Publications by authors named "Pottel H"
Article Synopsis
- The study aimed to enhance the Lund-Malmö GFR equation using rescaled cystatin C (r-LMR) and validate it against measured GFR in a large cohort of children and adults.
- Validation results showed that r-LMR performed with 86.2% accuracy in adults, outpacing the CAPA equation, indicating r-LMR is a reliable method for estimating GFR.
- The findings suggest that adapting the Lund-Malmö equation for rescaled cystatin C yields similar results to those based on rescaled creatinine, hinting at a reduced future need for specific GFR estimating equations.
Chagas disease following infection with Trypanosoma cruzi is a major public health issue, with the disease spreading beyond endemic regions and becoming more global due to the migration of infected individuals. The currently available anti-parasitic drugs, nifurtimox and benznidazole, remain insufficiently evaluated for their efficacy in adult patients. A key challenge is the lack of markers for parasitological cure, which also precludes the development of new treatments.
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- The study evaluates the effectiveness of machine learning (ML) techniques in predicting glomerular filtration rate (GFR) compared to the traditional EKFC equation, which measures kidney function.
- Using data from 19,629 patients across 13 cohorts, the researchers tested various ML methods, particularly focusing on factors like age, sex, and serum creatinine levels.
- Results indicated that the random forest (RF) method performed similarly to EKFC, with slight advantages for RF in younger patients, suggesting ML could enhance future GFR prediction methods.
Background: Creatinine-based equations are the most used to estimate glomerular filtration rate (eGFR). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), the re-expressed Lund-Malmö Revised (r-LMR) and the European Kidney Function Consortium (EKFC) equations are the most validated. The EKFC and r-LMR equations have been suggested to have better performances in young adults, but this is debated.
View Article and Find Full Text PDFInternational consensus supports the development of standardized protocols for measured glomerular filtration rate (mGFR) to facilitate the integration of mGFR testing in both clinical and research settings. To this end, the European Kidney Function Consortium convened an international group of experts with relevant experience in mGFR. The working group performed an extensive literature search to inform the development of recommendations for mGFR determination using 1-compartment plasma clearance models and iohexol as the exogenous filtration marker.
View Article and Find Full Text PDFBackground And Hypothesis: The estimation of glomerular filtration rate (GFR) is one main tool to detect renal disease. The most used biomarker remains serum creatinine and the European Kidney Function Consortium (EKFCcrea) equation is the most validated in Europe. More recently, cystatin C, has been proposed.
View Article and Find Full Text PDFIntroduction: [F]FDG PET/CT noninvasively disproves acute kidney allograft rejection (AR) in kidney transplant recipients (KTRs) with suspected AR. However, the correlation of biopsy-based Banff vs. PET/CT-based scores of acute inflammation remains unknown, as does the prognostic performance of [F]FDG PET/CT at one year suspected AR.
View Article and Find Full Text PDFBackground: Children with overweight and obesity are at risk for developing chronic kidney disease (CKD). During lifestyle adjustment, the first step in the treatment of childhood obesity, body proportions are likely to change. The aim of this study was to examine how lifestyle intervention affects creatinine-based kidney function estimation in children with overweight and obesity.
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- The Schwartz equation is widely used to estimate GFR in European children, but its applicability for African children remains uncertain.
- A study involving 513 African children found that normalizing serum creatinine using European Q-values was effective, with 93.4% of participants falling within the reference range.
- Among various equations tested, the FAS-Age formula was the most reliable as it showed no dependency on age or sex and does not require height measurements.
Background: Extremely low birth weight (ELBW) neonates (birth weight ≤ 1000 g) are at high risk to develop drug-induced acute kidney injury (AKI). However, we lack a pragmatic detection tool to capture their time-dependent (patho)physiologic serum creatinine (Scr) patterns. Pottel et al.
View Article and Find Full Text PDFBackground: 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.
View Article and Find Full Text PDFEstimating glomerular filtration rate (GFR) is important in daily practice to assess kidney function and adapting the best clinical care of patients with and without chronic kidney disease. The new creatinine-based European Kidney Function Consortium (EKFC) equation is used to estimate GFR. This equation was developed and validated mainly in European individuals and based on a rescaled creatinine, with the rescaling factor (Q-value) defined as the median normal value of serum creatinine in a given population.
