Hepatitis C Therapy with Long Term Remission after Renal Transplantation

2002 ◽  
Vol 25 (12) ◽  
pp. 1189-1193 ◽  
Author(s):  
S. Bunnapradist ◽  
F. Fabrizi ◽  
J. Vierling ◽  
P. Martin ◽  
A. Moudgil ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Hepatitis C ◽  
Antiviral Agents ◽  
Hcv Infection ◽  
Induction Phase ◽  
Limited Information ◽  
Post Transplantation ◽  
Stage Renal Disease ◽  
End Stage

Hepatitis C virus infection (HCV) is common in patients with end-stage renal disease (ESRD) and long observation periods have shown the detrimental effect of HCV infection on patient and graft survival after renal transplantation. At present, interferon is the most important agent for the treatment of hepatitis C in ESRD; however, limited information exists concerning the long-term response of patients who undergo renal transplantation after successful antiviral therapy. We describe the evolution of HCV infection in a dialysis patient with hepatitis C who was successfully treated with interferon alpha and then underwent renal transplantation. He received aggressive immunosuppression during the induction phase and for allograft rejection; however, regular screening showed complete absence of biochemical and virological relapse of HCV over a 6-year post-transplantation period. We conclude that interferon can offer excellent response in selected dialysis patients with hepatitis C. Alternative strategies with newer antiviral agents are currently under active investigation.

scholarly journals Effects of renal transplantation on erectile dysfunction: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Irham Arif Rahman ◽  
Nur Rasyid ◽  
Ponco Birowo ◽  
Widi Atmoko
Keyword(s):  
Systematic Review ◽  
Erectile Dysfunction ◽  
Kidney Transplantation ◽  
Renal Transplantation ◽  
End Stage Renal Disease ◽  
Erectile Function ◽  
Meta Analysis ◽  
Post Transplantation ◽  
Stage Renal Disease ◽  
End Stage

AbstractErectile dysfunction (ED) is a major global health burden commonly observed in patients with end-stage renal disease (ESRD). Although renal transplantation improves the problem in some patients, it persists in ≈20–50% of recipients. Studies regarding the effects of kidney transplantation on ED present contradictory findings. We performed a systematic review to summarise the effects of kidney transplantation on ED. A systematic literature search was performed across PubMed, Cochrane, and Scopus databases in April 2020. We included all prospective studies that investigated the pre and posttransplant international index of erectile function (IIEF-5) scores in recipients with ED. Data search in PubMed and Google Scholar produced 1326 articles; eight were systematically reviewed with a total of 448 subjects. Meta-analysis of IIEF-5 scores showed significant improvements between pre and post transplantation. Our findings confirm that renal transplantation improves erectile function. Furthermore, transplantation also increases testosterone level. However, the evidence is limited because of the small number of studies. Further studies are required to investigate the effects of renal transplantation on erectile function.

scholarly journals Calcium Metabolism following Renal Transplantation

1994 ◽  
Vol 31 (2) ◽  
pp. 125-128 ◽  
Author(s):  
Anne M Straffen ◽  
DJS Carmichael ◽  
Angela Fairney ◽  
B Hulme ◽  
M Snell
Keyword(s):  
Renal Transplantation ◽  
Calcium Homeostasis ◽  
End Stage Renal Disease ◽  
Post Transplantation ◽  
Dihydroxyvitamin D ◽  
1,25 Dihydroxyvitamin D ◽  
Transplant Patients ◽  
The Status ◽  
Stage Renal Disease ◽  
End Stage

Abnormalities of calcium homeostasis are a recognized feature of end-stage renal disease. The treatment of choice is renal transplantation, but this does not always result in normalization of the biochemical profile. Persistent hypercalcaemia is well documented and our study was undertaken to investigate the status of the calcium regulating hormones in renal patients post-transplantation. Serum calcium, parathyroid hormone, 1,25-dihydroxyvitamin D (1,25(OH)2D) and osteocalcin concentrations were measured in post-transplant patients. Twenty per cent of the patients had subnormal 1,25(OH)2D concentrations while 55% had biochemical evidence of hyperparathyroidism but only 5% were hypercalcaemic. Time elapsed since transplantation was not correlated with any of the analytes investigated and there was no relationship between persistent impairment of renal function and abnormalities of calcium homeostasis.

