scholarly journals Risk Factors of Ureteral Stenosis in Kidney Transplant Recipients: A Retrospective Study in National Referral Hospital in Indonesia

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Gampo A. Irdam ◽  
Bobby Sutojo ◽  
Putu A. R. Raharja
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Donor Number ◽  
Kidney Transplant Recipients ◽  
Ureteral Stenosis ◽  
Ischemic Time ◽  
Urological Complications ◽  
Recipient Age ◽  
Kidney Transplantations

Ureteral stenosis is one of the most common urological complications following kidney transplantations. It is occurred in 2–10% of patients and poses a significant problem to the patients as it may lead to permanent damage to renal damage. Identification of risk factors is important to prevent the incidence of ureteral stenosis. Thus, we aim to determine the risk factors of ureteral stenosis in the Indonesian population. This is a retrospective analysis of 487 kidney transplant patients performed in Cipto Mangunkusumo Hospital between 2014 and 2018. We collected and compared donor and recipient demography data in recipients who developed ureteral stenosis and recipients who did not develop ureteral stenosis. Ureteral stenosis was defined as the presence of hydronephrosis from ultrasound and increased number of serum creatinine. The overall incidence of ureteral stenosis post-kidney transplantation in our center is 6.6% (32 from 487 patients) from January 2014 until June 2018. We found that older donor and recipient age more frequent in developing ureteral stenosis post-kidney transplantation ( p  < 0.001). We also found that donors with number of arteries more than 2 ( p  < 0.001) and prolonged warm ischemic time ( p  < 0.05) are more frequently to develop ureteral stenosis post-kidney transplantation. There is no association between type II diabetes mellitus and hypertension with ureteral stenosis in this study. Donor age, recipient age, donor number of arteries more than 2, and prolonged warm ischemia time are associated with ureteral stenosis after kidney transplantation.

scholarly journals Correlation of Prolonged Total Ischemic Time with Body Mass Index in Kidney Transplant: A Single Center Report

2021 ◽  
Vol 5 (11) ◽  
pp. 1009-1013
Author(s):  
Eriawan Agung Nugroho ◽  
Erwin Wibowo ◽  
Prathita Amanda Aryani
Keyword(s):  
Body Mass Index ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Body Mass ◽  
The Body ◽  
Health Concern ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Ischemic Time ◽  
Increased Risk

Background: Chronic kidney disease (CKD) is a rising health concern worldwide, especially in Indonesia. The treatment of choice for end-stage renal disease is Kidney Transplantation.1 Numerous studies showed that prolonged total ischemic ischemic time may cause hypoxia of the graft tissue and increased risk of ischemia and reperfusion injury (IRI) and delayed graft function (DGF).2 Body mass index of kidney transplant recipients may cause prolonged duration of the procedure, as well as prolonged total ischemic time. This study aimed to determine the correlation between prolonged total ischemic time with body mass index. Method: This was an observational and cross-sectional analysis at Kariadi General Hospital Semarang involving patients who underwent kidney transplantation from January 2016 to December 2019. The total ischemic time was recorded intraoperatively. The Body Mass Index data were provided by medical records. The program used to statistically analyze the data was SPSS 23.0, and Spearman was used for hypothesis testing. Result: This study included 25 kidney transplant recipients. The mean total ischemic time was 43,27 ± 6,63 minutes. There was a significant positive correlation between prolonged ischemic time and body mass index (r= 0,506 ; p= 0,010). Conclusion: Prolonged total ischemic time was positively correlated with increased body mass index and these results are statistically significant.

scholarly journals Correlation of Prolonged Total Ischemic Time with Body Mass Index in Kidney Transplant: A Single Center Report

2021 ◽  
Vol 5 (4) ◽  
pp. 919-924
Author(s):  
Eriawan Agung Nugroho ◽  
Erwin Wibowo ◽  
Prathita Amanda Aryani
Keyword(s):  
Body Mass Index ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Body Mass ◽  
The Body ◽  
Health Concern ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Ischemic Time ◽  
Increased Risk

