scholarly journals Sex differences in uric acid levels in kidney transplant recipients and their donors: a preliminary retrospective cross-sectional study

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Mineaki Kitamura ◽  
Yasushi Mochizuki ◽  
Tsuyoshi Matsuda ◽  
Yuta Mukae ◽  
Hiromi Nakanishi ◽  
...  
Keyword(s):  
Renal Function ◽  
Uric Acid ◽  
Kidney Transplantation ◽  
Linear Regression ◽  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cross Sectional ◽  
Renal Prognosis ◽  
The Mean

Abstract Background Higher serum uric acid (UA) levels are associated with poorer renal prognosis. In kidney transplantation, both donors and recipients are diagnosed as having chronic kidney diseases (CKD) based on renal function; however, their UA levels slightly vary. Elucidating the differences in UA would help improve kidney prognosis, especially for recipients. Therefore, we investigated UA levels in kidney transplant recipients by comparing them to those in their donors. Methods In this retrospective cross-sectional survey, background information and blood examination results were collected from the donors just before donation and after transplantation in the donors and recipients. Associations between UA and sex estimated glomerular filtration rate (eGFR), and body mass index (BMI) were evaluated. Data were assessed by the Wilcoxon rank-sum test for continuous variables and the chi-squared test for categorical variables; multiple linear regression analyses were performed to determine which factors were associated with renal function before and after transplantation. Results Participant characteristics were as follows. The mean donor age (n = 45, 16 men and 29 women) was 55 ± 11 years, and the mean recipient age (n = 45, 25 men and 20 women) was 46 ± 16 years. Sex-related differences (UA levels in men were predominant) existed in the UA of donors before (P < 0.001) and after donation (P < 0.001). Conversely, there were no significant sex-related differences in the UA of recipients (P = 0.51); the mean standardized eGFRs were similar in donors and recipients after transplantation. Multivariate linear regression analysis showed donor UA only correlated with donor sex before donation (P = 0.008). After donation, donor UA was associated with donor sex (P = 0.006), eGFR (P < 0.001), and BMI (P = 0.02). Notably, the UA of recipients after transplantation was only associated with eGFR (P = 0.003). Conclusions Sex has less impact on UA in recipients than in donors. UA has a greater impact on renal prognosis in women than men, even at the same UA level. Therefore, attention should be given to UA levels in female recipients. These findings can be useful for determining patient prognosis following kidney transplantation in both donors and recipients.

A Cross-Sectional Study of the Association Between Chronic Oral Disease Burden and Serum Biomarkers in Kidney Transplant Recipients

2021 ◽  
pp. 152692482110648
Author(s):  
Layna Cristine Brito Rocha ◽  
Danila Lorena Nunes-dos-Santos ◽  
Elisa Miranda Costa ◽  
Samira Vasconcelos Gomes ◽  
Vandilson Pinheiro Rodrigues ◽  
...  
Keyword(s):  
Uric Acid ◽  
Kidney Transplant ◽  
Disease Burden ◽  
Serum Biomarkers ◽  
Oral Disease ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cross Sectional

Introduction Poor oral health can negatively affect general health and quality of life of kidney transplant recipients. The study aimed to investigate the association between chronic oral disease burden, serum biomarkers, and comorbidities in kidney transplant recipients. Design A cross-sectional comparative study was conducted with 44 patients after kidney transplant. The burden of chronic oral disease was composed of the following observable variables: moderate periodontitis and presence of dental caries. Serum biomarkers and comorbidities data were collected. The chi-square or Fisher's exact tests for categorical variables and Student's t-test or Mann–Whitney test for continuous variables were used. Robust Poisson regression was used to model the association. Results Higher levels of mean uric acid ( P = .01) and creatinine ( P = .03) were observed in the group of patients with oral disease burden, while the highest level of high-density lipoprotein was observed in the group without oral disease. Higher values of uric acid were associated with the occurrence of chronic oral disease burden (Adjusted PR = 1.24, 95% CI: 1.03-1.48, P = .019). There was no statistical difference between the groups with and without oral disease burden in comorbidities present. Conclusion The findings suggest that chronic oral diseases burden can be associated with uric acid and creatinine levels in kidney transplant recipients.

scholarly journals Conversion from Extended-Dose-Release Tacrolimus to Melt-Dose Tacrolimus in High Metabolizer Patients: Is the New Formulation of LPCT the Best Option for High Metabolizer Kidney Transplanted Patients?

