Haemodynamics of Stable Renal Transplant Recipients

1980 ◽  
Vol 59 (s6) ◽  
pp. 377s-379s ◽  
Author(s):  
K. E. Kim ◽  
O. Bates ◽  
P. Lyons ◽  
J. Pitone ◽  
E. W. Martinez ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Cardiac Index ◽  
Creatinine Clearance ◽  
Blood Volume ◽  
Total Peripheral Resistance ◽  
Peripheral Resistance ◽  
Plasma Renin ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
The Mean

1. Haemodynamics, blood volume, plasma renin concentration and creatinine clearance were evaluated in 24 stable renal transplant recipients. 2. The mean cardiac index of the transplant recipients was not different from that of the normal subjects. 3. The transplant recipients comprised eight hypertensive and 16 normotensive patients. The mean cardiac index was the same in eight hypertensive and 16 normotensive patients. Thus the hypertension of stable renal transplant recipients is sustained by a high total peripheral resistance. 4. The mean blood volume, plasma renin concentration and creatinine clearance were similar in eight hypertensive and 16 normotensive patients. Therefore the hypertension of stable renal transplant recipients is not related to blood volume expansion, elevated peripheral renin or low creatinine clearance. The cause of the elevated total peripheral resistance in hypertension in stable renal transplant recipients remains to be elucidated.

scholarly journals Radical prostatectomy outcomes in renal transplant recipients: a retrospective case series of Thai patients

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kun Sirisopana ◽  
Pocharapong Jenjitranant ◽  
Premsant Sangkum ◽  
Kittinut Kijvikai ◽  
Suthep Pacharatakul ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Renal Transplant ◽  
Operative Time ◽  
Case Series ◽  
Urinary Continence ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Estimated Blood Loss ◽  
The Mean

Abstract Background The incidence of prostate cancer in renal transplant recipients (RTR) is similar to the general population. Radical prostatectomy (RP) is the standard of care in the management of clinically localized cancer, but is considered complicated due to the presence of adhesions, and the location of transplanted ureter/kidney. To date, a few case series or studies on RP in RTR have been published, especially in Asian patients. This study aimed to evaluate the efficacy and safety and report the experience with RP on RTR. Methods We retrospectively reviewed data of 1270 patients who underwent RP from January 2008 to March 2020, of which 5 patients were RTR. All available baseline characteristics, perioperative and postoperative data (operative time, estimated blood loss (EBL), complications, length of hospital stay, complication), pathological stage, Gleason score, surgical margin status, and pre/postoperative creatinine were reviewed. Results Of the 5 RTR who underwent RPs (1 open radical prostatectomy (ORP), 1 laparoscopic radical prostatectomy (LRP), 2 robotic-assisted laparoscopic radical prostatectomies (RALRP), and 1 Retzius-sparing RALRP (RS-RALRP)) prostatectomy, the mean age (± SD) was 70 (± 5.62) years. In LRP and RALRP cases, the standard ports were moved slightly medially to prevent graft injury. The mean operative time ranged from 190 to 365 min. The longest operative time and highest EBL (630 ml) was the ORP case due to severe adhesion in Retzius space. For LRP and RALRP cases, the operative times seemed comparable and had EBL of ≤ 300 ml. All RPs were successful without any major intra-operative complication. There was no significant change in graft function. The restorations of urinary continence were within 1 month in RS-RALRP, approximately 6 months in RALRP, and about 1 year in ORP and LRP. Three patients with positive surgical margins had prostate-specific antigen (PSA) persistence at the first follow-up and 1 had later PSA recurrence. Two patients with negative margins were free from biochemical recurrence at 47 and 3 months after their RP. Conclusions Our series suggested that all RP techniques are safe and feasible mode of treatment for localized prostate cancer in RTR.

scholarly journals 2662. Methenamine Hippurate Decreases the Incidence of Urinary Tract Infections in Adult Renal Transplant Recipients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S931-S932
Author(s):  
Orlando Quintero ◽  
Yoram Puius ◽  
Vagish Hemmige
Keyword(s):  
Urinary Tract ◽  
Renal Transplant ◽  
Creatinine Clearance ◽  
Kidney Transplant ◽  
Urinary Tract Infections ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Transplant Patients ◽  
Number Of Patients ◽  
Tract Infections

