Publications of Bernard DUBOIS
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See detailA simple modification of dialysate potassium: its impact on plasma potassium concentrations and the electrocardiogram
DELANAYE, Pierre ULiege; KRZESINSKI, François ULiege; DUBOIS, Bernard ULiege et al

in Clinical Kidney Journal (2019)

Background. Sudden death is frequent in haemodialysis (HD) patients. Both hyperkalaemia and change of plasma potassium(K) concentrations induced by HD could explain this. The impact of increasing ... [more ▼]

Background. Sudden death is frequent in haemodialysis (HD) patients. Both hyperkalaemia and change of plasma potassium(K) concentrations induced by HD could explain this. The impact of increasing dialysate K by 1 mEq/L on plasma K concentrations and electrocardiogram(ECG) results before and after HD sessions was studied. Methods. Patients with pre-dialysis K>5.5 mEq/L were excluded. ECG and K measurements were obtained before and after the first session of the week for 2 weeks. Then, K in the dialysate was increased (from 1 or 3 to 2 or 4 mEq/L, respectively). Blood and ECG measurements were repeated after 2 weeks of this change. Results. Twenty-seven prevalent HD patients were included. As expected, a significant decrease in K concentrations was observed after the dialysis session, but this decrease was significantly lower after the switch to an increased dialysate K. The pre-dialysis K concentrations were not different after changing, but post-dialysis K concentrations were higher after switching (P<0.0001), with a lower incidence of post-dialysis hypokalaemia. Regarding ECG, before switching, the QT interval (QT) dispersion increased during the session, whereas no difference was observed after switching. One week after switching, post-dialysis QT dispersion [38 (34–42) ms] was lower than post-dialysis QT dispersion 2 weeks and 1 week before switching [42 (38–57) ms, P¼0.0004; and 40 (35–50) ms, P¼0.0002]. Conclusions. A simple increase of 1 mEq/L of K in the dialysate is associated with a lower risk of hypokalaemia and a lower QT dispersion after the dialysis session. Further study is needed to determine if such a strategy is associated with a lower risk of sudden death. [less ▲]

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See detailFibrillation auriculaire et anticoagulation chez le patient hémodialysé : une décision difficile
DELANAYE, Pierre ULiege; BOUQUEGNEAU, Antoine ULiege; DUBOIS, Bernard ULiege et al

in Néphrologie et Thérapeutique (2017)

Cardiovascular mortality of hemodialysis patients remains a major problem. The prevalence and incidence of atrial fibrillation in this population are more important than in the general population. The ... [more ▼]

Cardiovascular mortality of hemodialysis patients remains a major problem. The prevalence and incidence of atrial fibrillation in this population are more important than in the general population. The indication of antivitamin K therapy (AVK) in this context of atrial fibrillation must be weighted against the increased risk of bleeding. Unfortunately, and contrary to the general population, an indication of anticoagulation based on embolic or hemorrhagic risk scores is not as clearly established in the hemodialysis population. No prospective randomized study has investigated the benefit/risk balance of anticoagulant treatment in hemodialysis subjects. This article is a review of the current literature on this topic, showing the prevalence of thromboembolic but also bleeding events in the hemodialysis population. The impact of AVK treatment in this specific population is also reviewed. To the best of our knowledge, the indication of treatment must be individualized. [less ▲]

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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 ULiege 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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See detailHome blood pressure in kidney transplant recipients (Ktr) - Validity of different schedules of self-monitoring
SAINT-REMY, Annie ULiege; WEEKERS, Laurent ULiege; BONVOISIN, Catherine ULiege et al

in Journal of Hypertension (2016, September), 34(e supplement 2), 119

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See detailHOME BLOOD PRESSURE IN KIDNEY TRANSPLANT RECIPIENTS (Ktr)-VALIDITY OF DIFFERENT SCHEDULES OF SELF-MONITORING
Saint-Remy, Annie ULiege; WEEKERS, Laurent ULiege; BONVOISIN, Catherine ULiege et al

Poster (2016, June 11)

Office blood pressure (OBP) coupled with 24-h ambulatory monitoring (24-h ABPM) or home self-monitoring (HBPM) allow a more accurate assessment of BP control in treated hypertensive patients and ... [more ▼]

Office blood pressure (OBP) coupled with 24-h ambulatory monitoring (24-h ABPM) or home self-monitoring (HBPM) allow a more accurate assessment of BP control in treated hypertensive patients and identification of different phenotypes of BP. ESH/ESC guidelines (2013) recommended 7 days of home measurements (3 days at least) but that duration is questioned. The present study examined if we can reduce, and to what extent, the 7-days schedule for home measurements in treated hypertensive kidney transplant recipients (ktr) while keeping a reliable assessment of their BP status? [less ▲]

