Post-transplant malignant neoplasia associated with cyclosporine-based immunotherapy: prevalence, risk factors and survival in feline renal transplant recipients

Introduction and Aim: Post Transplant Diabetes Mellitus (PTDM) constitutes a major co-morbidity that has significant impact on the patient and renal allograft outcome. Various traditional risk factors like dialysis vintage, immunosuppressive medication, viral infections have known to be associated with PTDM. Novel risk factors and its causative role in PTDM remains unexplored. The study looked at the incidence of PTDM at 6 months post renal transplantation and correlation of PTDM with known traditional and novel risk factors like pre-transplant C-reactive protein (CRP) level and Trace element deficiency. Material and Methods: 30 consecutive renal transplant recipients more than 18 years of age were inducted into the study. Demographic data, known pre-transplant and post-transplant risk factors associated with development of PTDM were collected. Pre-transplant CRP and serum Trace element (Aluminum, Copper, Selenium and Zinc) levels were estimated. PTDM was diagnosed by home based glucometer monitoring and confirmed by Oral glucose tolerance test (OGTT). Results: The incidence of PTDM was 36.6% at six months post renal transplant. Among the pre-transplant risk factors, higher age and positive family history of diabetes mellitus had a strong association with the occurrence of PTDM. Pre-transplant Zinc deficiency emerged as a significant novel risk factor for the development of PTDM. Conclusion: Apart from known traditional risk factors, novel risk factors are associated with development of PTDM.

Download Full-text

P1778PROFILE OF NON-BACTERIAL INFECTIONS SPECIFIC TO RENAL TRANSPLANT RECIPIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1778 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Anurag Gupta ◽

Rahul Kanjilal ◽

Devinder Singh Rana ◽

A K Bhalla ◽

Ashwani Gupta ◽

...

Keyword(s):

Risk Factors ◽

Renal Transplant ◽

Graft Rejection ◽

Bacterial Infections ◽

Viral Infections ◽

Pneumocystis Jirovecii Pneumonia ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Post Transplant ◽

History Of

Abstract Background and Aims Infections in renal transplant recipients are a major cause of morbidity and mortality. It is the one of the major cause of patient death with functioning graft. Hence this project was done to study the profile of non-bacterial infections specific to renal transplant recipients and to determine the risk factors associated with such infections. Method Renal-transplant recipients admitted to the department of nephrology with suspected infection were included in the study. Results : A total of 342 patients were included in the study. The mean age of the patients was 45.2 ± 13.3 years. 17.5% had ABO incompatible renal transplant. 91% (87% received leukocyte depleting and 4% received non-leukocyte depleting agents) had received induction as majority had three or more HLA mismatch (70%) and the most common donor was wife. 12.8% had history of graft rejection. A total of 147 infectious episodes were encountered in 121 patients. The incidence of non-bacterial infections was 35% (121/342). Viral infections (68/147 = 46%) and invasive fungal infections (44/147 = 30%) were the most common. Cytomegalovirus infection was the most common 35%. Other viral infections encountered were BK virus associated nephropathy (2.3%) and reactivation of Hepatitis B or C virus (2.6%). The most common site of invasive fungal infection were lower respiratory tract, urinary tract, CNS cryptococcosis, soft tissue infection or cellulitis and oesophageal candidiasis in 41%, 32%, 9%, 9% and 9% respectively. Aspergillus (61%) and Rhizopus (33%) was the most common organism causing fungal pneumonia. Four patients were diagnosed with Pneumocystis jirovecii pneumonia. Majority (60%) of the infections were detected after one year post-transplant. Risk factors found to have statistically significance were ABO incompatibility, diabetes mellitus (pre or post-transplant) and history of graft rejection. Nine patients (7%) died of non-bacterial infections specific to renal transplant recipients. Conclusion Non-bacterial infections are not uncommon in Indian scenario and the timeline of such infections has changed.

