scholarly journals Clinical factors associated with severe hypophosphataemia after kidney transplant

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Maximilian R. Ralston ◽  
Karen S. Stevenson ◽  
Patrick B. Mark ◽  
Colin C. Geddes
Keyword(s):  
Linear Regression ◽  
Living Donor ◽  
Linear Regression Analysis ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Donor Age ◽  
Single Centre ◽  
Post Transplantation ◽  
Factors Associated ◽  
Donor Transplant

Abstract Background The mechanism by which hypophosphataemia develops following kidney transplantation remains debated, and limited research is available regarding risk factors. This study aimed to assess the association between recipient and donor variables, and the severity of post-transplantation hypophosphataemia. Methods We performed a single-centre retrospective observational study. We assessed the association between demographic, clinical and biochemical variables and the development of hypophosphataemia. We used linear regression analysis to assess association between these variables and phosphate nadir. Results 87.6% of patients developed hypophosphataemia. Patients developing hypophosphataemia were younger, had a shorter time on renal replacement therapy, were less likely to have had a parathyroidectomy or to experience delayed graft function, were more likely to have received a living donor transplant, from a younger donor. They had higher pre-transplantation calcium levels, and lower alkaline phosphatase levels. Receipt of a living donor transplant, lower donor age, not having had a parathyroidectomy, receiving a transplant during the era of tacrolimus-based immunosuppression, not having delayed graft function, higher pre-transplantation calcium, and higher pre-transplantation phosphate were associated with lower phosphate nadir by multiple linear regression. Conclusions This analysis demonstrates an association between variables relating to better graft function and hypophosphataemia. The links with biochemical measures of mineral-bone disease remain less clear.

CYP3A5*3 and CYP2C8*3 variants influence exposure and clinical outcomes of tacrolimus-based therapy

2020 ◽  
Vol 21 (1) ◽  
pp. 7-21 ◽  
Author(s):  
Fabiana Dalla Vecchia Genvigir ◽  
Antony Brayan Campos-Salazar ◽  
Claudia Rosso Felipe ◽  
Helio Tedesco-Silva ◽  
José Osmar Medina-Pestana ◽  
...  
Keyword(s):  
Protective Factors ◽  
Clinical Outcomes ◽  
Living Donor ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Early Exposure ◽  
Post Transplantation ◽  
Kidney Recipients ◽  
Reduced Risk

Aim: The influence of variants in pharmacokinetics-related genes on long-term exposure to tacrolimus (TAC)-based therapy and clinical outcomes was investigated. Patients & methods: Brazilian kidney recipients were treated with TAC combined with everolimus (n = 178) or mycophenolate sodium (n = 97). The variants in CYP2C8, CYP2J2, CYP3A4, CYP3A5, POR, ABCB1, ABCC2, ABCG2, SLCO1B1 and SLCO2B1 were analyzed. Main results: CYP3A5*3/*3 genotype influenced increase in TAC concentration from week 1 to month 6 post-transplantation (p < 0.05). The living donor and CYP2C8*3 variant were associated with reduced risk for delayed graft function (OR = 0.07; 95% CI = 0.03–0.18 and OR = 0.45; 95% CI = 0.20–0.99, respectively, p < 0.05). Conclusion: The CYP3A5*3 variant is associated with increased early exposure to TAC. Living donor and CYP2C8*3 variant seem to be protective factors for delayed graft function in kidney recipients.

scholarly journals Lower rate of delayed graft function is observed when epidural analgesia for living donor nephrectomy is administered

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Wolfgang Baar ◽  
Ulrich Goebel ◽  
Hartmut Buerkle ◽  
Bernd Jaenigen ◽  
Kai Kaufmann ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Living Donor ◽  
Graft Function ◽  
Donor Nephrectomy ◽  
Delayed Graft Function ◽  
Living Donor Nephrectomy

scholarly journals Hospitalization costs among immobile patients with hemorrhagic or ischemic stroke in China: a multicenter cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hongpeng Liu ◽  
Chen Zhu ◽  
Jing Cao ◽  
Jing Jiao ◽  
Baoyun Song ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Ischemic Stroke ◽  
Linear Regression ◽  
Average Length ◽  
Linear Regression Analysis ◽  
Hospital Charges ◽  
Hospital Level ◽  
Cross Sectional ◽  
Factors Associated ◽  
Hospitalization Costs