Background: Chronic kidney disease (CKD) is a rising health concern worldwide, especially in Indonesia. The treatment of choice for end-stage renal disease is Kidney Transplantation.1 Numerous studies showed that prolonged total ischemic ischemic time may cause hypoxia of the graft tissue and increased risk of ischemia and reperfusion injury (IRI) and delayed graft function (DGF).2 Body mass index of kidney transplant recipients may cause prolonged duration of the procedure, as well as prolonged total ischemic time. This study aimed to determine the correlation between prolonged total ischemic time with body mass index. Method: This was an observational and cross-sectional analysis at Kariadi General Hospital Semarang involving patients who underwent kidney transplantation from January 2016 to December 2019. The total ischemic time was recorded intraoperatively. The Body Mass Index data were provided by medical records. The program used to statistically analyze the data was SPSS 23.0, and Spearman was used for hypothesis testing. Result: This study included 25 kidney transplant recipients. The mean total ischemic time was 43,27 ± 6,63 minutes. There was a significant positive correlation between prolonged ischemic time and body mass index (r= 0,506 ; p= 0,010). Conclusion: Prolonged total ischemic time was positively correlated with increased body mass index and these results are statistically significant.

scholarly journals Post-Transplant Diabetes Mellitus in Kidney Transplant Recipients: A Multi-Center Study

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0000862021
Author(s):  
Rubab F. Malik ◽  
Yaqi Jia ◽  
Sherry G. Mansour ◽  
Peter P. Reese ◽  
Isaac E. Hall ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Kidney Transplant ◽  
Graft Failure ◽  
De Novo ◽  
Kidney Transplant Recipients ◽  
Post Transplant ◽  
Kidney Recipients ◽  
Recipient Age

Background: De novo post-transplant diabetes mellitus (PTDM) is a common complication after kidney transplant (KT). Most recent studies are single-center with various approaches to outcome ascertainment. Methods: In a multi-center longitudinal cohort of 632 non-diabetic adult kidney recipients transplanted in 2010-2013, we ascertained outcomes through detailed chart review at 13 centers. We hypothesized that donor characteristics such as sex, HCV infection, and kidney donor profile index (KDPI) and recipient characteristics such as age, race, BMI, and increased HLA mismatches would affect the development of PTDM among KT recipients. We defined PTDM as hemoglobin A1c ≥6.5%, pharmacological treatment for diabetes, or documentation of diabetes in electronic medical records. We assessed PTDM risk factors and evaluated for an independent time-updated association between PTDM and graft failure using regression. Results: Mean recipient age was 52±14 years, 59% were male, 49% were Black. Cumulative PTDM incidence 5 years post-KT was 29% (186). Independent baseline PTDM risk factors included older recipient age (p<0.001) and higher BMI (p=0.006). PTDM was not associated with all-cause graft failure [adjusted Hazard Ratio (aHR) 1.10 (95% CI: 0.78-1.55)], death-censored graft failure [aHR 0.85 (0.53-1.37)], or death [aHR 1.31 (0.84-2.05)] at median follow-up of 6 (4.0,6.9) years post-KT. Induction and maintenance immunosuppression were not different between patients who did and did not develop PTDM. Conclusions: PTDM occurred commonly, and higher baseline BMI was associated with PTDM. PTDM was not associated with graft failure or mortality during the 6-year follow-up, perhaps due to short follow-up.

scholarly journals Infectious events in kidney transplant recipients from deceased expanded criteria donors: a prospective cohort

2021 ◽  
Vol 55 ◽  
Author(s):  
Sirlei Regina de Sousa ◽  
Cassiane Dezoti da Fonseca ◽  
Monica Taminato ◽  
Maria de Fatima Fernandes Vattimo ◽  
Angélica Gonçalves Silva Belasco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Cause Of Death ◽  
Prospective Cohort ◽  
Cytomegalovirus Infection ◽  
Multidrug Resistant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Expanded Criteria

