scholarly journals Acute kidney injury in an infant of a kidney allograft recipient

2019 ◽  
Vol 13 (1) ◽  
pp. 123-124
Author(s):  
Serkan Aktürk ◽  
Rezzan Eren Sadioğlu ◽  
Şule Şengül ◽  
Kenan Keven
Keyword(s):  
Acute Kidney Injury ◽  
Transplant Recipient ◽  
Whole Blood ◽  
Umbilical Vein ◽  
Kidney Transplant Recipient ◽  
Kidney Injury ◽  
Maternal Blood ◽  
Blood Levels ◽  
Fetal Complications ◽  
The Relationship

Abstract Tacrolimus has been used in pregnant organ recipients for >20 years, and the relationship between fetal complications and the amount of tacrolimus crossing the placenta is still controversial. We report the case of a kidney transplant recipient who used tacrolimus and gave birth to an offspring that developed, shortly after birth, an acute kidney injury caused by tacrolimus exposure, which was detected by measuring tacrolimus levels in the umbilical vein, as well as in maternal blood. Even if whole-blood levels of tacrolimus are within the therapeutic range throughout pregnancy, the amount of tacrolimus could reach toxic levels.

scholarly journals First Reported Case in Romania of a Successfully Treated Severe COVID-19 in a Kidney Transplant Recipient: A Focus on Acute Kidney Injury

2020 ◽  
Vol 10 (3) ◽  
pp. 174-179
Author(s):  
Flaviu Tosa ◽  
Roxana Manaila ◽  
Alina Elec ◽  
Tudor Moisoiu ◽  
Liviu Ghervan ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Transplant Recipient ◽  
Kidney Transplant ◽  
Kidney Transplant Recipient ◽  
Clinical Status ◽  
Organ Transplant ◽  
Treatment Strategies ◽  
Kidney Injury ◽  
Kidney Graft ◽  
Kidney Involvement

As coronavirus disease 2019 (COVID-19) caused by the novel virus SARS-CoV-2 is expanding worldwide, kidney involvement seems to be part of the spectrum of its effects. Moreover, the prognosis of the disease seems to be worse in immunocompromised patients when compared to the general population, with 4–5 times higher mortality rates. However, the overall impact on long-term function of the kidney graft is unknown. We report on a case of a 46-year-old kidney transplant recipient who was successfully treated for severe COVID-19 pneumonia. The clinical course was complicated by transient acute kidney injury, most likely due to tubulo-interstitial involvement, with return to the baseline of the creatinine level by the time of discharge. We discuss the characteristics and differential diagnosis of acute kidney injury, as well as management of immunosuppression in connection with overall clinical status and evolution of kidney function. The case is illustrative for dilemmas that transplant professionals may face in the absence of evidence-based, efficient COVID-19 therapy. The risk-benefit balance of the yet to be approved treatment strategies may be weighed differently in organ transplant recipients owing to their immunocompromised status and potential drug interactions with immunosuppressive therapy.

scholarly journals Tacrolimus Toxicity due to Biliary Obstruction in a Combined Kidney and Liver Transplant Recipient

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Samuel Chan ◽  
Michael T. Burke ◽  
David W. Johnson ◽  
Ross S. Francis ◽  
David W. Mudge
Keyword(s):  
Transplant Recipient ◽  
Biliary Obstruction ◽  
Kidney Transplant Recipient ◽  
Kidney Injury ◽  
Therapeutic Window ◽  
Therapeutic Drug ◽  
Blood Levels ◽  
Liver And Kidney ◽  
The Impact ◽  
Very High

The immunosuppressant tacrolimus has a narrow therapeutic window, necessitating therapeutic drug monitoring to maintain efficacy and minimise toxicity. There are very few reports examining the impact of impaired biliary excretion on tacrolimus blood levels or toxicity. We report the case of a 26-year-old combined liver and kidney transplant recipient, who developed acute biliary obstruction leading to tacrolimus toxicity with very high blood tacrolimus levels. Despite a careful evaluation, no alternative cause was found for her acute kidney injury, and her kidney function returned to previous baseline within several days following treatment of the biliary obstruction and temporary withdrawal of tacrolimus.

scholarly journals Skin lesions and acute kidney injury in a kidney transplant recipient