The impact of renal transplantation on survival in hepatitis C-positive end-stage renal disease patients

1997 ◽  
Vol 29 (4) ◽  
pp. 608-614 ◽  
Author(s):  
Greg A. Knoll ◽  
Martha R. Tankersley ◽  
Jeannette Y. Lee ◽  
Bruce A. Julian ◽  
John J. Curtis
Keyword(s):  
Renal Transplantation ◽  
Hepatitis C ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

‘Real-life’ experience with direct-acting antiviral agents for hepatitis C virus in end-stage renal disease

2018 ◽  
Vol 41 (7) ◽  
pp. 363-370 ◽  
Author(s):  
Rebeca García-Agudo ◽  
Sami Aoufi-Rabih ◽  
Mercedes Salgueira-Lazo ◽  
Carmen González-Corvillo ◽  
Fabrizio Fabrizi
Keyword(s):  
Chronic Kidney Disease ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
End Stage Renal Disease ◽  
Antiviral Agents ◽  
Direct Acting Antiviral ◽  
Stage Renal Disease ◽  
Direct Acting ◽  
End Stage ◽  
Direct Acting Antiviral Agents

Background and Aims: The advent of direct-acting antiviral agents promises to change the management of hepatitis C in patients with end-stage renal disease, a patient group where the treatment of hepatitis C was historically challenging. We investigated the safety and efficacy of all-oral, interferon-free direct-acting antiviral agents for the treatment of hepatitis C in a ‘real-world’ group of patients with end-stage renal disease. Methods: We performed a single-arm, multi-centre study in a cohort (n=30) of patients with advanced chronic kidney disease (mostly on dialysis) who underwent antiviral therapy with direct-acting antiviral agents. The primary end-point was sustained virologic response (serum hepatitis C virus RNA < 15 mIU/mL, 12 weeks after treatment ended). We collected data on on-treatment adverse events, serious adverse events and laboratory abnormalities. Results: In total, 23 (77%) and 7 (23%) patients underwent regular dialysis and had chronic kidney disease at pre-dialysis stage, respectively. Six regimens were adopted: elbasvir/grazoprevir ( n = 6), ledipasvir/sofosbuvir ± ribavirin ( n = 4), PrOD regimens ± ribavirin ( n = 10), simeprevir + daclatasvir ( n = 3), sofosbuvir + daclatasvir ± ribavirin ( n = 3), sofosbuvir + ribavirin ( n = 4). The SVR12 rate was 90% (95% confidence interval, 74%; 96%). A total of 27 (90%) patients achieved SVR12; there were three virologic failures – two were non-responders and one had a viral breakthrough while on therapy. Adverse events occurred in 53% (16/30) (95% confidence interval, 0.39; 0.73) of patients and were managed clinically without discontinuation of therapy or hospitalization. The most common adverse event was anaemia ( n = 12) that required blood transfusions in seven individuals; deterioration of kidney function occurred in one (14%). Conclusion: All-oral, interferon-free therapy with direct-acting antiviral agents for chronic hepatitis C virus in advanced chronic kidney disease was effective and well tolerated in a ‘real-life’ clinical setting. Careful monitoring of haemoglobin and serum creatinine during therapy with direct-acting antiviral agents is suggested. Studies are under way to address whether sustained viral response translates into better survival in this population.

scholarly journals Diálise Peritoneal nos Dois Primeiros Anos de Vida: Experiência de uma Unidade de Nefrologia e Transplantação Renal Pediátrica

