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3. Comparison between the EKFC-equation and machine learning models to predict Glomerular Filtration Rate

Author

Felipe Kenji Nakano, Anna Åkesson, Jasper de Boer, Klest Dedja, Robbe D’hondt, Fateme Nateghi Haredasht, Jonas Björk, Marie Courbebaisse, Lionel Couzi, Natalie Ebert, Björn O. Eriksen, R. Neil Dalton, Laurence Derain-Dubourg, Francois Gaillard, Cyril Garrouste, Anders Grubb, Lola Jacquemont, Magnus Hansson, Nassim Kamar, Christophe Legendre, Karin Littmann, Christophe Mariat, Toralf Melsom, Lionel Rostaing, Andrew D. Rule, Elke Schaeffner, Per-Ola Sundin, Arend Bökenkamp, Ulla Berg, Kajsa Åsling-Monemi, Luciano Selistre, Anders Larsson, Ulf Nyman, Antoine Lanot, Hans Pottel, Pierre Delanaye, and Celine Vens

Subjects
Medicine, Science
Abstract

Abstract In clinical practice, the glomerular filtration rate (GFR), a measurement of kidney functioning, is normally calculated using equations, such as the European Kidney Function Consortium (EKFC) equation. Despite being the most general equation, EKFC, just like previously proposed approaches, can still struggle to achieve satisfactory performance, limiting its clinical applicability. As a possible solution, recently machine learning (ML) has been investigated to improve GFR prediction, nonetheless the literature still lacks a general and multi-center study. Using a dataset with 19,629 patients from 13 cohorts, we investigate if ML can improve GFR prediction in comparison to EKFC. More specifically, we compare diverse ML methods, which were allowed to use age, sex, serum creatinine, cystatin C, height, weight and BMI as features, in internal and external cohorts against EKFC. The results show that the most performing ML method, random forest (RF), and EKFC are very competitive where RF and EKFC achieved respectively P10 and P30 values of 0.45 (95% CI 0.44;0.46) and 0.89 (95% CI 0.88;0.90), whereas EKFC yielded 0.44 (95% CI 0.43; 0.44) and 0.89 (95% CI 0.88; 0.90), considering the entire cohort. Small differences were, however, observed in patients younger than 12 years where RF slightly outperformed EKFC.

Published
2024
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4. Comparison between the EKFC-equation and machine learning models to predict Glomerular Filtration Rate

Author

Nakano, Felipe Kenji, Åkesson, Anna, de Boer, Jasper, Dedja, Klest, D’hondt, Robbe, Haredasht, Fateme Nateghi, Björk, Jonas, Courbebaisse, Marie, Couzi, Lionel, Ebert, Natalie, Eriksen, Björn O., Dalton, R. Neil, Derain-Dubourg, Laurence, Gaillard, Francois, Garrouste, Cyril, Grubb, Anders, Jacquemont, Lola, Hansson, Magnus, Kamar, Nassim, Legendre, Christophe, Littmann, Karin, Mariat, Christophe, Melsom, Toralf, Rostaing, Lionel, Rule, Andrew D., Schaeffner, Elke, Sundin, Per-Ola, Bökenkamp, Arend, Berg, Ulla, Åsling-Monemi, Kajsa, Selistre, Luciano, Larsson, Anders, Nyman, Ulf, Lanot, Antoine, Pottel, Hans, Delanaye, Pierre, and Vens, Celine

Published
2024
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8. MDRD or CKD-EPI study equations for estimating prevalence of stage 3 CKD in epidemiological studies: which difference? Is this difference relevant?

Author

Maillard Nicolas, Mariat Christophe, Cavalier Etienne, Delanaye Pierre, and Krzesinski Jean-Marie

Subjects
Diseases of the genitourinary system. Urology, RC870-923
Abstract

Abstract Background Prevalence of stage 3 chronic kidney disease (CKD) is increasing according to the NHANES study. Prevalence has been calculated using the MDRD study equation for estimating glomerular filtration rate (GFR). Recently, a new estimator based on creatinine, the CKD-EPI equation, has been proposed which is presumed to better perform in normal GFR ranges. The aim of the study was to measure the difference in prevalence of stage 3 CKD in a population using either the MDRD or the CKD-EPI study equations. Methods CKD screening is organized in the Province of Liège, Belgium. On a voluntary basis, people aged between 45 and 75 years are invited to be screened. GFR is estimated by the MDRD study equation and by the "new" CKD-EPI equations. Results The population screened consisted in 1992 people (47% of men). Mean serum creatinine was 0.86 ± 0.20 mg/dL. The prevalence of stage 3 CKD in this population using the MDRD or the CKD-EPI equations was 11.04 and 7.98%, respectively. The prevalence of stage 3 CKD is significantly higher with the MDRD study equation (p < 0,0012). Conclusions Prevalence of stage 3 CKD varies strongly following the method used for estimating GFR, MDRD or CKD-EPI study equations. Such discrepancies are of importance and must be confirmed and explained by additional studies using GFR measured with a reference method.

