Health Literacy among patients with end‐stage kidney disease and kidney transplant recipients

End-stage kidney disease has a negative impact on patients’ quality of life. People who receive a kidney transplant experience an improvement in many areas of their daily life. Sexuality is a general component of health, which can be affected by end-stage kidney disease and kidney transplant. The aim of this study was to explore and understand the experiences and perspectives of kidney transplant recipients regarding their sexuality. A qualitative study based on Gadamer’s hermeneutic philosophy was carried out. Two focus groups and nine interviews were conducted with 18 kidney transplant recipients. Data were audio-recorded, transcribed, and analyzed with the help of qualitative analysis software. Two main themes emerged from the data: (1) “The impact of a kidney transplant on sexuality”, with the subthemes “sexuality is relegated to the background”, “physical decline acts as a sexual inhibitor”, and “changes in sexual activity following a kidney transplant”; (2) “Sexual education in kidney transplant recipients” with the subthemes “sexuality: a hidden concern amongst kidney transplant recipients” and “talking about sexuality with healthcare professionals”. Sexuality is a frequent concern among kidney transplant recipients. The physiological and emotional changes experienced after kidney transplant exert a great influence on their sexuality. Healthcare professionals rarely discuss sexuality concerns with kidney transplant recipients. Professional sexual education and assistance are necessary to improve sexual health satisfaction of kidney transplant recipients.

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Outcomes of Kidney Transplant Recipients with Sickle Cell Disease: An Analysis of the 2000–2019 UNOS/OPTN Database

Journal of Clinical Medicine ◽

10.3390/jcm10143063 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3063

Author(s):

Napat Leeaphorn ◽

Charat Thongprayoon ◽

Pradeep Vaitla ◽

Panupong Hansrivijit ◽

Caroline C. Jadlowiec ◽

...

Keyword(s):

Kidney Transplant ◽

Graft Survival ◽

Patient Survival ◽

Transplant Recipients ◽

Cell Disease ◽

Kidney Transplant Recipients ◽

Allograft Survival ◽

End Stage Kidney Disease ◽

Kidney Recipients ◽

End Stage

Background: Lower patient survival has been observed in sickle cell disease (SCD) patients who go on to receive a kidney transplant. This study aimed to assess the post-transplant outcomes of SCD kidney transplant recipients in the contemporary era. Methods: We used the OPTN/UNOS database to identify first-time kidney transplant recipients from 2010 through 2019. We compared patient and allograft survival between recipients with SCD (n = 105) vs. all other diagnoses (non-SCD, n = 146,325) as the reported cause of end-stage kidney disease. We examined whether post-transplant outcomes improved among SCD in the recent era (2010–2019), compared to the early era (2000–2009). Results: After adjusting for differences in baseline characteristics, SCD was significantly associated with lower patient survival (HR 2.87; 95% CI 1.75–4.68) and death-censored graft survival (HR 1.98; 95% CI 1.30–3.01), compared to non-SCD recipients. The lower patient survival and death-censored graft survival in SCD recipients were consistently observed in comparison to outcomes of recipients with diabetes, glomerular disease, and hypertension as the cause of end-stage kidney disease. There was no significant difference in death censored graft survival (HR 0.99; 95% CI 0.51–1.73, p = 0.98) and patient survival (HR 0.93; 95% CI 0.50–1.74, p = 0.82) of SCD recipients in the recent versus early era. Conclusions: Patient and allograft survival in SCD kidney recipients were worse than recipients with other diagnoses. Overall SCD patient and allograft outcomes in the recent era did not improve from the early era. The findings of our study should not discourage kidney transplantation for ESKD patients with SCD due to a known survival benefit of transplantation compared with remaining on dialysis. Urgent future studies are needed to identify strategies to improve patient and allograft survival in SCD kidney recipients. In addition, it may be reasonable to assign risk adjustment for SCD patients.

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The Risk of Stroke in Kidney Transplant Recipients with End-Stage Kidney Disease

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16030326 ◽

2019 ◽

Vol 16 (3) ◽

pp. 326 ◽

Cited By ~ 2

Author(s):

Shih-Ting Huang ◽

Tung-Min Yu ◽

Ya-Wen Chuang ◽

Mu-Chi Chung ◽

Chen-Yu Wang ◽

...