2020 ◽  
Vol 4 (1) ◽  
pp. 18-21
Author(s):  
Paolo Carta ◽  
Federica Curci ◽  
Leonardo Caroti ◽  
Larti Aida ◽  
Lorenzo Di Maria ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Dose Level ◽  
Extended Release ◽  
Blood Levels ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Dose Ratio ◽  
New Formulation

Tacrolimus (FK506) is the most widely used anti-rejection drug in kidney transplantation, especially its extended release Tacrolimus formulation (ER-Tac, Advagraf), which is used when target blood levels can be difficult to reach in high metabolizer patients. In this retrospective monocentric study, we analyzed the effect of a switch from ER-Tac to LifeCycle Pharma Tacrolimus (LPCT, Envarsus) on the dose/level ratio of FK506 in high metabolizer patients that cannot achieve target blood levels in the first 6 months after transplantation.We observed a statistically significant improvement in the level to dose ratio after the switch. Renal function remained stable. We also observed a reduction in the development of tremors. Our data suggest that LPCT can be used in a safer way in high metabolizer kidney transplant recipients.

MO999COMPARISON OF BASILIXIMAB VS NO INDUCTION ON 12-MONTHS RENAL FUNCTION IN KIDNEY TRANSPLANT RECIPIENTS IN THE TACROLIMUS ERA

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Zdenek Lys ◽  
Ivo Valkovsky ◽  
Pavel Havranek ◽  
Jarmila Dedochova ◽  
Jana Polaskova ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
Serum Creatinine ◽  
Kidney Transplant ◽  
Interleukin 2 ◽  
Graft Function ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Median Serum ◽  
Transplant Center

Abstract Background and Aims IL2-RA (Interleukin 2 receptor antagonist) are recommended for the induction immunosuppression of kidney transplant recipients in patients with low/standard immunological risk. Studies showing the effectiveness of these substances have often been performed in patients taking cyclosporine. We aimed to find out whether the same results would be obtained with the more effective tacrolimus in an immunosuppressive regimen. Method Induction immunosuppression using IL2-RA basiliximab in all patients undergoing kidney transplantation has been routinely used in our transplant center since April 1, 2018. We retrospectively compared outcomes of kidney transplantation of the last 40 patients before introduction of induction and the first 40 patients after the induction (monitored period of analysis is June 2017 to January 2019). All patients in each group received baseline immunosuppression of tacrolimus, corticosteroid and mycophenolate. We selected patients with low immunological risk (1st transplant, panel reactive antibodies up to 20%, without donor specific antibodies, donation after brain death) in both groups and evaluated their renal outcomes (serum creatinine and estimated glomerular filtration rate/eGFR) at 12 months after transplantation. Results Patients in the groups withnout and with basiliximab induction were of comparable age (51.9 years vs. 54.7) and with similar retransplantation rate (20%). The 1-year survival of patients and kidneys was the same (97.4% patient survival and 92.1% renal survival). Renal transplant function at 12 months was analyzed in 21 patients without and 19 patients with basiliximab induction with low baseline immunological risk. The patients who received basiliximab inductive immunosuppression had better graft function 12 months compared to patients without basiliximab administration: median serum creatinine level 112 µmol/L vs. 127 µmol/L (P=0.047) and eGFR 0.85 ml/s vs. 0.77 ml/s (P=0.347). Better renal function was also shown in the subgroup of patients older than 65 years. Conclusion At our transplant center, the introduction of basiliximab induction in patients at low immunological risk led to improved graft function in the short term despite the growing subpopulation of geriatric patients.

scholarly journals THE EFFECT OF HYPERURICEMIA AND ALLOPURINOL ON OUTCOME OF KIDNEY TRANSPLANT RECIPIENTS

2021 ◽  
Author(s):  
Ersin Nazlican ◽  
Neshat Yucel ◽  
Saime Paydas ◽  
Ilker Unal
Keyword(s):  
Uric Acid ◽  
Retrospective Study ◽  
Confidence Interval ◽  
Kidney Transplant ◽  
Low Dose ◽  
Graft Loss ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Renal Functions ◽  
The Mean

