scholarly journals Beneficial Effect of Conversion to Belatacept in Kidney-Transplant Patients with a Low Glomerular-Filtration Rate

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Julie Belliere ◽  
Céline Guilbeau-Frugier ◽  
Arnaud Del Bello ◽  
Laure Esposito ◽  
Caroline Capuani ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Kidney Transplant ◽  
Kidney Function ◽  
Filtration Rate ◽  
Case Reports ◽  
Rescue Therapy ◽  
Mtor Inhibitors ◽  
Transplant Patients ◽  
Kidney Transplant Patients

Belatacept has been found to be efficient at preserving good kidney function in maintenance kidney-transplant patients. Herein, we report on the use of belatacept as a rescue therapy for two kidney-transplant patients presenting with severe adverse events after treatment with calcineurin inhibitors (CNIs) and mammalian target-of-rapamycin (mTOR) inhibitors. Two kidney-transplant patients developed severely impaired kidney function after receiving CNIs. The use of everolimus was associated with severe angioedema. Belatacept was then successfully used to improve kidney function in both cases, even though estimated glomerular-filtration rate before conversion was <20 mL/min. These case reports show that belatacept can be used as a rescue therapy, even if kidney function is very low in kidney-transplant patients who cannot tolerate CNIs and/or mTOR inhibitors.

Accurately simple estimation of glomerular filtration rate in kidney transplant patients

2002 ◽  
Vol 34 (4) ◽  
pp. 1148-1151 ◽  
Author(s):  
K Manotham ◽  
V Booranalertpaisarn ◽  
S Eiam-Ong ◽  
S Chusil ◽  
K Praditpornsilpa ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Kidney Transplant ◽  
Filtration Rate ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Simple Estimation

scholarly journals A Risk Score to Guide Cystatin C Testing to Detect Occult-Reduced Estimated Glomerular Filtration Rate

2015 ◽  
Vol 42 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Carmen A. Peralta ◽  
Paul Muntner ◽  
Rebecca Scherzer ◽  
Suzanne Judd ◽  
Mary Cushman ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Racial Differences ◽  
Kidney Function ◽  
Cystatin C ◽  
Risk Score ◽  
Filtration Rate ◽  
Bayesian Model Averaging ◽  
Estimated Glomerular Filtration Rate ◽  
Risk Function

Background/Aims: Persons with occult-reduced estimated glomerular filtration rate (eGFR <60 ml/min/1.73 m2 detected by serum cystatin C but missed by creatinine) have high risk for complications. Among persons with preserved kidney function by creatinine-based eGFR (eGFRcreat >60 ml/min/1.73 m2), tools to guide cystatin C testing are needed. Methods: We developed a risk score to estimate an individual's probability of reduced eGFR by cystatin C (eGFRcys <60 ml/min/1.73 m2) in The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study and externally validated in the Third National Health and Nutrition Examination Survey (NHANES III). We used logistic regression with Bayesian model averaging and variables available in practice. We assessed performance characteristics using calibration and discrimination measures. Results: Among 24,877 adults with preserved kidney function by creatinine, 13.5% had reduced eGFRcys. Older and Black participants, current smokers and those with higher body mass index, lower eGFRcreat, diabetes, hypertension and history of cardiovascular disease were more likely to have occult-reduced eGFR (p < 0.001). The final risk function had a c-statistic of 0.87 in REGARDS and 0.84 in NHANES. By risk score, 72% of occult-reduced eGFR cases were detected by screening only 22% of participants. Conclusions: A risk score using characteristics readily accessible in clinical practice can identify the majority of persons with reduced eGFRcys, which is missed by creatinine.

scholarly journals Immune Response after SARS-CoV-2 Vaccination in Kidney Transplant Patients

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1327
Author(s):  
Ruta Vaiciuniene ◽  
Brigita Sitkauskiene ◽  
Inga Arune Bumblyte ◽  
Egle Dalinkeviciene ◽  
Edita Ziginskiene ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Antibody Response ◽  
Kidney Transplant ◽  
Kidney Function ◽  
Hemoglobin Level ◽  
Total Leucocyte Count ◽  
Binary Logistic Regression Analysis ◽  
Cd8 Cells ◽  
Transplant Patients ◽  
Kidney Transplant Patients

Background and Objectives: The prospective study was conducted to evaluate humoral and cellular immune responses after two doses of BNT162b2 (Pfizer-BioNTech) vaccine and possible relation with other factors (medication, etc.) in kidney transplant patients. Materials and Methods: Out of 167 vaccinated patients, 136 agreed to a follow-up visit three to six weeks after vaccination. Results: Only 39 patients (29%) developed antibody response against SARS-CoV-2 (≥35.2 binding antibody units (BAU)/mL) after full vaccination. Multivariate binary logistic regression analysis showed that predictive factors for good antibody response to the COVID-19 vaccine were better kidney function, higher hemoglobin level, and no use of mycophenolate mofetil for immunosuppression. For seropositive kidney transplant patients there was a significant negative correlation between anti-SARS-CoV-2 antibody titer and CD4/CD8 ratio (Spearman’s correlation coefficient −0.4, p = 0.02), percentage of CD19+ cells (r = −0.37, p = 0.02), and a positive correlation with percentage of CD8+ cells (r = 0.4, p = 0.01). There was an increase of total leucocyte count after vaccination in the total studied population, and in the group of responders. Conclusions: Only one third of kidney transplant patients develop sufficient antibody responses after full COVID-19 vaccination with Pfizer-BioNTech. Better kidney function, higher hemoglobin level, and no use of mycophenolate mofetil for immunosuppression increases the adequacy of response. The antibody titers correlated positively with relative number of CD8+ cells and negatively with CD4/CD8 ratio in responders.

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