Keyword(s):

Kidney Disease ◽

General Population ◽

Kidney Transplant ◽

Lower Risk ◽

Cox Regression ◽

Research Database ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Increased Risk ◽

End Stage

Background: The incidence of stroke after kidney transplantation is poorly understood. Our study aimed to determine the incidence and predictors of stroke as well as mortality from stroke in kidney transplant recipients (KTRs). Methods: This retrospective cohort study used the National Health Insurance Research Database in Taiwan to study KTRs (N = 4635), patients with end-stage renal disease (ESRD; N = 69,297), and patients from the general population who were chronic kidney disease (CKD)-free and matched by comorbidities (N = 69,297) for the years 2000 through 2010. The risk of stroke was analyzed using univariate and multivariate Cox regression models and compared between study cohorts. Findings: Compared with the ESRD subgroup, KTRs had a significantly lower risk of overall stroke (adjusted hazard ratio (aHR) = 0.37, 95% confidence interval (CI) = 0.31–0.44), ischemic stroke (aHR = 0.45, 95% CI = 0.37–0.55), and hemorrhagic stroke (aHR = 0.20, 95% CI = 0.14–0.29). The risk patterns for each type of stroke in the KTR group were not significantly different than those of the CKD-free control subgroup. The predictors of stroke were age and diabetes in KTRs. All forms of stroke after transplantation independently predicted an increased risk of subsequent mortality, and the strongest risk was related to hemorrhagic events. Interpretation: KTRs had a lower risk of stroke than ESRD patients, but this risk was not significantly different from that of the CKD-free comorbidities-matched general population group. Although stroke was relatively uncommon among cardiovascular events, it predicted unfavorable outcome in KTRs.

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Kidney transplant recipients with polycystic kidney disease have a lower risk of post-transplant BK infection than those with end-stage renal disease due to other causes

Transplant Infectious Disease ◽

10.1111/tid.12974 ◽

2018 ◽

Vol 20 (6) ◽

pp. e12974 ◽

Cited By ~ 2

Author(s):

Callie Plafkin ◽

Tripti Singh ◽

Brad C. Astor ◽

Sandesh Parajuli ◽

Gauri Bhutani ◽

...

Keyword(s):

Kidney Disease ◽

Renal Disease ◽

Kidney Transplant ◽

End Stage Renal Disease ◽

Lower Risk ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Polycystic Kidney ◽

Stage Renal Disease ◽

End Stage

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Long-term Glomerular Filtration Rate and Kidney Disease: Improving Global Outcomes Stage Stability After Conversion to Once-Daily Tacrolimus in Kidney Transplant Recipients

Transplantation Proceedings ◽

10.1016/j.transproceed.2018.04.076 ◽

2019 ◽

Vol 51 (1) ◽

pp. 147-152 ◽

Cited By ~ 2

Author(s):

F. Tinti ◽

I. Umbro ◽

L. Poli ◽

A. Cappoli ◽

M. Garofalo ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Kidney Disease ◽

Glomerular Filtration ◽

Kidney Transplant ◽

Filtration Rate ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Once Daily

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The determinants, biomarkers, and consequences of microvascular injury in kidney transplant recipients

AJP Renal Physiology ◽

10.1152/ajprenal.00163.2018 ◽

2019 ◽

Vol 316 (1) ◽

pp. F9-F19 ◽

Cited By ~ 1

Author(s):

Alice Doreille ◽

Mélanie Dieudé ◽

Heloise Cardinal

Keyword(s):

Kidney Disease ◽

Kidney Transplant ◽

Interstitial Fibrosis ◽

Ischemia Reperfusion ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Hla Antibodies ◽

Microvascular Injury ◽

Antibody Mediated Rejection ◽

Peritubular Capillaries

Independent of the initial cause of kidney disease, microvascular injury to the peritubular capillary network appears to play a central role in the development of interstitial fibrosis in both native and transplanted kidney disease. This association is explained by mechanisms such as the upregulation of profibrotic genes and epigenetic changes induced by hypoxia, capillary leakage, endothelial and pericyte transition to interstitial fibroblasts, as well as modifications in the secretome of endothelial cells. Alloimmune injury due to antibody-mediated rejection and ischemia-reperfusion injury are the two main etiologies of microvascular damage in kidney transplant recipients. The presence of circulating donor-specific anti-human leukocyte antigen (HLA) antibodies, histological findings, such as diffuse C4d staining in peritubular capillaries, and the extent and severity of peritubular capillaritis, are commonly used clinically to provide both diagnostic and prognostic information. Complement-dependent assays, circulating non-HLA antibodies, or evaluation of the microvasculature with novel imaging techniques are the subject of ongoing studies.

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