EURECA-m e-Newsletter
Year 6 Issue 2 December 2015
In this issue:
EURECA-m Registry Update
LUST approaching the target and producing initial scientific outputs
Report from EURECA-m CME Course on Clinical impact of novel players in CKD progression and CKD complication
EURECA-m Board Members
Gérard Michel London (EURECA-m Chairman)
Alberto Ortiz Arduan (EURECA-m Secretary)
Charles J. Ferro, United Kingdom
Gunnar Heine, Germany
Mehmet Kanbay, Turkey (Co-Editor in Chief of EURECA-m Newsletter)
Francesca Mallamaci, Italy
Ziad A. Massy, France
Patrick Rossignol, France (Co-Editor in Chief of EURECA-m Newsletter)
Raymond Vanholder, Belgium
Marianne C. Verhaar, The Netherlands
EURECA-m Advisor and LUST Study Coordinator
Carmine Zoccali, Italy

EURECA-m Registry Clinical Coordinator
Francesca Mallamaci, Italy

EURECA-m External Consultant for Nutritional Aspects in Cardiovascular Diseases in CKD
Denise Fouque, France
Epidemiology and Biostatistics Consultants
Kitty J Jager, The Netherlands
Friedo W Dekker, The Netherlands
Giovanni Tripepi, Italy
Cecile Couchoud, France

Dear EURECA-m members, dear colleagues,

We are very pleased to share with you the latest and exciting news from our working group!

Two important reviews from EURECA-m got published recently in Hypertension (Validity of Vascular Calcification as a Screening Tool and as a Surrogate End Point in Clinical Research. – Zoccali et al), and in the Lancet (The double challenge of resistant hypertension and chronic kidney disease. - Rossignol et al). The complete reference may be found at the URL:  and    .

In the current issue of our newsletter you will especially find an update on the EURECA-m Registry by Prof. Mallamaci , on the LUST trial by Prof. Zoccali and on the recent EURECA-m CME course held in Madrid (September 4th-5th, 2015) by Prof Ortiz.

We invite you to also kindly inform your colleagues interested in the relationship between the kidney and the cardiovascular system about the opportunity to become an EURECA-m Member. For any info concerning the EURECA-m membership: ; for directly registering as a Member: .

Stay tuned!

Sincerely yours,

Mehmet Kanbay
Prof. Mehmet Kanbay
EURECA-m Newsletter co-Editor in Chief
Patrick Rossignol
Prof. Patrick Rossignol
EURECA-m Newsletter co-Editor in Chief
  EURECA-m Registry Update

As we have already stated in the previous newsletter, at the EURECA-m/LUST meeting held during the ERA-EDTA Congress in London, we presented some preliminary and exploratory analyses of ABPM measurements collected in a single Centre belonging to the EURECA-m working group (Reggio Calabria). These analyses were aimed at assessing the agreement between the diagnosis of hypertension based on Pre-dialysis Blood Pressure (BP), Home BP values and 44h ABPM (which is considered the golden standard for BP measurement).
Briefly, these preliminary results indicated that Pre-dialysis BP is rather inaccurate for the diagnosis of hypertension in dialysis patients. Indeed, these results from Reggio Calabria are in keeping with Agarwal’s previously published data in the Afro-American haemodialysis population in Indianapolis (USA).

The discussion of these data at the ERA-EDTA meeting in London,  brought about an agreement among centres to start with a new project and to share efforts to confirm in the European haemodialysis patients, what had already been documented in Agarwal’s previous study . In our new project, we first want to address the feasibility of the procedure itself in a sizeable cohort of European dialysis patients. For this reason, at the meeting we invited everyone with an interest in Cardiovascular and Renal Medicine to join this new project under the umbrella of the EURECA-m working group. Since then a preliminary protocol has been circulating among many European dialysis centres. The project has two major aims:
1) to confirm in a large unselected HD population in Europe, the findings previously described in a series of Afro-American dialysis patients;
2) to test ABPM feasibility and tolerability in HD patients and in a well-matched group of essential hypertensives.

read more

Prof. Mallamaci
Prof. Francesca Mallamaci
EURECA-m Registry Clinical Coordinator
Claudia Torino
Claudia Torino
EURECA-m Registry and LUST Study Manager
  LUST approaching the target and producing initial scientific outputs