2016 ◽  
Vol 29 (9) ◽  
pp. 525
Author(s):  
Sofia Deuchande ◽  
Tânia Mano ◽  
Cristina Novais ◽  
Rute Machado ◽  
Rosário Stone ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Term Survival ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Peritoneal dialysis is the dialytic method of choice in chronic end-stage renal disease in children. This study main purposewas to characterize the long-term survival of a pediatric population who began peritoneal dialysis within the first two years of life.Material and Methods: A descriptive and retrospective study was performed in a portuguese nephrology and renal transplantation pediatric unit, between January 1991 and August 2014. End-stage renal disease etiology, mortality, comorbidities and complications of peritoneal dialysis and end-stage renal disease, growth and psychomotor development were evaluated.Results: Twenty children started peritoneal dialysis within the first two years of life. There were six deaths, but no deaths of children with primary chronic kidney disease were registered over the past decade. The 14 living children were characterized; 13 were males. Congenital abnormalities of the kidney and urinary tract were the leading etiology of chronic kidney disease (45%). The average age start of peritoneal dialysis was 6.1 months; six children started before 30 days of life. Peritonitis was the most frequent cause of hospitalization. Ten children were transplanted at an average age of 5.3 years. All of the children who are still in peritoneal dialysis have short stature, but nine of the transplanted have final height within the expected for their mid-parental height target range. Nine (64%)had some type of neurodevelopmental delay.Discussion: Peritoneal dialysis is a technique possible and feasible since birth, as evidenced in the study, as more than half of children successfully started it before 6 months of life. It allows long-term survival until the possibility of renal transplantation despite the associated morbidity, including peritonitis and complications of chronic renal disease. The ten transplanted children improved their growth, recovered from chronic anemia and improved dyslipidemia, compared with the period of dialysis. However, the average waiting time until the renal transplant was 5.3 years higher than other international centers.Conclusion: These data support the use of peritoneal dialysis from birth, but complications and the worst growth reflect the need to develop strategies to optimize care relating to nutrition, growth and development and to reduce pre-transplant time.

scholarly journals The outcome of Daclatasvir and low dose Sofosbuvir therapy in end-stage renal disease patients with hepatitis C virus infection

2020 ◽  
pp. 3-8
Author(s):  
M. Mostafi ◽  
M. Jabin ◽  
Z. Chowdhury ◽  
M.U. Khondoker ◽  
S.M. Ali ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Side Effects ◽  
End Stage Renal Disease ◽  
Low Dose ◽  
Hcv Infection ◽  
Full Dose ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Rapid progression of chronic kidney disease (CKD) is seen in patients with hepatitis C virus (HCV) infection compared with uninfected patients. Despite the high efficacy of direct-acting antivirals (DAAVs), their cost represents a limiting factor to their use in developing countries. Aim. This study aimed to evaluate the efficacy of low dose Sofosbuvir along with Daclatasvir in the management of HCV infection in end-stage renal disease (ESRD) patients. Methods. A total of 82 HCV positive patients on ESRD were included in this study. The patients were observed for six months without antiviral drugs. Patients who remained seropositive were divided into two groups. The first group included 26 (37%) patients who were treated with half-dose Sofosbuvir 200 mg and Daclatasvir 60 mg and the second group consisted of 44 (63%) patients who have been treated with full-dose Sofosbuvir 400 mg and Velpatasvir 100 mg irrespective of HCV infection genotype for 12 weeks also. Results. 12 (14%) patients became seronegative spontaneously. All patients (100%) of both groups achieved sustained virological response with undetectable HCV RNA in 12 weeks of the treatment. There were nonsignificant gastrointestinal side effects in the full dose Sofosbuvir group. All patients tolerated the DAAs well. No patient discontinued antiviral therapy due to side effects Conclusion. In this study, the spontaneous seroconversion of HCV was 14%. Low-dose Sofosbuvir along with Daclatasvir was safe and as effective as full-dose Sofosbuvir and Velpatasvir in the treatment of HCV in ESRD patients. Low-dose Sofosbuvir regimen can be recommended for HCV infection treatment in ESRD patients.

scholarly journals Evaluation of long-term outcomes of deceased donor renal transplantation in patients with end-stage renal disease

2019 ◽  
Vol 8 (2) ◽  
pp. 29-29
Author(s):  
Jaiju James Chakola ◽  
Varun Mamidi ◽  
Vamsi Krishna Makkena ◽  
Jayakumar Matcha ◽  
Ramprasad Elumalai
Keyword(s):  
Renal Transplantation ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Deceased Donor ◽  
Long Term Outcomes ◽  
Stage Renal Disease ◽  
End Stage
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