scholarly journals Practice Patterns in the Acceptance of Medically Complex Living Kidney Donors with Obesity, Hypertension, Family History of Kidney Disease, or Donor-Recipient Age Discrepancy

2021 ◽  
Author(s):  
Ziad Arabi ◽  
Muhammad Bukhari ◽  
Abdullah Hamad ◽  
Abdulrahman Altheaby ◽  
Saleh Kaysi
Keyword(s):  
Blood Glucose ◽  
Family History ◽  
Kidney Disease ◽  
Practice Patterns ◽  
Unknown Etiology ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
History Of ◽  
Recipient Age ◽  
Age Discrepancy

Abstract Background To assess the practice patterns of the acceptance of medically complex living kidney donors (MCLKDs). Methods We distributed a survey to nephrologists and transplant surgeons (TS) across the world through major international transplant societies. The survey contained questions regarding obesity, abnormal blood glucose profile, mild hypertension, donor-recipient age discrepancy, or family history of kidney disease of unknown etiology. Results In total, 239 respondents from 29 countries (42% were nephrologists and 58% were TS).Most respondents would allow donations from obese donors, especially if they intended to lose weight but would be cautious if these donors had abnormal blood glucose or family history of diabetes mellitus. In hypertensive donors, future pregnancy plans mattered in decisions regarding the acceptance of female donors. Most respondents would allow young donors but would be more cautious if they had a future risk of hypertension or a family history of kidney disease of unknown etiology. They would also allow donations from an older person if prolonged waiting time was anticipated. We found multiple areas of consensus of practice among the diverse members of international transplant societies, with some interesting variations among nephrologists and TS. Conclusions This survey highlights the practice patterns of the acceptance of MCLKDs among the international community. In the absence of clear guidelines, this survey provides additional information to counsel kidney donors with these conditions.

P1697MULTI- NATIONAL SURVEY AMONG NEPHROLOGISTS AND TRANSPLANT SURGEONS ABOUT THE SUITABILITY AND ACCEPTABILITY OF MARGINAL LIVE KIDNEY DONORS WITH OBESITY OR ABNORMAL BLOOD SUGAR PROFILE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ziad Arabi ◽  
Mohammad Bukhari
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Family History ◽  
Blood Sugar ◽  
Kidney Donation ◽  
Morbidly Obese ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
History Of ◽  
Sugar Profile

Abstract Background and Aims There are no clear guidelines about the suitability and acceptance of living- kidney donors with obesity or abnormal blood sugar profile. Method To form a consensus about the acceptance of these donors, a survey was distributed to nephrologists and transplant surgeons in different countries and through AST and ERA-EDTA. Results Of a total of (n=122) respondents from 22 countries: 80% (N= 96) were nephrologists and 20% (N=23) were transplant surgeons. The majority were heavily involved in pre-transplant evaluations of donors and recipients and have > 6 years in practice. 75% of the respondents will accept obese donors (BMI 30-35) if donors show some weight loss before donation or at least show commitment to lose weight in the future. However, the presence of a strong family history of diabetes ( DM) in obese donors (even with normal fasting blood sugar (FBS) and hemoglobin A1C [ Hgb A1C]) mandates weight lose preferably to BMI of 30 ( n=46, 38% ) or at least to lose some weight before being considered for donation (n=30, 25%). On the other hand, morbidly obese donors (BMI 36-40) with normal FBS, Hgb A1C and negative family history of DM thought to need to decrease their weight to BMI 30 ( 47% of the respondents) or at least lose some weight before being considered for donation ( n=30, 25%). However, 22% of the respondents would decline these donors due to the risk of relapse of obesity. If an obese donor started to have impaired fasting blood sugar ( IFG), the majority (47%) will decline him/her because of the higher risk to develop DM. (33%) will delay the donation till BMI reaches below 30 and IFG is resolved as a result of weight reduction. Most of the respondents (52%) will not rely solely on isolated mildly elevated Hgb A1C (e.g. Hgb A1C = 5.7- 6) or isolated (IFG) as the critical indicator to decline a young donor with normal weight and normal FBS. Instead 2hrs- glucose tolerance test will be indicated. The presence of even mild and controlled diabetes in a middle age (e.g. 55 years old donor) thought to be a contraindication for kidney donation in 62% of the respondents. However, such donors might be allowed to donate if no alternative donor is available after clearly explaining the risks (23%). In regard to resolved DM after bariatric surgery and weight loss, 43% of the respondents said they will consider them for donation if two years passed after bariatric surgery without obesity relapse (43%). Up to one forth may consider these donors earlier (once BMI is below 30). Despite the surgical difficulties related to obesity in kidney donors, transplant surgeons seem more likely than nephrologists to accept obese donors (P= 0.046), morbidly obese ( P=NS). Conclusion Living kidney donors with isolated obesity, (IFG), mildly abnormal HgbA1C or history of bariatric surgery are still considered for kidney donation by many centers. However, donors with more than one abnormality especially at young age are not considered for donation.