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- Creatinine-based eGFR is not very accurate for individuals due to factors like muscle mass affecting serum creatinine levels, while cystatin C provides a more consistent measure but doesn’t outperform creatinine alone.
- A new CKD-EPI equation has shown some bias based on race and performs poorly in Europe, while the EKFC equation offers better accuracy across age groups and populations, including non-white Europeans.
- There is a push for improvements in GFR estimation methods, like standardizing cystatin C assays, integrating muscle mass data, and exploring new biomarkers, alongside addressing discrepancies between cystatin C and creatinine to enhance patient outcomes.
Serum creatinine and serum cystatin C are the most widely used renal biomarkers for calculating the estimated glomerular filtration rate (eGFR), which is used to estimate the severity of kidney damage. In this review, we present the basic characteristics of these biomarkers, their advantages and disadvantages, some basic history, and current laboratory measurement practices with state-of-the-art methodology. Their clinical utility is described in terms of normal reference intervals, graphically presented with age-dependent reference intervals, and their use in eGFR equations.
View Article and Find Full Text PDFBackground: A new cystatin C based European Kidney Function Consortium (EKFC) equation was recently developed for adults, using the same mathematical form as the previously published full age spectrum creatinine based EKFC-equation (EKFC). In the present study the cystatin C based EKFC-equation is extended to children, by defining the appropriate cystatin C rescaling factor Q.
Methods: Rescaling factor Q for cystatin C was defined as: a) 0.
Objectives: In this study we evaluate the efficacy and safety of a treatment protocol with standard dose of hydroxychloroquine plus azithromycin in patients hospitalized with COVID-19 infection.
Methods: We conducted a retrospective analysis to compare the 28-day mortality rate in 352 patients treated with hydroxychloroquine with or without azithromycin (HCQ-group) in our hospital with a contemporary control group of 3533 patients receiving standard of care from the Belgian Collaborative Group on COVID-19 Hospital Surveillance.
Results: All patients who received at least one dose of treatment were included in the analysis.
Objectives: To make glomerular filtration rate (GFR) estimating equations applicable across populations with different creatinine generation by using rescaled serum creatinine (sCr/Q) where sCr represents the individual creatinine level and Q the average creatinine value in healthy persons of the same population.
Methods: GFR measurements (mGFR, plasma clearance of Cr-EDTA) were conducted in 964 adult Black Europeans. We established the re-expressed Lund-Malmö revised equation (r-LMR) by replacing serum creatinine (sCr) with rescaled creatinine sCr/Q.
Glomerular filtration rate (GFR) is estimated in clinical practice from equations based on the serum concentration of endogenous biomarkers and demographic data. The 2009 creatinine-based Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI) was recommended worldwide until 2021, when it was recalibrated to remove the African-American race factor. The CKD-EPI and CKD-EPI equations overestimate GFR of adults aged 18-30 years, with a strong overestimation in estimated GFR (eGFR) at age 18 years.
View Article and Find Full Text PDFThe 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.
View Article and Find Full Text PDFKey Points: Surgical AVF ligation in KTRs is associated with a significant increase in diastolic BP while systolic BP remains stable. AVF closure in KTRs leads to an improvement of LV and LA morphology and a decrease in serum NT-proBNP levels. There is no significant effect of AVF ligation on kidney allograft function: The eGFR remains stable over time.
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- Acute Kidney Injury (AKI) is a rapid decline in kidney function commonly found in critically ill patients, and has strong links to chronic kidney disease (CKD) and increased mortality.
- Machine learning models were created using patient data to predict outcomes after severe AKI (stage 3), focusing on the likelihood of developing CKD within three to six months and assessing mortality risks with advanced algorithms like random forests and XGBoost.
- The study included 101 patients, and results indicated that the machine learning models outperformed traditional predictive methods, suggesting they could improve clinical decision-making for AKI patients by identifying those at higher risk for CKD and mortality, especially when supplemented with unlabeled data.
Background: Acute Kidney Injury (AKI) is frequently seen in hospitalized and critically ill patients. Studies have shown that AKI is a risk factor for the development of acute kidney disease (AKD), chronic kidney disease (CKD), and mortality.
Methods: A systematic review is performed on validated risk prediction models for developing poor renal outcomes after AKI scenarios.