Tilman B Drüeke

Tilman B Drüeke
French Institute of Health and Medical Research | Inserm · UFR Médecine/Pharmacie, Université de Picardie Jules Verne, Amiens

MD

About

426
Publications
22,644
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19,182
Citations
Additional affiliations
January 2009 - December 2012
UFR Médecine/Pharmacie, Université de Picardie Jules Verne
Position
  • Université de Picardie Jules Verne
January 1983 - September 2009
Hôpital Universitaire Necker
Position
  • Institut national de la santé et de la recherche médicale (Inserm)
October 1979 - September 2009
Hôpital Necker (AP-HP)
Position
  • Assistance Publique – Hôpitaux de Paris (AP-HP)

Publications

Publications (426)
Article
Full-text available
In chronic kidney disease (CKD), calcium-sensing receptor (CaSR) expression and function have been extensively studied in parathyroid tissue and vascular tissues. To examine whether similar changes occurred in other tissues, we measured total and surface CaSR expression in monocytes of patients with various stages of CKD and healthy volunteers resp...
Article
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Introduction In the general population, urinary sodium-to-potassium (uNa/K) ratio associates more strongly with high blood pressure (BP) than either urinary sodium or potassium alone. Whether this is also the case among patients with chronic kidney disease (CKD) is unknown. Methods We studied the associations of spot urine sodium-to-creatinine (uN...
Article
Full-text available
Hyperphosphatemia is a common complication in patients with chronic kidney disease (CKD), particularly in those requiring renal replacement therapy. The importance of controlling serum phosphate has long been recognized based on observational epidemiological studies that linked increased phosphate levels to adverse outcomes and higher mortality ris...
Article
Background Hyperphosphatemia control is a major issue in hemodialysis patients. Both sevelamer and nicotinamide are prescribed for this purpose. In addition, they exert pleiotropic effects such as an improvement of inflammatory status and potentially enhanced clearance of uremic toxins. In the present secondary analysis of the NICOREN trial, we inv...
Article
The calcimimetic cinacalcet is used to treat secondary hyperparathyroidism in patients receiving dialysis, and asymptomatic hypocalcemia is often observed following its initiation. Here we investigated the incidence, predictors and therapeutic consequences of hypocalcemia by a post hoc analysis of the randomized, double-blind, placebo-controlled EV...
Article
Full-text available
Importance Secondary hyperparathyroidism contributes to extraskeletal calcification and is associated with all-cause and cardiovascular mortality. Control is suboptimal in the majority of patients receiving hemodialysis. An intravenously (IV) administered calcimimetic could improve adherence and reduce adverse gastrointestinal effects. Objective T...
Article
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Importance Secondary hyperparathyroidism contributes to extraskeletal complications in chronic kidney disease. Objective To evaluate the effect of the intravenous calcimimetic etelcalcetide on serum parathyroid hormone (PTH) concentrations in patients receiving hemodialysis. Design, Setting, and Participants Two parallel, phase 3, randomized, pla...
Data
Crude incidence rates and adjusted hazard ratios for recurrent stroke and coronary heart disease according to chronic kidney disease and hypertension control status
Data
Crude mortality rates and adjusted hazard ratios for all-cause and cardiovascular deaths according to chronic kidney disease and hypertension control status
Data
Crude incidence rates and adjusted hazard ratios for stroke and coronary heart disease according to chronic kidney disease and hypertension control status
Article
Full-text available
Introduction Chronic kidney disease (CKD) is often associated with poor hypertension control and treatment resistance, but whether CKD modifies the effect of hypertension control on outcomes is unknown. Methods We studied 10-year mortality and cardiovascular events according to hypertension control status and CKD (glomerular filtration rate <60 ml...
Article
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Dialysis patients exhibit an inverse, L- or U-shaped association between blood pressure and mortality risk, in contrast to the linear association in the general population. We prospectively studied 9333 hemodialysis patients in France, aiming to analyze associations between predialysis systolic, diastolic, and pulse pressure with all-cause mortalit...
Article
Vascular calcification and kidney fibrosis are 2 important features of chronic kidney disease. Bone morphogenetic proteins/growth differentiation factors and their receptors are implicated in the pathogenesis of both processes. Modulation of the bone morphogenetic protein/growth differentiation factor pathways by a soluble chimeric protein that con...
Article
Chronic metabolic acidosis stimulates bone resorption, resulting in loss of calcium and bicarbonate from bone. Both osteoblasts and osteoclasts sense extracellular H+ by the G-protein coupled receptor, OGR1, whose activation leads to increased bone resorption as well as decreased bone formation. Krieger et al. examined the effect of OGR1 knockout i...
Article
It is commonly held that osteitis fibrosa and mixed uremic osteodystrophy are the predominant forms of renal osteodystrophy in patients with chronic kidney disease. Osteitis fibrosa is a high-turnover bone disease resulting mainly from secondary hyperparathyroidism, and mixed uremic osteodystrophy is in addition characterized by a mineralization de...
Article