scholarly journals Kidney Microstructural Features at the Time of Donation Predict Long-term Risk of Chronic Kidney Disease in Living Kidney Donors

2021 ◽  
Vol 96 (1) ◽  
pp. 40-51 ◽  
Author(s):  
Massini A. Merzkani ◽  
Aleksandar Denic ◽  
Ramya Narasimhan ◽  
Camden L. Lopez ◽  
Joseph J. Larson ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Donors ◽  
Living Kidney Donors

scholarly journals Apolipoprotein L1 and Chronic Kidney Disease Risk in Young Potential Living Kidney Donors

2018 ◽  
Vol 267 (6) ◽  
pp. 1161-1168 ◽  
Author(s):  
Jayme E. Locke ◽  
Deirdre Sawinski ◽  
Rhiannon D. Reed ◽  
Brittany Shelton ◽  
Paul A. MacLennan ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Risk ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
Chronic Kidney Disease Risk ◽  
Apolipoprotein L1

scholarly journals Lipoprotein glomerulopathy associated with the Osaka/Kurashiki APOE variant: two cases identified in Latin America

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Joaquim Nelito da Silveira-Neto ◽  
Guilherme Jinson de Oliveira Ahn ◽  
Precil Diego Miranda de Menezes Neves ◽  
Vinicius Augusto Ferreira Baptista ◽  
Stanley de Almeida Araújo ◽  
...  
Keyword(s):  
Latin America ◽  
Family History ◽  
Kidney Disease ◽  
Genetic Analysis ◽  
Apolipoprotein E ◽  
Total Cholesterol ◽  
Kidney Biopsy ◽  
Lipoprotein Glomerulopathy ◽  
History Of ◽  
Secondary Causes

Abstract Background Lipoprotein glomerulopathy (LPG) is a rare autosomal dominant disease caused by mutations in APOE, the gene which encodes apolipoprotein E. LPG mainly affects Asian individuals, however occasional cases have also been described in Americans and Europeans. Herein we report two unrelated Brazilian patients with LPG in whom genetic analyses revealed the APOE-Osaka/Kurashiki variant. Case presentation - case 1 A 29-year-old Caucasian male sought medical attention with complaints of face swelling and foamy urine for the last 3 months. He denied a family history of kidney disease, consanguinity, or Asian ancestry. His tests showed proteinuria of 12.5 g/24 h, hematuria, serum creatinine 0.94 mg/dL, albumin 2.3 g/dl, total cholesterol 284 mg/dL, LDL 200 mg/dL, triglycerides 175 mg/dL, and negative screening for secondary causes of glomerulopathy. A kidney biopsy revealed intraluminal, laminated deposits of hyaline material in glomerular capillaries consistent with lipoprotein thrombi. These findings were confirmed by electron microscopy, establishing the diagnosis of LPG. His apolipoprotein E serum level was 72 mg/dL and genetic analysis revealed the APOE pathogenic variant c.527G > C, p.Arg176Pro in heterozygosis, known as the Osaka/Kurashiki mutation and positioned nearby the LDL receptor binding site. Case 2 A 34-year-old Caucasian man sought medical assessment for renal dysfunction and hypertension. He reported intermittent episodes of lower-limb edema for 3 years and a family history of kidney disease, but denied Asian ancestry. Laboratorial tests showed BUN 99 mg/dL, creatinine 10.7 mg/dL, total cholesterol 155 mg/dL, LDL 79 mg/dL, triglycerides 277 mg/dL, albumin 3.1 g/dL, proteinuria 2.7 g/24 h, and negative screening for secondary causes of glomerulopathy. His kidney biopsy was consistent with advanced chronic nephropathy secondary to LPG. A genetic analysis also revealed the Osaka/Kurashiki variant. He was transplanted a year ago, displaying no signs of disease relapse. Conclusion We report two unrelated cases of Brazilian patients with a diagnosis of lipoprotein glomerulopathy whose genetic assessment identified the APOE-Osaka/Kurashiki pathogenic variant, previously only described in eastern Asians. While this is the second report of LPG in Latin America, the identification of two unrelated cases by our medical team raises the possibility that LPG may be less rare in this part of the world than currently thought, and should definitely be considered when nephrotic syndrome is associated with suggestive kidney biopsy findings.

