scholarly journals GIPERPARATIREOZ POSLEALLOTRANSPLANTATsII TRUPNOY POChKII ORTOTOPIChESKOY TRANSPLANTATsII SERDTsA

2008 ◽  
Vol 11 (2) ◽  
pp. 16-21
Author(s):  
I. A. PRONChENKO ◽  
I. P. ERMAKOVA ◽  
N. A. TOMILINA ◽  
R. N. VEDERNIKOVA ◽  
T. K. KOLIAShVILI ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
Femoral Neck ◽  
Heart Transplantation ◽  
Kidney Transplant ◽  
Men And Women ◽  
Estrogen Level ◽  
Kidney Recipients ◽  
Hemodialysis Duration ◽  
Pth Level

Analyses of frequency, rate, main rise mechanisms of hyperparatyroidism and its role in bone losses were estimated in crossmatch research of 158 kidney and 25 heart recipients. Hyperparathyroidism frequency was more following kidney then heart transplantation (74% vs 36%, p=0,000), PTH level being higher in kidney recipients and in women higher then in men with kidney transplant. Hyperparathyroidism in women was associated with hemodialysis duration before operation and the estrogen level which was more in pre- then in postmenopause while PTH level was lesser in pre- then postmenopause. In men PTH level as in heart as in kidney groups was associated with renal function and cumulative prednisolone doses. Hyperparathyroidism in men and women after kidney transplantation followed aхial BMD losses so as in men after kidney and heart transplantation -periferal skeleton (femoral neck) BMD losses.

scholarly journals A Kidney Transplant Recipient with Recurrent Henoch-Schönlein Purpura Nephritis Successfully Treated with Steroid Pulse Therapy and Epipharyngeal Abrasive Therapy

Nephron ◽  
2020 ◽  
pp. 1-5
Author(s):  
Mika Fujimoto ◽  
Kan Katayama ◽  
Kouhei Nishikawa ◽  
Shoko Mizoguchi ◽  
Keiko Oda ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
Transplant Recipient ◽  
Kidney Transplant ◽  
Kidney Transplant Recipient ◽  
Pulse Therapy ◽  
Steroid Pulse Therapy ◽  
Steroid Pulse ◽  
Schonlein Purpura ◽  
Purpura Nephritis

There is no specific treatment for recurrent Henoch-Schönlein purpura nephritis (HSPN) in a transplanted kidney. We herein report a case of a kidney transplant recipient with recurrent HSPN that was successfully treated with steroid pulse therapy and epipharyngeal abrasive therapy (EAT). A 39-year-old Japanese man developed HSPN 4 years ago and had to start hemodialysis after 2 months despite receiving steroid pulse therapy followed by oral prednisolone, plasma exchange therapy, and cyclophosphamide pulse therapy. He had undergone tonsillectomy 3 years earlier in the hopes of achieving a better outcome of a planned kidney transplantation and received a living-donor kidney transplantation from his mother 1 year earlier. Although there were no abnormalities in the renal function or urinalysis 2 months after transplantation, a routine kidney allograft biopsy revealed evidence of mesangial proliferation and cellular crescent formation. Mesangial deposition for IgA and C3 was noted, and he was diagnosed with recurrent HSPN histologically. Since the renal function and urinalysis findings deteriorated 5 months after transplantation, 2 courses of steroid pulse therapy were performed but were ineffective. EAT using 0.5% zinc chloride solution once per day was combined with the third course of steroid pulse therapy, as there were signs of chronic epipharyngitis. His renal function recovered 3 months after daily EAT and has been stable for 1.5 years since transplantation. Daily EAT continued for >3 months might be a suitable strategy for treating recurrent HSPN in cases of kidney transplantation.

scholarly journals Analysis of the physical aspects of quality of life of kidney recipients

2015 ◽  
Vol 49 (1) ◽  
pp. 76-81 ◽  
Author(s):  
Ana Elza Oliveira de Mendonça ◽  
Marina de Góes Salvetti ◽  
Eulália Maria Chaves Maia ◽  
Ana Cristina de Oliveira e Silva ◽  
Gilson de Vasconcelos Torres
Keyword(s):  
Quality Of Life ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
World Health ◽  
Need For Treatment ◽  
Kidney Recipients ◽  
Quality Of Life Scale ◽  
Before And After ◽  
Health Organization

OBJECTIVE To identify the main factors of the physical domain modified after kidney transplantation and analyze the influence of those aspects in the perception of Overall quality of life (QOL). METHOD Longitudinal study, conducted with 63 chronic kidney patients, evaluated before and after kidney transplant, using the quality of life scale proposed by the World Health Organization. RESULTS We observed significant improvement in the physical aspects of QOL after kidney transplantation. Significant correlations were observed between physical aspects and the Overall QOL. CONCLUSION The kidney transplant generated improvement in all physical aspects of QOL. The factors that showed stronger correlation with the Overall QOL before the transplant were the capacity to work and pain. After the transplant, the perception of need for treatment was the factor that showed stronger correlation with the Overall QOL.

scholarly journals The incidence of interstitial and vascular kidney rejection after pancreas-kidney transplantation.