Refers to: Drüeke T. Plenary Lecture: Salt—a health problem? 52nd European Renal Association–European Dialysis and Transplant Association (ERA-EDTA) Congress. May 2015; London, UK.
Article
The effect of the calcimimetic cinacalcet on cardiovascular disease in patients undergoing hemodialysis with secondary hyperparathyroidism was assessed in the Evaluation of Cinacalcet Hydrochloride Therapy to Lower Cardiovascular Events trial. This was the largest (in size) and longest (in duration) randomized controlled clinical trial undertaken i...
Article
Full-text available
Among patients receiving hemodialysis, abnormalities in calcium regulation have been linked to an increased risk of cardiovascular events. Cinacalcet lowers serum calcium concentrations through its effect on parathyroid hormone secretion and has been hypothesized to reduce the risk of cardiovascular events. In observational cohort studies, prescrip...
Article
Iron deficiency in patients with chronic kidney disease (CKD) can be corrected by the oral or intravenous route. The natural intestinal barrier against iron overload is circumvented by intravenous iron. The balance between benefit and risk of high iron doses remains unclear. In a randomized controlled trial in CKD patients, Agarwal et al. find simi...
Article
Background: In chronic kidney disease (CKD), blood vessels are permanently exposed to uremic toxins such as indoxyl sulfate (IS). We hypothesized that IS could alter vascular tone and that reducing its serum concentration could be beneficial. Design: We studied acute and longer-term effects of IS and AST-120, an oral charcoal adsorbent, on vascu...
Article
The management of chronic kidney disease-mineral and bone disorder requires the assessment of bone turnover, which most often is based on parathyroid hormone (PTH) concentration, the utility of which remains controversial. Cross-sectional retrospective diagnostic test study. 492 dialysis patients from Brazil, Portugal, Turkey, and Venezuela with pr...
Article
Patients with end-stage renal disease often have derangements in calcium and phosphorus homeostasis and resultant secondary hyperparathyroidism (sHPT), which may contribute to the high prevalence of arterial stiffness and hypertension. We conducted a secondary analysis of the Evaluation of Cinacalcet Hydrochloride Therapy to Lower Cardiovascular Ev...
Article
Chronic kidney disease (CKD) is characterized by vascular remodeling and the retention of uremic toxins, several of which are independently associated with the high cardiovascular mortality rate in CKD patients. Whether the association between these uremic toxins and cardiovascular mortality is due to induction of vascular dysfunction and resulting...
Poster
Background: Oxidized PTH (oxPTH) has no PTH/PTHrp receptor (PTH1R)- stimulating properties, whereas non-oxidized PTH (n-oxPTH) is an agonist at PTH1R. However, PTH oxidation has been ignored in the development of PTH assays: the intact PTH (iPTH) assays currently used, recognize both n-oxPTH and oxPTH. We recently developed an assay that separately...
Article
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Introduction and Aims: The burden of cardiovascular disease in dialysis patients is high. Partly this is due to deterioration of mineral homeostasis. Animal studies suggest that low levels of Klotho, a protein linked to aging, might constitute a key factor in this deterioration. The purpose of the present study was to determine the relationship bet...
Article
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Introduction and Aims: Previous studies suggested that sevelamer hydrochloride attenuates progression of arterial calcification and may reduce the risk of death in a head-to-head comparison with calcium-based phosphate binders. In the real world, however, sevelamer is often used as add-on or alternative therapy for patients with hyperphosphatemia w...
Article
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Chronic kidney disease (CKD) is regarded as a state of Klotho deficiency and FGF23 excess. In patients with CKD a strong association has been found between increased serum FGF23 and mortality risk, possibly via enhanced atherosclerosis, vascular stiffness, and vascular calcification. The aim of this study was to examine the hypothesis that soluble...
Article
Full-text available
Chronic kidney disease is characterized by a progressive reduction of glomerular filtration rate and/or the appearance of proteinuria, and subsequently the progressive retention of organic waste compounds called uremic toxins (UT). Over the last decades, a large number of such compounds have been identified and their effects on organs and tissues,...
Article
This article summarizes relevant clinical studies that recently were devoted to the role of uremic toxins in outcomes of patients with chronic kidney disease and uremia. We summarize observational data linking uremic toxins (phosphate, the dimethylarginines, uric acid, and several large peptidic middle molecules and protein-bound solutes) to outcom...
Article
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Vascular calcification (VC) is a risk factor for cardiovascular mortality in the setting of chronic kidney disease (CKD). Pyrophosphate (PPi), an endogenous molecule that inhibits hydroxyapatite crystal formation, has been shown to prevent the development of VC in animal models of CKD. However, the possibility of harmful effects of exogenous admini...
Article
Full-text available
Context: The clinical course of secondary hyperparathyroidism (sHPT) in patients on hemodialysis is not well described, and the effect of the calcimimetic cinacalcet on disease progression is uncertain. Objective: Our objective was to describe 1) the clinical course of sHPT in patients treated with phosphate binders and/or vitamin D sterols and...
Article
Full-text available