ABSTRACT Objective: Analyze risk factors for infection in kidney transplant recipients from deceased expanded criteria donors (DECD) in the first two years of follow-up. Method: This is a prospective cohort study with 466 patients from DECD who underwent kidney transplantation in 2015 and 2016 in Brazil. A total of 551 events were recorded. The largest incidence of infectious events occurred in the first month after kidney transplantation. Cytomegalovirus infection was the most common infectious episode. Results: The incidence rate of infections was 57.1%. Among bacterial infections, only 4% were due to multidrug-resistant microorganisms. The death rate was 3.3% (15) patients. The main cause of death was infectious (73.3%). Hospitalization until the first infection (aOR:1.61), Number of infections in 1 year (aOR:40.16), and Cytomegalovirus infection (aOR:13.84) was risk factors for infection by multidrug resistant microorganisms (MDR). Conclusion: Infection incidence with MDR bacteria was high among kidney transplant recipients from DECD, and the main cause of death was infection. Survival was high among patients with infection.

scholarly journals Pretransplant Serum Uromodulin and Its Association with Delayed Graft Function Following Kidney Transplantation—A Prospective Cohort Study

2021 ◽  
Vol 10 (12) ◽  
pp. 2586
Author(s):  
Stephan Kemmner ◽  
Christopher Holzmann-Littig ◽  
Helene Sandberger ◽  
Quirin Bachmann ◽  
Flora Haberfellner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Operating Characteristics ◽  
Lower Odds ◽  
Increased Risk

Delayed graft function (DGF) following kidney transplantation is associated with increased risk of graft failure, but biomarkers to predict DGF are scarce. We evaluated serum uromodulin (sUMOD), a potential marker for tubular integrity with immunomodulatory capacities, in kidney transplant recipients and its association with DGF. We included 239 kidney transplant recipients and measured sUMOD pretransplant and on postoperative Day 1 (POD1) as independent variables. The primary outcome was DGF, defined as need for dialysis within one week after transplantation. In total, 64 patients (27%) experienced DGF. In multivariable logistic regression analysis adjusting for recipient, donor and transplant associated risk factors each 10 ng/mL higher pretransplant sUMOD was associated with 47% lower odds for DGF (odds ratio (OR) 0.53, 95% confidence interval (95%-CI) 0.30–0.82). When categorizing pretransplant sUMOD into quartiles, the quartile with the lowest values had 4.4-fold higher odds for DGF compared to the highest quartile (OR 4.41, 95%-CI 1.54–13.93). Adding pretransplant sUMOD to a model containing established risk factors for DGF in multivariable receiver-operating-characteristics (ROC) curve analysis, the area-under-the-curve improved from 0.786 [95%-CI 0.723–0.848] to 0.813 [95%-CI 0.755–0.871, p = 0.05]. SUMOD on POD1 was not associated with DGF. In conclusion, higher pretransplant sUMOD was independently associated with lower odds for DGF, potentially serving as a non-invasive marker to stratify patients according to their risk for developing DGF early in the setting of kidney transplantation.

scholarly journals Biochemical Characteristics of Bone Mineral Metabolism before and throughout the First Year after Kidney Transplantation, Persistent Hyperparathyroidism, and Risk Factors in a Latin Population

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Lourdes Balcázar-Hernández ◽  
Guadalupe Vargas-Ortega ◽  
Baldomero González-Virla ◽  
Martha Cruz-López ◽  
Raúl Rodríguez-Gómez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Bone Mineral ◽  
Mineral Metabolism ◽  
Hypovitaminosis D ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Bone Mineral Metabolism ◽  
Persistent Hyperparathyroidism