Published
2010
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14. Post-intensive care syndrome after a critical COVID-19: cohort study from a Belgian follow-up clinic

Author

Anne-Françoise Rousseau, Pauline Minguet, Camille Colson, Isabelle Kellens, Sourour Chaabane, Pierre Delanaye, Etienne Cavalier, J. Geoffrey Chase, Bernard Lambermont, and Benoit Misset

Subjects
COVID-19, Critical care, Critical illness, Post-intensive care syndrome, Survivors, Survivorship, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Purpose Many patients with coronavirus disease 2019 (COVID-19) required critical care. Mid-term outcomes of the survivors need to be assessed. The objective of this single-center cohort study was to describe their physical, cognitive, psychological, and biological outcomes at 3 months following intensive care unit (ICU)-discharge (M3). Patients and methods All COVID-19 adults who survived an ICU stay ≥ 7 days and attended the M3 consultation at our multidisciplinary follow-up clinic were involved. They benefited from a standardized assessment, addressing health-related quality of life (EQ-5D-3L), sleep disorders (PSQI), and the three principal components of post-intensive care syndrome (PICS): physical status (Barthel index, handgrip and quadriceps strength), mental health disorders (HADS and IES-R), and cognitive impairment (MoCA). Biological parameters referred to C-reactive protein and creatinine. Results Among the 92 patients admitted to our ICU for COVID-19, 42 survived a prolonged ICU stay and 32 (80%) attended the M3 follow-up visit. Their median age was 62 [49–68] years, 72% were male, and nearly half received inpatient rehabilitation following ICU discharge. At M3, 87.5% (28/32) had not regained their baseline level of daily activities. Only 6.2% (2/32) fully recovered, and had normal scores for the three MoCA, IES-R and Barthel scores. The main observed disorders were PSQI > 5 (75%, 24/32), MoCA

Published
2021
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15. Comparison of Plasma Clearance With Early-Compartment Correction Equations and Urinary Clearance in High GFR Ranges

Author

Pierre Delanaye, Emmanuelle Vidal-Petiot, Thomas Stehlé, Laurence Dubourg, François Gaillard, Gunnar Sterner, Christine A. White, Sandrine Lemoine, Vincent Audard, Dominique Prié, Etienne Cavalier, Marie Courbebaisse, Hans Pottel, and Martin Flamant

Subjects
51Cr-EDTA, glomerular filtration rate, inulin, iohexol, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Introduction: Glomerular filtration rate (GFR) is measured from the late plasma disappearance curve of an exogenous tracer, after correction for the early decay—corresponding to the distribution of the tracer—using various equations. These equations display the highest discrepancies in the GFR range above 90 ml/min per 1.73 m2, and their respective performances against a reference, urinary GFR measurement are unclear. Methods: In patients with mGFR >90 ml/min per 1.73 m2 from 6 different cohorts, we compared GFR obtained from the plasma clearance of iohexol or 51Cr-ethylenediamine tetraacetic acid (EDTA), after correction using Chantler (C), Bröchner-Mortensen (BM), Fleming (F), Jodal-Bröchner-Mortensen (JBM), and Ng (N) equations, with urinary clearance of the same tracers or inulin. Results: In 438 participants (median age 41 [39–42] years, 43% women), the median urinary clearance was 100.8 (94.7–112.6) ml/min per 1.73 m2. Plasma clearances using the correction equations were 105.7 (96.8–119.2), 102.4 (95.2–112.9), 100.7 (93.6–111.1), 102.6 (95.2–113.4), and 106.0 (98.2–117.6) ml/min per 1.73 m2 for C, BM, F, JBM, and N, respectively. Concordance correlation coefficients between plasma and urinary clearances were poor for all equations. Compared with urinary clearances, BM, F, and JBM displayed the best accuracy within 10% (73%, 72%, and 71%, respectively, vs. 63% and 66% for C and N), whereas BM and JBM had the lowest median biases. Accuracy of all equations was especially low in the hyperfiltration range (urinary clearance >130 ml/min per 1.73 m2). Conclusion: The BM and JBM equations displayed the best overall performances to correct for the early disappearance curve. Results of these equations should be interpreted with caution, especially in the highest GFR range.

Published
2021
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16. Iohexol plasma clearance for measuring glomerular filtration rate: effect of different ways to calculate the area under the curve

Author

Hans Pottel, Elke Schaeffner, Natalie Ebert, Markus van der Giet, and Pierre Delanaye

Subjects
Iohexol plasma clearance, Multiple samples, One sample, Measured GFR, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Abstract Background Measuring glomerular filtration rate (GFR) using iohexol plasma clearance has been proposed as the preferred way for GFR determination. The extended multiple-sample protocol is based on fitting the full concentration-time decay-curve, and from the obtained fit-parameters, the area under the curve (AUC) and GFR (the injected dose divided by the AUC) were calculated. The goal of the current study is to evaluate the impact of different fitting procedures on the precision of GFR-results obtained from the full concentration-time curve, and compare these results with those obtained with simplified multiple-samples and single-sample protocols. Methods The concentration-time curves of 8 samples at times 30, 60, 90, 120, 150, 180, 240 and 300 min after bolus injection of iohexol of 570 adults, aged 70+, from the Berlin Initiative Study (BIS), were analysed. The fit-parameters for the two-compartment model (double-exponential decay curve), and from these, the AUC and GFR were obtained with 8 different fitting procedures. Results The two-compartmental non-linear least squares fitting procedure showed the best accuracy (541 out of 570 reported GFR-results were within 5% of the majority of the 8 fitting methods). The two-compartmental slope-intercept fitting procedure was not always applicable and the non-compartmental fitting procedures did not always allow to calculate the GFR. All correction formulas for the simplified late multiple-samples methods showed acceptable accuracy and precision with a preference for Ng’s correction formula (Lin’s CCC = 0.992, bias = 0.5 ± 2.5). Jacobsson’s iterative method was the best one-sample method, with Lin’s CCC = 0.983 and bias = − 0.6 ± 3.4. Conclusion The fitting procedure has an important impact on the precision of the calculated AUC and GFR. The simplified late-sample protocols and one-sample methods did not suffer from fitting problems and showed acceptable equivalence when compared to the full compartment GFR-results. Trial registration The “Berlin Initiative Study” is officially registered with the German Register for Clinical Studies (“Deutschen Register Klinischer Studien”(DRKS)) under registration number DRKS00017058 , since April 12, 2019, and it is also visible on the WHO clinical trials registry platform (within the next 4 weeks after the registration date).

