Trial to investigate the impact of haemodialysis before transplant surgery on early kidney allograft function

Chronic kidney disease (CKD) is recognized as an irreversible reduction of functional nephrons and leads to an increased risk of various pathological conditions, including cardiovascular disease and neurological disorders, such as coronary artery calcification, hypertension, and stroke. In addition, CKD patients have impaired immunity against bacteria and viruses. Conversely, kidney transplantation (KT) is performed for patients with end-stage renal disease as a renal replacement therapy. Although kidney function is almost normalized by KT, immunosuppressive therapy is essential to maintain kidney allograft function and to prevent rejection. However, these patients are more susceptible to infection due to the immunosuppressive therapy required to maintain kidney allograft function. Thus, both CKD and KT present disadvantages in terms of suppression of immune function. Periodontal disease is defined as a chronic infection and inflammation of oral and periodontal tissues. Periodontal disease is characterized by the destruction of connective tissues of the periodontium and alveolar bone, which may lead to not only local symptoms but also systemic diseases, such as cardiovascular diseases, diabetes, liver disease, chronic obstructive pulmonary disease, and several types of cancer. In addition, the prevalence and severity of periodontal disease are significantly associated with mortality. Many researchers pay special attention to the pathological roles and clinical impact of periodontal disease in patients with CKD or KT. In this review, we provide information regarding important modulators of periodontal disease to better understand the relationship between periodontal disease and CKD and/or KT. Furthermore; we evaluate the impact of periodontal disease on various pathological conditions in patients with CKD and KT. Moreover, pathogens of periodontal disease common to CKD and KT are also discussed. Finally, we examine the importance of periodontal care in these patients. Thus, this review provides a comprehensive overview of the pathological roles and clinical significance of periodontal disease in patients with CKD and KT.

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Fibrous Intimal Thickening at Implantation Adversely Affects Long-Term Kidney Allograft Function

Transplantation Journal ◽

10.1097/tp.0b013e31818bbe06 ◽

2009 ◽

Vol 87 (1) ◽

pp. 72-78 ◽

Cited By ~ 22

Author(s):

Annemie T. Woestenburg ◽

Gert A. Verpooten ◽

Dirk K. Ysebaert ◽

Eric A. Van Marck ◽

Dierik Verbeelen ◽

...

Keyword(s):

Intimal Thickening ◽

Kidney Allograft ◽

Allograft Function

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Preservation of epoxyeicosatrienoic acid bioavailability prevents renal allograft dysfunction and cardiovascular alterations in kidney transplant recipients

Scientific Reports ◽

10.1038/s41598-021-83274-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Thomas Duflot ◽

Charlotte Laurent ◽

Anne Soudey ◽

Xavier Fonrose ◽

Mouad Hamzaoui ◽

...

Keyword(s):

Endothelial Function ◽

Kidney Transplant ◽

Plasma Levels ◽

Renal Allograft ◽

Transplant Recipients ◽

Loss Of Function ◽

Kidney Transplant Recipients ◽

Allograft Dysfunction ◽

Allograft Function ◽

The Impact

AbstractThis study addressed the hypothesis that epoxyeicosatrienoic acids (EETs) synthesized by CYP450 and catabolized by soluble epoxide hydrolase (sEH) are involved in the maintenance of renal allograft function, either directly or through modulation of cardiovascular function. The impact of single nucleotide polymorphisms (SNPs) in the sEH gene EPHX2 and CYP450 on renal and vascular function, plasma levels of EETs and peripheral blood monuclear cell sEH activity was assessed in 79 kidney transplant recipients explored at least one year after transplantation. Additional experiments in a mouse model mimicking the ischemia–reperfusion (I/R) injury suffered by the transplanted kidney evaluated the cardiovascular and renal effects of the sEH inhibitor t-AUCB administered in drinking water (10 mg/l) during 28 days after surgery. There was a long-term protective effect of the sEH SNP rs6558004, which increased EET plasma levels, on renal allograft function and a deleterious effect of K55R, which increased sEH activity. Surprisingly, the loss-of-function CYP2C9*3 was associated with a better renal function without affecting EET levels. R287Q SNP, which decreased sEH activity, was protective against vascular dysfunction while CYP2C8*3 and 2C9*2 loss-of-function SNP, altered endothelial function by reducing flow-induced EET release. In I/R mice, sEH inhibition reduced kidney lesions, prevented cardiac fibrosis and dysfunction as well as preserved endothelial function. The preservation of EET bioavailability may prevent allograft dysfunction and improve cardiovascular disease in kidney transplant recipients. Inhibition of sEH appears thus as a novel therapeutic option but its impact on other epoxyfatty acids should be carefully evaluated.