2021 ◽  
Vol 21 (6) ◽  
pp. 2298-2300
Author(s):  
Shai Chazin ◽  
Osaid Saqqa ◽  
Anil Paramesh ◽  
Sixto Giusti
Keyword(s):  
Acute Kidney Injury ◽  
Transplant Recipient ◽  
Kidney Transplant ◽  
Kidney Transplant Recipient ◽  
Kidney Injury ◽  
Skin Lesions

scholarly journals Modification of immunosuppressive agents in a kidney transplant recipient with COVID-19 and acute kidney injury

2021 ◽  
Vol 15 (09) ◽  
pp. 1273-1276
Author(s):  
Thanawat Vongchaiudomchoke ◽  
Vittawin Sawangduan ◽  
Tosapon Sinpanee ◽  
Nipon Chalermphunchai ◽  
Kumtorn Lelamali ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Transplant Recipient ◽  
Kidney Transplant ◽  
Kidney Transplant Recipient ◽  
Immunosuppressive Agents ◽  
Organ Transplant ◽  
Kidney Injury ◽  
Limited Data ◽  
Organ Rejection ◽  
Calcineurin Inhibitor Nephrotoxicity

Introduction: An outbreak of coronavirus disease-19 (COVID-19) has occurred in different parts of the world. Although a large piece of information regarding the epidemiology, clinical features, and management of COVID-19 has been reported in the general population, there is very limited data regarding organ transplant recipients, particularly regarding the management of maintenance immunosuppressive agents during infection. Methodology: We described a case of kidney transplant recipient from Thailand who had COVID-19 pneumonia and severe acute kidney injury. Results: The patient’s serum creatinine peaked at 7.0 mg/dL on day 15 of illness and returned to baseline value of 2.0 mg/dL on day 26 of illness. We have shown how we modified tacrolimus, mycophenolate, and steroids in the patient who had received favipiravir and lopinavir/ritonavir for COVID-19 pneumonia. Conclusions: In this case, successful modification of this immunosuppressive regimen was accomplished to reduce drug interaction complications, aiming to avoid calcineurin inhibitor nephrotoxicity while maintaining appropriate levels of immunosuppression to prevent organ rejection and to promote the patient’s recovery from infection.

Association between Procalcitonin and Acute Kidney Injury in Patients with Bacterial Septic Shock

2021 ◽  
pp. 1-10
Author(s):  
Guang Fu ◽  
Hai-chao Zhan ◽  
Hao-li Li ◽  
Jun-fu Lu ◽  
Yan-hong Chen ◽  
...  
Keyword(s):  
Septic Shock ◽  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Piecewise Linear ◽  
Kidney Injury ◽  
Multiple Logistic Regression ◽  
Primary Analysis ◽  
Female Patients ◽  
Potential Biomarker ◽  
The Relationship

Objective: The objective of this study was to assess the relationship between serum procalcitonin (PCT) and acute kidney injury (AKI) induced by bacterial septic shock. Methods: A retrospective study was designed which included patients who were admitted to the ICU from January 2015 to October 2018. Multiple logistic regression and receiver operating characteristic (ROC) as well as smooth curve fitting analysis were used to assess the relationship between the PCT level and AKI. Results: Of the 1,631 patients screened, 157 patients were included in the primary analysis in which 84 (53.5%) patients were with AKI. Multiple logistic regression results showed that PCT (odds ratio [OR] = 1.017, 95% confidence interval [CI] 1.009–1.025, p < 0.001) was associated with AKI induced by septic shock. The ROC analysis showed that the cutoff point for PCT to predict AKI development was 14 ng/mL, with a sensitivity of 63% and specificity 67%. Specifically, in multivariate piecewise linear regression, the occurrence of AKI decreased with the elevation of PCT when PCT was between 25 ng/mL and 120 ng/mL (OR 0.963, 95% CI 0.929–0.999; p = 0.042). The AKI increased with the elevation of PCT when PCT was either <25 ng/mL (OR 1.077, 95% CI 1.022–1.136; p = 0.006) or >120 ng/mL (OR 1.042, 95% CI 1.009–1.076; p = 0.013). Moreover, the PCT level was significantly higher in the AKI group only in female patients aged ≤75 years (p = 0.001). Conclusions: Our data revealed a nonlinear relationship between PCT and AKI in septic shock patients, and PCT could be used as a potential biomarker of AKI in female patients younger than 75 years with bacterial septic shock.

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