Published
2021
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18. Proteinuria in COVID-19: prevalence, characterization and prognostic role

Author

Huart, Justine, Bouquegneau, Antoine, Lutteri, Laurence, Erpicum, Pauline, Grosch, Stéphanie, Résimont, Guillaume, Wiesen, Patricia, Bovy, Christophe, Krzesinski, Jean-Marie, Thys, Marie, Lambermont, Bernard, Misset, Benoît, Pottel, Hans, Mariat, Christophe, Cavalier, Etienne, Burtey, Stéphane, Jouret, François, and Delanaye, Pierre

Published
2021
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19. Survivors of COVID-19 mostly recover from tubular proteinuria and acute kidney injury after hospital discharge

Author

Bouquegneau, Antoine, Huart, Justine, Lutteri, Laurence, Erpicum, Pauline, Grosch, Stéphanie, Résimont, Guillaume, Wiesen, Patricia, Rousseau, Anne-Françoise, Bovy, Christophe, Krzesinski, Jean-Marie, Thys, Marie, Lambermont, Bernard, Misset, Benoît, Pottel, Hans, Darcis, Gilles, Cavalier, Etienne, Jouret, François, and Delanaye, Pierre

Published
2021
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23. Glomerular Filtration Rate Estimation in Adults: Myths and Promises

Author

Delanaye, Pierre, Cavalier, Etienne, Stehlé, Thomas, and Pottel, Hans

Abstract

Background:In daily practice, glomerular filtration rate (GFR) is estimated with equations including renal biomarkers. Among these biomarkers, serum creatinine remains the most used. However, there are many limitations with serum creatinine, which we will discuss in the current review. We will also discuss how creatinine-based equations have been developed and what we can expect from them in terms of performance to estimate GFR. Summary:Different creatinine-based equations have been proposed. We will show the advantages of the recent European Kidney Function Consortium equation. This equation can be used in children and adults. This equation can also be used with some flexibility in different populations. Key Messages:GFR is estimated by creatinine-based equations, but the most important for nephrologists is probably to know the limitations of these equations.

Published
2024
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24. Epidemiology of acute kidney injury adverse events with SGLT2 inhibitors: A meta-analysis of observational cohort studies

Author

Pierre Delanaye and Andre J. Scheen

Subjects
Acute kidney injury, Meta-analysis, Nephrotoxicity, RAAS inhibitors, Real-life, SGLT2 inhibitors, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

Sodium-glucose cotransporter type 2 inhibitors (SGLT2is) have proven long-term nephroprotective effects in large prospective cardiovascular and renal outcome placebo-controlled trials, which follow a initial transient dip of estimated glomerular filtration rate. Nevertheless, case reports of acute kidney injury (AKI) associated with SGLT2i therapy were reported, leading the US Food and Drug Administration to publish a warning in 2016. Of note, the incidence of AKI events was not increased and often reduced in outcome trials that compared SGLT2i treatment with placebo. However, patients in real-life might be at higher risk because of a more frailty profile and a less strict supervision. In a meta-analysis of 9 cohorts from 8 observational studies worldwide, the relative risk of AKI was significantly reduced (HR 0.61, 95% CI 0.55–0.67, I² = 70%) in SGLT2i users (725 AKI events/68,802 patients) compared with non-users (treated with other glucose-lowering agents, including incretin-based compounds: 977 AKI events/67,458 patients). In conclusion, observational studies in real-world conditions confirm the results reported in placebo-controlled outcome trials and show a reduction in AKI episodes in patients with type 2 diabetes treated with SGLT2is compared with those treated with other glucose-lowering agents. Overall, the renal safety of SGLT2is should be acknowledged by physicians, even if dehydration should be avoided.