Abstract Background Urinary tract infections (UTIs) are a common complication of renal transplantation. Methenamine hippurate is a non-antibiotic alternative that reduces the frequency of UTIs in selected non-transplant patients, but which is not recommended in renal insufficiency. We conducted a retrospective study to determine the efficacy of methenamine prophylaxis in our kidney transplant population, and identify subgroups for which efficacy is greatest. Methods Retrospective chart review of adult kidney transplant patients at Montefiore Medical Center who were prescribed methenamine during January 1, 2016–December 31, 2017, with extraction of clinical data in the year before and after prophylaxis. Variables included demographics, creatinine clearance and hemoglobin A1c levels at the time of prescription, incidence of UTIs as determined by standardized literature definitions, hospital admissions for infections, and antibiotic use. Results The incidence of UTIs per 1000 patient-days decreased significantly, from 9.66 (95% CI 7.53–12.40) the year before to 3.24 (95% CI 2.00–5.24) the year after (P < 0.001). The effect was significantly more pronounced in patients who were transplanted due to diabetic nephropathy, with a decreased incidence of 13.05 (95% Cl 10.00–17.02) UTIs/1000 patient-days to 2.90 (95% Cl 1.58–5.32) in diabetics (P < 0.001), vs. 5.50 (95% Cl 3.65–8.28) UTIs/1000 patient-days to 3.81 (95% Cl 1.70–8.55) in non-diabetics (P = 0.44). The number of days of antibiotics for UTIs per 1000 days also decreased significantly for all patients, from 128.58 (95% CI 94.87–174.28) the year before to 49.78 (95% CI 31.74–78.07) the year after (P = 0.001). No significant differences in efficacy were seen based on sex or renal function. Three patients with indwelling urinary catheters or who required intermittent catheterization did not appear to benefit Conclusion Methenamine prophylaxis decreases the incidence of UTIs and number of antibiotic days in adult renal transplant recipients. This effect was seen even in patients with reduced creatinine clearance. Patients with diabetes benefited the most. The small number of patients who required catheterization did not appear to benefit. Disclosures All authors: No reported disclosures.

scholarly journals Prevalence and prognostic factors for erectile dysfunction in renal transplant recipients

2013 ◽  
Vol 1 (4) ◽  
pp. 383 ◽  
Author(s):  
Jaime A. Wong ◽  
Joseph Lawen ◽  
Bryce Kiberd ◽  
Waleed K. Alkhudair
Keyword(s):  
Diabetes Mellitus ◽  
Renal Transplant ◽  
Erectile Function ◽  
Short Form ◽  
Cross Sectional Study ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Cross Sectional ◽  
The Mean ◽  
Prevalence Of Diabetes Mellitus

Introduction: The purpose of this study was to determine the prevalence of erectiledysfunction (ED) at our institution in the postrenal transplant populationand to compare those patients who had ED with those who did not have ED, with respect to several patient characteristics.Methods: We conducted a cross-sectional study of male renal transplant recipientswho were in attendance at the transplant clinic from April 1, 2004, toMarch 31, 2006. Erectile function was evaluated using the International Indexof Erectile Function short form questionnaire. Patients were also screened fordepression using the Beck Depression Inventory. We performed a chart reviewto obtain various patient characteristics.Results: This study involved 55 patients. Their average age was 50 years oldand the mean duration of the current transplant was 7.9 years. ED was identifiedin 28 of the patients (51%). More patients with ED were over age 50 years(64% v. 26%, p = 0.004). There was a higher prevalence of diabetes mellitus(39% v. 11%, p = 0.02) in patients with ED compared with those patients withoutED. More patients with ED were depressed compared with those patientswho did not have ED (29% v. 7%, p = 0.04). These 3 factors were significantlyassociated with ED and this relationship was confirmed on multivariateanalysis.Conclusion: ED remains a common problem in the renal transplant population.The cause of ED is multifactorial, with increasing age and the presenceof diabetes mellitus and depression increasing the risk of ED.