Abstract Background In this study, we aimed to analyze the hospitalization costs for immobile patients with hemorrhagic stroke (IHS) or ischemic stroke (IIS) in China and to determine the factors associated with hospitalization costs. Methods We evaluated patients with IHS and IIS hospitalized between November 2015 and July 2016 in six provinces or municipality cities of China. Linear regression analysis was used to examine the association with hospitalization costs and predictors. Results In total, 1573 patients with IHS and 3143 with IIS were enrolled and analyzed. For IHS and IIS, the average length of stay (LoS) was 17.40 ± 12.3 and 14.47 ± 11.55 days. The duration of immobility was 12.11 ± 9.98 and 7.36 ± 9.77 days, respectively. Median hospitalization costs were RMB 47000.68 (interquartile range 19,827.37, 91,877.09) for IHS and RMB 16578.44 (IQR 7020.13, 36,357.65) for IIS. In both IHS and IIS groups, medicine fees accounted for more than one-third of hospitalization costs. Materials fees and medical service fees accounted for the second and third largest proportions of hospital charges in both groups. Linear regression analysis showed that LoS, hospital level, and previous surgery were key determinants of hospitalization costs in all immobile patients with stroke. Subgroup analysis indicated that hospital level was highly correlated with hospitalization costs for IHS whereas pneumonia and deep vein thrombosis were key factors associated with hospitalization costs for IIS. Conclusions We found that hospitalization costs were notably higher in IHS than IIS, and medicine fees accounted for the largest proportion of hospitalization costs in both patient groups, perhaps because most patients ended up with complications such as pneumonia thereby requiring more medications. LoS and hospital level may greatly affect hospitalization costs. Increasing the reimbursement ratio of medical insurance for patients with IHS is recommended. Decreasing medicine fees and LoS, preventing complications, and improving treatment capability may help to reduce the economic burden of stroke in China.

Donor Age Amplifies the Detrimental Effects of Cold Ischemia Time on Long-Term Kidney Allograft Survival Independently of the Occurrence of Delayed Graft Function or Early Acute Rejection

2020 ◽  
Vol 18 (4) ◽  
pp. 436-443
Author(s):  
Pedro Rincon Cintra da Cruz ◽  
Aderivaldo Cabral Dias Filho ◽  
Viviane Brandão Bandeira Mello Santana ◽  
Rubia Bethania Biela Boaretto ◽  
Cassio Luis Zanettini Riccetto
Keyword(s):  
Acute Rejection ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Cold Ischemia Time ◽  
Donor Age ◽  
Allograft Survival ◽  
Cold Ischemia ◽  
Kidney Allograft ◽  
Ischemia Time

scholarly journals Perioperative factors associated with delayed graft function in renal transplant patients

2018 ◽  
Vol 40 (4) ◽  
pp. 360-365
Author(s):  
Milton Halyson Benevides de Freitas ◽  
Luciana Cavalcanti Lima ◽  
Tania Cursino de Menezes Couceiro ◽  
Wilton Bernadino da Silva ◽  
João Marcelo de Andrade ◽  
...  
Keyword(s):  
Risk Factor ◽  
Renal Transplantation ◽  
Renal Transplant ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Cold Ischemia Time ◽  
Cold Ischemia ◽  
Factors Associated ◽  
Combined Anesthesia ◽  
Anesthesia Technique

ABSTRACT Introduction: Successful renal transplant and consequent good graft function depend on a good surgical technique, an anesthetic that ensures the hemodynamic stability of the receiver, and appropriate conditions of graft and recipient. Several factors can interfere with the perfusion of the graft and compromise its viability. The objective of this study was to evaluate perioperative factors associated with delayed graft function (DGF) in renal transplantation patients. Methods: This is a historical cohort study of patients who underwent renal transplantation between 2011 and 2013. Three hundred and ten transplants were analyzed. DGF was defined as the need for dialysis during the first week post-transplant. Logistic regression with a stepwise technique was used to build statistical models. Results: Multivariate analysis revealed the following risk factor for DGF: combined anesthesia technique (OR = 3.81, 95%CI, 1.71 to 9.19), a fluid regimen < 50 mL·kg-1 (OR = 3.71, 95%CI, 1.68 to 8.61), dialysis for more than 60 months (OR = 4.77, 95%CI, 1.93 to 12.80), basiliximab (OR = 3.34, 95%CI, 1.14 to 10.48), cold ischemia time > 12 hour (OR = 5.26, 95%CI, 2.62 to 11.31), living donor (OR = 0.19, 95%CI, 0.02 to 0.65), and early diuresis (OR = 0.02, 95%CI, 0.008 to 0.059). The accuracy of this model was 92.6%, calculated using the area under the ROC curve. The incidence of DGF in the study population was 76.1%. Conclusions: Combined anesthesia technique, dialysis for more than 60 months, basiliximab, and cold ischemia time > 12 hours are risk factor for DGF, while liberal fluid regimens and kidneys from living donors are protective factors.

scholarly journals Factors Associated With Delayed Graft Function and Their Influence on Outcomes of Kidney Transplantation

2016 ◽  
Vol 48 (7) ◽  
pp. 2267-2271 ◽  
Author(s):  
F. Salazar Meira ◽  
J. Zemiacki ◽  
A.E. Figueiredo ◽  
L. Viliano Kroth ◽  
D. Saute Kochhann ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Factors Associated
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