Health Literacy of Living Kidney Donors and Kidney Transplant Recipients

α-Klotho is a known anti-aging protein that exerts diverse physiological effects, including phosphate homeostasis. Klotho expression occurs predominantly in the kidney and is significantly decreased in patients with chronic kidney disease. However, changes in serum klotho levels and impacts of klotho on outcomes among kidney transplant (KTx) recipients and kidney donors remain unclear. A literature search was conducted using MEDLINE, EMBASE, and Cochrane Database from inception through October 2019 to identify studies evaluating serum klotho levels and impacts of klotho on outcomes among KTx recipients and kidney donors. Study results were pooled and analyzed utilizing a random-effects model. Ten cohort studies with a total of 431 KTx recipients and 5 cohort studies with a total of 108 living kidney donors and were identified. After KTx, recipients had a significant increase in serum klotho levels (at 4 to 13 months post-KTx) with a mean difference (MD) of 243.11 pg/mL (three studies; 95% CI 67.41 to 418.81 pg/mL). Although KTx recipients had a lower serum klotho level with a MD of = −234.50 pg/mL (five studies; 95% CI −444.84 to −24.16 pg/mL) compared to healthy unmatched volunteers, one study demonstrated comparable klotho levels between KTx recipients and eGFR-matched controls. Among kidney donors, there was a significant decrease in serum klotho levels post-nephrectomy (day 3 to day 5) with a mean difference (MD) of −232.24 pg/mL (three studies; 95% CI –299.41 to −165.07 pg/mL). At one year following kidney donation, serum klotho levels remained lower than baseline before nephrectomy with a MD of = −110.80 pg/mL (two studies; 95% CI 166.35 to 55.24 pg/mL). Compared to healthy volunteers, living kidney donors had lower serum klotho levels with a MD of = −92.41 pg/mL (two studies; 95% CI −180.53 to −4.29 pg/mL). There is a significant reduction in serum klotho levels after living kidney donation and an increase in serum klotho levels after KTx. Future prospective studies are needed to assess the impact of changes in klotho on clinical outcomes in KTx recipients and living kidney donors.

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Nepalese Kidney Transplant Recipient in a Follow up Clinic: Related and Unrelated Living Donor

Journal of Nepal Medical Association ◽

10.31729/jnma.296 ◽

2008 ◽

Vol 47 (171) ◽

Cited By ~ 3

Author(s):

Ram Krishna Dulal ◽

S Karki

Keyword(s):

Kidney Transplantation ◽

Kidney Transplant ◽

Kidney Transplant Recipient ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Kidney Donors ◽

Female Ratio ◽

Long Run ◽

The Usa

A cohort retrospective study was conducted on all follow up kidney transplant recipients at Transplant Follow up Clinic from June 16, 2003 to July 15, 2008. The main objective of this study was to find out the demographic pattern of the kidney transplant recipients and type of donors. Among 452 recipients, the transplantation were done in India (449), Germany (2) and in the USA (1) with male to female ratio of 3:1. Kidney donors were unrelated 315 (69.69%), related 134 (29.43%) and some did not disclose 4 (0.88%). Most of the kidney transplantation (93.75%) were done in 45 different hospitals in India and about three quarters (71.7%) of them were operated in the private hospitals in various states of India; only 2 (4.16%) in Germany and 1 (2.08%) in USA. Newar was the largest population 142 (31.4%) and second largest group was Mangol 124 (27.4.4%) that comprised of Gurung, Rai, Magar, Tamang etc. Brahmins were the third largest population 91 (20.1%). In this study the youngest recipients was 14 years and the oldest was of 75 years. The mean age was 41 (SD 13.84). This study showed that 35 (7.7%) died, 8 (1.7%) reported rejection and underwent re-transplantation and 238 patient have lost follow up till early 2008. Kidney transplantation should be promoted as it is cheaper compared to dialysis in the long run. This study found that unrelated kidney donors have outnumbered the related donors in Nepalese kidney transplant recipients which emphasize the importance of unambiguous documentation and also a provision of lawful action against the middle-men if found involved in an illegal kidney related activities in Nepal. Organ transplantation is an important integral part of human health and should be regularize and promote lawfully to protect humans from trafficking for kidney, possible kidnapping, killing and stealing.

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Identifying Core Variables Associated With Health Literacy in Kidney Transplant Recipients

Progress in Transplantation ◽

10.1177/1526924819893285 ◽

2020 ◽

Vol 30 (1) ◽

pp. 38-47 ◽

Cited By ~ 3

Author(s):

Kari Gire Dahl ◽

Marit Helen Andersen ◽

Kristin Hjorthaug Urstad ◽

Ragnhild S. Falk ◽

Eivind Engebretsen ◽

...

Keyword(s):

Health Care ◽

Kidney Transplantation ◽

Health Literacy ◽

Kidney Transplant ◽

Health Care Providers ◽

Vulnerable Groups ◽

Care Providers ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Cross Sectional

Background: A kidney transplantation requires complex self-care skills and adequate follow-up from health-care providers. Identifying strengths and limitations in different aspects of health literacy (HL) and associated variables are central to being able to improve health care. The objective of this study was to identify core variables associated with independent domains of HL 8 weeks following a kidney transplantation. Methods: A single-center cross-sectional study was conducted, wherein 159 kidney transplant recipients answered the Health Literacy Questionnaire (HLQ). Multivariable linear regression with backward elimination was used to investigate variables possibly associated with the 9 domains of HL. Results: The transplant recipients had the lowest scores in “appraisal of health information” and “navigating the healthcare system.” The highest scores were found in “feeling understood and supported by health-care providers” and “ability to actively engage with health-care provider.” General perceived self-efficacy, transplant-specific knowledge, and general health were the driving variables in several of the HL domains. Conclusions: The HLQ provides a more complex picture of strengths and limitations related to HL, as well as important knowledge about vulnerable groups following a kidney transplantation. The study offers an important supplement to the field of HL in kidney transplant care.

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