Published
2021
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27. Determination of iohexol by capillary blood microsampling and UHPLC-MS/MS

Author

Valentin Ion, Caroline Legoff, Etienne Cavalier, Pierre Delanaye, Anne-Catherine Servais, Daniela-Lucia Muntean, and Marianne Fillet

Subjects
Therapeutics. Pharmacology, RM1-950
Abstract

One of the most important tools used to evaluate kidney function in the context of chronic kidney disease or other renal function related pathologies is the exploration of glomerular filtration rate (GFR). Iohexol is up to this moment a good candidate molecule for the GFR assessment since it exhibits minimum protein binding rates and minimum extra-renal clearance, being neither secreted nor reabsorbed at the tubular level. This study proposes and evaluates a new LC-MS/MS method for the iohexol determination from capillary blood, prelevated using volumetric absorbative microsampling (VAMS) systems. As an alternative to VAMS, a brand new HemaPEN® device for micro-prelevation was also tested. A new high throughput sample preparation protocol adapted for iohexol quantification from whole blood VAMS samples was developed. The medium term stability study of iohexol in dried whole blood VAMS samples that was conducted showed a good stability of this molecule for up to 12 days. By collecting only 10 μL of blood, iohexol can be analyzed from dried whole blood VAMS samples for concentration ranges between 1 and 250 μg/mL. Due to the analyte stability in VAMS for up to 12 days, this approach might be successfully applied for GFR assessment for clinical cases allowing minimum invasiveness and even delayed analysis. Keywords: Microsampling, Iohexol, VAMS, LC-MS/MS, HemaPEN

Published
2019
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28. Outcome Improvement Between the First Two Waves of the Coronavirus Disease 2019 Pandemic in a Single Tertiary-Care Hospital in Belgium

Author

Bernard Lambermont, MD, PhD, Anne-Françoise Rousseau, MD, PhD, Laurence Seidel, MSc, Marie Thys, MSc, Jonathan Cavalleri, MD, Pierre Delanaye, MD, PhD, J. Geoffrey Chase, PhD, Pierre Gillet, MD, PhD, and Benoit Misset, MD

Subjects
Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Objectives:. To compare patient management and outcome during the first and second waves of the coronavirus 2019 pandemic. Design:. Single-center prospective cohort study. Setting:. Tertiary-care University Hospital. Patients:. All adult patients admitted in either the first (from March 15 to May 15, 2020) or second (from October 1 to November 30, 2020) wave of coronavirus disease 2019. Interventions:. None. Measurements and Main Results:. Primary outcome was 30-day mortality. During the second wave of the coronavirus disease 2019 pandemic, 33 patients (4.8%) were transferred due to overcrowding and excluded from analysis. There were 341 (first wave of the coronavirus disease 2019 pandemic) and 695 (second wave of the coronavirus disease 2019 pandemic) coronavirus disease 2019 patients admitted to the hospital, with median age first wave of the coronavirus disease 2019 pandemic as 68 (57–80) and second wave of the coronavirus disease 2019 pandemic as 71 (60–80) (p = 0.15), and similar admission severity. For the first wave of the coronavirus disease 2019 pandemic versus second wave of the coronavirus disease 2019 pandemic, 30-day mortality was 74/341 (22%) and 98/662 (15%) (p = 0.007). In the ward, 11/341 (3.2%) and 404/662 (61%) received dexamethasone (p < 0.001); 6/341 (2%) and 79/662 (12%) received high-flow nasal oxygen (p < 0.0001); 2/341 (0.6%) and 88/662 (13.3%) received remdesivir (p < 0.0001); 249/341 (73%) and 0/662 (0%) received hydroxychloroquine (p < 0.0001); and 87/341 (26%) and 128/662 (19%) (p = 0.024) patients were transferred to ICU. On ICU admission, median Sequential Organ Failure Assessment was 6 (3–7) and 4 (3–6) (p = 0.02). High-flow nasal oxygen was given to 16/87 (18%) and 102/128 (80%) (p < 0.001); 69/87 (79%) and 56/128 (44%) received mechanical ventilation (p < 0.001) with durations 17 days (10–26 d) and 10 days (5–17 d) (p = 0.01). Median ICU length of stay was 14 days (5–27 d) and 6 days (3–11 d) (p < 0.001). Finally, 16/87 (18%) and 8/128 (6%) received renal replacement therapy (p = 0.0055); and 64/87 (74%) and 51/128 (40%) needed vasopressor support (p < 0.001). Conclusions:. The main therapeutic changes between the first wave of the coronavirus disease 2019 pandemic and the second wave of the coronavirus disease 2019 pandemic were use of steroids, unrestrictive use of high-flow nasal oxygen for hypoxemic patients, and transfer of patients to other geographic areas in the case of ICU overcrowding. These changes were associated with a decrease in 30-day mortality, ICU admission, and organ support.

Published
2021
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34. Data on the relation between renal biomarkers and measured glomerular filtration rate

Author

Hans Pottel, Laurence Dubourg, Elke Schaeffner, Bjørn Odvar Eriksen, Toralf Melsom, Edmund J. Lamb, Andrew D. Rule, Stephen T. Turner, Richard J. Glassock, Vandréa De Souza, Luciano Selistre, Karolien Goffin, Steven Pauwels, Christophe Mariat, Martin Flamant, Sebastjan Bevc, Pierre Delanaye, and Natalie Ebert

Subjects
Serum creatinine, Serum cystatin C, Measured glomerular filtration rate, Computer applications to medicine. Medical informatics, R858-859.7, Science (General), Q1-390
Abstract

The data presented in this article are related to the research article entitled “The Diagnostic Value of Rescaled Renal Biomarkers Serum Creatinine and Serum Cystatin C and their Relation with Measured Glomerular Filtration Rate” (Pottel et al. (2017) [1]). Data are presented demonstrating the rationale for the normalization or rescaling of serum cystatin C, equivalent to the rescaling of serum creatinine. Rescaling biomarkers brings them to a notionally common scale with reference interval [0.67–1.33]. This article illustrates the correlation between rescaled biomarkers serum creatinine and serum cystatin C by plotting them in a 2-dimensional graph. The diagnostic value in terms of sensitivity and specificity with measured Glomerular Filtration Rate as the reference method is calculated per age-decade for both rescaled biomarkers. Finally, the interchangeability between detecting impaired kidney function from renal biomarkers and from the Full Age Spectrum FAS-estimating GFR-equation and measured GFR using a fixed and an age-dependent threshold is shown.