Bone mineral metabolism disease, which included persistent hyperparathyroidism, is common after successful kidney transplantation (KT) and is related with negative outcomes in kidney transplant recipients. There is a lack of information about bone mineral metabolism, persistent hyperparathyroidism, and its risk factors in Latin kidney transplant recipients (KTRs). Material and Methods: A retrospective study was conducted in 74 patients aged 18–50 years with evolution of 12 months after KT and estimated glomerular filtration rate (eGFR) >60 ml/min; biochemical data of bone mineral metabolism before and at 1, 3, 6, and 12 months of KT were registered. Results. Age was 33 (IQR 27–37) years; 54% (n = 40) were men. Before KT, all patients had hyperparathyroidism, 40% (n = 30) hypocalcemia, 86% (n = 64) hyperphosphatemia, and 42% (n = 31) hyperphosphatasemia. After KT, an increase of calcium and a diminution of PTH, phosphorus, and alkaline phosphatase were corroborated (p=0.001). All patients had hypovitaminosis D (deficiency: 91% (n = 67); insufficiency: 9% (n = 7)); 40% (n = 30) had persistent hyperparathyroidism at 12 months. Hyperphosphatasemia before KT (OR = 4.17 (95% CI: 1.21–14.44); p=0.04), hyperparathyroidism at 6 months (OR = 1.84 (95% CI; 1.67–2.06); p=0.02), hypovitaminosis D at 6 months (OR = 3.94 (95% CI: 1.86–17.9); p=0.01), and hyperphosphatasemia at 6 months (OR = 1.47 (95% CI: 1.07–2.86); p=0.03) were risk factors for persistent hyperparathyroidism at 12 months after KT. Conclusion. Persistent hyperparathyroidism at 6 months, hypovitaminosis D, and hyperphosphatasemia are risk factors for persistent hyperparathyroidism at 1 year of KT in Latin population.

scholarly journals Gingival Overgrowth as a complication of kidney transplantation – Nepali perspective

2019 ◽  
Vol 2 (2) ◽  
pp. 259-264
Author(s):  
Swosti Thapa ◽  
Robin Bahadur Basnet ◽  
Bikal Shrestha ◽  
Amresh Thakur ◽  
Neesha Shrestha ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Oral Health ◽  
Oral Cavity ◽  
Kidney Transplant ◽  
Channel Blockers ◽  
Common Complication ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Gingival Overgrowth ◽  
Kidney Transplantations

Gingival Overgrowth is a known and common complication with multifactorial etiology seen in kidney transplant recipients. Gingival Overgrowth is induced in kidney transplant recipients by Cyclosporin A and Calcium Channel Blockers that are frequently prescribed to them as immunosuppressive and antihypertensive, respectively. There have been 1477 kidney transplantations in Nepal since the first kidney transplantation in 2008, but cases of gingival Overgrowth have not been reported in any publications. The aim of this review is to discuss the different aspects of gingival Overgrowth and its relevance to kidney transplant recipients of Nepal. This review will emphasize the need to examine the oral cavity of kidney transplant recipients. Genetic predisposition, oral health, and offending drugs are involved in the pathogenesis of gingival Overgrowth. This review discusses the pathogenesis, clinical features, and management aspects of gingival Overgrowth in kidney transplantation recipients. The reason for gingival Overgrowth not being reported in Nepal could be due to various reasons like favorable genes, good oral hygiene, or avoidance of drugs that cause gingival Overgrowth in kidney transplantation recipients. This could also be due to gingival Overgrowth being ignored by the patients and the treating doctors. These aspects are reviewed with reference to previous publications.

scholarly journals Lifestyle, Inflammation, and Vascular Calcification in Kidney Transplant Recipients: Perspectives on Long-Term Outcomes

2020 ◽  
Vol 9 (6) ◽  
pp. 1911 ◽  
Author(s):  
Camilo G. Sotomayor ◽  
Charlotte A. te Velde-Keyzer ◽  
Martin H. de Borst ◽  
Gerjan J. Navis ◽  
Stephan J.L. Bakker
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Kidney Transplant ◽  
Vascular Calcification ◽  
Graft Failure ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Long Term Outcomes