scholarly journals Perioperative fosfomycin disodium prophylaxis against urinary tract infection in renal transplant recipients: a randomized clinical trial

2020 ◽  
Vol 35 (11) ◽  
pp. 1996-2003 ◽  
Author(s):  
Rodrigo Rosado-Canto ◽  
Idalia Parra-Avila ◽  
Javier Tejeda-Maldonado ◽  
Cristopher Kauffman-Ortega ◽  
Francisco T Rodriguez-Covarrubias ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Placebo Group ◽  
Urinary Tract ◽  
Renal Transplant ◽  
Tract Infection ◽  
Asymptomatic Bacteriuria ◽  
Attractive Alternative ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
The Mean

Abstract Background Symptomatic urinary tract infection (UTI) is the most common infectious complication in renal transplant recipients (RTRs). Fosfomycin (FOS) is an attractive alternative for prophylaxis because it does not interact with immunosuppressants; although 90% is excreted unchanged in the urine, it does not require adjustment for renal function for single dose prophylaxis. Methods RTRs were recruited into this randomized, double-blind, placebo-controlled trial. Participants were randomized (1:1) to receive one 4 g dose of FOS disodium intravenously 3 h (FOS group) or placebo (placebo group) before placement and removal of a urinary catheter and before removal of a double-J ureteral stent. All participants received prophylaxis with trimethoprim/sulfamethoxazole. The main outcome was a comparison of the mean number of symptomatic UTI and asymptomatic bacteriuria (AB) episodes per patient during a 7-week follow-up period. The study was registered at ClinicalTrials.gov, NTC03235947. Results Eighty-two participants were included (41 in the FOS group and 41 in placebo group). The mean number of AB or symptomatic UTI episodes per patient was lower in the FOS group [intention-to-treat (ITT) 0.29 versus 0.60, P = 0.04]. The incidence of symptomatic UTI was lower in the FOS group (ITT, 7.3% versus 36.6%, P = 0.001), and there was no difference in the incidence of AB between both groups. The incidence of adverse events was similar in both groups. Conclusions FOS addition is an effective and safe strategy to reduce the number of symptomatic UTIs during the first 7 weeks after renal transplant.

Cardiorenal Syndrome in Renal Transplant Recipients: Prevalence, Clinical Presentation, Treatment, and Outcome

2020 ◽  
Vol 10 (5) ◽  
pp. 333-339
Author(s):  
Nikolina Basic-Jukic ◽  
Ivana Juric ◽  
Vesna Furic-Cunko
Keyword(s):  
Renal Transplant ◽  
Creatinine Clearance ◽  
Renal Allograft ◽  
Clinical Presentation ◽  
Cardiorenal Syndrome ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Fluid Removal ◽  
Background Data

Background: Data on the cardiorenal syndrome (CRS) in renal transplant recipients (RTR) are scarce. We investigated the prevalence, clinical presentation, treatment, and outcomes of patients with CRS in our renal transplant cohort. Methods: Charts and medical records of adult RTR were investigated to identify patients with renal allograft dysfunction and heart failure (HF) with reduced (HFrEF) or preserved (HFpEF) ejection fraction. Results: From December 2009 to December 2019, a total of 1,610 patients received a kidney allograft at our institution. CRS was diagnosed in 9 patients (0.56%) a median of 11 years after transplantation (4–20 years). Seven of the patients were male, and 2 were female. The median age when CRS was diagnosed was 71 years (64–80 years). The major presenting symptom was dyspnea. Five patients had HFrEF, and 4 had HFpEF. The patient’s median basal creatinine clearance was 37 mL/min (range 29–77 mL/min). At hospitalization, it was decreased to 24 mL/min (range 13–45 mL/min). The patients were treated with diuretics, but 5 of them required extracorporeal fluid removal. At the 16-month follow-up (median), all patients with HFpEF were alive and had returned to initial levels of creatinine clearance. Two of the 5 HFrEF had died, and 2 needed permanent extracorporeal water removal. Conclusion: CRS after renal transplantation was rare (<1.0%), but CRS in HFreF patients was associated with a poor outcome.