Published
2017
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35. Glomerular hyperfiltration: part 2-clinical significance in children.

Author

Adebayo, O.C., Nkoy, A.B., Heuvel, L.P.W.J. van den, Labarque, V., Levtchenko, E.N., Delanaye, P., Pottel, H., Adebayo, O.C., Nkoy, A.B., Heuvel, L.P.W.J. van den, Labarque, V., Levtchenko, E.N., Delanaye, P., and Pottel, H.

Abstract

01 augustus 2023, Contains fulltext : 295990.pdf (Publisher’s version ) (Closed access), Glomerular hyperfiltration (GHF) is a phenomenon that can occur in various clinical conditions affecting the kidneys such as sickle cell disease, diabetes mellitus, autosomal dominant polycystic kidney disease, and solitary functioning kidney. Yet, the pathophysiological mechanisms vary from one disease to another and are not well understood. More so, it has been demonstrated that GHF may occur at the single-nephron in some clinical conditions while in others at the whole-kidney level. In this review, we explore the pathophysiological mechanisms of GHF in relation to various clinical conditions in the pediatric population. In addition, we discuss the role and mechanism of action of important factors such as gender, low birth weight, and race in the pathogenesis of GHF. Finally, in this current review, we further highlight the consequences of GHF in the progression of kidney disease.

Published
2023

36. Analytical Performance Specifications for 25-Hydroxyvitamin D Examinations

Author

Etienne Cavalier, Callum G. Fraser, Harjit P. Bhattoa, Annemieke C. Heijboer, Konstantinos Makris, Candice Z. Ulmer, Hubert W. Vesper, Samuel Vasikaran, Pierre Lukas, Pierre Delanaye, Anna Carobene, and on behalf of the IFCC-IOF Committee for Bone Metabolism

Subjects
analytical performance specifications biological variation, measurement uncertainty, vitamin D, 25(OH)-vitamin D, Nutrition. Foods and food supply, TX341-641
Abstract

Currently the 25-hydroxy vitamin D (25(OH)D) concentration is thought to be the best estimate of the vitamin D status of an individual. Unfortunately, its measurement remains complex, despite recent technological advances. We evaluated the biological variation (BV) of 25(OH)D in order to set analytical performance specifications (APS) for measurement uncertainty (MU). Six European laboratories recruited 91 healthy participants. The 25(OH)D concentrations in K3-EDTA plasma were examined weekly for up to 10 weeks in duplicate on a Lumipulse G1200 (Fujirebio, Tokyo, Japan). The linear regression of the mean 25(OH)D concentrations at each blood collection showed that participants were not in a steady state. The dissection of the 10-sample collection into two subsets, namely collections 1–5 and 6–10, did not allow for correction of the lack of homogeneity: estimates of the within-subject BV ranged from 5.8% to 7.1% and the between-subject BV ranged from 25.0% to 39.2%. Methods that would differentiate a difference induced by 25(OH)D supplementation at p < 0.05 should have MU < 13.6%, while at p < 0.01, the MU should be

Published
2021
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37. Estimating Glomerular Filtration Rate in China: Is the European Kidney Function Consortium (EKFC) Equation the Solution?

Author

Delanaye, Pierre and Pottel, Hans

Abstract

The new European Kidney Function Consortium (EKFC) creatinine-based equation has been developed to be applicable over the entire age range (from 2 to 100 years) without any loss of performance in young adults and without loss of continuity in estimating glomerular filtration rate (GFR) between adolescents and adults. This goal is obtained by better taking into account the relationship between serum creatinine (SCr) and age in the estimating GFR model. This is accomplished by rescaling SCr, namely, dividing SCr by so-called Q value which is the median normal value of SCr concentration in a given healthy population. The better performance of the EKFC equation, compared to the current equations, has been shown in large European and African cohorts. Such good results are also suggested in cohorts from China, including in the current issue of Nephron. The good performance of the EKFC equation is observed, especially when the authors used a specific Q value for their populations notwithstanding GFR was measured by a controversial method. Using a population-specific Q value could make the EFKC equation universally applicable.

Published
2024
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38. Réflexions sur les scores et les définitions de l'insuffisance rénale aiguë.