1995 ◽  
Vol 5 (11) ◽  
pp. 1918-1925
Author(s):  
J G Boonstra ◽  
J A Bruijn ◽  
J Hermans ◽  
H H Lemkes ◽  
J Ringers ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Graft Survival ◽  
Induction Therapy ◽  
Vascular Rejection ◽  
Renal Graft ◽  
Kidney Recipients ◽  
Kidney Rejection ◽  
Pancreas Kidney Transplantation ◽  
Renal Graft Survival

Several groups have reported that recipients of a simultaneous pancreas-kidney transplantation suffer from more kidney rejection episodes than do recipients of a kidney transplantation (1-6). However, it is not known whether this is interstitial rejection, vascular rejection, or both. In this study, the renal biopsies and transplantectomies of 45 pancreas-kidney and 48 kidney transplant recipients were evaluated for the presence of interstitial and vascular rejection. Furthermore, the influence of OKT3 induction therapy on rejection after pancreas-kidney transplantation was studied. Of the 45 pancreas-kidney recipients. 4 patients did not suffer from rejection during follow-up, 28 suffered only from interstitial rejection, and 13 suffered from vascular (with or without interstitial) rejection, whereas 12, 19, and 14 of the 48 kidney transplant patients had no rejection, interstitial rejection, or vascular (with or without interstitial) rejection, respectively. Three patients with a kidney transplant were treated for rejection although no biopsy was taken. In the pancreas-kidney group, 38 of the total of 149 biopsies and transplantectomies taken contained no rejection, 92 had interstitial rejection, and 19 had vascular rejection. In the kidney group, these values were 13, 41, and 25, respectively, of 79 biopsies and transplantectomies taken (P = 0.002). Five-year renal graft survival was 79% in the kidney group and 60% in the pancreas-kidney group. Renal graft survival rates differed significantly (P = 0.02). Renal graft survival and occurrence of rejection did not reach significance between pancreas-kidney recipients treated with OKT3 induction therapy and pancreas-kidney recipients receiving conventional triple therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

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 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.

scholarly journals Cardiac Inotropes Offer Protection of Renal Function in Patients with Kidney Transplantation

2020 ◽  
Vol 45 (2) ◽  
pp. 331-338
Author(s):  
Ning Guo ◽  
Zehua Wang ◽  
Laurine M. Bow ◽  
Xianquan Cui ◽  
Luwei Zhang ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
Treatment Group ◽  
Kidney Transplant ◽  
Graft Function ◽  
Control Group ◽  
Transplant Patients ◽  
Inotropic Drugs ◽  
Intraoperative Management ◽  
Kidney Transplant Patients

Introduction: Impaired cardiac function is one of the most concomitant symptoms in patients with kidney failure after long-term dialysis. In addition, the preservation of adequate perfusion pressure to the graft plays a significant role in the intraoperative management during kidney transplantation, but the use of positive inotropic drugs in kidney transplant patients has been studied less. We investigated the protective effects of renal function by means of cardiac inotropes in kidney transplant patients. Methods: Eighty-nine patients that received kidney transplantation between April 2014 and December 2016 at Qilu Hospital were included and randomly divided into the treatment group receiving levosimendan and a control group. All kidney recipients received ABO-compatible donors. A poor outcome was defined as one of the following: delayed graft function, graft hemorrhage, or nephrectomy. Results: The treatment group had a better composite outcome and the level of neutrophil gelatinase-associated lipocalin was also lower than in the control group. Conclusion: Inotropic drugs may play a protective role in renal function in kidney transplantation.

scholarly journals Hematopoietic Mononuclear Cell Transplant with Minimal Gvhd in up to Completely Mismatched Unrelated Recipients

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3243-3243
Author(s):  
Suzanne T Ildstad
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
T Cell ◽  
Kidney Transplant ◽  
Whole Blood ◽  
Peripheral Blood ◽  
Chronic Gvhd ◽  
Mixed Chimerism ◽  
Cell Transplant ◽  
Kidney Graft