OBJECTİVE: Kidney transplant recipients (KTRs) may have increased serum uric acid (SUA) level due to presence of existing greft dysfunction and used immunosuppressives. In this retrospective study, we evaluated effect of high SUA levels and allopurinol therapy in KTRs on renal functions. PATIENTS and METHODS: 113 KTRs of 233 KTRs included, had elevated SUA level (G1). Fiftyseven of G1 received allopurinol treatment (G1A+) and 56 patients (G1A-) did not. 56 of 118 patients who were followed for five years (G5) were hyperuricemic (G5-1) and 26 of G5-1 treated with allopurinol (G5-1A+) and 30 of them did not (G5-1A-). 62 patients were normourisemic (G5-2). RESULTS: Of the 233 patients included the mean age was 42.8±11.6 (17-76), 164 were male (70.0%). In 2. year graft loss developed in 9 (7.5 %) and 18 (15.9%) of G2 and G1 respectively (p = 0.045). According to allopurinol therapy 10 of the graft loss occurred in the G1A+ and 8 in the G1A- (p=0,330). Graft loss occurred in 12 (21%) and 9 (14%) in G5-1 and G5-2 respectively (p = 0.62). Graft loss occurred in 7 (23 %) and 5 (19%) in G5-1A+ and G5-1A- respectively P = 0.71). Considering the first 2 in G5; in G5-1 graft loss was higher than in the G5-2 (p = 0.023), and higher SUA levels increased the graft loss by 3.6 times compared to normal SUA levels (95% confidence interval: 1,2-12.70). CONCLUSION: There was a significant relationship between high SUA levels and graf loss in kidney transplant recipients in 2 years and 5 years. Treatment of high SUA with alIopurinol therapy had protective effect on renal functions. So that hyperuricemia should be treated and low dose allopurinol can be option for treatment of hyperuricemia therefore prevention of loss of kidney function in kidney transplant recipients.

Ultrasound elastography correlations between anthropometrical parameters in kidney transplant recipients

2019 ◽  
Vol 67 (8) ◽  
pp. 1137-1141 ◽  
Author(s):  
Leelo Järv ◽  
Ingrid Kull ◽  
Zivile Riispere ◽  
Anne Kuudeberg ◽  
Margus Lember ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Shear Wave Elastography ◽  
Ultrasound Elastography ◽  
Transplant Recipients ◽  
Donor Age ◽  
Kidney Transplant Recipients ◽  
Cross Sectional ◽  
Non Invasive ◽  
The Mean ◽  
Elasticity Measurement

Ultrasound elastography (USE) is a method to assess the stiffness of parenchymatous organs. Shear wave elastography (SWE) is considered to be the most suitable elastography method for the non-invasive kidney transplant (KTx) elasticity assessment. The aim of this study was to assess the implementability of SWE for the evaluation of kidney transplant elasticity measurement depending on the depth of an allograft, body mass index (BMI) and donor age. Secondly, to investigate the associations between SWE stiffness measurements and the clinical parameters. This cross-sectional prospective study involved consecutive 100 KTx patients were grouped according to time from transplantation and their BMI (in BMI<25 group the mean was 22.1±2.4, n=42 and in BMI≥25 group the mean BMI was 29.9±3.3, n=58). Mean estimated glomerular filtration rate was almost similar in both groups: <25 group 54.3 and ≥25 group 53.4 mL/min. Mean elastography results were found statistically different (p=0.006) BMI<25 (8.95±5.84 kPa) and BMI≥25 (5.95±3.16 kPa) groups. Significant correlation was found between SWE and the depth of the measurement (r=−0.4, p<0.05). The variations in USE stiffness values were smallest in patients group with lower BMI. In conclusion, we demonstrated that the non-invasive USE measurement stiffness result depends on a patient’s BMI, the depth of renal allograft and donor age.

scholarly journals Identifying Core Variables Associated With Health Literacy in Kidney Transplant Recipients