Knowledge, Attitude, practice, and their associated factor towards Diabetes Mellitus among peoples live in Debre Markos Town, North West Ethiopia, Amhara Regional State, Ethiopia 2020 GC

2022 ◽  
Author(s):  
Addisu Simachew ◽  
Habtamu Temesgen
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Family History ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Educational Level ◽  
Good Practice ◽  
Favorable Attitude ◽  
Family History Of Diabetes ◽  
History Of

Abstract Background: Diabetes mellitus is a group of metabolic disease in which there is high blood glucose level over a prolonged period of time, chronic multi system disease related to abnormal insulin production, impaired insulin utilization and both. Risk of diabetes are obesity, being young or old age, family history of diabetes, history gestational diabetes, impaired, glucose metabolism, physical inactivity and ethnicity/race respectively. In type one diabetes mellitus insulin injection is needed to control the blood glucose level where as in type two diabetes mellitus the first line treatment is life style modification like diet management, exercise, and weight reduction then if uncontrolled use oral hypoglycemic agent.Objective: The main aim of the study was to assess Knowledge, Attitude, practice and their associated factor towards diabetes mellitus in Debre Markos town, northwest , Amhara Regional state, Ethiopia 2020 GC.Methodology: a community based cross-sectional study was conduct from June to July for 403 respondents using systematic random sampling technique to select the household after select the first household by lottery method. Data collected through self administered questions, the collected data process and analysis manually using pen, pencil, tally sheet and present in tables, graphs and charts respectively.Result: based on our study 138 (34.6%) of the respondents were classified as having inadequate knowledge, whereas 261(65.4%) of the respondents were deemed to be knowledgeable. from the participant 186(46.6%) had unfavorable attitude while 213(53.4%) had favorable attitude towards diabetes mellitus. Overall practice of the participant was 37.8% good practice and 62.2% poor practice. Single individuals 5.133 times (AOR=5.133, CI=1.737, 15.051) more likely knowledgeable than those divorced. Family history of diabetes mellitus 5.019 times (AOR=5.02- CI=1.59-15.76) more likely had favorable attitude than those who had no family history of DM. secondary educational level were 2.34 times (AOR=2.34, CI=1.14- 0.78) more likely good practice than those with able to read and write and persons in primary educational level. DM patients 2.811 times (AOR=2.81-95%, CI=0.99- 7.97) more likely good practice than non-diabetic.Conclusion: majority of the participant’s relatively knowledgeable. The overall attitude of the participant was more than half was favorable attitude. Majority of the study participants were poor practice regarding to DM controlling and management. Knowledge of the participant highly significant association with marital status, income and practice, practice also strong association with level of education and attitude significantly associated with family history of DM

Yearly Trends of Chronic Kidney Disease III Progressions in Living Kidney Donors

2019 ◽  
Vol 51 (8) ◽  
pp. 2539-2542
Author(s):  
Hyung Ho Lee ◽  
Joon Chae Na ◽  
Young Eun Yoon ◽  
Hyung Soon Lee ◽  
Kyu Ha Huh ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Donors ◽  
Living Kidney Donors
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