Download Full-text

Variability in the leptin receptor gene and other risk factors for post-transplant diabetes mellitus in renal transplant recipients

Annals of Medicine ◽

10.1080/07853890.2019.1614656 ◽

2019 ◽

Vol 51 (2) ◽

pp. 164-173 ◽

Cited By ~ 2

Author(s):

Sonia Mota-Zamorano ◽

Enrique Luna ◽

Guadalupe Garcia-Pino ◽

Luz M. González ◽

Guillermo Gervasini

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Renal Transplant ◽

Leptin Receptor ◽

Receptor Gene ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Post Transplant

Download Full-text

Post-Transplant Glomerulonephritis in Live-Donor Renal Transplant Recipients: Clinical Course and Risk Factors

After the Kidney Transplant - The Patients and Their Allograft ◽

10.5772/21354 ◽

2011 ◽

Author(s):

Ahmed Akl ◽

Hany Adel ◽

Ehab Waf

Keyword(s):

Risk Factors ◽

Renal Transplant ◽

Clinical Course ◽

Renal Transplant Recipients ◽

Live Donor ◽

Transplant Recipients ◽

Post Transplant

Download Full-text

Post-Transplant Diabetes Mellitus and Prediabetes in Renal Transplant Recipients: An Update

Nephron ◽

10.1159/000514288 ◽

2021 ◽

pp. 1-13

Author(s):

Ana Elena Rodríguez-Rodríguez ◽

Esteban Porrini ◽

Mads Hornum ◽

Javier Donate-Correa ◽

Raúl Morales-Febles ◽

...

Keyword(s):

Diabetes Mellitus ◽

Renal Transplant ◽

Cell Function ◽

Cell Damage ◽

Current Evidence ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Post Transplant ◽

Β Cell Function

Post-transplant diabetes mellitus (PTDM) is a frequent and relevant complication after renal transplantation: it affects 20–30% of renal transplant recipients and increases the risk for cardiovascular and infectious events. Thus, understanding pathogenesis of PTDM would help limiting its consequences. In this review, we analyse novel aspects of PTDM, based on studies of the last decade, such as the clinical evolution of PTDM, early and late, the reversibility rate, diagnostic criteria, risk factors, including pre-transplant metabolic syndrome and insulin resistance (IR) and the interaction between these factors and immunosuppressive medications. Also, we discuss novel pathogenic factors, in particular the role of β-cell function in an environment of IR and common pathways between pre-existing cell damage and tacrolimus-induced toxicity. The relevant role of prediabetes in the pathogenesis of PTDM and cardiovascular disease is also addressed. Finally, current evidence on PTDM treatment is discussed.

Download Full-text

Calcium and phosphate levels after kidney transplantation and long-term patient and allograft survival

Clinical Kidney Journal ◽

10.1093/ckj/sfaa061 ◽

2020 ◽

Author(s):

Julio Chevarria ◽

Donal J Sexton ◽

Susan L Murray ◽

Chaudhry E Adeel ◽

Patrick O’Kelly ◽

...

Keyword(s):

Risk Factors ◽

Renal Transplant ◽

Graft Failure ◽

Graft Function ◽

Renal Transplant Recipients ◽

Post Transplant ◽

All Cause Mortality ◽

Transplant Function ◽

The Republic ◽

The Impact

Abstract Background Non-traditional cardiovascular risk factors, including calcium and phosphate derangement, may play a role in mortality in renal transplant. The data regarding this effect are conflicting. Our aim was to assess the impact of calcium and phosphate derangements in the first 90 days post-transplant on allograft and recipient outcomes. Methods We performed a retrospective cohort review of all-adult, first renal transplants in the Republic of Ireland between 1999 and 2015. We divided patients into tertiles based on serum phosphate and calcium levels post-transplant. We assessed their effect on death-censored graft survival and all-cause mortality. We used Stata for statistical analysis and did survival analysis and spline curves to assess the association. Results We included 1525 renal transplant recipients. Of the total, 86.3% had hypophosphataemia and 36.1% hypercalcaemia. Patients in the lowest phosphate tertile were younger, more likely female, had lower weight, more time on dialysis, received a kidney from a younger donor, had less delayed graft function and better transplant function compared with other tertiles. Patients in the highest calcium tertile were younger, more likely male, had higher body mass index, more time on dialysis and better transplant function. Adjusting for differences between groups, we were unable to show any difference in death-censored graft failure [phosphate = 1.14, 95% confidence interval (CI) 0.92–1.41; calcium = 0.98, 95% CI 0.80–1.20] or all-cause mortality (phosphate = 1.10, 95% CI 0.91–1.32; calcium = 0.96, 95% CI 0.81–1.13) based on tertiles of calcium or phosphate in the initial 90 days. Conclusions Hypophosphataemia and hypercalcaemia are common occurrences post-kidney transplant. We have identified different risk factors for these metabolic derangements. The calcium and phosphate levels exhibit no independent association with death-censored graft failure and mortality.

Download Full-text