Calcium oxalate (CaOx) is the most prevalent type of kidney stone. The amount of oxalate excreted in the urine is a major risk factor for CaOx stone formation. The study by Siener et al. makes a substantial contribution to our understanding of how Oxalobacter formigenes affects oxalate metabolism and excretion in humans and hence influences the ris...
Article
Full-text available
Vascular calcification (VC), an independent and strong predictor of cardiovascular risk, is often found in CKD patients. The degree of VC is providing incremental prognostic value over traditional risk markers. There is interest in improving our understanding of mechanisms, establishing diagnostic methods and effective prevention and treatment moda...
Article
Purpose of review: This review presents new evidence related to molecular mechanisms involved in the process of cardiovascular calcification, as well as to discuss new biomarkers and novel therapeutic strategies related to vascular calcification in chronic kidney disease (CKD) patients. Recent findings: microRNAs have emerged as potential player...
Article
Background: Atherosclerosis and vascular calcification are major contributors to cardiovascular morbidity and mortality among chronic kidney disease patients. The mevalonate pathway may play a role in this vascular pathology. Farnesyltransferase inhibitors such as R115777 block one branch of mevalonate pathway. We studied the effects of farnesyltr...
Article
Klotho is a protein that exerts paracrine and endocrine functions. In chronic kidney disease (CKD), its expression is decreased in several tissues. This decrease probably plays important roles in various complications associated with CKD, in both a fibroblast growth factor-23 (FGF23)-dependent and an FGF23-independent manner. The clinical diagnosis...
Article
The Kidney Disease Improving Global Outcomes (KDIGO) clinical practice guideline for anemia in chronic kidney disease (CKD) is designed to assist health-care providers in treating CKD patients with anemia. A guideline is not intended to define a standard of care, and should not be construed as one, nor should it be interpreted as prescribing an exc...
Article
Full-text available
Increased serum phosphorus levels are associated with cardiovascular disease in patients with chronic kidney disease (CKD) and in the general population. High phosphate levels may play a direct role in vascular dysfunction. We investigated here the effects of phosphate loading and of the phosphate binder sevelamer-HCl on vascular function. CKD and...
Article
Full-text available
Secondary hyperparathyroidism (sHPT) and other abnormalities associated with chronic kidney disease-mineral bone disorder can contribute to dystrophic (including vascular) calcification. Dietary modification and variety of medications can be used to attenuate the severity of sHPT. However, it is unknown whether any of these approaches can reduce th...
Article
ences between studies may be explained by different doses, types of vitamin D sterols used and treatment duration. Of note, different types of active vitamin D derivatives, when given in high amounts to animals with CKD, are not endowed with the same calcification-inducing capacity. Thus, paricalcitol has been shown to be less pro-calcifying in ura...
Article
Full-text available
Patients with chronic kidney disease (CKD) have a high prevalence of vascular calcification, and cardiovascular disease is the leading cause of death in this population. However, the molecular mechanisms of vascular calcification, which are multifactorial, cell-mediated and dynamic, are not yet fully understood. We need to address ways to improve o...
Article
Full-text available
The recently developed non-invasive high-intensity focussed ultrasound (HIFU) technique for the destruction of parathyroid adenomas could also be of interest for the treatment of secondary hyperparathyroidism (SHP) in patients with chronic kidney disease (CKD). We conducted a pilot study using this method. Five chronic haemodialysis patients with s...
Article
The hormone fibroblast growth factor 23 (FGF23) is involved in mineral homeostasis but may also have a role in vascular calcification and bone mineralization. In a cohort of 142 patients with CKD stages 2-5D, plasma FGF23 was independently associated with aortic calcification but not with pulse wave velocity or bone mineral density. FGF23 is involv...
Article
Kidney International aims to inform the renal researcher and practicing nephrologists on all aspects of renal research. Clinical and basic renal research, commentaries, The Renal Consult, Nephrology sans Frontieres, minireviews, reviews, Nephrology Images, Journal Club. Published weekly online and twice a month in print.
Article
Full-text available
The uremic syndrome is attributed to the progressive retention of a large number of compounds which, under normal conditions, are excreted by healthy kidneys. The compounds are called uremic toxins when they interact negatively with biological functions. The present review focuses on a specific class of molecules, namely the family of protein-bound...
Article
Full-text available
Atherosclerosis and vascular calcification (VC) progression in chronic kidney disease is favored by disturbances of mineral metabolism. We compared the effect of phosphate binder lanthanum (La) carbonate with sevelamer-HCl on atherosclerosis, VC and bone structure and function in mice with chronic renal failure (CRF). Apolipoprotein E-deficient (ap...
Article
Full-text available
Vascular calcification is frequent in the general population. Its incidence increases with age. It contributes to cardiovascular morbidity and mortality in patients with advanced atherosclerosis, in the presence or absence of diabetes mellitus and chronic kidney disease (CKD). Both diabetes and CKD aggravate its degree of severity and accelerate it...