS (MS/MS). The results were evaluated relative to bias compared with the target values assigned based on a combination of measurements at Ghent University (Belgium) and the U.S. National Institute of Standards and Technology using reference measurement procedures for the determination of 25(OH)D2 and 25(OH)D3. CV and mean bias for each laboratory and assay platform were assessed and compared with previously established VDSP performance criteria, namely CV </= 10% and mean bias </= 5%. Nearly all LC-MS/MS results achieved VDSP criteria, whereas only 50% of IAs met the criterion for a </=10% CV and only three of eight IAs achieved the </=5% bias. These results establish a benchmark for the evaluation of 25(OH)D assay performance and standardization activities in the future. [less ▲]

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See detailEvaluation of a New Fully Automated Assay for Plasma Intact FGF23.
Souberbielle, Jean-Claude; Prie, Dominique; Piketty, Marie-Liesse et al

in Calcified Tissue International (2017), 101(5), 510-518

Several FGF23 immunoassays are available. However, they are reserved for research purposes as none have been approved for clinical use. We evaluated the performances of a new automated assay for intact ... [more ▼]

Several FGF23 immunoassays are available. However, they are reserved for research purposes as none have been approved for clinical use. We evaluated the performances of a new automated assay for intact FGF23 on the DiaSorin Liaison platform which is approved for clinical use. We established reference values in 908 healthy French subjects aged 18-89 years, and measured iFGF23 in patients with disorders of phosphate metabolism and in patients with chronic kidney disease (CKD). Intra-assay CV was 1.04-2.86% and inter-assay CV was 4.01-6.3%. The limit of quantification was <10 ng/L. Serum iFGF23 concentrations were considerably lower than EDTA values highlighting the importance of using exclusively EDTA plasma. Liaison iFGF23 values were approximately 25% higher than Immutopics values. In the 908 healthy subjects, distribution of the Liaison iFGF23 values was Gaussian with a mean +/- 2SD interval of 22.7-93.1 ng/L. Men had a slightly higher level than women (60.3 +/- 17.6 and 55.2 +/- 17.2 ng/L, respectively). Plasma iFGF23 concentration in 11 patients with tumour-induced osteomalacia, 8 patients with X-linked hypophosphatemic rickets, 43 stage 3a, 43 stage 3b, 43 stage 4, 44 stage 5 CKD patients, and 44 dialysis patients were 217.2 +/- 144.0, 150.9 +/- 28.6, 98.5 +/- 42.0, 130.8 +/- 88.6, 130.8 +/- 88.6, 331.7 +/- 468.2, 788.8 +/- 1306.6 and 6103.9 +/- 11,178.8 ng/L, respectively. This new iFGF23 assay available on a platform that already allows the measurement of other important parameters of the mineral metabolism is a real improvement for the laboratories and clinicians/researchers involved in this field. [less ▲]

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See detailDid creatinine standardization give benefits to the evaluation of glomerular filtration rate?
Piéroni, L; Bargnoux, AS; Cristol, JP et al

in EJIFCC (2017), 28(4), 251-257

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See detailImpact of the type of dialysis membranes on the circulating concentration of markers of vitamin D metabolism.
Cavalier, Etienne ULiege; Torres, Pablo U.; Dubois, Bernard E. et al

in International Journal of Artificial Organs (2017)

INTRODUCTION: Kidney Disease Improving Global Outcomes (KDIGO) guidelines recommend vitamin D supplementation in hemodialyzed patients to monitor 25(OH)-vitamin D 25(OH)D levels. However, patient-to ... [more ▼]

INTRODUCTION: Kidney Disease Improving Global Outcomes (KDIGO) guidelines recommend vitamin D supplementation in hemodialyzed patients to monitor 25(OH)-vitamin D 25(OH)D levels. However, patient-to-patient inconsistency can be observed in response to the treatment. In this study, we aimed to evaluate the impact of the dialysis membrane on 25(OH)D, albumin (Alb) and vitamin D-binding protein (VDBP), the major players of vitamin D transport and storage. MATERIAL AND METHODS: Alb (Cobas), VDBP (R&D) and 25(OH)D (liquid chromatography-tandem mass spectrometry) were measured in 75 patients before and after a 4-hour dialysis session. Ten dialysis membranes were used: FX10, FX80, FX800, BK-2.1F, BG-2.1U, Rexeed 15 A, Rexeed 21 A, TS 1.8 SL and TS 2.1 SL manque la ELISIO 21H. Accordingly, 13 patients were dialyzed with membranes possessing high adsorption and high cut-off properties (BK), 17 with membranes possessing high adsorption but usual cut-off properties (BG) and all the remaining 45 patients with polysufone (PS) membranes with usual adsorptive and cut-off properties. Among these 45 patients treated with PS, we compared those treated by classical dialysis (HD) (n = 14) and hemodiafiltration (HDF) (n = 31). Results were corrected for total extracellular volume to take into consideration the hemoconcentration after dialysis. RESULTS: The 3 analytes showed a decreased concentration after the dialysis session. The decrease of ALB, VDBP and 25(OH)D was similar with the adsorptive (BG) and PS membranes. However, patients treated with adsorptive and high cut-off membrane (BK) presented a significantly higher decrease values of Alb (-9.6%[-15.1; -7.5]), of VDBP (-20.6%[-36.6; -17.2] and 25(OH)D (-17%[-27.3; -12.3]) compared to other membranes (BG and PS).When we limited our study to PS membranes, we did not observe any significant difference between the HD or HDF modalities in the decrease for any of the studied parameters. CONCLUSIONS: A significant loss of Alb, VDBP and 25(OH)D occurs after a dialysis session. This loss is significantly more important when patients are dialyzed with high adsorption and high cut-off dialysis membranes. [less ▲]

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