LUST Study was inaugurated in March 2013 with an enrolment target of 500 patients. The enrolment is still ongoing because some centres encountered unexpected problems: from ethical (ethical committees) to logistics and competition with other ongoing projects at local level.
From the beginning of the Study some centres withdrew, recently also the “Fundación Jiménez Díaz” - Madrid, Spain and the “Hospital S. Maria della Scaletta” - Imola, Italy left.  
The current number of active LUST centres is 18. It is now clear that some centres will be unable to maintain the enrolment target stated initially (at least 25 patients per centre). Yet, on the positive side, we have the good news that an additional Greek research unit (directed by Dr. Pantelis Sarafidis, Thessaloniki University) has accepted to join LUST. Dr. Sarafidis is confident that he can enrol at least 25 patients, which helps reaching the planned enrolment target.  The two Greek centres we already have in LUST (Dr. Aristeidis Stavroulopoulos’ centre in Athens and Dr. Siamopoulos and Dr. Balafa’s centre in Ioannina) are among the top performers in LUST. Also taking into account the scientific profile of Dr. Sarafidis, we are confident that the standing of Greek centres in LUST may only grow in quality and quantity.
A second new LUST centre is being established in Lecco (Dr. Francesco Pontoriero).  The Lecco unit is one of the largest and the best nephrology centres in Italy, therefore we foresee no problem for the Lecco unit to successfully attain the expected number of enrolees (25 patients).  
We also have ongoing contacts with other units in order to compensate the unexpectedly low enrolment rate in some LUST centres.
The total number of patients correctly registered by LUST centres is 296. To date, 266 patients have a baseline visit, 188 the first follow-up visit and 120 had the second follow-up visit. The third and last follow-up visit was performed for all patients at the coordinating centre in Reggio Calabria, Italy, and for 1 patient enrolled in Wroclaw, Poland.
To improve the enrolment rate and to ensure the completeness of the data collection, Claudia Torino monitors, day by day, the data entry of all involved centres and sends reminders (the frequency depends on the performance of the centre) to Study leaders and coordinators. Thanks to the continuous feedback we have received and still receive, the platform works nicely.
Skype meetings with local coordinators are periodically performed and the frequency of these electronic meetings will be intensified in the months ahead.
During the last ERA-EDTA Congress (London -UK-, May 2015), we had a meeting with the majority of LUST Study investigators. During this meeting we promised to draft a manuscript (the first LUST paper) testing the reliability of lung auscultation for the detection of various degrees of lung congestion.  The results of these analyses are very interesting since fully expose the scarce reliability of lung auscultation to estimate the severity of lung congestion in dialysis patients.  We are confident that we may circulate a draft of this paper by the first week of December, together with our Christmas greetings.
We heartily thank you the ERA-EDTA and the involved centres for the efforts they are making for advancing this shared project.

Prof. Carmine Zoccali
LUST Study Coordinator
  Report from EURECA-m CME Course on Clinical impact of novel players in CKD progression and CKD complication

A successful EURECA-m CME Course was held at IIS-Fundacion Jimenez Diaz in Madrid the 4th and 5th September 2015 on “Clinical impact of novel players in CKD progression and CKD complications”, coordinated by myself, Prof. Alberto Ortiz, and with the collaboration of the Spanish Kidney Research Network REDINREN.
The event was accredited by EACCME and assigned 6 European CME Credits (ECMEC); the EACCME -European Accreditation Council for Continuing Medical Education- is an institution of the Union of European Medical Specialists (UEMS).
The Course had a total of 72 full-time attendees that hailed from different corners of Spain and Europe. In order to facilitate attendance by younger nephrologists, three international travel grants were awarded.
The key topics covered by world-known leaders in the field were obesity and wasting in CKD: lessons from malignancy and microbes, including the microbiota, inflammation-induced wasting and obesity; novel contributors to CKD progression, covering the role of sympathetic overactivity, the genetic epidemiology to uric acid, and the clinical relevance of inflammation; new players in CKD-MBD and novel roles for older stars, covering the role of osteoblasts, FGF-23, sclerostin and phosphate; and optimized RAAS blockade and beyond, covering personalized RAAS blockade, hyperkalemia management and clinical experience beyond RAAS blockade in diabetic kidney disease.
Professors Fouque, Heine, Kanbay, London, Mallamaci, Massy, Ortiz, Praga, Rossignol, Vanholder, Wiecek and Zoccali provided excellent lectures and updates on the subjects. The presentation “Clinical experience beyond RAAS blockade in diabetic kidney disease” by the Young Nephrologists Platform (YNP) member, Dr. Beatriz Fernandez-Fernandez, merits special mention for its clarity and vision.
At the end of the Course first part there was a Meet-the-Expert session which allowed clinicians and researchers, both young and experienced, to interact with speakers and chairs. Furthermore, after the Course conclusion, a written evaluation was completed by the youngest attendees and those with the best results were awarded with a free 2016 ERA-EDTA membership.

Alberto Ortiz
Prof. Alberto Ortiz Arduan
EURECA-m Secretary
EURECA-m Website: