ERYTHROPOIESIS STIMULATING AGENTS HAVE BENEFICIAL EFFECT ON GRAFT FUNCTION IN KIDNEY TRANSPLANT PATIENTS WITH POSTTRANSPLANT ANEMIA.

2010 ◽  
Vol 90 ◽  
pp. 909
Author(s):  
N. Ichimaru ◽  
T. Moriyama ◽  
K. Yazawa ◽  
M. Okumi ◽  
J. Kaimori ◽  
...  
2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Zorica Dimitrijevic ◽  
Branka Mitic ◽  
Goran Paunovic ◽  
Karolina Paunovic ◽  
Danijela Tasic ◽  
...  

Abstract Background and Aims Post-transplant weight gain and particularly visceral fat gain has been linked to the development of metabolic disorders and cardiovascular disease. Moreover, the effect of obesity on graft function after kidney transplantation has recently become a subject of interest. The aim of our study was to investigate the association of body mass index (BMI), body fat percentage (BF%) and waist-to-hip ratio (WHR) with the kidney function in kidney transplant patients. Method We conducted a cross-sectional study that enrolled 80 kidney transplant patients aged 23–75 years (mean age 46.7 ± 11.5 years, 60% males). Anthropometric measurements of weight, height, waist, and hip circumferences in addition to skinfold thickness were obtained. BH% was calculated using a 4-site skinfold thickness method calculated through the Jackson-Pollock equation with a Harpenden caliper, utilizing a BF% cutoff of 35% for women and 25% for men to define obesity. Results The calculated BMI in our study group was 32.7±8.7 kg/m2, a mean BF% of 29.9±8.5% and a mean WHR of 0.9±0.1 Statistically significant difference in GFR, BMI, WHR and BF% were observed between males and females (r=0.455, p=0.02; r=0.412, p=0.016; r=0.437, p=0.022; r=0.348, p=0.011), respectively. After adjustment for age, gender, donor group, donor age and years of dialysis before transplantation, higher levels of all obesity measures were related to lower eGFR: BMI per 1 SD (β coefficient −3.883, 95% confidence interval [CI] −5,422 to −3,132), WHR (β coefficient −4.443, 95% CI −6.201 to −3.772), and BF% (β coefficient −3.722, 95% CI −4.332 to −3.461). The combination of higher BF% (BF% >33 kg/m2) and central obesity (WHR >0.85 for women, >0.90 for men) was associated with the lowest eGFR compared with that in lean subjects. Conclusion The combination of high BF% and WHR may be an important risk factor for lower GFR in a kidney transplant recipient.


2019 ◽  
Vol 13 (11) ◽  
Author(s):  
Axel Cayetano-Alcaraz ◽  
Juan Sebastian Rodriguez-Alvarez ◽  
Mario Vilatobá-Chapa ◽  
Josefina Alberú-Gómez ◽  
Bernardo Gabilondo-Pliego ◽  
...  

Introduction: Ureteral stricture (US) in the kidney transplant recipient is a rare complication that can lead to morbidity and graft loss. Risk factor recognition is crucial in the prevention and management of this entity. Delayed graft function (DGF), as defined by the need for dialysis in the first week after transplantation, has been proposed as a risk factor in previous studies. Our objective is to determine the impact of DGF in US development in kidney transplant patients. Methods: We designed a matched case-control study. US cases in kidney transplant recipients were identified in the 2008–2017 period. We defined US as the rise in serum creatinine associated with findings suggesting obstruction in ultrasound, scintigraphy, or retrograde pyelogram; any other cause of graft dysfunction was excluded. Controls were defined as kidney transplant recipients from the same population and period without US, matched in a 1:2 fashion by age, sex, and donor type. Results: From 532 kidney transplant patients, 31 cases and 62 controls were included. Cumulative US incidence was 58 per 1000 cases. When calculating for odds ratio (OR), post-operative urinoma (OR 3.2; 95% confidence interval [CI] 2.36–4.37) and ureteral duplication (OR 3.29; 95% CI 2.40–4.51) were associated with an increased risk for US, while DGF was not found to be statistically significant as a risk factor (OR 3.3; 95% CI 0.96–11.52). No statistically significant differences were found between groups in other pre- and post-transplant-related factors. Conclusions: DGF was not associated with US in our cohort; however, ureteral duplication and postoperative urinoma were associated with an increased risk of graft ureteral stenosis development.