Author

Delanaye, Pierre and Mariat, Christophe

Abstract

L'insuffisance rénale aiguë (IRA) est une entité pathologique très complexe. La définition de l'IRA a heureusement évolué ces dernières années en faveur d'une certaine harmonisation. Plusieurs scores ont été proposés (RIFLE, AKIN et KDIGO). Ils se basent tous sur une définition dynamique qui prend en compte les variations de créatinine sérique d'une part, et de débit urinaire d'autre part. Ces scores ne sont cependant pas parfaits et certaines limitations sont à souligner. Il n'en reste pas moins qu'ils ont permis d'harmoniser la définition d'IRA et, par là même, de mieux appréhender cette pathologie compliquée. Acute kidney injury (AKI) is a complex pathological status. The definition of AKI has fortunately evolved in the last years on the way of a sort of standardization. Several AKI scores have been proposed (RIFLE, AKIN, and KDIGO). These scores are all dynamic, as they are based on variations of serum creatinine and urine output. Such scores are however not without any limitations that we will discuss in the current article. All in one, these scores have led to a harmonization of the definition of AKI which allows clinicians to better apprehend this complex disease. [ABSTRACT FROM AUTHOR]

Published
2023
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43. Proceedings of Réanimation 2017, the French Intensive Care Society International Congress

Author

Kamilia, Chtara, Regaieg, Kais, Baccouch, Najeh, Chelly, Hedi, Bahloul, Mabrouk, Bouaziz, Mounir, Jendoubi, Ali, Abbes, Ahmed, Belhaouane, Houda, Nasri, Oussama, Jenzri, Layla, Ghedira, Salma, Houissa, Mohamed, Belkadi, Kamal, Harti, Youness, Nsiri, Afak, Khaleq, Khalid, Hamoudi, Driss, Harrar, Rachid, Thieffry, Camille, Wallet, Frédéric, Parmentier-Decrucq, Erika, Favory, Raphaël, Mathieu, Daniel, Poissy, Julien, Lafon, Thomas, Vignon, Philippe, Begot, Emmanuelle, Appert, Alexandra, Hadj, Mathilde, Claverie, Paul, Matt, Morgan, Barraud, Olivier, François, Bruno, Jamoussi, Amira, Jazia, Amira Ben, Marhbène, Takoua, Lakhdhar, Dhouha, Khelil, Jalila Ben, Besbes, Mohamed, Goutay, Julien, Blazejewski, Caroline, Joly-Durand, Isabelle, Pirlet, Isabelle, Weillaert, Marie Pierre, Beague, Sebastien, Aziz, Soufi, Hafiane, Reda, Hattabi, Khalid, Bouhouri, Mohamed Aziz, Hammoudi, Driss, Fadil, Abdelaziz, Harrar, Rachid Al, Zerouali, Khalid, Medhioub, Fatma Kaaniche, Allela, Rania, Algia, Najla Ben, Cherif, Samar, Slaoui, Mohamed Taoufik, Boubia, Souhail, Hafiani, Y., Khaoudi, A., Cherkab, R., Elallam, W., Elkettani, C., Barrou, L., Ridaii, M., Mehdi, Rihi El, Schimpf, Caroline, Mizrahi, Assaf, Pilmis, Benoît, Le Monnier, Alban, Tiercelet, Kelly, Cherin, Mélanie, Bruel, Cédric, Philippart, Francois, Bailly, Sébastien, Lucet, Jc, Lepape, Alain, L’hériteau, François, Aupée, Martine, Bervas, Caroline, Boussat, Sandrine, Berger-Carbonne, Anne, Machut, Anaïs, Savey, Anne, Timsit, Jean-François, Razazi, Keyvan, Rosman, Jérémy, de Prost, Nicolas, Carteaux, Guillaume, Jansen, Chloe, Decousser, Jean Winoc, Brun-Buisson, Christian, Dessap, Armand Mekontso, M’rad, Aymen, Ouali, Zouhour, Barghouth, Manel, Kouatchet, Achille, Mahieu, Rafael, Weiss, Emmanuel, Schnell, David, Zahar, Jean-Ralph, Artiguenave, Margaux, Sophie, Paktoris-Papine, Espinasse, Florence, Sayed, Faten El, Dinh, Aurélien, Charron, Cyril, Geri, Guillaume, Vieillard-Baron, Antoine, Repessé, Xavier, Kallel, Hatem, 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Adrien, Laribi, Said, Garot, Denis, Dequin, Pierre François, Guillon, Antoine, Fergé, Jean-Louis, Abgrall, Gwénolé, Hinault, Ronan, Vally, Shazima, Roze, Benoit, Chaplain, Agathe, Chabartier, Cyrille, Savidan, Anne-Charlotte, Marie, Sabia, Cabie, Andre, Resiere, Dabor, Valentino, Ruddy, Mehdaoui, Hossein, Benarous, Lucas, Soda-Diop, Marième, Bouzana, Fouad, Perrin, Gilles, Bourenne, Jeremy, Eon, Béatrice, Lambert, Dominique, Trebuchon, Agnes, Poncelet, Géraldine, Le Bourgeois, Fleur, Michael, Levy, Camille, Guillot, Naudin, Jérôme, Deho, Anna, Dauger, Stéphane, Sauthier, Michaël, Bergeron-Gallant, Krystale, Emeriaud, Guillaume, Jouvet, Philippe, Tiebergien, Nicolas, Jacquet-Lagrèze, Matthias, Fellahi, Jean-Luc, Baudin, Florent, Essouri, Sandrine, Javouhey, Etienne, Guérin, Claude, Lampin, Marie, Mamouri, Ouardia, Devos, Patrick, Karaca-Altintas, Yasemin, Vinchon, Matthieu, Brossier, David, Eltaani, Redha, Teyssedre, Sonia, Sabine, Meyet, Bouchut, Jean-Christophe, Peguet, Olivier, 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Rafaa, Kouraichi, Nadia, Jouet, Emilie, Badin, Julie, Fermier, Brice, Feller, Marc, Serie, Mathieu, Pillot, Jérôme, Marie, William, Gisbert-Mora, Chloé, Vinclair, Camille, Lesbordes, Pierre, Mathieu, Pascal, De Brabant, Fabienne, Muller, Emmanuel, Robaux, Marie-Aline, Giabicani, Mikhael, Marchalot, Antoine, Gelinotte, Stéphanie, Declercq, Pierre Louis, Eraldi, Jean-Pierre, Bougerol, François, Meunier-Beillard, Nicolas, Devilliers, Hervé, Rigaud, Jean-Philippe, Verrière, Camille, Ardisson, Fanny, Kentish-Barnes, Nancy, Jacq, Gwenaëlle, Chermak, Akli, Lautrette, Alexandre, Legrand, Matthieu, Soummer, Alexis, Thiery, Guillaume, Cottereau, Alice, Canet, Emmanuel, Caujolle, Marie, Allyn, Jérôme, Valance, Dorothée, Brulliard, Caroline, Martinet, Olivier, Jabot, Julien, Gallas, Thomas, Vandroux, David, Allou, Nicolas, Durand, Arthur, Nevière, Rémi, Delguste, Florian, Boulanger, Eric, Preau, Sebastien, Martin, Ruste, Cochet, Hélène, Ponthus, Jean Pierre, Amilien, Virginie, Tchir, Martial, 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Published
2017
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44. Numerical and Experimental Study of Microchannel Performance on Flow Maldistribution