2020 ◽  
Vol 30 (1) ◽  
pp. 38-47 ◽  
Author(s):  
Kari Gire Dahl ◽  
Marit Helen Andersen ◽  
Kristin Hjorthaug Urstad ◽  
Ragnhild S. Falk ◽  
Eivind Engebretsen ◽  
...  
Keyword(s):  
Health Care ◽  
Kidney Transplantation ◽  
Health Literacy ◽  
Kidney Transplant ◽  
Health Care Providers ◽  
Vulnerable Groups ◽  
Care Providers ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cross Sectional

Background: A kidney transplantation requires complex self-care skills and adequate follow-up from health-care providers. Identifying strengths and limitations in different aspects of health literacy (HL) and associated variables are central to being able to improve health care. The objective of this study was to identify core variables associated with independent domains of HL 8 weeks following a kidney transplantation. Methods: A single-center cross-sectional study was conducted, wherein 159 kidney transplant recipients answered the Health Literacy Questionnaire (HLQ). Multivariable linear regression with backward elimination was used to investigate variables possibly associated with the 9 domains of HL. Results: The transplant recipients had the lowest scores in “appraisal of health information” and “navigating the healthcare system.” The highest scores were found in “feeling understood and supported by health-care providers” and “ability to actively engage with health-care provider.” General perceived self-efficacy, transplant-specific knowledge, and general health were the driving variables in several of the HL domains. Conclusions: The HLQ provides a more complex picture of strengths and limitations related to HL, as well as important knowledge about vulnerable groups following a kidney transplantation. The study offers an important supplement to the field of HL in kidney transplant care.

scholarly journals The association of serum uromodulin with allograft function and risk of urinary tract infection in kidney transplant recipients

2020 ◽  
Vol 10 (1) ◽  
pp. e02-e02
Author(s):  
Vahideh Ebrahimzadeh Attari ◽  
Arezoo Maddah ◽  
Zahra Shahveghar Asl ◽  
Mahsa Jalili ◽  
Mohammad Reza Ardalan ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Renal Function ◽  
Urinary Tract ◽  
Tract Infection ◽  
Kidney Transplant ◽  
Cross Sectional Study ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplantation ◽  
Cross Sectional

Introduction: There is some evidence to suggest that low levels of uromodulin in urine and serum are associated with decreased renal function and increased mortality risk. Objectives: This study is designed to measure circulating uromodulin levels and explore their relationship to urinary tract infection and renal function in kidney transplant recipients. Patients and Methods: In this cross-sectional study, 90 eligible kidney transplant recipients were evaluated 6–12 months of post-transplantation. Fasting blood samples were taken to determine the serum level of uromodulin with urea, creatinine, and other biochemical characteristics. Urine samples were taken for analysis and culture. Kidney function was estimated based on the chronic kidney disease epidemiology collaboration (CKD-EPI) creatinine equation and the modification of diet in renal disease (MDRD) equation. Results: Patients’ serum uromodulin levels were significantly correlated with their serum creatinine (P = 0.024) and estimated glomerular filtration rate by the EPI equation (eGFR-EPI, P = 0.038). There was no significant association between serum uromodulin levels and incidence of urinary tract infection of post-transplantation (P > 0.05). Conclusion: Serum and urine uromodulin levels may be regarded as the predictive indicators of renal function. However, given the lack of studies on the association between serum uromodulin levels and urinary tract infection risks in kidney transplant recipients, further research is needed to clarify uromodulin’s protective effect against urinary tract infection.

scholarly journals Plasmapheresis Reduces Mycophenolic Acid Concentration: A Study of Full AUC0–12 in Kidney Transplant Recipients

2019 ◽  
Vol 8 (12) ◽  
pp. 2084 ◽  
Author(s):  
Sudarat Piyasiridej ◽  
Natavudh Townamchai ◽  
Suwasin Udomkarnjananun ◽  
Somratai Vadcharavivad ◽  
Krit Pongpirul ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Mycophenolic Acid ◽  
Cross Sectional Study ◽  
Immunosuppressive Drug ◽  
Kidney Transplant Recipients ◽  
Cross Sectional ◽  
Transplant Patients ◽  
The Mean ◽  
The Difference