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See detailEfficiency of delivery observed treatment in hemodialysis patients: the example of the native vitamin D therapy
DELANAYE, Pierre ULiege; CAVALIER, Etienne ULiege; Fafin, Coraline et al

in Journal of Nephrology (2016), 29(1), 99-103

Introduction Adherence to therapy is a relevant challenge in chronic hemodialysis patients. The directly observed therapy (DOT) could be an effective method to increase adherence for specific therapies ... [more ▼]

Introduction Adherence to therapy is a relevant challenge in chronic hemodialysis patients. The directly observed therapy (DOT) could be an effective method to increase adherence for specific therapies. We aimed to study the performance of DOT versus home medication. We follow the impact of providing native vitamin D directly by the nurse after a dialysis session on the 25-hydroxyvitamin [25(OH)D] concentrations. Methods In this observational study, we included 38 dialysis patients treated by stable dosage of cholecalciferol. DOT was implemented in December 2010. We considered the concentrations of 25-OH vitamin D three times before (T1 = June 2010, T2 = July 2010 and T3 = September 2010) and three times after the modification of prescription (T4 = February 2011, T5 = March 2011 and T6 = April 2011). Results Median age was 72 [62; 79] years and 48 % were diabetics. Mean body mass index was 26 ± 5 kg/m2 and median dialysis vintage was 20 [8; 46] months. The patients were compared to themselves. Before DOT, median concentrations of 25(OH)D were 27 (14–36), 23 (17–31), 31 (22–38) ng/mL at T1, T2 and T3, respectively. When DOT was effective, the concentrations significantly increased to 34 (28–44), 35 (29–41), 39 (32–47) ng/mL at T4, T5 and T6, respectively. Before DOT, 19 patients (50 %) reached the target of 30 ng/mL. After DOT, 29 patients (76 %) reached the target concentration of 30 ng/ mL. Conclusions In hemodialysis patients, DOT is both simple and effective to increase the therapeutic impact to native vitamin D. [less ▲]

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See detailHome Blood Pressure in Kidney Transplant Recipients (ktr)- Validity of different schedules of self-monitoring
Saint-Remy, Annie ULiege; WEEKERS, Laurent ULiege; BONVOISIN, Catherine ULiege et al

Conference (2015, October 24)

HOME BLOOD PRESSURE IN KIDNEY TRANSPLANT RECIPIENTS (KTR)-Validity of different schedules of self-monitoring A. Saint-Remy, L. Weekers, C. Bonvoisin, P. Xhignesse, B.Dubois, JM. Krzesinski NEPHROLOGY ... [more ▼]

HOME BLOOD PRESSURE IN KIDNEY TRANSPLANT RECIPIENTS (KTR)-Validity of different schedules of self-monitoring A. Saint-Remy, L. Weekers, C. Bonvoisin, P. Xhignesse, B.Dubois, JM. Krzesinski NEPHROLOGY - CHU LIEGE AIM: Office blood pressure (OBP), 24-h ambulatory monitoring (ABPM) and home self- monitoring (HBP) allow assessing BP control in treated HT patients. For HBP, ESH guidelines recommend 7 days of measurements but that duration is questioned. The present study analyzed the agreement between daytime ABP and different schedules for HBP in 70 treated hypertensive KTR. METHOD: BP control defined by OBP <140/90 and daytime ABP or HBP <135/85 mmHg was tested in 70 KTR (mean age 56 ± 11 y; mean graft survival 7 ± 6.6 y). OBP and HBP were measured with an Omron M6 and 24-h ABPM with a Spacelabs 90207. HBP was measured on consecutive days (2 times in morning and 2 times at evening/day), the first day was discarded for the mean calculation. Agreement between daytime and HBP was studied when HBP was measured during 7, 5 or 3 days. RESULTS: BP was uncontrolled in 50% of the KTR based on OBP, in 61 % according to daytime ABP and even in 64 % with HBP. Sensitivity (Se) testing agreement between daytime ABP and HBP decreased progressively when number of days was shortened: the highest Se was observed for a 7 days duration with 1st day discarded (86 %). Specificity (Sp) fluctuated around 70 % and was the highest for a 5 (73 %) and 3 days schedule. However the 5 days schedule had higher Se (83 %) than the 3 days. Proportions of KTR correctly classified according to daytime ABP were 79 %, 79 % and 78 % with the 7, 5 or 3 days schedule, respectively. CONCLUSIONS: HBP, easier and less restricting method than 24h ABPM, is a good alternative to daytime ABPM as nearly 80 % of treated KTR were similarly classified. HBP recording period can be shortened to 5 days according to Se and Sp. A 3 days schedule seems more risky reducing the chance to identify masked HT due to a decreased drug adherence. [less ▲]