37 patients have been transplanted in a phase 2 protocol to establish chimerism to induce tolerance in up to 0 of 6 matched related and unrelated recipients of living donor renal allografts (KTx). The protocol is based upon tolerogenic CD8+/TCR- facilitating cells (FC) and nonmyeloablative conditioning. Recipients were conditioned with fludarabine (30mg/m2 days -5,-4,-3), cyclophosphamide (50mg/kg day-3 and+3), 200 cGy TBI (day-1) followed by KTx (day0). G-CSF mobilized peripheral blood mononuclear cells were apheresed from the donor >2 weeks before kidney transplantation, processed to remove graft-versus-host disease (GVHD)-producing cells yet retain CD34 +cells and FC, and cryopreserved until transplantation on day+1 after kidney transplantation. Immunosuppression consisted of mycophenolate mofetil and tacrolimus. 36 patients have reached at least 1 year of follow up (range 12-105 months) and are the focus of this analysis. Patients ranged in age from 18-65 yrs. Enrollment was agnostic to degree of HLA match; 2 were 6/6 and 3 5/6 matched related using high resolution allele level typing, with the remainder 4/6 to 0/6 matched related (n=15) or unrelated (n=16) Two of the recipients were renal re-transplants. Tacrolimus/MMF immunosuppression (IS) was weaned and discontinued at 1 year if chimerism (>50% whole blood and T cell), normal renal function and normal kidney transplant biopsy were noted. 34 of 36 subjects exhibited peripheral blood donor chimerism at one month post KTx. Durable chimerism allowing for full IS withdrawal developed in 26 (time off IS from 1- 88 months); the majority (23/26) showed >95% donor whole blood/T cell chimerism. Three have exhibited stable-mixed chimerism ranging between 40% - 60%. Three patients failed to develop chimerism. Transient chimerism occurred in 8 patients. Durably chimeric patients retained chimerism after removal of IS, remain rejection-free without donor-specific antibody (DSA) and show immunocompetence to vaccinations. None have had to resume immunosuppression. Transiently chimeric subjects resumed endogenous hematopoiesis and are maintained on low-dose IS with stable renal function. There have been two cases of GVHD: one grade 2 lower GI acute GVHD that developed during conversion from tacrolimus to sirolimus that responded to steroids; this patient has developed moderate chronic GVHD of the skin. He is off IS. The second presented late following development of severe gastrointestinal symptoms and manifested treatment-resistant lower GI GVHD with associated tissue-invasive CMV colitis that proved fatal at 11 months post-Tx. There have been two additional kidney graft losses, both related to early infections. A second subject death occurred in a heavy (>100 pack yr) smoker who developed advanced stage lung cancer 4.5 years after Tx. A third subject developed pneumococcal sepsis > 4 years after transplant. He had not undergone the recommended pneumococcal vaccination post HSCT. Overall patient survival is 91.8% and death censored graft survival 94.1%. These rates compare favorably to treatment-related mortality rates after standard of care renal transplant. In summary, high levels of durable chimerism and tolerance with a low (5.5%) incidence of GVHD has been achieved in up to 0 of 6 matched related and unrelated recipients of FCR001 + kidney transplant. Figure Disclosures Ildstad: Talaris Therapeutics Inc: Employment, Equity Ownership, Other: Founder and CSO.

Impaired renal function is an independent risk factor for complications after surgery for femoral neck fracture

2021 ◽  
pp. 112070002110285
Author(s):  
Pradip Ramamurti ◽  
Safa C Fassihi ◽  
David Sacolick ◽  
Alex Gu ◽  
Chapman Wei ◽  
...  
Keyword(s):  
Renal Function ◽  
Risk Factor ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Impaired Renal Function ◽  
Independent Risk Factor ◽  
Femoral Neck Fractures ◽  
Stage 4 ◽  
Ckd Stage ◽  
Neck Fracture

Background: The metabolic abnormalities that occur secondary to chronic kidney disease (CKD) increase the risk of femoral neck fractures compared to the general population. The purpose of this study is to determine whether impaired renal function is an independent risk factor for complications after surgery for femoral neck fracture. Methods: The ACS-NSQIP database was reviewed for patients who underwent total hip arthroplasty, hemiarthroplasty and open reduction internal fixation (ORIF) for femoral neck fractures between 2007 and 2018. Patients were split into cohorts based on calculated estimated glomerular filtration rate. Demographic information, comorbidities, and 30-day complications were analysed with univariate and multivariate analyses using chi-square, Fischer’s exact and analysis of variance testing. Results: The total number of patients for the study was 163,717. Patients with CKD stage 4 and 5 had an increased rate of any complication (39.1 and 36.7% respectively) compared with higher eGFRs ( p  < 0.001). Similarly, 30-day mortality was increased at 6.0% and 6.7% for both stage 4 and 5 ( p  < 0.001). By multivariate regression, those with CKD Stage 4 and 5 were at increased risk for any complication compared to patients with a normal preoperative eGFR of 90–120 ( p  < 0.001). Conclusions: This study demonstrated that patients with CKD Stage 4 and 5 are at increased risks of all complications, including death, renal, pulmonary and thromboembolic disease. Therefore, these patients should be cared for from a multidisciplinary approach with close attention to postoperative medications and fall prevention to help mitigate the risk of complications in the immediate postoperative period.

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