After decades of pioneering and improvement, kidney transplantation is now the renal replacement therapy of choice for most patients with end-stage kidney disease (ESKD). Where focus has traditionally been on surgical techniques and immunosuppressive treatment with prevention of rejection and infection in relation to short-term outcomes, nowadays, so many people are long-living with a transplanted kidney that lifestyle, including diet and exposure to toxic contaminants, also becomes of importance for the kidney transplantation field. Beyond hazards of immunological nature, a systematic assessment of potentially modifiable—yet rather overlooked—risk factors for late graft failure and excess cardiovascular risk may reveal novel targets for clinical intervention to optimize long-term health and downturn current rates of premature death of kidney transplant recipients (KTR). It should also be realized that while kidney transplantation aims to restore kidney function, it incompletely mitigates mechanisms of disease such as chronic low-grade inflammation with persistent redox imbalance and deregulated mineral and bone metabolism. While the vicious circle between inflammation and oxidative stress as common final pathway of a multitude of insults plays an established pathological role in native chronic kidney disease, its characterization post-kidney transplant remains less than satisfactory. Next to chronic inflammatory status, markedly accelerated vascular calcification persists after kidney transplantation and is likewise suggested a major independent mechanism, whose mitigation may counterbalance the excess risk of cardiovascular disease post-kidney transplant. Hereby, we first discuss modifiable dietary elements and toxic environmental contaminants that may explain increased risk of cardiovascular mortality and late graft failure in KTR. Next, we specify laboratory and clinical readouts, with a postulated role within persisting mechanisms of disease post-kidney transplantation (i.e., inflammation and redox imbalance and vascular calcification), as potential non-traditional risk factors for adverse long-term outcomes in KTR. Reflection on these current research opportunities is warranted among the research and clinical kidney transplantation community.

Urological complications after kidney transplant

2021 ◽  
Vol 11 (9) ◽  
pp. 526-533
Author(s):  
Paweł Polski ◽  
Monika Kusz ◽  
Adam Alzubedi
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Management Options ◽  
Transplant Survival ◽  
Diagnosis And Management ◽  
Urological Complications

Urological complications after kidney transplantation are common and can have a significant impact on the function of the transplant, survival and morbidity of the patient. This review looks at the incidence of urological complications, risk factors, diagnosis, and management options for the most common urological complications.

Incidence and Risk Factors for Leukopenia in Kidney Transplant Recipients Receiving Valganciclovir for Cytomegalovirus Prophylaxis

2018 ◽  
Vol 28 (2) ◽  
pp. 124-133 ◽  
Author(s):  
Xinyun Liang ◽  
Olusegun Famure ◽  
Yanhong Li ◽  
S. Joseph Kim
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Kidney Transplantation ◽  
Blood Cell ◽  
Cell Count ◽  
Kidney Transplant ◽  
Baseline Body Mass Index ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Blood Cell Count

Context: Valganciclovir is used not only for cytomegalovirus prophylaxis after kidney transplantation but can also induce leukopenia, thereby making patients more susceptible to other infections. The epidemiology of leukopenia in patients on valganciclovir remains poorly understood. Objective: To determine the incidence and risk factors for leukopenia in patients receiving valganciclovir for cytomegalovirus prophylaxis after kidney transplantation. Methods: In this single-center, retrospective, cohort study, we included kidney recipients transplanted from January 1, 2003, to December 31, 2010, to determine the incidence and risk factors for leukopenia in patients who received valganciclovir for cytomegalovirus prophylaxis. The Kaplan-Meier product limit method was used to graphically assess time to leukopenia, and risk factors were assessed using Cox proportional hazards models. Results: A total of 542 kidney transplant recipients were included in the study cohort. The cumulative incidence of leukopenia at 6 months posttransplant was 39.3% (11.0% for neutropenia). Low baseline white blood cell count (hazard ratio [HR] 2.34 [95% confidence interval [CI], 1.37-4.00]) and high baseline body mass index (HR 1.05 [95% CI, 1.02-1.09]) were independently associated with an increased risk of leukopenia, while higher Cockcroft-Gault creatinine clearance (HR 0.87 [95% CI, 0.78-0.97]) was significantly associated with a decreased risk of leukopenia. Conclusions: These data suggest that recipient baseline white blood cell count, baseline body mass index, and kidney function are clinical predictors of new-onset leukopenia after kidney transplantation. Our results may inform the approach to cytomegalovirus prophylaxis to reduce the risk of valganciclovir-induced leukopenia in kidney transplant recipients.

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