Effect of Sotalol on Haemodynamics and Renin—Angiotensin—Aldosterone System in Hypertensive Patients

1976 ◽  
Vol 51 (1) ◽  
pp. 9-17 ◽  
Author(s):  
A. Verniory ◽  
M. Staroukine ◽  
F. Delwiche ◽  
M. Telerman
Keyword(s):  
Blood Pressure ◽  
Angiotensin Ii ◽  
Cardiac Index ◽  
Total Peripheral Resistance ◽  
Excretion Rate ◽  
Peripheral Resistance ◽  
Plasma Renin ◽  
Hypertensive Patients ◽  
Receptor Blocking ◽  
Plasma Angiotensin

1. Twenty-three hypertensive patients were treated by sotalol, a pure beta-adrenergic receptor blocking agent. The drug produced a significant decrease of blood pressure in nineteen patients. 2. On average, cardiac index decreased but not significantly; heart rate decreased and stroke index increased significantly. Total peripheral resistance varied in both directions. 3. Sotalol determined a fall in plasma renin concentration (only significant in the high-renin group), a fall in plasma angiotensin II concentration and in urinary excretion rate of aldosterone accompanied by a rise in plasma potassium concentration. 4. The fall of blood pressure was not correlated with the decreases of renin and angiotensin II concentrations or excretion rate of aldosterone. However, in the placebo period plasma angiotensin II concentration was significantly correlated with total peripheral resistance; during sotalol treatment the variations of these two parameters seemed also to be correlated. 5. There was a poor correlation between decreases of cardiac output and of blood pressure; it was impossible to foresee the magnitude of the lowering of the blood pressure from the initial cardiac index. 6. The association of a diuretic with sotalol enhanced the hypotensive effect of the beta-receptor blocking drug, without significant increase of plasma renin and angiotensin II concentrations.

scholarly journals BK Virus Associated Nephropathy, a Cause of Early Renal Allograft Dysfunction: A Single Centre Study

2017 ◽  
Vol 13 (2) ◽  
pp. 140-145
Author(s):  
S. Shrestha ◽  
P.G. Kerr ◽  
J. Kanellis ◽  
K.R. Polkinghorne ◽  
F. Brown ◽  
...  
Keyword(s):  
Renal Transplant ◽  
De Novo ◽  
Bk Virus ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Graft Dysfunction ◽  
Early Graft ◽  
The Mean ◽  
The Difference ◽  
Early Graft Dysfunction

Background BK virus associated nephropathy (BKVN) is an important cause of early graft dysfunction in renal transplant recipients. The present study was carried out to determine the burden of BKVN in a single renal transplant centre in Australia.Method A retrospective analysis of de novo renal transplant recipients from 2010 to 2013 was performed to identify biopsy proven BKVN. Estimated glomerular filtration rate (eGFR) was compared at baseline, at BKVN diagnosis and 3 and 12 months post-diagnosis.Result Of the 317 de novo renal transplants recipients in the study period, 20 (6.3%) developed BKVN. The mean age was 54.8 ± 13.1 years and 13 (65%) were male. The mean time from transplant to BKVN was 8.7 ± 6.7 months with 17 (85%) diagnosed within 12 months. Four recipients each were diagnosed BKVN on 3 and 12 month surveillance biopsy. Six (30%) had normal eGFR at diagnosis. Mean eGFR at diagnosis was 38.8 ± 19.2 ml/min/1.73 m2, which was significantly lower (p < 0.01) than that at baseline (50.3 ± 16.4 ml/min/1.73 m2). eGFR improved numerically at 3 and 12 months post-diagnosis, however the difference was not significant. One patient had graft failure, 19 months after diagnosis.Conclusion BKVN generally occurs in first post-transplant year and is an important cause of early graft dysfunction. Surveillance biopsy helps in detecting subclinical BKVN.

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