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See detailLe cas clinique du mois : prise en charge d'une hypophosphatémie
HUART, Justine ULiege; DUBOIS, Bernard ULiege; Krzesinski, Jean-Marie ULiege et al

in Revue Médicale de Liège (2015), 70(4), 163-168

Hypophosphatemia is defined by a serum phosphate level lower than 0.8 mmol/l. If hypophosphatemia is chronically maintained, it is associated with muscular, osteous, neurological or cardio-respiratory ... [more ▼]

Hypophosphatemia is defined by a serum phosphate level lower than 0.8 mmol/l. If hypophosphatemia is chronically maintained, it is associated with muscular, osteous, neurological or cardio-respiratory disorders. We describe a patient with isolated hypophosphatemia, detail the mechanisms of phosphate homeostasis, and envisage the differential diagnosis of hypophosphatemia. Furthermore, we propose a sequential decisional algorithm based on basic biological tests and few complementary investigations. Treatment options are reviewed. [less ▲]

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See detailEpidémiologie de la lithiase urinaire sur base d'une analyse morpho-constitutionnelle
Castiglione, Vincent ULiege; JOURET, François ULiege; Bruyère, Olivier ULiege et al

in Néphrologie et Thérapeutique (2015), 11

Urolithiasis is a common condition, with a prevalence of 10% and a male/female ratio above 1 according to large national series. Various types of urinary stones have been described upon their mineral ... [more ▼]

Urolithiasis is a common condition, with a prevalence of 10% and a male/female ratio above 1 according to large national series. Various types of urinary stones have been described upon their mineral content and/or their morphology. Hence, a combined morpho-constitutional (M-C) classification has been proposed. In order to detail the prevalence of urolithiasis in general and of each M-C type in particular upon age and gender in Belgium, we retrospectively studied the database of a reference center for urolithiasis analysis. Between 2010 and 2013, 2195 stones were characterized. We excluded 45 nonbiological stones and 281 stones, which originated from outside the study zone. Among 1869 stones,1293 (69.2%) affected men. Prevalence peak of urolithiasis was observed between 50–60 years of age in both genders. The M-C analysis was available for 1854 stones (99.2%): multiple morphological types were concomitantly identified in 49.3%. In the whole population, the main mineral constituent was whewellite (54.4%), mainly organized as type Ia (94%). Weddellite was found in 19.8%, with an equal distribution between types IIa and IIb. Uric acid was the 3rd most frequent constituent in man, with a similar distribution between IIIa and IIIb. Phosphate was uncommon in man (8.2%), but frequent in woman (26.6%) with a type IVa1 organization. Prevalence of M-C types changes with aging, i.e. decrease of weddellite and increase of whewellite and uric acid in both genders. This retrospective analysis of a single-center database of urinary stones helps characterize the M-C epidemiology of urolithiasis in Belgium. [less ▲]

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See detailimpact of stopping vitamin K antagonist therapy on concentrations of dephospho-uncarboxylated Matrix Gla protein
DELANAYE, Pierre ULiege; DUBOIS, Bernard ULiege; LUKAS, Pierre ULiege et al

in Clinical Chemistry and Laboratory Medicine (2015), 53(8), 191-193

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See detailImpact of the dialysis membrane on the Vitamin D metabolims markers
CAVALIER, Etienne ULiege; DUBOIS, Bernard ULiege; Urena, Pablo et al

Poster (2014, November)

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See detailÉpidémiologie de la lithiase urinaire en Province de Liège
Castiglione, Vincent ULiege; JOURET, François ULiege; Bruyère, Olivier ULiege et al

Conference (2014, October 17)

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See detailÉpidémiologie de la lithiase urinaire en Province de Liège
Castiglione, Vincent ULiege; Jouret, François ULiege; Bruyère, Olivier ULiege et al

in Néphrologie et Thérapeutique (2014, October 01), 10(5), 270

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See detailEpidémiologie de la lithiase urinaire en Province de Liège
GADISSEUR, Romy ULiege; Castiglione, Vincent ULiege; JOURET, François ULiege et al

in Néphrologie et Thérapeutique (2014, September), 10(5), 270

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