Author

Jojomon Joseph, Danish Rehman, Michel Delanaye, Gian Luca Morini, Rabia Nacereddine, Jan G. Korvink, and Juergen J. Brandner

Subjects
micro channel, reduced model, wire-net perturbators, s-shaped perturbators, high-temperature heat exchangers, Mechanical engineering and machinery, TJ1-1570
Abstract

Miniaturized heat exchangers are well known for their superior heat transfer capabilities in comparison to macro-scale devices. While in standard microchannel systems the improved performance is provided by miniaturized distances and very small hydraulic diameters, another approach can also be followed, namely, the generation of local turbulences. Localized turbulence enhances the heat exchanger performance in any channel or tube, but also includes an increased pressure loss. Shifting the critical Reynolds number to a lower value by introducing perturbators controls pressure losses and improves thermal efficiency to a considerable extent. The objective of this paper is to investigate in detail collector performance based on reduced-order modelling and validate the numerical model based on experimental observations of flow maldistribution and pressure losses. Two different types of perturbators, Wire-net and S-shape, were analyzed. For the former, a metallic wire mesh was inserted in the flow passages (hot and cold gas flow) to ensure stiffness and enhance microchannel efficiency. The wire-net perturbators were replaced using an S-shaped perturbator model for a comparative study in the second case mentioned above. An optimum mass flow rate could be found when the thermal efficiency reaches a maximum. Investigation of collectors with different microchannel configurations (s-shaped, wire-net and plane channels) showed that mass flow rate deviation decreases with an increase in microchannel resistance. The recirculation zones in the cylindrical collectors also changed the maldistribution pattern. From experiments, it could be observed that microchannels with S-shaped perturbators shifted the onset of turbulent transition to lower Reynolds number values. Experimental studies on pressure losses showed that the pressure losses obtained from numerical studies were in good agreement with the experiments (

Published
2020
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45. A Hybrid Numerical Methodology Based on CFD and Porous Medium for Thermal Performance Evaluation of Gas to Gas Micro Heat Exchanger

Author

Danish Rehman, Jojomon Joseph, Gian Luca Morini, Michel Delanaye, and Juergen Brandner

Subjects
reduced model, lmtd method, conjugate heat transfer (cht), compressible fluid, maldistribution, Mechanical engineering and machinery, TJ1-1570
Abstract

In micro heat exchangers, due to the presence of distributing and collecting manifolds as well as hundreds of parallel microchannels, a complete conjugate heat transfer analysis requires a large amount of computational power. Therefore in this study, a novel methodology is developed to model the microchannels as a porous medium where a compressible gas is used as a working fluid. With the help of such a reduced model, a detailed flow analysis through individual microchannels can be avoided by studying the device as a whole at a considerably less computational cost. A micro heat exchanger with 133 parallel microchannels (average hydraulic diameter of 200 μ m) in both cocurrent and counterflow configurations is investigated in the current study. Hot and cold streams are separated by a stainless-steel partition foil having a thickness of 100 μ m. Microchannels have a rectangular cross section of 200 μ m × 200 μ m with a wall thickness of 100 μ m in between. As a first step, a numerical study for conjugate heat transfer analysis of microchannels only, without distributing and collecting manifolds is performed. Mass flow inside hot and cold fluid domains is increased such that inlet Reynolds number for both domains remains within the laminar regime. Inertial and viscous coefficients extracted from this study are then utilized to model pressure and temperature trends within the porous medium model. To cater for the density dependence of inertial and viscous coefficients due to the compressible nature of gas flow in microchannels, a modified formulation of Darcy−Forschheimer law is adopted. A complete model of a double layer micro heat exchanger with collecting and distributing manifolds where microchannels are modeled as the porous medium is finally developed and used to estimate the overall heat exchanger effectiveness of the investigated micro heat exchanger. A comparison of computational results using proposed hybrid methodology with previously published experimental results of the same micro heat exchanger showed that adopted methodology can predict the heat exchanger effectiveness within the experimental uncertainty for both cocurrent and counterflow configurations.