2006 ◽  
Vol 21 (10) ◽  
pp. 2930-2937 ◽  
Author(s):  
Christian Plank ◽  
Kerstin Benz ◽  
Kerstin Amann ◽  
Kai-Dietrich Nüsken ◽  
Katalin Dittrich ◽  
...  

2019 ◽  
Vol 142 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Anat Gafter-Gvili ◽  
Uzi Gafter

Posttransplantation anemia (PTA) is common among kidney transplant patients. Early PTA is usually defined as anemia which develops up to 6 months after transplantation, and late PTA is defined as anemia which develops after 6 months. There are multiple causes, with iron deficiency being the major contributor. The occurrence of late PTA has been associated with impaired graft function. Early PTA has been shown to be a predictor of late PTA. PTA is associated with reduced mortality, reduced graft survival, and a decline in GFR. The association with mortality is related to the severity of the anemia and to specific causes of anemia. Treatment of PTA should probably begin as soon as possible after kidney transplantation. The optimal target hemoglobin level in kidney transplant recipients with anemia is higher than recommended in chronic kidney disease and should probably be up to 12.5–13 g/dL. In order to achieve this target, appropriate treatment with erythropoiesis-stimulating agents (ESA) and iron is indicated.


2010 ◽  
Vol 42 (10) ◽  
pp. 4047-4048 ◽  
Author(s):  
F. Tinti ◽  
A. Meçule ◽  
L. Poli ◽  
A. Bachetoni ◽  
I. Umbro ◽  
...  

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Orsolya Cseprekal ◽  
Adrienn Marton ◽  
Sara Molnar ◽  
Attila Patonai ◽  
Attila Fintha ◽  
...  

Abstract Background and Aims Pretransplant or de novo donor specific antibodies (DSA) may lead to active or chronic active antibody mediated rejection (a and cABMR) as leading cause of graft loss after kidney transplantation. There is no treatment protocol approved for ABMR. Anti Il-6 tocilizumab (TCZ), inhibitor of DSA production, is a potential approach to stabilize kidney allograft function, however, evidence based results are not available. In our retrospective case series analysis, we assessed the changes in DSA and eGFR during and at the end of treatment with TCZ. Method In our single center case series analysis, 10 kidney transplant patients with biopsy proven ABMR (aABMR 6, cABMR 4, age 43±10.5ys, 6 males, time since transplantation 18(2-119)months, 7 first transplant, serum creatinine 224±80 umol/L at baseline) were studied between January 2017 – June 2019. Total plasma exchange (PE) (5x) was followed by TCZ (8 mg/kg, 1x monthly for 6 months) in case of a and cABMR. Intravenous immunoglobulin (IVIG, 1gr/kg) was added in case of aABMR. Routine laboratory parameters and DSA were reported retrospectively. Results 6 aABMR patients completed the treatment protocol. Class I DSA decreased significantly (MFI 4457(635-14084) vs. 877(595-5678); p=0.007), but Class II DSA remained the same during the treatment (MFI 4725 (586-17615) vs. 8097 (671-14636) p=NS). eGFR of aABMR patients and 1 cABMR patient were stabilized. 3 cABMR patients returned to dialysis. Reversible elevation of liver transaminases were detected in three patients. There was no any serious adverse event recorded. Conclusion The opportunely timed TCZ seems to be effective in reducing Class I DSA and stabilize graft function in patients with aABMR. Further studies are needed to prove the long-term efficacy and the exact role of TCZ in cABMR among kidney transplant patients.


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