Background: Mycophenolic acid (MPA), a crucial immunosuppressive drug, and plasmapheresis, an effective immunoreduction method, are simultaneously used for the management of various immune-related diseases, including kidney transplantation. While plasmapheresis has been proven efficient in removing many substances from the blood, its effect on MPA plasma levels remains unestablished. Objectives: To evaluate the full pharmacokinetics of MPA by measuring the area under the time–concentration curve (AUC0–12), which is the best indicator for MPA treatment monitoring after each plasmapheresis session, and to compare the AUC0–12 measurements on the day with and on the day without plasmapheresis. Methods: A cross-sectional study was conducted in kidney transplantation recipients who were taking a twice-daily oral dose of mycophenolate mofetil (MMF, Cellcept®) and undergoing plasmapheresis at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, during January 2018 and January 2019. The MPA levels were measured by an enzymatic method (Roche diagnostic®) 0, 1/2, 1, 2, 3, 4, 6, 8, and 12 h after MMF administration, for AUC0–12 calculation on the day with and on the day without plasmapheresis sessions. Plasmapheresis was started within 4 h after administering the oral morning dose of MMF. Our primary outcome was the difference of AUC0–12 between the day with and the day without plasmapheresis. Results: Forty complete AUC measurements included 20 measurements on the plasmapheresis day and other 20 measurements on the day without plasmapheresis in six kidney transplant patients. The mean age of the patients was 56.2 ± 20.7 years. All patients had received 1000 mg/day of MMF for at least 72 h before undergoing 3.5 ± 1.2 plasmapheresis sessions. The mean AUC on the day with plasmapheresis was lower than that on the day without plasmapheresis (28.22 ± 8.21 vs. 36.79 ± 10.29 mg × h/L, p = 0.001), and the percentage of AUC reduction was 19.49 ± 24.83%. This was mainly the result of a decrease in AUC0–4 of MPA (23.96 ± 28.12% reduction). Conclusions: Plasmapheresis significantly reduces the level of full AUC0–12 of MPA. The present study is the first to measure the full AUC0–12 in MPA-treated patients undergoing plasmapheresis. Our study suggests that a supplementary dose of MPA is necessary for patients undergoing plasmapheresis.

scholarly journals The association of serum dephosphorylated-uncarboxylated matrix gamma carboxyglutamate protein (dp-ucMGP) as a marker of vascular vitamin K status with allograft function in kidney transplant recipients

2019 ◽  
Vol 9 (3) ◽  
pp. e24-e24
Author(s):  
Vahideh Ebrahimzadeh Attari ◽  
Zahra Shahvegharasl ◽  
Pouya Fathalizadeh ◽  
Sajjad Pourasghary ◽  
Mohammadali Mohajel Shoja ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Serum Level ◽  
Kidney Transplant ◽  
Kidney Function ◽  
Vitamin K ◽  
High Serum ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cross Sectional ◽  
Allograft Function

Introduction: Kidney transplantation has considerably increased the survival and life quality of patients with end-stage renal disease. Objectives: The current study was designed to investigate the circulating level of dephosphorylateduncarboxylated matrix gamma carboxyglutamate protein (dp-ucMGP) as a marker of vitamin K status and vascular calcification in kidney transplant recipients as well as its association with the allograft function. Patients and Methods: In this cross-sectional study, 90 eligible kidney transplant recipients were evaluated in the post-transplant phase (about 6-12 months after kidney transplantation). The serum levels of dp-ucMGP, urea, creatinine and other biochemical indices were determined. Results: The mean serum level of dp-ucMGP was 3.78±3.79 µg/L. Most of the participants (80%) had a normal range of serum dp-ucMGP (<4 µg/L). However, 10 % had high serum dp-ucMGP (>12 µg/L). Serum dp-ucMGP did not have any statistical significant association with serum urea, creatinine and kidney function (P>0.05). Conclusion: Further epidemiologic studies are needed to assess the time trends of dp-ucMGP after renal transplant and its relation to kidney function, since high serum level of dp-ucMGP may make kidney transplant recipients prone to various cardiovascular disease (CVD) and transplant rejection.

Sign in / Sign up

Export Citation Format

Share Document