scholarly journals Depressive symptoms, frailty, and adverse outcomes among kidney transplant recipients

2018 ◽  
Vol 32 (10) ◽  
pp. e13391 ◽  
Author(s):  
Jonathan M. Konel ◽  
Fatima Warsame ◽  
Hao Ying ◽  
Christine E. Haugen ◽  
Alexandra Mountford ◽  
...  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Filipe S. Mira ◽  
Joana Oliveira ◽  
Filipa Sousa ◽  
Dora Antunes ◽  
Ana Carolina Figueiredo ◽  
...  

Abstract Objectives Maternal and fetal complications can occur in pregnant kidney transplant recipients. Since these are high-risk pregnancies, they require a multidisciplinary follow-up to prematurely detect adverse events. Identifying factors that would affect fetal, maternal and graft outcomes is essential to further stratify the risk of pregnant kidney transplant recipients. Methods All pregnancies in kidney transplant recipients followed in a single center for 30 years were included. Data included previous transplant information and blood and urine tests performed before pregnancy. Impact of graft function on fetal, maternal and graft outcomes was evaluated. Results There were 41 pregnancies among 34 patients. Mean gestational age of 35 ± 3 weeks. Caesarean section was performed in 69.4% of patients. Five pregnancies were unsuccessful (12.2%). Four patients suffered an acute graft dysfunction (9.8%) and 12 (29.3%) had a serious maternal hypertensive disorder (preeclampsia, eclampsia or HELLP syndrome). Graft function before pregnancy showed significant correlation with adverse outcomes. Conclusions A proteinuria >669 mg/g, serum creatinine >1.75 mg/dL and glomerular filtration rate <36.2 mL/min/1.73 m2 before pregnancy were correlated to graft dysfunction during pregnancy. Similar values of proteinuria were also associated with a risk of maternal hypertensive disorders and pregnancy failure. Therefore, in patients with proteinuria and graft dysfunction, follow-up should be stricter to quickly detect complications.


2018 ◽  
Vol 15 (6) ◽  
Author(s):  
Aghil Habibi Soola ◽  
Farbod Ebadi Fardeazar ◽  
Mahnaz Solhi ◽  
Firouz Amani

2015 ◽  
Vol 26 (12) ◽  
pp. 3114-3122 ◽  
Author(s):  
Donald E. Hricik ◽  
Richard N. Formica ◽  
Peter Nickerson ◽  
David Rush ◽  
Robert L. Fairchild ◽  
...  

2020 ◽  
Vol 7 ◽  
pp. 205435812090867
Author(s):  
Ngan N. Lam ◽  
Devon J. Boyne ◽  
Robert R. Quinn ◽  
Peter C. Austin ◽  
Brenda R. Hemmelgarn ◽  
...  

Background: Due to their history of renal disease and exposure to immunosuppression, kidney transplant recipients with a failing graft may be at higher risk of adverse outcomes compared to nontransplant controls. Understanding the burden of disease in transplant recipients may inform treatment decisions of people whose native kidneys are failing and may be eligible for a transplant. Objective: To compare mortality and morbidity in kidney transplant recipients with a failing graft to matched nontransplant controls. Design: Retrospective cohort study. Setting: Alberta, Canada. Patients: Kidney transplant recipients with a failing graft were identified as having at least 2 estimated glomerular filtration rate (eGFR) measurements between 15-30 mL/min/1.73 m2 (90-365 days apart). We also identified nontransplant controls with a similar degree of kidney dysfunction. Measurements: Mortality and hospitalization. Methods: We propensity-score matched 520 kidney transplant recipients with a failing graft to 520 nontransplant controls. Results: The median age of the matched cohort was 57 years and 40% were women. Compared to matched nontransplant controls, recipients with a failing graft had a higher hazard of death (hazard ratio, 1.54; 95% confidence interval [CI], 1.28-1.85; p < .001) and a higher rate of all-cause hospitalization (rate ratio, 1.67; 95% CI, 1.42-1.97; p < .001). Kidney transplant recipients also had a higher rate of several cause-specific hospitalizations including genitourinary, cardiovascular, and infectious causes. Limitations: Observational design with the risk of residual confounding. Conclusions: A failing kidney transplant is associated with an increased burden of mortality and morbidity beyond chronic kidney disease. This information may assist the discussion of prognosis in kidney transplant recipients with a failing graft and the design of strategies to minimize risks.


2017 ◽  
Vol 13 (04) ◽  
pp. 557-564 ◽  
Author(s):  
Katalin Z. Ronai ◽  
Andras Szentkiralyi ◽  
Alpar S. Lazar ◽  
Akos Ujszaszi ◽  
Csilla Turanyi ◽  
...  

2021 ◽  
pp. 129-137
Author(s):  
I. V. Lekareva ◽  
A. L. Emelianova ◽  
E. V. Kalinina ◽  
A. R. Babaeva ◽  
E. V. Scherbinina

The course and management of coronavirus infection (CI) in patients with severe comorbidity are extremely important scientific and practical issues in the era of COVID-19. Kidney transplant recipients make up one of the most vulnerable groups for CI-associated adverse outcomes. Considering the presence of comorbidities, the optimal pharmacotherapy regimens for CI and its complications have not yet been worked out for these patients. In this article, we present two clinical observations demonstrating typical manifestations of coronavirus pneumonia (CP) in kidney transplant recipients, the COVID-19 diagnostic and verification algorithm, and the therapeutic options used to achieve a favorable outcome of CP and to prevent fatal complications. Our findings confirm that in kidney transplant recipients CP is linked to increased disease severity with rapid progression of lung damage and a high risk of developing systemic complications, including thrombotic microangiopathy. It is shown that compliance with the current recommendations for a rational combination of antiviral, anti-inflammatory, anticoagulant and basic immunosuppressive agents in this group of patients provides good treatment outcomes and prevents kidney transplant failure. Two adverse outcomes in the observed group were due to associated opportunistic infection. Based on our findings and clinical data, we conclude that preemptive therapy with IL-6 inhibitors or colchicine is an effective therapeutic option in kidney transplant recipients.


2017 ◽  
Vol 101 (1) ◽  
pp. 182-190 ◽  
Author(s):  
Petr Jarolim ◽  
Brian L. Claggett ◽  
Michael J. Conrad ◽  
Myra A. Carpenter ◽  
Anastasia Ivanova ◽  
...  

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