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High urinary interleukin-2 in late post-transplant period portends a risk of decline in kidney allograft function: a preliminary study

BMC Research Notes ◽

10.1186/s13104-017-2936-7 ◽

2017 ◽

Vol 10 (1) ◽

Cited By ~ 1

Author(s):

Andriy V. Trailin ◽

Marina V. Pleten ◽

Tetyana I. Ostapenko ◽

Nadiia F. Iefimenko ◽

Olexandr S. Nykonenko

Keyword(s):

Interleukin 2 ◽

Kidney Allograft ◽

Post Transplant ◽

Allograft Function ◽

Preliminary Study

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Adverse effect of donor vasopressor support on immediate and one-year kidney allograft function

Surgery ◽

10.1016/s0039-6060(96)80014-6 ◽

1996 ◽

Vol 120 (4) ◽

pp. 663-666 ◽

Cited By ~ 40

Author(s):

Renee marshall ◽

Nasimul Ahsan ◽

Saleena Dhillon ◽

Michael Holman ◽

Harold C. Yang

Keyword(s):

Adverse Effect ◽

Kidney Allograft ◽

Vasopressor Support ◽

Allograft Function ◽

One Year

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Incidence, risk factors, and the impact of allograft pyelonephritis on renal allograft function

Transplant Infectious Disease ◽

10.1111/tid.12568 ◽

2016 ◽

Vol 18 (5) ◽

pp. 647-660 ◽

Cited By ~ 7

Author(s):

R. Singh ◽

S.E. Geerlings ◽

H. Peters-Sengers ◽

M.M. Idu ◽

C.J. Hodiamont ◽

...

Keyword(s):

Risk Factors ◽

Renal Allograft ◽

Allograft Function ◽

Incidence Risk ◽

The Impact

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Pre-Transplant Histological Assessment Provides a Useful Predictor of Subsequent Kidney Allograft Function

Transplantation Journal ◽

10.1097/01.tp.0000543076.52776.db ◽

2018 ◽

Vol 102 ◽

pp. S340-S341

Author(s):

Adam Brayne ◽

Patrick Trotter ◽

Daniel Hart ◽

Gavin Pettigrew ◽

Menna Clatworthy

Keyword(s):

Kidney Allograft ◽

Histological Assessment ◽

Allograft Function

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P1639DEVELOPMENT OF SELF-LIMITED LOW-LEVEL BK VIREMIA/VIRURIA SUGGESTS IDEAL IMMUNOSUPPRESSION TO SUPPRESS T-CELL AND ANTIBODY-MEDIATED REJECTION AND PRESERVE KIDNEY ALLOGRAFT FUNCTION

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1639 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Bettina Näf ◽

Thomas Müller ◽

Rudolf Peter Wuthrich ◽

Thomas Schachtner

Keyword(s):

Lower Incidence ◽

De Novo ◽

Allograft Survival ◽

Kidney Allograft ◽

Low Level ◽

Antibody Mediated Rejection ◽

Maintenance Immunosuppression ◽

Allograft Function ◽

High Level ◽

Egfr Slope

Abstract Background and Aims Polyomavirus BK (BKV) viremia has been suggested as a surrogate marker of overimmunosuppression. Due to recent advances in monitoring strategies and pre-emptive therapy, progression to BKV-associated nephropathy (BKVN) has been reduced. Reduction of maintenance immunosuppression during BKVN, however, has been associated with both T-cell mediated rejection (TCMR), antibody-mediated rejection (ABMR), and inferior kidney allograft outcomes. Although the administration of intravenous immunoglobulins (IVIG) failed to treat BKVN, IVIG may have properties to reduce allosensitization. Method We studied 860 kidney transplant recipients (KTRs) predominantly under tacrolimus-based triple-drug maintenance immunosuppression from 2009 to 2018. We identified 130 KTRs (15.1%) with high-level BK viremia >10,000 copies/mL (presumptive BKVN), 180 KTRs (20.9%) with low-level BK viremia <10,000 copies/mL, 85 KTRs (9.9%) with isolated BK viruria, and 465 KTRs (54.1%) with no BK viruria/viremia. Kidney allograft outcomes with respect to TCMR, ABMR, development of de novo donor-specific antibodies (DSA), kidney allograft survival, and estimated glomerular filtration rate (eGFR) slope were analysed. Due to the increased incidence of TCMR and ABMR among KTRs with presumptive BKVN, 48 of 130 KTRs (36.9%) with high-level BK viremia starting from 2015 received IVIG (0.5 g/kg of body weight) on a biweekly basis during BKV replication. Results Very interestingly, KTRs with low-level BK viremia/viruria showed a significantly lower incidence of TCMR compared to KTRs with no BK viremia/viruria and KTRs with high-level BK viremia (p<0.05). In addition, KTRs with low-level BK viremia/viruria showed a significantly lower incidence of ABMR compared to KTRs with high-level BK viremia (p<0.05). No differences were observed with respect to the development of de novo DSA (MFI>5000) between KTRs with low-level BK viremia/viruria, KTRs with no BK viremia/viruria, and KTRs with high-level BK viremia (p>0.05). KTRs with low-level BK viremia/viruria showed superior kidney allograft survival and lower eGFR slope compared to KTRs with no BK viremia/viruria and KTRs with high-level BK viremia (p<0.05). The administration of IVIG during high-level BK viremia didn’t impact the development of TCMR, ABMR, development of de novo DSA, eGFR slope, and kidney allograft survival (p<0.05). Conclusion Our results show that low-level BK viremia/viruria is associated with suppression of TCMR and ABMR in the early period posttransplantation, and preservation of kidney allograft function in the long-term. The administration of IVIG didn’t prove beneficial to reduce allosensitization among KTRs with high-level BK viremia.

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