Published
2020
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46. One-year mortality of patients with ST-Elevation myocardial infarction: Prognostic impact of creatinine-based equations to estimate glomerular filtration rate.

Author

Yoann Bataille, Olivier Costerousse, Olivier F Bertrand, Olivier Moranne, Hans Pottel, and Pierre Delanaye

Subjects
Medicine, Science
Abstract

BACKGROUND:Renal dysfunction is associated with worse outcomes after primary percutaneous coronary intervention (PCI). However, whether glomerular filtration rate (GFR) estimated with various equations can equally predict outcomes after ST-Elevation Myocardial Infarction (STEMI) is still debated. METHODS:We compared the clinical impact of 3 different creatinine-based equations (Cockcroft and Gault (CG), CKD-epidemiology (CKD-EPI) and Full Age Spectrum (FAS)) to predict 1-year mortality in STEMI patients. RESULTS:Among 1755 consecutive STEMI patients who had undergone primary PCI included between 2006 and 2011, median estimated GFR was 79 (61;96) with the CG, 81 (65;95) with CKD-EPI and 75 (60;91) mL/min/1.73 m2 with FAS equation. Reduced GFR values were independently associated with 1-year mortality risk with the 3 equations. Receiver operating curves (ROC) of CG and FAS equations were significantly superior to the CKD-EPI equation, p = 0.03 and p = 0.01, respectively. Better prediction with FAS and CG equations was confirmed by net reclassification index. CONCLUSIONS:Our results suggest that in STEMI patients who have undergone primary PCI, 1-year mortality is better predicted by CG or FAS equations compared to CKD-EPI.

Published
2018
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47. Performance of glomerular filtration rate estimation equations in Congolese healthy adults: The inopportunity of the ethnic correction.

Author

Justine B Bukabau, Ernest K Sumaili, Etienne Cavalier, Hans Pottel, Bejos Kifakiou, Aliocha Nkodila, Jean Robert R Makulo, Vieux M Mokoli, Chantal V Zinga, Augustin L Longo, Yannick M Engole, Yannick M Nlandu, François B Lepira, Nazaire M Nseka, Jean Marie Krzesinski, and Pierre Delanaye

Subjects
Medicine, Science
Abstract

In the estimation of glomerular filtration rate (GFR), ethnicity is an important determinant. However, all existing equations have been built solely from Caucasian and Afro-American populations and they are potentially inaccurate for estimating GFR in African populations. We therefore evaluated the performance of different estimated GFR (eGFR) equations in predicting measured GFR (mGFR).In a cross-sectional study, 93 healthy adults were randomly selected in the general population of Kinshasa, Democratic Republic of the Congo, between June 2015 and April 2016. We compared mGFR by plasma clearance of iohexol with eGFR obtained with the Modified Diet in Renal Disease (MDRD) equation with and without ethnic factor, the Chronic Kidney Disease Epidemiology (CKD-EPI) serum creatinine (SCr)-based equation, with and without ethnic factor, the cystatin C-based CKD-EPI equation (CKD-EPI SCys) and with the combined equation (CKD-EPI SCrCys) with and without ethnic factor. The performance of the equations was studied by calculating bias, precision and accuracy within 30% (P30) of mGFR.There were 48 women and 45 men. Their mean age was 45.0±15.7 years and the average body surface area was 1.68±0.16m2. Mean mGFR was 92.0±17.2 mL/min/1.73m2 (range of 57 to 141 mL/min/1.73m2). Mean eGFRs with the different equations were 105.5±30.1 and 87.2±24.8 mL/min/1.73m2 for MDRD with and without ethnic factor, respectively; 108.8±24.1 and 94.3x20.9 mL/min/1.73m2 for CKD-EPI SCr with and without ethnic factor, respectively, 93.5±18.6 mL/min/1.73m2 for CKD-EPI SCys; 93.5±18.0 and 101±19.6 mL/min/ 1.73m2 for CKD-EPI SCrCys with and without ethnic factor, respectively. All equations slightly overestimated mGFR except MDRD without ethnic factor which underestimated by -3.8±23.0 mL/min /1.73m2. Both CKD-EPI SCr and MDRD with ethnic factors highly overestimated mGFR with a bias of 17.9±19.2 and 14.5±27.1 mL/min/1.73m2, respectively. There was a trend for better P30 for MDRD and CKD-EPI SCr without than with the ethnic factor [86.0% versus 79.6% for MDRD (p = 0.21) and 81.7% versus 73.1% for the CKD-EPI SCr equations (p = 0.057)]. CKD-EPI SCrCys and CKD-EPI SCys were more effective than creatinine-based equations.In the Congolese healthy population, MDRD and CKD-EPI equations without ethnic factors had better performance than the same equations with ethnic factor. The equations using Cys C (alone or combined with SCr) performed better than the creatinine-based equations.

Published
2018
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